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Walking for transportation in Hong Kong Chinese urban elders: a cross-sectional study on what destinations matter and when

Ester Cerin12*, Ka-yiu Lee3, Anthony Barnett1, Cindy HP Sit4, Man-chin Cheung5, Wai-man Chan5 and Janice M Johnston6

Author Affiliations

1 School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, Victoria, Australia

2 Institute of Human Performance, The University of Hong Kong, Pokfulam Road, Hong Kong, SAR, Hong Kong

3 School of Nursing, The University of Hong Kong, Sassoon Road, Hong Kong, SAR, Hong Kong

4 Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, N.T, Hong Kong, SAR, Hong Kong

5 Department of Health, Elderly Health Service, 35/F Hopewell Centre, 183 Queens Road West, Wan Chai, Hong Kong, SAR, Hong Kong

6 School of Public Health, University of Hong Kong, Sassoon Road, Hong Kong, SAR, Hong Kong

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International Journal of Behavioral Nutrition and Physical Activity 2013, 10:78  doi:10.1186/1479-5868-10-78

Published: 20 June 2013



Walking for transport can contribute to the accrual of health-enhancing levels of physical activity in elders. Identifying destinations and environmental conditions that facilitate this type of walking has public health significance. However, most findings are limited to Western, low-density locations, while a larger proportion of the global population resides in ultra-dense Asian metropolises. We investigated relationships of within-neighborhood objectively-measured destination categories and environmental attributes with walking for transport in 484 elders from an ultra-dense metropolis (Hong Kong).


We estimated relationships of diversity (number of different types) and prevalence of within-neighborhood destination categories (environmental audits of 400 m buffers surrounding residential addresses) with transport-related walking (interviewer–administered questionnaire) in 484 Chinese-speaking elders able to walk unassisted and living in 32 neighborhoods stratified by socio-economic status and transport-related walkability. We examined the moderating effects of safety and pedestrian infrastructure-related neighborhood attributes on destination-walking associations.


Participants reported on average 569 and 254 min/week of overall and within-neighborhood walking for transport, respectively. The prevalence of public transit points and diversity of recreational destinations were positively related to overall walking for transport. The presence of a health clinic/service and place of worship, higher diversity in recreational destinations, and greater prevalence of non-food retails and services, food/grocery stores, and restaurants in the neighborhood were predictive of more within-neighborhood walking for transport. Neighborhood safety-related aspects moderated the relationship of overall walking for transport with the prevalence of public transit points, this being positive only in safe locations. Similar moderating effects of safety-related attributes were observed for the relationships of within-neighborhood walking for transport with diversity of recreational and entertainment destinations. Pedestrian-infrastructure attributes acted as moderators of associations of within-neighborhood walking for transport with prevalence of commercial destination categories. Composite destinations indices consisting of destination categories related to the specific measures of walking were positively associated with walking for transport.


The availability of both non-commercial and commercial destinations may promote within-neighborhood walking for transport, while recreational facilities and public transit points may facilitate overall walking for transport. However, destination-rich areas need to also provide adequate levels of personal safety and a physically-unchallenging pedestrian network.

Utilitarian walking; Elders; China; Environmental audit; Neighborhood; Destinations