The influence of walkability on walking for transportation during the COVID-19 pandemic in the city of São Paulo, Brazil: a cohort study

Background: Less is known about the prospective pattern of walking for transportation and the influence of more walkable neighborhoods in middle-income countries, mainly after COVID-19. Objective: To analyze the influence of walkability on walking for transportation in São Paulo residents in the periods 2014-2015 (baseline) and 2020-2021(2nd wave). Methods: It was a cohort study conducted with a sample of 1,434 individuals (35.5% of baseline) in São Paulo city, Brazil. At baseline information was collected by face-to-face interview and at the 2nd wave by telephone interview. The outcomes analyzed were walking for transportation ≥ 10 minutes/week and ≥150 minutes/week, measured by the IPAQ long version . The exposure was more walkable neighborhoods grouped into quartiles considering the walkability in the 500m and 1,000m buffers. The covariates analyzed were sex, age group, and educational level. Multilevel mixed-effects logistic regressions were performed considering three models: 1) crude; 2) adjusted for time; and 3) adjusted for time, sex, age groups, and educational level. Results: There was a significant increase in adults who used walking for transportation during the follow-up period (≥ 10 minutes/week: 60.2% versus 71.0%; ≥ 150 minutes/week: 19.9% versus 23.3%) The multilevel models showed that subjects who were located in more walkable neighborhoods in the 1,000m buffer were more likely to walk for transportation ≥ 10 minutes/week (OR=1.46; CI95%:1.10-1.93) and ≥150 minutes/week (OR=1.38; CI95%:1.08-1.76), regardless of the covariates. Conclusions: Living in more walkable neighborhoods can influence walking for transportation, regardless of the individual characteristics of the subjects. It is important that future studies analyze the relationship between financial investments to improve urban mobility as a strategy to encourage active transportation.