ABSTRACT Living close to green areas and regions with high walkability index contribute to reducing the risk of diseases, but there are few longitudinal studies in low-and middle-income countries. In São Paulo, there was an important policy to implement bicycle paths, and the protective effect of physical activities on diseases such as hypertension is already known. To verify the relationships between possible changes in exposure to bike paths within 1 km of homes with leisure-time physical activity (LTPA), we used data from a cohort where n=1,431 people were evaluated between 2014/2015 and 2020/2021. LTPA and hypertension were assessed by questionnaires. The availability of bike paths within 1 km of residential addresses was evaluated between 2015 and 2020 by georeferencing and changes in the period were calculated. Bivariate statistical associations and multilevel analyzes were performed. There was an increase in hypertension (from 26.2% to 35.6%) and in LTPA (from 36.4% to 47.6%), but they were inversely associated in both periods (p<0.001). The increase of exposition in bike paths was more localized in the central regions of the city. Multilevel analyzes showed that people who were exposed to positive maintenance or an increase in bike paths were more likely to practice LTPA in the period (OR=1.39 CI95% 1.07-1.79). However, it is necessary to expand these facilities throughout the city of São Paulo to reduce environmental inequalities and to contribute more effectively to the prevention of hypertension.

RESUMO Residir nas proximidades de áreas verdes e em regiões com altos índices de caminhabilidade contribui para diminuir o risco de doenças, mas existem poucos estudos longitudinais em países de baixa e média rendas. Em São Paulo houve uma política importante de implementação de ciclovias e já é conhecido o efeito protetor das práticas de atividades físicas em doenças como a hipertensão arterial. Para verificar as relações entre possíveis mudanças na exposição às ciclovias a até 1 km das residências com as práticas de Atividade Física no Lazer (AFL), utilizamos dados de uma coorte onde foram avaliadas n=1.431 pessoas entre 2014/2015 e 2020/2021. As AFL e a hipertensão foram avaliadas por questionários. A disponibilidade de ciclovias a até 1 km dos endereços residenciais foi avaliada entre 2015 e 2020 por georreferenciamento e foram calculadas as mudanças no período. Foram realizadas associações estatísticas bivariadas e análises multiníveis. Houve aumento na hipertensão (de 26,2% para 35,6%) e na AFL (de 36,4% para 47,6%), mas foram associadas inversamente em ambos os períodos (p<0,001). O aumento das ciclovias foi mais localizado em regiões centrais da cidade. As análises multiníveis mostraram que as pessoas que foram expostas a manutenção positiva ou aumento da exposição de ciclovias tiveram mais chances de praticarem AFL no período (OR=1,39 IC95% 1,07-1,79). No entanto, é preciso ampliar esta estrutura por toda a cidade de São Paulo, para que possamos diminuir as iniquidades ambientais e contribuir de forma mais efetiva para a prevenção da hipertensão.

Abstract Aim: Describe public leisure spaces in a city in the state of São Paulo, associating distribution, quantity, and quality of attributes to the São Paulo Index of Social Vulnerability (IPVS). Methods: Descriptive observational study in Rio Claro (Brazil), evaluating aspects of comfort, aesthetic accessibility, and fitness for physical activity through the Physical Activity Resource Assessment (PARA) instrument in squares, parks, and habitable beds in the urban area of the municipality, using the IPVS 2010, as a basic instrument for social vulnerability. The analysis of variance (ANOVA) was adopted to verify the difference in the number of attributes and the Kruskal-Wallis test for the quality of attributes in each location evaluated according to the IPVS. Results: One hundred thirty-two squares, 2 parks, and 10 flower beds were evaluated. The ANOVA results showed that attributes related to comfort, cleanliness, aesthetics, and safety, and accessibility proved to be significant in squares and parks, while cleanliness, aesthetics, and safety showed significance in construction sites, both before the IPVS 2 - Very low vulnerability. For quality, Kruskal test Wallis identified significance in places for the practice of PA and comfort structures in parks and squares and places for the practice of PA and cleaning, aesthetics, and safety in construction sites. 92.4% of spaces are in places of low social vulnerability, with only 2.1% in places of high vulnerability. Conclusion: Our findings show poor quality of the structures, considering the attributes of comfort, cleanliness, aesthetics, and safety, and accessibility structure. In addition, most of the structures were distributed in the central areas with less social vulnerability.

Resumo Os fatores associados à mortalidade podem ser distintos em cada região e identificá-los contribuem para o desenvolvimento de políticas públicas voltadas à promoção e prevenção de saúde. Assim, os objetivos do estudo foram verificar fatores associados à mortalidade e analisar a influência da atividade física na mortalidade em adultos e idosos, residentes no município de Rio Claro - SP. Foi realizado um estudo de coorte em que o primeiro momento ocorreu no ano de 2008 e o segundo em 2014. Os participantes responderam questões sociodemográficas, nível de atividade física (NAF), variáveis de saúde e hábitos alimentares. No caso dos sujeitos que não foram encontrados após três tentativas, vizinhos e parentes foram questionados se tinham o contato daquela pessoa ou se a mesma havia falecido. Para analisar os fatores associados à mortalidade, foram utilizados três modelos de Regressão Logística para amostras complexas independentes (NAF total; NAF no transporte; NAF no lazer), por meio do programa SPSS versão 21.0, adotado um p<0,05. As variáveis que tiveram associação com a mortalidade nos três modelos foram: “sexo masculino”, “idoso” e “percepção de saúde ruim/muito ruim”. Além disso, não houve uma proteção para pessoas que praticavam 150 minutos ou mais de atividade física por semana quando comparados com indivíduos insuficientemente ativos e inativos. Estes achados podem nortear políticas públicas voltadas, principalmente, para a saúde de idosos, pessoas com ercepção de saúde ruim e homens na cidade de Rio Claro - SP.

Abstract The factors associated to mortality may be distinct in each region and identifying them can contribute to develop public policies related to health promotion and prevention. Thus, the aims of this study were verify the factors associated with mortality and the influence of physical activity on the mortality rates of adults and elderly living in the city of Rio Claro, SP. The first moment of the cohort study was conducted in 2008 and the second in 2014. Participants answered questions about socio-demographic level, level of physical activity (PA), health and eating habits variables. In the case of individuals who were not found after three attempts, neighbors and relatives were questioned about whether they had the contact with that person or if he/she had passed away. To analyze factor associated to mortality, three independent Logistic Regression models for complex samples were used (total PA; commuting PA; leisure PA), as well as the SPSS software version 21.0, considering p<0.05. The variables that were associated with mortality in the three models were: “male sex”, “elderly” and “poor/very poor health perception”. Further, individuals who spent 150 min/week of physical activity did not showed any protection against mortality when compared with those who did not achieve the recommendation. These results can guide public policies, mainly, to the health of the elderly, people with poor health perception and men.