The association between workplace built environment and metabolic health: A systematic review and meta-analysis

Abstract

Background: Metabolic health is one of the key determinants of healthy living. Specifically, maintaining healthy weight, regulation of blood pressure, lipids and glucose over the life course have been reported to be protective on chronic diseases and premature mortality. With the global workforce spending, on average, one-third of the weekly time budget in the workplace, the role of workplace environment in enhancing metabolic health becomes important. However, there has thus far been no review synthesizing evidence on the links between workplace built environment and metabolic health. Methods: A systematic review and meta-analysis was conducted synthesizing evidence on the associations of built environment attributes measured within the workplace neighbourhood and metabolic health. A total of 16 studies that fulfilled the inclusion/exclusion criteria were identified via systematic search of English language peer-refereed publications up to July 2021, in six databases. A systematic coding system was developed, indicating significant findings in expected/unexpected directions including null findings, and the quality of the pooled study was assessed. The Weighted-Z test method that accounts for the study quality was used to examine the strength of evidence. Results: A quarter of the pooled studies were categorized to be of high quality. Among the workplace built environment attributes of access to/density of recreational facilities, street pattern, access to/density of destinations and services, and land use mix, very strong evidence was found for the association between access to/density of destinations and services and metabolic health (p < 0.001); specifically, access to full service establishments such as supermarkets, grocery stores and restaurants (p = 0.001). A relatively weak association between proximity to workplace and metabolic health (p = 0.019) was also reported. Discussion: Given the lack of high quality studies, overall confidence in the currently available evidence is 'low'. Well-designed longitudinal studies with rigorous measurements for exposures and outcome variables are necessary. Keywords: Built environment; Metabolic health; Obesity; Systematic review; Workplace.