Impact of built environment on physical activity and obesity among children and adolescents in China: a narrative systematic review
Open accessAbstract
BACKGROUND: Neighborhood built environment may profoundly influence children's physical activity (PA) and body weight. This study systematically reviewed scientific evidence regarding the impact of built environment on PA and obesity among children and adolescents in China. METHODS: A keyword and reference search was conducted in Active Living Research, Cochrane Library, PubMed, and Web of Science. Studies that met all of the following criteria were included in the review: (1) study designs-experimental studies, observational studies, and qualitative studies; (2) study subjects-Chinese children and/or adolescents aged ≤17 years; (3) exposures-neighborhood built environment; (4) outcomes-PA and/or body weight status; (5) article type-peer-reviewed publications; (6) time window of search-from the inception of an electronicbibliographic database to May 31, 2018; (7) country-China; and (8) language-articles written in English. RESULTS: A total of 20 studies, including 16 cross-sectional studies, 3 longitudinal studies, and 1 descriptive study, met the predetermined selection criteria and were included in the review. A total of 13 studies adopted subjective built environment measures reported by parents and/or children,2 adopted objective measures (e.g., geographical information system, field observations), and 5 adopted both objective and subjective measures. PA behaviors included PA, physical inactivity, sedentary behavior, active/passive commuting from/to school, and park visits. Among the 16 studies that provided some quantitative estimates of the influence of built environment on PA and body weight status, all reported a statistically significant relationship in the expected direction. Availability and accessibility in proximity to greenspaces, parks, recreational facilities, and sidewalks were found to be associated with increased PA levels, reduced sedentary behaviors, and/or active commuting among Chinese childrenand adolescents. In contrast, the absence of bike lanes and living in higher density residential areas were associated with increased likelihood of childhood overweight and obesity. CONCLUSION: Neighborhood built environment plays an important role in Chinese children's PA engagement and weight outcomes. Building new exercise facilities and enhancing the accessibility of existing facilities hold the potential to enhance PA engagement among Chinese children and adolescents. In addition, urban designs that incorporate sidewalks, bike lanes, walking paths, less motorized traffic, and lower residential density are likely to promote PA and prevent childhood obesity in China.
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In China, built environmental features in the community, such as availability and accessibility of open space, recreational facilities and walkable sidewalks, are likely to facilitate increased physical activity and active commuting, as well as reduced sedentary behaviours among Chinese children and adolescents.
“Evidence from China indicates that built environmental features in the community, such as availability and accessibility of open space, recreational facilities and walkable sidewalks, are likely to facilitate increased physical activity and active commuting, as well as reduced sedentary behaviours among Chinese children and adolescents.”
From Physical activity and health in Chinese children and adolescents: expert consensus statement (2020) (2020) · cites this paper as [109]
There is consistent evidence of various environmental influences on the physical activity levels of children and adolescents.
“There is consistent evidence of various environmental influences on the physical activity levels of children and adolescents.109–112”
From Physical activity and health in Chinese children and adolescents: expert consensus statement (2020) (2020) · cites this paper as [109]
Commonly reported factors influencing physical activity levels include socioeconomic status (income and education), the physical environment (ambient air and water) and the built environment (neighbourhood design, parks and recreational facilities, green space, safety, access to physical activity facilities and street connectivity).
“Commonly reported factors influencing physical activity levels include socioeconomic status (income and education), the physical environment (ambient air and water) and the built environment (neighbourhood design, parks and recreational facilities, green space, safety, access to physical activity facilities and street connectivity).”
From Physical activity and health in Chinese children and adolescents: expert consensus statement (2020) (2020) · cites this paper as [109]
In China, features such as the lack of bike lanes and high residential density are likely to be associated with childhood overweight and obesity.
“In contrast, features such as the lack of bike lanes and high residential density are likely to be associated with childhood overweight and obesity.109”
From Physical activity and health in Chinese children and adolescents: expert consensus statement (2020) (2020) · cites this paper as [109]
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“, insufficient exercise facilities [40]) and an obesogenic environment (e.”
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How street greenery facilitates active travel for university students
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“Active travel (AT) can prevent health risks by increasing physical activity (Passi-Solar et al., 2020; Wang et al., 2022a), and the relationship between the built environment and AT has received growing attention in recent years (An et al., 2019; Ding and Gebel, 2012; Yang et al., 2021a).”
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Investigating the barriers preventing adolescents from physical activities in urban green spaces
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Physical activity and prevention of chronic disease in Chinese youth: a public health approach
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“Existing research has extensively explored the relationship between PA and the built environment and reached mixed conclusions (Ewing and Cervero, 2001; An et al., 2019).”
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Predictive Analysis of Health/Physical Fitness in Health-Promoting Lifestyle of Adolescents
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“Among recreational facilities, urban green spaces (UGS) in particular have been attracting attention [22].”
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Identifying the Antecedents of University Students’ Usage Behaviour of Fitness Apps
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“The government expects obese teenagers will reach 49.5 million in 2030 [18].”
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Effect of marriage on overweight and obesity: evidence from China
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“The results of this study provide evidence of psychometric properties that support the NEWS-CC to assess PA-related neighborhood environment among children in China cities that share similar urban forms with Hong Kong.”
BackgroundInfluentialAnalysis of Urban Built Environment Impacts on Outdoor Physical Activities—A Case Study in China
Li, B., Liu, Q., Wang, T., He, H., Peng, Y., & Feng, T. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.861456 · Cited by 14 · see citing works
“Urban Built Environment Factors and Activity Analysis Angels Identification Based on the existing research results, the most identified factors which influence the urban walking and running activities in Changsha China are given in Table 1, together with the abbreviations (10, 11, 43, 54).”
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“Research indicates that children in neighborhoods with recreational facilities and safe infrastructure for walking and cycling tend to be more active and less sedentary [25–27].”
BackgroundAnalyzing the link between built environment and physical activity: a spatial study in suburban area
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“Therefore, objectively-measured park environmental characteristics influencing park use for PA have not been thoroughly examined in high-density cities and warrant further research [34].”
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Preschool children's indoor and outdoor playground HSV color preferences
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Built environment and childhood obesity
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“used a systematic literature review and found that the built environment has a significant impact on childhood and adolescent obesity in China, as well as that residential and surrounding sidewalks and parks are all relevant to the healthy development of children and adolescents (29).”
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“5c Residential PA Location – Y(1)/N(0) All residential PA locations (gyms, fitness centers, health clubs, and pools) [20,49,50]”
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“The availability of safe and accessible spaces for PA, such as parks, sidewalks, and recreational facilities, varies across local, regional, national, and international locations [91,92].”
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“4,17,18 In addition, studies have highlighted the detrimental impact of the presence of electronic devices at home on recreational screen time and sleep duration among adolescents.”
BackgroundUrban green space and mental well-being of Aotearoa New Zealand adolescents: A path analysis
Zhang, Y., Zhao, J., Mavoa, S., Ikeda, E., Clark, T. C., Crengle, S. M., & Smith, M. (2022) · Wellbeing Space and Society · doi:10.1016/j.wss.2022.100085 · Cited by 10 · see citing works
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Marriage and Its Influence on Overweight and Obesity: Insights from China
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Sedentary Lifestyle and the Threat of Obesity Among Young People
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BackgroundThe Intersection of Neighborhood Environments, Adverse Childhood Experiences, and Health Equity
Schroeder, K., Noll, J. G., Suglia, S. F., Hall, A., & Sarwer, D. B. (2025) · PEDIATRICS · doi:10.1542/peds.2024-069605 · Cited by 5 · see citing works
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BackgroundGeospatial analytics for promoting a healthy peri-urban city: A health-cartographic perspective
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“Likewise, the absence of bike paths and living in higher density areas were associated with a higher likelihood of being overweight and obese in Chinese children.(22) Evidence from Brazil suggests that higher perceived availability of facilities of the food, physical activity, and social-assistance environments near h…”
BackgroundActive commuting to school by Chinese school-age children
Lin, L., & He, L. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-814694-1.00018-x · Cited by 5 · see citing works
La influencia del espacio físico en el proceso de enseñanza-aprendizaje de la Educación Física
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Obesity in Children : Long-Term Causes and Consequences
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“The trajectories of its users are logged and visually represented as heat maps on its platform [29], where highlighted areas indicate high concentrations of human activity, and lighter shades correspond to lower activity levels.”
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The Innovation and Development of College English Blended Teaching Model in the Network Environment
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A Review of the Role of Built Environment and Temperature in the Development of Childhood Obesity
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“Some recent reviews studying the effect of the built environment on obesity were identified [2,3,10,20-26].”
BackgroundMethodResultInfluentialEDUCATIONAL INTERVENTION: PROMOTING PHYSICAL ACTIVITY TO CONTROL AND PREVENT CHILDHOOD OBESITY
Soares, J. M., Queiróga, M. R., Novello, D., & da Silva, C. C. (2026) · Revista Multidisciplinar do Nordeste Mineiro · doi:10.66104/z9y4m435 · Cited by 3 · see citing works
Chaudhary, A., Mahmood, S., Jamil, M., Khan, A., & Butt, M. Z. I. (2022) · Pakistan Journal of Health Sciences · doi:10.54393/pjhs.v3i07.372 · Cited by 3 · see citing works
- Authors
- An, R., Shen, J., Yang, Q., & Yang, Y.
- Affiliations
- University of Illinois Urbana-Champaign (US)
- Beijing Sport University (CN)
- East China Normal University (CN)
- Corresponding author
- An, Ruopeng
- Venue
- Journal of Sport and Health Science
- Publisher
- Elsevier BV
- Published
- 2019-03
- Volume
- 8
- Issue
- 2
- Pages
- 153-169
- ISSN
- 2213-2961 (ISSN-L)
- 2095-2546
- PMC
- PMC6451055
- OpenAlex
- W2901880988
- Cited by
- 172
- References
- 60
- Citations by year
- 2026: 19 · 2025: 24 · 2024: 31 · 2023: 26 · 2022: 22 · 2021: 25 · 2020: 18 · 2019: 7
- FWCI
- 2.30
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- Locations
- Journal of sport and health science/Journal of Sport and Health Science (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Social Sciences › Transportation › Urban Transport and Accessibility
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Urban Green Space and Health
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- built environment, physical activity, childhood obesity, adolescents, sedentary behavior, active commuting, park accessibility, green spaces, recreational facilities, bicycle lanes, housing density, urban design, China
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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