Cited by 1,394Urban Transport and AccessibilityUrban Green Space and HealthPhysical Activity and Health

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Physical activity in relation to urban environments in 14 cities worldwide: a cross-sectional study

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Sallis, James F, Cerin, Ester, Conway, Terry L, Adams, Marc A, Frank, Lawrence D, Pratt, Michael, Salvo, Deborah, Schipperijn, Jasper, Smith, Graham, Cain, Kelli L, Davey, Rachel, Kerr, Jacqueline, Lai, Poh-Chin, Mitáš, Josef, Reis, Rodrigo, Sarmiento, Olga L, Schofield, Grant, Troelsen, Jens, Van Dyck, Delfien, De Bourdeaudhuij, Ilse, Owen, Neville·2016·The Lancet

DOI 10.1016/s0140-6736(15)01284-2PMC PMC10833440

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Abstract

Background Physical inactivity is a global pandemic responsible for over 5 million deaths annually through its effects on multiple non-communicable diseases. We aimed to document how objectively measured attributes of the urban environment are related to objectively measured physical activity, in an international sample of adults.Methods We based our analyses on the International Physical activity and Environment Network (IPEN) adult study, which was a coordinated, international, cross-sectional study. Participants were sampled from neighbourhoods with varied levels of walkability and socioeconomic status. The present analyses of data from the IPEN adult study included 6822 adults aged 18-66 years from 14 cities in ten countries on five continents. Indicators of walkability, public transport access, and park access were assessed in 1·0 km and 0·5 km street network buffers around each participant's residential address with geographic information systems. Mean daily minutes of moderate-to-vigorous-intensity physical activity were measured with 4-7 days of accelerometer monitoring. Associations between environmental attributes and physical activity were estimated using generalised additive mixed models with gamma variance and logarithmic link functions.Results Four of six environmental attributes were significantly, positively, and linearly related to physical activity in the single variable models: net residential density (exp[b] 1·006 [95% CI 1·003-1·009]; p=0·001), intersection density (1·069 [1·011-1·130]; p=0·019), public transport density (1·037 [1·018-1·056]; p=0·0007), and number of parks (1·146 [1·033-1·272]; p=0·010). Mixed land use and distance to nearest public transport point were not related to physical activity. The difference in physical activity between participants living in the most and least activity-friendly neighbourhoods ranged from 68 min/week to 89 min/week, which represents 45-59% of the 150 min/week recommended by guidelines.Interpretation Design of urban environments has the potential to contribute substantially to physical activity. Similarity of findings across cities suggests the promise of engaging urban planning, transportation, and parks sectors in efforts to reduce the health burden of the global physical inactivity pandemic.Funding Funding for coordination of the IPEN adult study, including the present analysis, was provided by the National Cancer Institute of National Institutes of Health (CA127296) with studies in each country funded by different sources.

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Authors: Sallis, J. F., Cerin, E., Conway, T. L., Adams, M. A., Frank, L. D., Pratt, M., Salvo, D., Schipperijn, J., Smith, G., Cain, K. L., Davey, R., Kerr, J., Lai, P.-C., Mitáš, J., Reis, R., Sarmiento, O. L., Schofield, G., Troelsen, J., Van Dyck, D., De Bourdeaudhuij, I., & Owen, N.
Affiliations: University of California San Diego (US)
Australian Catholic University (AU)
Arizona State University (US)
University of British Columbia (CA)
Emory University (US)
Instituto Nacional de Salud Pública (MX)
University of Southern Denmark (DK)
University of Staffordshire (GB)
University of Canberra (AU)
Palacký University Olomouc (CZ)
Pontifícia Universidade Católica do Paraná (BR)
Universidad de Los Andes (CO)
Auckland University of Technology (NZ)
Baker Heart and Diabetes Institute (AU)
Corresponding author: Sallis, James F
ORCID: Sallis, James F
Cerin, Ester
Conway, Terry L
Adams, Marc A
Frank, Lawrence D
Pratt, Michael
Salvo, Deborah
Schipperijn, Jasper
Cain, Kelli L
Davey, Rachel
Kerr, Jacqueline
Mitáš, Josef
Reis, Rodrigo
Sarmiento, Olga L
Schofield, Grant
Troelsen, Jens
Owen, Neville
Venue: The Lancet
Publisher: Elsevier BV
Published: 2016-05
Volume: 387
Issue: 10034
Pages: 2207-2217
ISSN: 0099-5355 (ISSN-L)
0140-6736
DOI: 10.1016/s0140-6736(15)01284-2
PMC: PMC10833440
OpenAlex: W2323455124
Cited by: 1,394
References: 30
Citations by year: 2026: 202 · 2025: 157 · 2024: 127 · 2023: 125 · 2022: 127 · 2021: 142 · 2020: 153 · 2019: 116 · 2018: 127 · 2017: 88 · 2016: 30
FWCI: 198.15
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The Lancet (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
The HKU Scholars Hub (University of Hong Kong) (acceptedVersion, cc-by-nc-nd)
University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion, cc-by-nc-nd)
Research Bank (Australian Catholic University) (submittedVersion)
University of Canberra Research Portal (submittedVersion)
Ghent University Academic Bibliography (Ghent University) (submittedVersion)
Staffordshire Online Repository (Staffordshire University) (submittedVersion)
Swinburne figshare (Swinburne University of Technology) (submittedVersion)
Funders: National Cancer Institute (NCI)
National Institutes of Health (NIH)
HK Research Grants Council (HKU740907H, 747807H)
University of Hong Kong University Research Council
NIH (R01 HL67350)
National Heart, Lung, and Blood Institute (R01 CA127296 (NCI))
Colciencias (519_2010)
Australian Research Council (FT3 140100085)
National Health and Medical Research Council (569940)
NHMRC
Victorian Government
Ministry of Education, Youth and Sports (MSM 6198959221)
Health Research Council of New Zealand (07/356)
Centers for Disease Control and Prevention (CDC) Foundation
Medical Research Council
CDC Foundation
Topics: Social Sciences › Transportation › Urban Transport and Accessibility
Social Sciences › Urban Studies › Urban Green Space and Health
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
Keywords: physical activity, urban environment, walkability, housing density, intersection density, public transport accessibility, park accessibility, land use, physical inactivity, neighbourhood design, urban planning, accelerometer-measured activity, cross-city comparison, non-communicable diseases, socioeconomic status, mixed land use, parks and recreation, transport infrastructure, built environment and health
MeSH terms: Adolescent, Adult, Aged, Cities, City Planning, Cross-Sectional Studies, Environment Design, Female, Humans, Male, Middle Aged, Urban Health, Exercise, Walking, Monitoring, Ambulatory, Young Adult

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