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Physical activity in relation to urban environments in 14 cities worldwide: a cross-sectional study
Open accessAbstract
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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“For example, even apart from directly saving health costs from better-quality housing, housing located in activity-friendly neighborhoods may lead to more physical activity and thus generate health benefits, including reductions in the prevalence of obesity (146).”
From Review of the Impact of Housing Quality on Inequalities in Health and Well-Being (2023) · cites this paper as [146]
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Metadata
- 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
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2016-05
- Volume
- 387
- Issue
- 10034
- Pages
- 2207-2217
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- 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
- 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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