Physical Activity and the Built Environment

Development of a New Field of Research

September 2003 can be considered the public launch of the study of built environment and physical activity. In that month

both the American Journal of Public Health and American Journal of Health Promotion published special issues on built

environment, physical activity, and health. A notable characteristic of the journals was the unusual diversity of academic

disciplines represented, including public health, behavioral sciences, urban planning, transportation, leisure studies,

landscape architecture, economics, and law. One of the studies received massive media coverage introducing a new topic to

the American public and the physical activity field.1

Studying the built environment requires researchers to move beyond psychosocial models that guide individual behavior

change strategies to broader ecological models. Ecological models teach that behavior has multiple levels of influence,

including biological, psychological, social/cultural, physical environment, and policy factors. Change strategies are likely to

be most effective when they alter all of those factors.2 Intervening on multiple levels means changing people and

environments. Interest in environmental and policy change as a public health priority was accelerated by concern about the

obesity epidemic. Several authors identified environmental and policy change as the only feasible approach to creating

massive population changes in physical activity and dietary behaviors needed to halt the obesity epidemic.3, 4 However, a lack

of data on the relation of environments and policies to behavior prevented an evidence-based approach, so filling research

gaps became a priority. 

Researchers in different fields from urban planning, geography, leisure sciences, psychology and public health were

encouraged to form transdisciplinary teams by the CDC’s (Centers for Disease Control and Prevention) Active Community

Environments program. Since 2000, The Robert Wood Johnson Foundation’s active living initiatives have stimulated rapid

growth of the field by devoting over $70 million to research, community

demonstration projects, and policy change. The National Institutes of Health’s and

CDC’s Obesity and Built Environment research program, spearheaded by the

National Institute of Environmental Health Sciences, is contributing to the

continuing growth of this field.

This paper reflects three major trends in the field. First, the research comes from

numerous disciplines that vary in the built environment factors and outcomes of

interest. For example, urban planners have focused on the relation of overall

community design to walking and cycling for transportation, while health and

recreation researchers mainly were interested in how access to recreation facilities

was associated with leisure-time activity. Second, more recently, transdisciplinary

teams are blending their expertise to develop new methods to examine how

multiple aspects of the built environment are related to total physical activity.5

Third, different aspects of the built environment are expected to be important for

various subgroups, especially as defined by age, race/ethnicity, and

socioeconomic status (SES).

Effects of Environmental Interventions

The strongest evidence of causal effects comes from randomized controlled trials,

but there are no such studies of built environments.6 It is not possible for

researchers to randomly assign either people or environmental interventions to

specific places. There are several quasi-experimental evaluations that provide

Series 7, No. 4 Dec 2006

Published quarterly by the

President’s Council on

Physical Fitness and Sports

Washington, D.C.

★

Guest Authors:

James F. Sallis, Ph.D.

Jacqueline Kerr, Ph.D.

San Diego State University

★

Co-edited by:

Dr. Deborah Young, University of

Maryland, Dr. Robert P. Pangrazi,

Arizona State University, and

Dr. Barbara Ainsworth,

Arizona State University

President’s Council on Physical Fitness and Sports

ResearchDi est
evidence that changing built environments can change

behavior. For example, in two studies introduction of a

new trail appeared to increase physical activity,7, 8 but

another study found no effect.9 Adding markings to school

playgrounds increased physical activity of children,10 and

physical improvements around schools, such as adding

sidewalks, improving street crossings, and slowing traffic,

can stimulate more walking to school.11, 12 Studies

assessing activity levels before and after major building

projects are also underway in Australia, the UK, and

Sweden.

Investigating environmental components in intervention

studies that focused on individual change is also a

promising strategy to strengthen the evidence. For

example, intervention participants who reported higher

levels of safety from traffic had greater improvements in

physical activity than those with more concerns about

traffic-related safety.13 Prospective studies monitoring

change in perceptions of the environment will also add

to the evidence.14 However, most of the studies dealing

with built environment and physical activity are crosssectional. 

Community Design and Physical

Activity

Urban planning and transportation researchers have been

studying how community design affects travel behavior

for several decades.15 They found people walked more

when they lived in areas with two characteristics: mixed

land use, in which homes, shops, and services are intermingled; and connected streets with frequent intersections

and short blocks that provide direct routes for pedestrians.

This general pattern of development is very common in

older parts of the United States and around the world in

places built before cars became the dominant mode of

transportation. Such communities are referred to as

“walkable,” meaning it is convenient to walk to several

destinations. Sometimes other concepts are included in

walkability, such as high residential density (often

required to support neighborhood shops), sidewalks lining

all streets, and buildings built right up to the sidewalk

rather than having parking lots between the building and

the street. The alternative low-walkable development

pattern is seen mainly in communities built since the

1950s and is commonly referred to as the suburbs or

sprawl. These places were designed to facilitate

automobile travel. It is not possible for most people in the

suburbs to walk for daily errands, and street patterns are

disconnected, with many winding streets, long blocks, and

cul-de-sacs. 

Studies of Adults

Reviews of numerous studies in the urban planning

literature consistently show people walk and cycle more

for transportation in high-walkable neighborhoods than in

low-walkable areas.16-18 A typical difference of one

walking trip per week translates into 30-60 more minutes

of physical activity, and this difference should persist as

long as the person lives in the same type of neighborhood.

Mixed land use, street connectivity, and residential density

are consistently supported as correlates of active travel,

while presence of sidewalks has inconsistent results. 

For the health field, a key question is whether walkability

is related to total physical activity. Studies using objective

accelerometer-based measures of physical activity

demonstrate total physical activity is substantially higher

among people living in high-walkable, compared to lowwalkable communities.19, 20 These findings generally are

supported whether built environments are measured by

self-report,21 observational audits22 or using Geographic

Information System (GIS) software.23 However, findings

are emerging that people’s perceptions of the environment

may not match the objective data.24, 25 Thus, both are

important to measure. 

Studies on physical activity and community design were

reviewed by panels from the Transportation Research

Board and Institute of Medicine26 and Task Force for

Community Preventive Services.27 Both groups concluded

there is a consistent association between land use patterns

and physical activity. Thus, land use is now accepted as an

important issue for physical activity and public health.

These groups recommended policy changes in zoning,

development regulations, and transportation investments

that would encourage development of more walkable

communities. 

Most studies focused on travel behavior or overall

physical activity. More recent studies have compared

different domains of activity, for example, walking for

transportation versus recreation, and found specific

community design attributes are related to each.28-30 This

is an important research area because these studies can

identify how to design communities that support several

types of physical activity.31

Several limitations to this literature have been identified.26, 27 Because virtually all the studies are crosssectional, there is the potential for self-selection bias in

which results can be explained by physically active people

choosing to live in neighborhoods where they can walk

or bike to nearby destinations.32 Prospective studies that

can follow people who move to different types of

neighborhoods are needed. Another limitation is that most

studies have been conducted on homogeneous samples or

have not analyzed whether associations generalize across

subgroups defined by sex, income, and race/ethnicity.

Some studies have found built environment and physical

activity were related in whites but not African

2
measures of physical activity.43, 51, 52 An important research

priority is to examine how community design attributes

may operate both similarly and differently for youth and

adults.

Studies of Older Adults

Though it is likely the principles of walkability support

walking for transportation among seniors, there are

additional specific age-related issues in considering how

to design activity-friendly communities. The design of the

environment must take into account the declining acuity

of senses.53, 54 Impaired hearing and vision need to be

compensated for by louder crossing signals and increased

lighting. Changes in gait and balance mean that hazards

such as uneven sidewalks and high curbs need to be

eliminated. Loss of stamina suggests more resting places

are required. Interviews with seniors revealed having

access to services was important so they could walk and

take care of daily activities, thus maintaining their

independence.55 Frequent crosswalks with sufficient

crossing time were a priority. Interviewees in one study

indicated their choice of walking routes was influenced by

length of route, sidewalk quality, people along the route,

traffic, signaled cross walks, safety from crime, and

scenery.56

A few quantitative studies illustrate the potential for the

built environment to support older adults’ physical

activity. In a Canadian study, physical activity was related

to presence of hills, biking and walking trails, street lights,

recreation facilities, seeing other people, and unattended

dogs.57 Li and colleagues found density, street

connectivity, and safety were related to walking.58

Patterson and Chapman reported women over 70 years old

living in neighborhoods with mixed services and good

pedestrian access to services walked more.59 Studies using

pedometers as objective measures of physical activity

provide more convincing results. Older women living

within a 20-minute walk of a park, trail, or store had more

total steps than those with no destinations, and there was a

direct relation between number of nearby destinations and

number of steps.60 In older overweight women,

predominance of older homes (representing more

pedestrian-friendly neighborhoods) and access to

destinations were related to more walking.61

Maintaining independence is a major goal for seniors, and

one study showed living in a mixed use neighborhood was

associated with better ability to perform daily activities.62

The evidence linking community design and walkability

factors with older adults’ physical activity is limited, but

results are consistent. Additional work is needed to

document the specific design factors that are particularly

important in creating activity-friendly communities for

seniors.

Americans,33, 34 which could be explained by lower levels

of perceived safety in low income neighborhoods that

could prevent residents from taking advantage of walkable

neighborhoods.35 Other studies have found gender

differences.36, 37 An emerging finding is that psychosocial

variables, such as attitudes, self-efficacy, and social

support, explain much more variance in physical activity

than does community design.38-40 One way to put this

finding in perspective is that altering the built

environment is likely to affect everyone living there on a

relatively permanent basis, so even a small effect on an

individual’s behavior is multiplied across people and time. 

Studies of Youth

Krizek proposed a model of the relevance of community

design for youth physical activity.41 Though youth have

different issues, such as commuting to school, access to

play areas, and role of parents, many of the walkability

associations with physical activity are presumed to be the

same for youth and adults. Two studies using GIS

measures of walkability and accelerometer measures of

physical activity supported the relevance of walkability

for adolescents.42, 43 In one study a walkability index

explained about the same amount of variance as sex and

ethnicity.

42 However, a finding that higher street

connectivity was related to lower activity levels in girls

suggests that young people may use cul-de-sacs and

suburban streets as play areas.43 Thus, street connectivity

could encourage walking for transportation while

discouraging play.

Active commuting to school can contribute to overall

physical activity,44 and there appears to be a connection

with community design. Kerr and colleagues found active

commuting was higher in high-walkable neighborhoods,

but this effect was seen for higher-income children only.45

Braza et al. reported more active commuting to school in

high density neighborhoods, but no relation to street

connectivity.46 Ewing and colleagues found more active

commuting when sidewalks were present, but no

association with density and land use mix.47 A significant

effect of sidewalks was replicated by Fulton et al.48

McMillan confirmed high active commuting in walkable

neighborhoods, but found other contributors, such as

perceived safety, traffic, and attitudes.49 Timperio and

colleagues reported the surprising finding that higher

street connectivity was associated with less active

commuting.50

The few studies of community design and youth physical

activity generally support a positive association of

walkability indicators with both walking to school and

total physical activity. There is some evidence that poorly

connected streets with less traffic could provide youth

with places to play and may encourage active commuting

to school. Many studies of youth benefit from objective

3
4

Recreation Environments and

Physical Activity

Researchers in the health, behavioral science, and leisure

science fields have studied the relation of recreation

environments and leisure-time physical activity for many

years, but until recently the literature was very small. The

main concept is that easy access to parks, trails, health

clubs, and other places for physical activity could

stimulate their use.63

Studies of Adults

Humpel and colleagues reviewed the health literature on

the environment and physical activity recently and found

only 19 studies.64 Only access to recreation facilities,

access to opportunities (such as activity programs), and

aesthetic factors were consistently associated with higher

levels of physical activity. Godbey and colleagues

summarized findings of leisure science research related to

active living.65 Parks are commonly used for a variety of

physical activities, with walking being the most common.

Distance to recreation facilities is strongly related to their

use, and degree of naturalness was positively related to

park use. Lee and Vernez-Moudon incorporated an urban

planning and transportation perspective in their review of

correlates of recreational physical activity.66 They pointed

out neighborhood sidewalks are a common place for

recreational walks, so sidewalks may be important for

both recreational and transportation physical activity.

Trails can also be used for transportation and recreation

purposes.67

Recent studies have confirmed and expanded early results.

Access to parks and trails is consistently related to activity

levels,22, 23, 68-70 with few exceptions.71 The evidence is

growing on the importance of aesthetics of recreation

facilities and neighborhoods in general for walking,39

running,72 and total leisure time physical activity.22, 69, 73

Presence and quality of sidewalks is emerging as an

important correlate of leisure walking29 and physical

activity.74 It is important to identify specific characteristics

of recreation facilities that are strongly related to physical

activity, because these findings can be translated into

policies and design guidelines. Giles-Corti et al. identified

people were very likely to walk in parks when they were

nearby, large, and had a variety of attractive features.75

Lindsey and colleagues reported the most used urban

trails were in densely populated neighborhoods with

mixed land uses and convenient parking.76

It is clear that having easy access to parks and trails is

associated with more walking and physical activity among

adults. Sidewalks also play a crucial role in supporting

physical activity. It appears people are more likely to use

these facilities if they are aesthetically pleasing. Important

research priorities are developing a better understanding

of how to build and equip parks and trails so they attract

more people for regular physical activity. 

Studies of Youth

In addition to their own yards, the main places where

children are physically active seem to be the

neighborhood streets and sidewalks, parks, and school

grounds.77, 78 So it is not surprising an early review found

proximity to recreation facilities and opportunities such as

programs were consistent correlates of physical activity in

children and adolescents.79 Recent studies mainly have

confirmed these early findings,52, 80-83 but some studies

report significance only in some groups43, 84 or no

significant associations.42 There is new evidence that

proximity to schools and their activity facilities is related

to physical activity.85 New studies extended adult findings

by showing aesthetics of recreation facilities and

neighborhoods are related to youth physical activity.80, 83

There is consistent evidence that children and adolescents

with recreation facilities near their homes are more likely

to be active than those with few facilities. One study

showed quality of facilities was more important than

simple proximity so examining the role of quality and

amenities at public recreation facilities is a priority.86

Because youth of different ages vary widely in common

types of activity and use different equipment and supplies,

it is important to learn how to design and equip parks and

other recreation facilities so they serve youth of all ages.

Studies of Older Adults

Older adults are likely to use parks for physical activity,65

but they also use sidewalks for walking and may rely on

senior centers for activity programs. There are enough

studies of recreation environments and physical activity in

older adults to indicate this is a promising area. For

example, Payne and colleagues reported older adults who

visited local parks were more active and had better mental

health than those who did not use parks.87 Li and

colleagues found proximity to parks, perceptions of

safety, and number of nearby recreation facilities were

related to walking in seniors.58 They built on this study by

following participants over one year to examine possible

reasons for the commonly seen decline in physical

activity. They found that over a 12-month period, walking

decreased less in older adults who lived in neighborhoods

with safe walking environments and access to recreation

facilities.88 Older adults may benefit from access to places

where they can feel safe being active. Because easy access

to shopping malls was associated with more walking,

providing access to facilities that serve these same

functions could be an effective intervention.89 Research on

built environments and physical activity among seniors is

just beginning.
Disparities in Recreation Environments

It is not clear whether all sociodemographic groups

benefit equally from having access to recreation facilities,

because this question rarely has been examined. However,

the findings appear contradictory. Reed and colleagues

found presence of sidewalks was related to physical

activity only in whites, not in African Americans.90

In a study by Wilson et al. access to trails was related to

physical activity in low socioeconomic status (SES)

participants, but not among the high SES.91 Additional

studies are needed to understand whether recreation

facility/physical activity associations generalize across

population subgroups.

There are physical activity disparities in youth, with lower

income and racial/ethnic minority youth usually having

lower activity levels, and a national study showed

recreational environments may help explain the

disparities.92 Thus, it is of great interest to determine

whether there are disparities in access to recreation

facilities which could affect physical activity of all age

groups. In self-report studies, lower-income adults

perceive less access to recreation facilities.91, 93 It is

surprising that two studies reported high income

participants had better access to free-for-use facilities such

as public parks, but not pay-for-use facilities such as

health clubs and dance studios.94, 95 In a large national

study using GIS-based measures, Gordon-Larsen and

colleagues found less access to both free and pay facilities

in low-education and high-minority areas.92 Another

national study replicated the finding of fewer private

recreation facilities in low-income and high-minority

communities.96

The evidence indicates that low-income and racial/ethnic

minority populations have less access to recreation

facilities. Thus, recreation policies and investments need

to ensure low-income communities have equal access to

recreation facilities. Disadvantaged communities need

better access to public parks and trails, because pay-foruse facilities are generally not available to them. 

Importance of the Social Environment

Though this paper focuses on the built environment, an

ecological perspective would indicate that built and social

environments are likely to act together to influence

physical activity. Of the many social environment issues

that could be relevant to physical activity, built

environment researchers have been most interested in

safety. Perceived or objective danger from crime or traffic

hazards could negate benefits of activity-friendly built

environments if people are too afraid to walk on the

streets, go to the park, or allow their children to play

outdoors. 

A 2002 review concluded the data on safety and physical

activity are inconsistent.64 However, many of the measures

of safety are crude, and many do not distinguish among

safety related to crime or traffic. There are enough

significant findings to justify further study of safety.

Several recent studies of youth report significant

associations of physical activity with crime safety86, 97-99, 100

or traffic safety,45, 101 though some do not support an

association.83, 102, 103 Among adults, African Americans

perceive their neighborhoods as less safe than whites,35 so

safety concerns could contribute to disparities in physical

activity. A finding that safety was related to walking in

whites but not in African Americans needs to be

replicated.34 In the adult literature, most recent studies

show an association of crime and physical activity.36, 70, 71, 74

Because there are built environment strategies for

reducing both the actual and perceived risk of crime,

safety variables should continue to be included in built

environment/physical activity studies.104

Conclusions

Current evidence about the association of various built

environment attributes with physical activity for

recreation and transportation purposes is summarized in

Table 1. Though not reviewed here, evidence is growing

for associations between the built environment and

obesity.105 Community design and walkability attributes

are related mainly to active transportation, although

several studies have shown walkability also is related to

total physical activity. Recreation environments mainly

support leisure-time physical activity, and this specific

effect is reflected in Table 1. Sidewalks are used

frequently for both transportation-related and leisure-time

physical activity, so they are one of the few variables

found to be related to both types of outcomes. Crime,

traffic safety and aesthetics have the potential to affect

both domains of activity. 

Adult populations have been studied most often and

seniors least often. It is likely the built environment has

different effects on men and women, high and low income

communities, and people from diverse racial and ethnic

backgrounds. Thus, the research needs to focus more on

the needs and concerns of more diverse populations. Other

research needs are to use more detailed measures of built

environments so findings can provide specific guidance to

policy makers and designers, use more rigorous

approaches such as prospective and quasi-experimental

designs, and understand how both community design and

recreation environments contribute to total physical

activity. 

Knowledge about the built environment and physical

activity is growing rapidly, and efforts already are being

made to use research findings to guide policy changes.

Working groups from the Transportation Research Board

and Institute of Medicine26 and Task Force for Community

5
Preventive Services27 concluded the evidence is

sufficient to recommend policy changes. The built

environment is a direct reflection of policies, and

creating more activity-friendly environments will

involve collaboration among multiple

government departments and sectors of society

outside government. Government agencies

dealing with zoning, planning, transportation,

building codes, education, and recreation are

directly responsible for the built environment

variables described throughout this paper.

Industries dealing with construction of

buildings and roads, real estate, recreation, and

health have important stakes in the built

environment, so they need to be engaged in

efforts to change policies. Because physical

activity is a significant determinant of health

and health care costs, there is a strong rationale

for adopting and implementing policies to

create built environments that make it

convenient, safe, and attractive for people of all

ages and circumstances to be physically active.

2007 PCPFS Science Board Members

Deborah Rohm Young, Ph.D., Chair

Barbara Ainsworth, Ph.D.

Wojtek Chodzko-Zajko, Ph.D.

Doris Corbett, Ph.D.

Patty Freedson, Ph.D.

Ed Howley, Ph.D.

Thom McKenzie, Ph.D.

Tedd Mitchell, M.D., PCPFS Member Liaison

James Morrow, Ph.D.

Maureen Weiss, Ph.D.

Weimo Zhu, Ph.D.

6

Table 1.

Built environment associations with physical activity

for transportation and leisure purposes, summarized by

age group.

Built Environment Attribute Active Active

Transport Recreation or

Total Physical

Activity

Findings for Adults

Walkability: mixed land use, ++ 0

street connectivity, residential

density

Sidewalks ? +

Proximity of recreation 0 ++

facilities (parks, trails, private

facilities)

Aesthetics of recreation xx ++

facilities

Studies of Youth

Walkability: mixed land use, + +

street connectivity, residential

density

Street connectivity ? ?

Sidewalks + +

Proximity of recreation xx ++

facilities (parks, trails, private

facilities)

Aesthetics of recreation xx +

facilities

Studies of Older Adults

Walkability: mixed land use, + +

street connectivity, residential

density

Sidewalks xx xx

Proximity of recreation xx +

facilities (parks, trails, private

facilities)

Aesthetics of recreation xx xx

facilities

Notes: ++: multiple findings of positive association; +: a few

findings of positive association; 0: a few findings of no

association; ? inconsistent findings; xx: insufficient studies to

summarize
7

Please Post

President’s Council on Physical Fitness & Sports

200 Independence Avenue, S.W., Washington, DC 20201

(202) 690-9000 • FAX (202) 690-5211

The evidence is growing on the

importance of aesthetics of

recreation facilities and

neighborhoods in general

for walking, running, and total

leisure time physical activity.

James F. Sallis, Ph.D.

Jacqueline Kerr, Ph.D.

Department of Psychology

San Diego State University

3900 Fifth Avenue, Suite 310

San Diego, CA 92103
8

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