Game design

Public transport

Cycling

Physical medicine and rehabilitation

Engineering

Transport engineering

Destinations

Environmental health

Archaeology

Population

Poison control

Physical activity

Life expectancy

Built environment

Tourism

Geography

Transportation planning

Human–computer interaction

Level design

Civil engineering

Walkability

Computer science

Nursing

Public health

Pathology

Natural experiment

Medicine

Annals of Behavioral Medicine

Physical inactivity is a global problem that increases the risk of many chronic diseases and shortens life expectancy. The built environment contributes to physical inactivity through accessibility of amenities and transportation patterns. With better urban planning, cities could be designed to enhance active transportation and population health on a permanent basis. We conducted a systematic review to identify determinants of the built environment associated with physical activity and to evaluate how changes in the built environment are associated with changes in physical activity. We searched six databases, from the inception of each until December 2015, for studies that were written in English, used longitudinal before-and-after design and assessed changes in both the built environment and physical activity. A total of 21 prospective cohort studies and 30 natural experiments were included in the review. The review showed that changes in the built environment and in physical activity were related. A higher objective accessibility and new infrastructure for walking, cycling and public transportation were associated with increased overall and transportation-related physical activity. Some evidence was found for perceived aesthetics and safety as determinants of physical activity. Improved objectively measured accessibility of different type of destinations and public transportation and land use mix were associated with increased physical activity. Creating new infrastructure for walking, cycling and public transportation could induce demand for walking and cycling. The results support the creation of compact and diverse residential areas and investments into infrastructure that encourage active modes of transportation.

The Built Environment as a Determinant of Physical Activity: A Systematic Review of Longitudinal Studies and Natural Experiments