In search of causality: a systematic review of the relationship between the built environment and physical activity among adults

Abstract

BackgroundEmpirical evidence suggests that an association between the built environment and physical activity exists. This evidence is mostly derived from cross-sectional studies that do not account for other causal explanations such as neighborhood self-selection. Experimental and quasi-experimental designs can be used to isolate the effect of the built environment on physical activity, but in their absence, statistical techniques that adjust for neighborhood self-selection can be used with cross-sectional data. Previous reviews examining the built environment-physical activity relationship have not differentiated among findings based on study design. To deal with self-selection, we synthesized evidence regarding the relationship between objective measures of the built environment and physical activity by including in our review: 1) cross-sectional studies that adjust for neighborhood self-selection and 2) quasi-experiments.MethodIn September 2010, we searched for English-language studies on built environments and physical activity from all available years in health, leisure, transportation, social sciences, and geographical databases. Twenty cross-sectional and 13 quasi-experimental studies published between 1996 and 2010 were included in the review.ResultsMost associations between the built environment and physical activity were in the expected direction or null. Land use mix, connectivity and population density and overall neighborhood design were however, important determinants of physical activity. The built environment was more likely to be associated with transportation walking compared with other types of physical activity including recreational walking. Three studies found an attenuation in associations between built environment characteristics and physical activity after accounting for neighborhood self-selection.ConclusionMore quasi-experiments that examine a broader range of environmental attributes in relation to context-specific physical activity and that measure changes in the built environment, neighborhood preferences and their effect on physical activity are needed.

Does Neighbourhood Walkability Moderate the Effects of Mass Media Communication Strategies to Promote Regular Physical Activity?

“…Walkability was examined in this study because of its consistent relationship with walking in the literature and because recreational walking was the most promoted activity in the campaign. Hypothesised environmental correlates of total physical activity on the other hand have had far more mixed results [38]. Although one other study did look at a walking-specific campaign and did not find a significant moderating effect by walkability [10], only self-reported walkability was measured, without objective verification which is recommended for environmental studies on walking [39].…”

Improving Current Practice in Reviews of the Built Environment and Physical Activity

“…Despite these challenges and limitations, in recent years some studies that examined the effects of changes to the environment have been published [27]. One recent literature review specifically focused on causality in the relationship between the built environment and physical activity by only including quasi-experimental studies and cross-sectional studies that controlled for residential preferences [27].…”

“…Despite these challenges and limitations, in recent years some studies that examined the effects of changes to the environment have been published [27]. One recent literature review specifically focused on causality in the relationship between the built environment and physical activity by only including quasi-experimental studies and cross-sectional studies that controlled for residential preferences [27]. Surprisingly, some literature reviews a priori excluded intervention studies and focused solely on cross-sectional studies, mentioning in the discussion that environmental interventions are needed to provide causal evidence [13,[28][29][30][31].…”

Characteristics of the environmental microscale and walking and bicycling for transportation among adults in Curitiba, Paraná State, Brazil

“…Other studies have shown the positive effect of environmental changes on commuting behavior 12,13,14,15 . However, a large share of the evidence comes from studies in high-income countries, which may not represent the urban and sociocultural characteristics of lower-income countries like those of Latin America 3,6,7 .…”

“…Evidence points to an association between variables in the perceived 5,9,10 and built environment 5,9,11,12 and transportation-related physical activity. Other studies have shown the positive effect of environmental changes on commuting behavior 12,13,14,15 .…”