Perceived built environment characteristics associated with walking and cycling across 355 communities in 21 countries

Research examining built environment (BE) characteristics and walking/cycling behaviors has been conducted primarily in high-income countries and conclusions cannot be applied directly to low-and middle-income countries. We evaluated perceived BE characteristics and walking/cycling behaviors across 355 urban commu-nities in 21 low-, middle-, and high-income countries using individual data for 39,908 adults in the Prospective Urban and Rural Epidemiology study. The 1-week long-form International Physical Activity Questionnaire was used to measure walking/cycling behaviors. Perceived BE characteristics were measured using the Neighborhood Environment Walkability Scale. Mixed effects logistic regression models examined associations between BE measures and walking for transport (>= 150 min/wk), walking for leisure (>= 150 min/wk), and any cycling for transport, controlling for individual, household, and community factors. Land-use mix diversity, land-use mix access, and street connectivity were associated with higher odds of walking for transport. Land-use mix diversity, land-use mix access, safety from traffic and safety from crime were associated with higher odds of walking for leisure. Land-use mix diversity, land-use mix access, and aesthetics were associated with higher odds of cycling. Differences in associations were observed by country-income status. Our findings can help guide policy makers globally to implement BE design to encourage walking and cycling behaviors.

Automated summary

This study investigated the relationship between built environment characteristics and walking/cycling behaviors in 355 urban communities across 21 low-, middle-, and high-income countries. The findings showed that land-use mix diversity, land-use mix access, street connectivity, safety from traffic, safety from crime, and aesthetics were associated with higher odds of walking and cycling behaviors. These results can inform policymakers globally in implementing built environment designs that encourage walking and cycling.