A National Plan for Physical Activity: The Enabling Role of the Built Environment

Background: Evidence shows significant relationships between aspects of the built environment and physical activity. Land use and transportation investments are needed to create environments that support and promote physical activity. Methods: The policy relevance of recent evidence on the built environment and physical activity is discussed, along with an assessment of near, medium, and longer term pricing and regulatory actions that could be considered to promote physical activity. These actions are evaluated based on their consistency with the current evidence on what would support and promote physical activity. Results: A wide range of pricing and regulatory strategies are presented that would promote physical activity. There is an unmet demand for activity friendly, walkable environments. Creating more walkable places is an essential component of a national plan to increase physical activity levels of Americans. Conclusions: The built environment is an enabler or disabler of physical activity. Creating more walkable environments is an essential step in averting what is currently a market failure where the supply and demand for walkable environments is misaligned. The desire to be more physically active would be supported through investments in walking, biking, and transit. Concentration of development within existing urban areas supported by transit and implementing pricing strategies can support physical activity.