The Neighbourhood Built Environment and Health-Related Fitness

Results from: “The neighbourhood built environment and health-related fitness: a narrative systematic review”

Frehlich L, Christie CD, Ronksley PE, Turin TC, Doyle-Baker P, McCormack GR

Physical activity, health-related fitness & the built environment

Participating in physical activity is associated with greater overall health and reduced risk for developing diseases such as cardiovascular disease (1), diabetes (2), and certain cancers (3), and is also positively associated with health-related fitness (4,5). Health-related fitness is a collection of multidimensional physiological attributes that delay the onset of morbidity of diseases related to living an inactive lifestyle. Health-related fitness includes morphologic, muscular, cardiorespiratory, motor, and metabolic components (5), and can be improved through physical activity, potentially even lower-intensity physical activity (6). While there is consistent evidence demonstrating the connection between the neighbourhood built environment and key built environment features that support physical activity (7), there is a lesser understanding of the relationship between the built-environment and health-related fitness or how this relationship may be mediated by physical activity. However, preliminary findings suggest significant associations between some neighbourhood features and health-related fitness (8), and that these associations remain after controlling for physical activity (9). A recent systematic review summarizes existent literature surrounding the associations between the neighbourhood built environment and health-related fitness in adult populations, and also summarizes studies that have considered these associations after controlling for physical activity.

The relationship between the built environment & health-related fitness

The systematic review includes 27 studies that consider the relationship between the neighbourhood built environment and health-related fitness, the majority of which were cross-sectional studies that objectively measured both the built-environment and at least one health-related fitness component. Summarizing the findings from these studies the review highlights that, in general, built environment features are positively associated with health-related fitness and that there is evidence suggesting these associations persist after controlling for physical activity. More specifically, the review discusses common built characteristics and health-related fitness components that are explored within these studies, namely design, density, diversity and desirability features, and morphological and cardiorespiratory components. Regarding these factors, the review suggests that a multiplicity of easily accessible destinations within a neighbourhood environment may be associated with favorable body composition and cardiorespiratory fitness.

Overall, this review speaks to a nuanced relationship between the built environment, health-related fitness and physical activity in that while physical activity may in many ways mediate the relationship between the built environment and health-related fitness, there are likely alternate pathways linking the two that are not mediated by physical activity. Findings from this review provide insight into future directions for exploring the built environment with regard to supporting health, emphasizing a need better understand its relationship to health-related fitness through explorations of the causal pathways between the two.

Suggested Citation: Frehlich L, Christie CD, Ronksley PE, Turin TC, Doyle-Baker P, McCormack GR. The neighbourhood built environment and health-related fitness: a narrative systematic review. International Journal of Behavioral Nutrition and Physical Activity. 2022 Sep 24;19(1):124.

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Posted April 15, 2025

Written by Calli Naish & Levi Frehlich

Infographic by Calli Naish