Study reveals how urban design shapes health of Canadian adults

When it comes to fitness, hitting the gym is often top of mind, but new research reveals that where you live might have a significant impact on your fitness level — an impact that could have far-reaching implications for urban design.

A  large-scale study has revealed noteworthy links between neighbourhood design and health-related fitness among Canadian adults who live in cities. The research, which included data from more than 12,000 Albertans, provides valuable insights into how environmental features like walkability and greenness can greatly impact physical health outcomes.

"Our findings emphasize the critical role of urban design in influencing health and well-being," says lead researcher Levi Frehlich, a PhD candidate in the Department of Community Health Sciences at the Cumming School of Medicine (CSM). "This research underscores the importance of creating environments that support physical activity and overall health."

The study shows that adults living in highly walkable neighbourhoods tend to have a lower body fat percentage. 

"We find that the more walkable your neighbourhood is, the lower your body fat percentage is," says Frehlich. "Although we have seen similar evidence with walkable neighbourhoods having lower body mass index, body fat percent is a better marker for overall health as it takes into account fat and muscle tissue."

This correlation suggests that designing cities to be more walkable could help combat obesity and improve body composition, says Frehlich.

"When people live in neighbourhoods where walking is easy and enjoyable, they naturally incorporate more physical activity into their daily lives."

The research utilized precise, objective measures such as body fat percentage and grip strength — a measure of hand and forearm muscle strength that is an important indicator of overall health — rather than relying solely on self-reported data.

In addition to walkability, the study found that increased neighbourhood greenness is positively linked with better grip strength, indicating that living in greener areas can enhance muscular strength and overall physical health.

"Although the evidence regarding green space and fitness is still emerging, it seems like having green space in your neighbourhood may allow you to undertake activities that promote muscular fitness, such as recreational sports or even outdoor resistance training," Frehlich says.

These associations remained significant even after accounting for physical activity and sedentary behaviour, highlighting the independent influence of the built environment on health-related fitness.

Frehlich emphasizes the importance of these findings. "While there have been studies in other regions, this research provides valuable insights specific to the Canadian urban context," he says. "It contributes to a localized understanding of how environmental factors impact health-related fitness in Canadian cities."

Designing healthier cities: Urban planning’s crucial role in public health

The implications of this research are far-reaching, especially for urban planners and public health officials.

"The key takeaway is that while urban densification is important, we must also consider how the environment impacts physical activity and fitness," Frehlich says.

"It seems that green spaces can play a vital role in shaping our fitness, so when we hear the words concrete jungle, perhaps we should think a little less concrete and a little more jungle."

Frehlich also notes the importance of practical implementations. "If we can work greenspaces into our densification efforts, I think everyone would benefit. And it doesn't have to be only on the ground floor; terraces and other elevated green areas that may provide opportunities for residents to engage in activity would theoretically have the same impact."

Building or redeveloping neighbourhoods is not a free endeavor, says Frehlich, but neither is having a sick population — especially in countries with a public health-care system.

“If building neighbourhoods to be more walkable or to have more green space can reduce the incidence of diabetes or cardiovascular disease, this saves us health-care dollars,” he says.

Dr. Gavin McCormack, PhD, Levi Frehlich's PhD supervisor, has dedicated his career to exploring how our living environments impact health.

"This research goes beyond simply looking at whether communities support physical activity," says McCormack, a member of the O’Brien Institute for Public Healthand the Libin Cardiovascular Institute at the CSM.

"We’re finding that neighbourhood features like walkability and green spaces are linked to key health indicators such as muscular strength and body composition. These environments contribute significantly to shaping our overall health."

McCormack emphasized that the findings from this study, along with others his team has conducted, highlight the importance of designing neighbourhoods that are walkable and have ample green spaces.

"City and urban planning professionals need to prioritize increasing the supply and affordability of neighbourhoods that support active living and promote health-related fitness," he says.

He also advises home-seekers to consider the health potential of a neighbourhood when choosing where to live.

"It's crucial to think about how the environment can support your overall fitness and well-being," McCormack says.

"Choosing a neighbourhood that encourages an active lifestyle can have lasting positive effects on your health.”

This study offers a clear message: urban design matters when it comes to our health, says Frehlich.

“By creating environments that support physical activity, we can make a significant impact on public health. These findings should inform future urban planning and public health strategies to improve fitness and well-being in our cities."

As cities continue to grow and evolve, integrating health-supportive features into urban design becomes increasingly necessary. This study offers valuable insights for creating urban environments that promote better health and quality of life for Canadians.

The study was supported by grants from Canadian Institutes of Health Research, Alberta Health, Alberta Cancer Foundation, Canadian Partnership Against Cancer and Health Canada, and substantial in-kind funding from Alberta Health Services.

Dr. Gavin McCormack, PhD, is a professor in the Department of Community Health Sciences and a member of the O’Brien Institute for Public Health and the Libin Cardiovascular Institute at the Cumming School of Medicine.