Effect of Urban Infrastructure on Physical Activity and Health Indicators: The Case of the City of Kaunas, Lithuania

Urban infrastructure is a key determinant of population health and physical activity. Well-planned environments support active lifestyles and reduce health risks. This study examined the relationship between urban infrastructure, physical activity, and health among 95 residents aged 40–75 in Kaunas, Lithuania, between 2019 and 2022, selected from a baseline cohort of 1086 participants. Data were collected through questionnaires assessing environmental perceptions and self-rated health, alongside objective indicators—daily step count, resting systolic (sBP) and diastolic (dBP) blood pressure, body mass index (BMI), waist circumference, and heart rate—measured using wearable devices. Participants living in areas with more favorable infrastructure showed lower sBP (130.84 vs. 153.68 mmHg), lower heart rate (62.64 vs. 74.01 bpm), reduced BMI, and higher weekly step counts (54,564 vs. 27,885). Regression analysis indicated that higher physical activity and better-perceived infrastructure (REIF) were significantly associated with improved cardiovascular health (β = −11.32 for sBP, p = 0.011). Interaction effects revealed that the positive impact of physical activity on self-rated health was more pronounced in supportive environments (β = −0.04, p = 0.006). These findings suggest that well-designed urban spaces with walkability, green areas, and low perceived pollution promote healthier lifestyles and reduce health risks, supporting health equity and long-term well-being.