The Association Between the Built Environment and Insufficient Physical Activity Risk Among Older Adults in China: Urban–Rural Differences and Non-Linear Effects

The built environment has been widely recognized as a critical determinant of physical activity among older adults. However, urban–rural disparities and the non-linear effects of environmental features remain underexplored. Using interpretable machine learning (random forest model) on nationwide representative data from 2526 older adults in the China Health and Retirement Longitudinal Study (CHARLS) database, this study identified both common and distinct risk factors for insufficient moderate-to-vigorous physical activity (MVPA) across diverse urban and rural contexts. The results revealed a location-based gradient in physical activity insufficiency: rural areas < suburban areas < central urban areas. Rural older adults faced greater constraints from safety concerns and transportation accessibility limitations. In comparison, urban older adults would benefit from targeted improvements in built environment quality, particularly elevator accessibility and diverse public activity spaces. Furthermore, non-linear relationships were observed between built environment features and physical activity, elucidating the “density paradox”: while moderate urban compactness promoted active behaviors, excessive density (>24,000 persons/km 2 ), perceived overcrowding, and over-proximity to specific facilities (<1 km) were linked to reduced MVPA. These findings underscore the necessity for differentiated policy interventions in urban and rural settings to address the distinct environmental needs of older adults. Meanwhile, in urban planning, it is crucial that we balance spatial compactness and functional diversity within optimal thresholds for creating sustainable and inclusive built environments. Although a compact design may enhance mobility, equal attention must be paid to preventing spatial disorder from over-densification.