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Built environment correlates of physical activity in low- and middle-income countries: A systematic review

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  • Sarah Elshahat
  • Michael O’Rorke
  • Deepti Adlakha

Abstract

Insufficient physical activity (PA) is the fourth major risk factor for many non-communicable diseases and premature mortality worldwide. Features of the built environment (BE) play a considerable role in determining population PA behaviors. The majority of evidence for PA-BE relationships comes from high-income countries and may not be generalizable to low- and middle-income countries (LMICs). We aim to systematically review the literature and assess the associations between perceived and/or objective BE characteristics and PA domains in LMICs. This review adopted a systematic search strategy for English language articles published between January 2000 and June 2019 from four electronic databases—Medline, Embase, Web of Science and PubMed—adhering to the PRISMA guidelines. Studies addressing the associations between self-reported and/or objective BE and PA were only included if they were conducted in LMICs, according to the World Bank classification list. Articles investigating PA-BE relationships across any age groups were included, and all study designs were eligible, except for qualitative studies and reviews. Thirty-three studies were included for evidence synthesis. Cross-sectional studies were the most prevailing study design (97%), revealing a notable gap in longitudinal PA-BE research in LMICs. A majority of the BE factors were not associated with different PA domains while others (e.g., density, proximity to services, aesthetics) exhibited an inconsistent association. Land-use mix diversity was positively associated with transport PA and the presence of recreation facilities resulted in an increase in PA during leisure-time. Increased safety from crime at night consistently increased total PA and walking levels. Research exploring the associations between BE attributes and PA behaviors in LMICs appears to be limited and is primarily cross-sectional. Longitudinal research studies with objective measures are needed for inferring well-grounded PA-BE causal relationships and informing the design of evidence-based environmental interventions for increasing PA levels in LMICs.

Suggested Citation

  • Sarah Elshahat & Michael O’Rorke & Deepti Adlakha, 2020. "Built environment correlates of physical activity in low- and middle-income countries: A systematic review," PLOS ONE, Public Library of Science, vol. 15(3), pages 1-19, March.
    • Handle: RePEc:plo:pone00:0230454
    DOI: 10.1371/journal.pone.0230454
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    1. Deepti Adlakha & Mina Chandra & Murali Krishna & Lee Smith & Mark A. Tully, 2021. "Designing Age-Friendly Communities: Exploring Qualitative Perspectives on Urban Green Spaces and Ageing in Two Indian Megacities," IJERPH, MDPI, vol. 18(4), pages 1-12, February.
    2. Feyisayo A. Wayas & Joanne A. Smith & Estelle V. Lambert & Natalie Guthrie-Dixon & Yves Wasnyo & Sacha West & Tolu Oni & Louise Foley, 2023. "Association of Perceived Neighbourhood Walkability with Self-Reported Physical Activity and Body Mass Index in South African Adolescents," IJERPH, MDPI, vol. 20(3), pages 1-16, January.
    3. Rafael Luciano de Mello & Adalberto Aparecido dos Santos Lopes & Rogério César Fermino, 2022. "Exposure to Public Open Spaces and Leisure-Time Physical Activity: An Analysis of Adults in Primary Health Care in Brazil," IJERPH, MDPI, vol. 19(14), pages 1-17, July.
    4. Martin Heine & Marelise Badenhorst & Chanel van Zyl & Gabriela Lima de Melo Ghisi & Abraham Samuel Babu & John Buckley & Pamela Serón & Karam Turk-Adawi & Wayne Derman, 2021. "Developing a Complex Understanding of Physical Activity in Cardiometabolic Disease from Low-to-Middle-Income Countries—A Qualitative Systematic Review with Meta-Synthesis," IJERPH, MDPI, vol. 18(22), pages 1-18, November.
    5. Diego Sales & Victor Matsudo & Mauro Fisberg & Clemens Drenowatz & Adilson Marques & Gerson Ferrari, 2022. "Perception of the Neighborhood Environment, Physical Activity by Domain and Sitting Time in Brazilian Adults," IJERPH, MDPI, vol. 19(23), pages 1-14, November.

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