Are compact cities a threat to public health?

Whereas compact cities have long been suggested to be the most sustainable solution for urban development, the health impacts of living in dense urban environments are contested. We present results from a mixed-methods study on the associations between built environment (residential location, neighbourhood density and distance from green space), and general health, back pain, headache, and depressive symptoms in Oslo metropolitan area, Norway. The study indicates that the built environment has some associations with health. However, it does not support claims from an earlier study of aggregate-scale comparisons of geographical districts about the overall negative health impacts of living in the central parts of Oslo. Overall, living close to the main city centre, appears to contribute to better self-reported general health, whereas high local-area density showed a slight opposite association. Otherwise, there were in general few associations between spatial characteristics of the neighbourhood and different health complaints. Based on this and earlier findings, we suggest that the built environment influences residents’ health via different mechanisms that are partly counteracting each other. Whereas inner-city dwellers are more exposed to air pollution and noise, they travel more by physically active modes, avoid time-consuming and dissatisfactory commutes, and might benefit from more social arenas.