International Journal of Public Health

, Volume 58, Issue 4, pp 615–625 | Cite as

Objectively measured walkability and active transport and weight-related outcomes in adults: a systematic review

  • Gerlinde Grasser
  • Delfien Van Dyck
  • Sylvia Titze
  • Willibald Stronegger



The aim of this study was to investigate which GIS-based measures of walkability (density, land-use mix, connectivity and walkability indexes) in urban and suburban neighbourhoods are used in research and which of them are consistently associated with walking and cycling for transport, overall active transportation and weight-related measures in adults.


A systematic review of English publications using PubMed, Science Direct, Active Living Research Literature Database, the Transportation Research Information Service and reference lists was conducted. The search terms utilised were synonyms for GIS in combination with synonyms for the outcomes.


Thirty-four publications based on 19 different studies were eligible. Walkability measures such as gross population density, intersection density and walkability indexes most consistently correlated with measures of physical activity for transport. Results on weight-related measures were inconsistent.


More research is needed to determine whether walkability is an appropriate measure for predicting weight-related measures and overall active transportation. As most of the consistent correlates, gross population density, intersection density and the walkability indexes have the potential to be used in planning and monitoring.


Walkability Density Land-use mix Connectivity Body weight Physical activity for transport 



Delfien van Dyck was supported by Research Foundation Flanders (FWO) B/09731/01.

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

38_2012_435_MOESM1_ESM.doc (414 kb)
Supplementary material 1 (DOC 414 kb)


  1. Bauman A, Bull F (2007) Environmental correlates of physical activity and walking in adults and children: a review of reviews. National Institute of Health and Clinical Excellence, LondonGoogle Scholar
  2. Berke EM, Koepsell TD, Moudon AV, Hoskins RE, Larson EB (2007) Association of the built environment with physical activity and obesity in older persons. Am J Pub Health 97(3):486–492. doi: 10.2105/AJPH.2006.085837 CrossRefGoogle Scholar
  3. Bodea TD, Garrow LA, Meyer MD, Ross CL (2008) Explaining obesity with urban form: a cautionary tale. Transp Res Part A Policy Pract 35:179–199Google Scholar
  4. Boer R, Zheng Y, Overton A, Ridgeway GK, Cohen DA (2007) Neighborhood design and walking trips in ten US metropolitan areas. Am J Prev Med 32:298–304PubMedCrossRefGoogle Scholar
  5. Brown BB, Yamada I, Smith KR, Zick CD, Kowaleski-Jones L, Fan JX (2009) Mixed land use and walkability: variations in land use measures and relationships with BMI, overweight, and obesity. Health Place 15:1130–1141PubMedCrossRefGoogle Scholar
  6. Brownson RC, Hoehner CM, Day K, Forsyth A, Sallis JF (2009) Measuring the built environment for physical activity: state of the science. Am J Prev Med 36(4 Suppl):S99–S123PubMedCrossRefGoogle Scholar
  7. Cao X, Mokhtarian PL, Handy SL (2009) Examining the impacts of residential self-selection on travel behaviour: a focus on empirical findings. Transp Rev 29(3):359–395. doi: 10.1080/01441640802539195 CrossRefGoogle Scholar
  8. Cerin E, Leslie E, Toit Ld, Owen N, Frank LD (2007) Destinations that matter: associations with walking for transport. Health Place 13(3):713–724. doi: 10.1016/j.healthplace.2006.11.002 PubMedCrossRefGoogle Scholar
  9. Chatman DG (2009) Residential choice, the built environment, and nonwork travel: evidence using new data and methods. Environ Plan A 41(5):1072–1089CrossRefGoogle Scholar
  10. Coombes E, Jones AP, Hillsdon M (2010) The relationship of physical activity and overweight to objectively measured green space accessibility and use. Soc Sci Med 70(6):816–822. doi: 10.1016/j.socscimed.2009.11.020 PubMedCrossRefGoogle Scholar
  11. Effective Practice Institute UoA The GATE Notes: a generic appraisal tool for epidemiology.; Last accessed 15th October 2011
  12. EPHPP (2009a) Quality assessment tool for quantitative studies. Effective public health practice project,; Last accessed 13th January 2012
  13. EPHPP (2009b) Quality assessment tool for quantitative studies dictionary. Effective public health practice project,; last accessed 13th January 2012
  14. Ewing R, Cervero R (2010) Travel and the built environment. J Am Plann Assoc 76(3):265–294CrossRefGoogle Scholar
  15. Feng J, Glass TA, Frank CC, Stewart WF, Schwartz BS (2009) The built environment and obesity: a systematic review of the epidemiological evidence. Health Place 16:175–190. doi: 10.1016/j.healthplace.2009.09.008 Google Scholar
  16. Forsyth A, D’Sousa E, Koepp J, Oakes JM, Schmitz KH, Zimmerman J, Rodriguez D, Song Y (2006) Environment and physical activity. GIS Protocols Version 4.0. University of Minnesota, Metropolitan Design CenterGoogle Scholar
  17. Forsyth A, Oakes JM, Schmitz KH, Hearst M (2007) Does residential density increase walking and other physical activity? Urb Stud 44(4):679–697. doi: 10.1080/00420980601184729 CrossRefGoogle Scholar
  18. Forsyth A, Hearst M, Oakes JM, Schmitz KH (2008) Design and destinations: factors influencing walking and total physical activity. Urb Stud 45(9):1973–1996. doi: 10.1177/0042098008093386 CrossRefGoogle Scholar
  19. Forsyth A, Oakes JM, Lee B, Schmitz KH (2009) The built environment, walking, and physical activity: is the environment more important to some people than others? Transp Res Part D Transp Environ 14:42–49CrossRefGoogle Scholar
  20. Frank L, Engelke P, Schmid T (2003) Health and community design. The impact of the built environment on physical activity. Island Press, WashingtonGoogle Scholar
  21. Frank LD, Andresen MA, Schmid TL (2004) Obesity relationships with community design, physical activity, and time spent in cars. Am J Prev Med 27:87–96PubMedCrossRefGoogle Scholar
  22. Frank LD, Schmid TL, Sallis JF, Chapman J, Saelens BE (2005) Linking objectively measured physical activity with objectively measured urban form: findings from SMARTRAQ. Am J of Prev Med 28(2 Suppl 2):S117–S125. doi: 10.1016/j.amepre.2004.11.001 CrossRefGoogle Scholar
  23. Frank LD, Sallis JF, Conway TL, Chapman JE, Saelens BE, Bachman W (2006) Many pathways from land use to health: associations between neighborhood walkability and active transportation, body mass index, and air quality. J Am Plann Assoc 72:75–87CrossRefGoogle Scholar
  24. Frank LD, Saelens BE, Powell KE, Chapman JE (2007) Stepping towards causation: do built environments or neighborhood and travel preferences explain physical activity, driving, and obesity? Soc Sci Med 65(9):1898–1914. doi: 10.1016/j.socscimed.2007.05.053 PubMedCrossRefGoogle Scholar
  25. Frank LD, Kerr J, Sallis JF, Miles R, Chapman JE (2008) A hierarchy of sociodemographic and environmental correlates of walking and obesity. Prev Med 47:172–178PubMedCrossRefGoogle Scholar
  26. Frank LD, Kerr J, Saelens BE, Sallis JF, Glanz K, Chapman JE (2009a) Food outlet visits, physical activity and body weight: variations by gender and race-ethnicity. Br J Sports Med 43:124–131PubMedCrossRefGoogle Scholar
  27. Frank LD, Sallis JF, Saelens BE, Leary L, Cain K, Conway TL, Hess PM (2009b) The development of a walkability index: application to the neighborhood quality of life study. Br J Sports Med. doi: 10.1136/bjsm.2009.058701 Google Scholar
  28. Frumkin H, Frank L, Jackson R (2004) Urban sprawl and public health. Island Press, WashingtonGoogle Scholar
  29. Giles-Corti B, Timperio A, Bull F, Pikora T (2005) Understanding physical activity environmental correlates: increased specificity for ecological models. Exerc Sport Sci Rev 33(4):175–181PubMedCrossRefGoogle Scholar
  30. Huang L, Stinchcomb DG, Pickle LW, Dill J, Berrigan D (2009) Identifying clusters of active transportation using spatial scan statistics. Am J Prev Med 37:157–166PubMedCrossRefGoogle Scholar
  31. Kitamura R, Mokhtarian PL, Laidet L (1997) A micro-analysis of land use and travel in five neighborhoods in the San Francisco Bay Area. Transportation 24:125–158CrossRefGoogle Scholar
  32. Lee C, Moudon AV (2006) Correlates of walking for transportation or recreation purposes. J Phys Act Health 3:S77–S98Google Scholar
  33. Leslie E, Coffee N, Frank L, Owen N, Bauman A, Hugo G (2007) Walkability of local communities: using geographic information systems to objectively assess relevant environmental attributes. Health Place 13(1):111–122. doi: 10.1016/j.healthplace.2005.11.001 PubMedCrossRefGoogle Scholar
  34. Li F, Harmer PA, Cardinal BJ, Bosworth M, Acock A, Johnson-Shelton D, Moore JM (2008) Built enviornment, adiposity, and physical activity in adults aged 50–75. Am J Prev Med 35:38–46PubMedCrossRefGoogle Scholar
  35. Li F, Harmer PA, Cardinal BJ, Bosworth M, Johnson-Shelton D, Moore JM, Acock A, Vongjaturapat N (2009) Built environment and 1 year change in weight and waist circumference in middle-aged and older adults. J Epidemiol 196(4):401–408Google Scholar
  36. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol 62(10):e1–e34PubMedCrossRefGoogle Scholar
  37. Lopez RP (2007) Neighborhood risk factors for obesity. Obesity 15(8):2111–2119PubMedCrossRefGoogle Scholar
  38. McGinn AP, Evenson KR, Herring AH, Huston SL, Rodriguez DA (2007) Exploring associations between physical activity and perceived and objective measures of the built environment. J Urb Health 84(2):162–184. doi: 10.1007/s11524-006-9136-4 CrossRefGoogle Scholar
  39. Oakes JM, Forsyth A, Schmitz KH (2007) The effects of neighborhood density and street connectivity on walking behavior: the Twin Cities walking study. Epidemiol Perspect Innov 4:16PubMedCrossRefGoogle Scholar
  40. Owen N, Humpel N, Leslie E, Bauman A, Sallis JF (2004) Understanding environmental influences on walking. Review and research agenda. Am J Prev Med 27(1):67–76. doi: 10.1016/j.amepre.2004.03.006 PubMedCrossRefGoogle Scholar
  41. Owen N, Cerin E, Leslie E, duToit L, Coffee N, Frank LD, Bauman AE, Hugo G, Saelens BE, Sallis JF (2007) Neighborhood walkability and the walking behavior of Australian adults. Am J Prev Med 33(5):387–395. doi: 10.1016/j.amepre.2007.07.025 PubMedCrossRefGoogle Scholar
  42. Owen N, De Bourdeaudhuij I, Sugiyama T, Leslie E, Cerin E, Van Dyck D, Bauman A (2010) Bicycle use for transport in an Australian and a Belgian city: associations with built-environment attributes. J Urb Health 87(2):189–198. doi: 10.1007/s11524-009-9424-x CrossRefGoogle Scholar
  43. Papas MA, Alberg AJ, Ewing R, Helzlsouer KJ, Gary TL, Klassen AC (2007) The built environment and obesity. Epidemiol Rev 29:129–143. doi: 10.1093/epirev/mxm009 PubMedCrossRefGoogle Scholar
  44. Petticrew M, Roberts H (2008) Systematic reviews in the social science: a practical guide. Blackwell, MaldenGoogle Scholar
  45. Pouliou T, Elliott SJ (2010) Individual and socio-environmental determinants of overweight and obesity in Urban Canada. Health Place 16(2):389–398. doi: 10.1016/j.healthplace.2009.11.011 PubMedCrossRefGoogle Scholar
  46. Rundle A, Diez Roux AV, Freeman L, Miller D, Neckerman K, Weiss CC (2007) The urban built environment and obesity in New York City: a multilevel analysis. Am J Health Promot 21:326–334PubMedCrossRefGoogle Scholar
  47. Rundle A, Neckerman KM, Freeman L, Lovasi GS, Purciel M, Quinn J, Richards C, Sircar N, Weiss C (2009) Neighborhood food environment and walkability predict obesity in New York City. Environ Health Perspect 117(3):442–447PubMedGoogle Scholar
  48. Saelens BE, Handy SL (2008) Built environment correlates of walking: a review. Med Sport Sci 40(7 Suppl):S550–S566CrossRefGoogle Scholar
  49. Saelens BE, Sallis JF, Black JB, Chen D (2003a) Neighborhood-based differences in physical activity: an environment scale evaluation. Am J Public Health 93(9):1552–1558PubMedCrossRefGoogle Scholar
  50. Saelens BE, Sallis JF, Frank LD (2003b) Environmental correlates of walking and cycling: findings from the transportation, urban design, and planning literature. Ann Behav Med 25(2):80–91PubMedCrossRefGoogle Scholar
  51. Sallis JF (2009) Measuring physical activity environments: a brief history. Am J Prev Med 36(4 Suppl):S86–S92. doi: 10.1016/j.amepre.2009.01.002 PubMedCrossRefGoogle Scholar
  52. Sallis JF, Glanz K (2009) Physical activity and food environments: solutions to the obesity epidemic. Milbank Q 87(1):123–154. doi: 10.1111/j.1468-0009.2009.00550.x PubMedCrossRefGoogle Scholar
  53. Sallis JF, Frank LD, Saelens BE, Kraft MK (2004) Active transportation and physical activity: opportunities for collaboration on transportation and public health research. Transp Res Part A 38:249–268. doi: 10.1016/j.tra.2003.11.003 Google Scholar
  54. Sallis JF, Saelens BE, Frank LD, Conway TL, Slymen DJ, Cain KL, Chapman JE, Kerr J (2009) Neighborhood built environment and income: examining multiple health outcomes. Soc Sci Med 68(7):1285–1293. doi: 10.1016/j.socscimed.2009.01.017 PubMedCrossRefGoogle Scholar
  55. Scott MM, Dubowitz T, Cohen DA (2009) Regional differences in walking frequency and BMI: what role does the built environment play for Blacks and Whites? Health Place 15:897–902CrossRefGoogle Scholar
  56. Smith KR, Brown BB, Yamada I, Kowaleski-Jones L, Zick CD, Fan JX (2008) Walkability and body mass index density, design, and new diversity measures. Am J Prev Med 35(3):237–244. doi: 10.1016/j.amepre.2008.05.028 PubMedCrossRefGoogle Scholar
  57. Van Dyck D, Cardon G, Deforche B, Sallis JF, Owen N, De Bourdeaudhuij I (2010a) Neighborhood SES and walkability are related to physical activity behavior in Belgian adults. Prev Med 50(Suppl 1):S74–S79. doi: 10.1016/j.ypmed.2009.07.027 PubMedCrossRefGoogle Scholar
  58. Van Dyck D, Cerin E, Cardon G, Deforche B, Sallis JF, Owen N, de Bourdeaudhuij I (2010b) Physical activity as a mediator of the associations between neighborhood walkability and adiposity in Belgian adults. Health Place 16(5):952–960. doi: 10.1016/j.healthplace.2010.05.011 PubMedCrossRefGoogle Scholar
  59. WHO (2006) Obesity and overweight. Accessed 2 Dec 2012
  60. Zick CD, Smith KR, Fan JX, Brown BB, Yamada I, Kowaleski-Jones L (2009) Running to the store? The relationship between neighborhood environments and the risk of obesity. Soc Sci Med 69(10):1493–1500. doi: 10.1016/j.socscimed.2009.08.032 PubMedCrossRefGoogle Scholar

Copyright information

© Swiss School of Public Health 2012

Authors and Affiliations

  • Gerlinde Grasser
    • 1
  • Delfien Van Dyck
    • 3
    • 4
  • Sylvia Titze
    • 2
  • Willibald Stronegger
    • 1
  1. 1.Institute of Social Medicine and EpidemiologyMedical University of GrazGrazAustria
  2. 2.Institute of Sport ScienceUniversity of GrazGrazAustria
  3. 3.Department of Movement and Sport Sciences, Faculty of Medicine and Health SciencesGhent UniversityGhentBelgium
  4. 4.Research Foundation FlandersBrusselsBelgium

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