Creating "activity-friendly environments" is recommended to promote physical activity, but potential co-benefits of such environments have not been well described. An extensive but non-systematic review of scientific and "gray" literature was conducted to explore a wide range of literature to understand the co-benefits of activity-friendly environments on physical health, mental health, social benefits, safety/injury prevention, environmental sustainability, and economics. Five physical activity settings were defined: parks/trails, urban design, transportation, schools, and workplaces/buildings.

KEY FINDINGS

• A total of 418 higher-quality findings were summarized based on direction of association and quality of source.
• The overall summary indicated 22 of 30 setting by outcome combinations showed “strong” evidence of co-benefits.
• Each setting had strong evidence of at least 3 of the 6 co-benefits, and parks and trails had strong evidence of all 6 co-benefits. Thus, for each setting there are multiple features that can be designed to both facilitate physical activity and produce co-benefits.
• All five physical activity settings could be designed so they have positive effects on economic outcomes, including increased home value, greater retail activity, reduced health care costs, and improved productivity.
• Activity-friendly design in all settings had strong evidence of environmental co-benefits based on reduced pollution and carbon emissions.
• There were many gaps in evidence of co-benefits in the schools and workplace settings as well the health consequences of environments that support active travel.
• Overall, there was little evidence of negative consequences of activity-friendly environments.

IMPLICATIONS

The most important conclusion of this review is that creating communities, transportation systems, schools, and buildings that make physical activity attractive and convenient also produces a wide range of other benefits for communities. Rather than thinking that designing one feature of a transportation system or school is sufficient, we encourage decision-makers and designers to consider how features in all settings can be optimized for physical activity and multiple other benefits. We urge mayors, other city officials, and staff in multiple departments to consult these findings as an aid in decision-making.

DESIGNED TO MOVE: ACTIVE CITIES

The findings from our Making the Case for Designing Active Cities is prominently featured in Designed to Move: Active Cities, a guide for city leaders that provides a comprehensive summary of the evidence base to-date, along with bright spots and specific recommendations for leaders to make any city an active city.