title: Co-benefits of designing communities for active living: an exploration of literature.
abstract: To reverse the global epidemic of physical inactivity that is responsible for more than 5 million deaths per year, many groups recommend creating "activity-friendly environments." Such environments may have other benefits, beyond facilitating physical activity, but these potential co-benefits have not been well described. The purpose of the present paper is to explore a wide range of literature and conduct an initial summary of evidence on co-benefits of activity-friendly environments. An extensive but non-systematic review of scientific and "gray" literature was conducted. Five physical activity settings were defined: parks/open space/trails, urban design, transportation, schools, and workplaces/buildings. Several evidence-based activity-friendly features were identified for each setting. Six potential outcomes/co-benefits were searched: physical health, mental health, social benefits, safety/injury prevention, environmental sustainability, and economics. A total of 418 higher-quality findings were summarized. 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 three co-benefits, with only one occurrence of a net negative effect. All settings showed the potential to contribute to environmental sustainability and economic benefits. Specific environmental features with the strongest evidence of multiple co-benefits were park proximity, mixed land use, trees/greenery, accessibility and street connectivity, building design, and workplace physical activity policies/programs. The exploration revealed substantial evidence that designing community environments that make physical activity attractive and convenient is likely to produce additional important benefits. The extent of the evidence justifies systematic reviews and additional research to fill gaps.
authors.affiliation: Active Living Research, University of California, San Diego, USA. jsallis@ucsd.edu.|Department of Family and Preventive Medicine, 3900 5th Avenue, Suite 310, San Diego, CA, 92119, USA. jsallis@ucsd.edu.
authors.forename: James F
authors.initials: JF
authors.lastname: Sallis
authors.affiliation: Active Living Research, University of California, San Diego, USA. scspoon@ucsd.edu.|Department of Family and Preventive Medicine, 3900 5th Avenue, Suite 310, San Diego, CA, 92119, USA. scspoon@ucsd.edu.
authors.forename: Chad
authors.initials: C
authors.lastname: Spoon
authors.affiliation: Cavill Associates Ltd, 185A Moss Lane, Bramhall, Stockport, Cheshire, SK7 1BA, UK. nick@cavill.net.
authors.forename: Nick
authors.initials: N
authors.lastname: Cavill
authors.affiliation: University of California San Diego/San Diego State University, Public Health Joint Doctoral Program, 3900 5th Avenue, Suite 310, San Diego, CA, 92119, USA. jkengelb@ucsd.edu.
authors.forename: Jessa K
authors.initials: JK
authors.lastname: Engelberg
authors.affiliation: James Cook University, Centre for Chronic Disease Prevention, PO Box 6811, Cairns, QLD, 4870, Australia. klaus.gebel@jcu.edu.au.
authors.forename: Klaus
authors.initials: K
authors.lastname: Gebel
authors.affiliation: Progress Health Partnerships Ltd, 5 Elmfield Road, Wigan, WN1 5RG, UK. mike.parker@progresshp.co.uk.
authors.forename: Mike
authors.initials: M
authors.lastname: Parker
authors.affiliation: University of California San Diego/San Diego State University, Public Health Joint Doctoral Program, 3900 5th Avenue, Suite 310, San Diego, CA, 92119, USA. cmt@ucsd.edu.
authors.forename: Christina M
authors.initials: CM
authors.lastname: Thornton
authors.affiliation: Active Living Research, University of California, San Diego, USA. dlou@ucsd.edu.|Department of Family and Preventive Medicine, 3900 5th Avenue, Suite 310, San Diego, CA, 92119, USA. dlou@ucsd.edu.
authors.forename: Debbie
authors.initials: D
authors.lastname: Lou
authors.affiliation: Active Living Research, University of California, San Diego, USA. amandawilson@ucsd.edu.|Department of Family and Preventive Medicine, 3900 5th Avenue, Suite 310, San Diego, CA, 92119, USA. amandawilson@ucsd.edu.
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Wilson
authors.affiliation: Active Living Research, University of California, San Diego, USA. ccutter@ucsd.edu.|Department of Family and Preventive Medicine, 3900 5th Avenue, Suite 310, San Diego, CA, 92119, USA. ccutter@ucsd.edu.
authors.forename: Carmen L
authors.initials: CL
authors.lastname: Cutter
authors.affiliation: The University of Sydney, Sydney School of Public Health, Edward Ford Building (A27), Sydney, NSW, 2006, Australia. melody.ding@sydney.edu.au.
authors.forename: Ding
authors.initials: D
authors.lastname: Ding
mesh_terms: D004779:Environment Design; D015444:Exercise; D006801:Humans; D011998:Recreation; D012111:Residence Characteristics; D012574:Schools; D014186:Transportation; D014937:Work; D017132:Workplace