Look around you. The layout of your neighborhood, the design of your street, the very materials that make up your home—they're all quietly influencing your health in ways science is just beginning to fully understand. From the air we breathe to how much we move, from our stress levels to our social connections, the built environment—all the human-made spaces where we live, work, and play—profoundly shapes our physical and mental well-being.
For decades, public health focused primarily on individual choices: exercise more, eat better, don't smoke. But a growing body of research reveals that our surroundings make those healthy choices easier or harder. Imagine trying to walk more in a neighborhood without sidewalks, or finding fresh food in an area with only fast-food outlets. Today, scientists, urban planners, and public health experts are converging on a powerful insight: designing healthier environments may be one of the most effective strategies for building a healthier society 1 6 .
What Exactly is the "Built Environment"?
The term "built environment" encompasses everything from the buildings we inhabit to the transportation systems we use, and the parks where we relax. It includes:
Buildings
Homes, offices, schools and other structures where we spend most of our time.
Public Spaces
Parks, plazas, sidewalks and other shared areas for recreation and social interaction.
Transportation Networks
Roads, bike lanes, public transit systems that determine how we move through our environment.
Food Environments
Grocery stores, restaurants, and food outlets that shape our dietary choices.
This human-made ecosystem constantly interacts with our health, for better or worse. It can expose us to toxins or protect us from them, encourage physical activity or discourage it, and even shape our mental state through factors like noise, crowding, or access to nature 6 9 .
How Our Surroundings Shape Our Health: The Key Mechanisms
Did You Know?
The U.S. Department of Health and Human Services now explicitly links neighborhood design to national health objectives, noting that "providing opportunities for people to walk and bike in their communities—like by adding sidewalks and bike lanes—can increase safety and help improve health and quality of life" 1 .
Health Impact Distribution by Built Environment Factors
A Landmark Experiment: What Happens When We Move to More Walkable Cities?
While the link between neighborhood design and health has long been suspected, proving cause and effect has been challenging. Do active people simply choose to live in walkable neighborhoods, or do these neighborhoods actually make people more active?
A groundbreaking 2025 study published in Nature addressed this question by leveraging a massive "natural experiment"—tracking physical activity changes when people relocated to cities with different levels of walkability 2 .
The Methodology: Smartphones as Scientific Instruments
Data Collection
The research team analyzed an astonishing 248,266 days of minute-by-minute step recordings from smartphone accelerometers, focusing on 5,424 users of the Azumio Argus app who relocated at least once during the study period.
Participant Movement
These participants moved a total of 7,447 times among 1,609 U.S. cities, creating a perfect opportunity to observe how changes in environment affect behavior 2 .
Walkability Measurement
The study used "walk scores"—a measure of how daily errands can be accomplished on foot—to quantify neighborhood walkability.
Analysis Period
By comparing activity levels for 90 days before and after each move, researchers could isolate the effect of the built environment from personal preferences 2 .
Study Scale
| Participants | 5,424 smartphone users who relocated |
| Observation Days | 248,266 days |
| Relocations | 7,447 moves between 1,609 cities |
| Measurement | Smartphone accelerometer (step counts) |
| Time Frame | 90 days before and after relocation |
Impact of Walkability Changes
| Relocation Direction | Daily Step Change | Health Equivalent |
| Low to high walkability | +1,100 steps | ~11 min extra walking |
| High to low walkability | -1,400 steps | ~14 min less walking |
| Various cities to NYC | +1,400 steps | ~14 min extra walking |
Compelling Results: The Power of Place
The findings were striking and clear:
- Moving from a less walkable (25th percentile) to a more walkable (75th percentile city increased walking by 1,100 daily steps on average
- The effect was particularly pronounced for moves to highly walkable cities like New York City, where relocating participants increased their activity by 1,400 daily steps
- The reverse was equally true—those moving from walkable to less walkable cities decreased their activity by a similar amount
- These changes were sustained over at least three months and consisted primarily of moderate-to-vigorous physical activity—the type most strongly linked to health benefits 2
Walkability Benefits Across Demographic Groups
Perhaps most importantly, the researchers found robust evidence against "residential self-selection"—the idea that people who choose to move to walkable areas were already more active. When people moved to areas with similar walkability to their previous neighborhood, no significant change in activity occurred, strongly suggesting that the environment itself caused the behavioral changes 2 .
Beyond Steps: The Broader Health Implications
The walkability study represents just one piece of a much larger picture. Research from Harvard's Department of Environmental Health notes that the built environment influences a wide range of health outcomes, including "asthma, injury, violence, healthy and unhealthy food consumption, mental health, [and] social capital" 9 .
Chronic Disease Connections
Our car-dependent, spread-out suburban design has been linked to higher rates of obesity, diabetes, and cardiovascular disease. One study noted that when traffic was reduced in Atlanta for the Olympic Games, peak ozone concentrations decreased by 27.9% and asthma emergency medical events simultaneously fell by 41.6%—a powerful demonstration of the direct health impact of our transportation choices 6 .
The Mental Health Component
A 2025 study in Scientific Reports analyzed built environment impacts across 19 major U.S. cities and found that certain building features profoundly influence urban mental health. The research, which used machine learning models to analyze Google Street View images and health data, revealed that traditional materials like wood and masonry (common in older buildings) were linked to better health compared to modern materials .
Health Outcomes Linked to Built Environment Factors
From Research to Reality: Creating Healthier Environments
The evidence clearly points to actionable strategies for building healthier communities:
Policy and Design Solutions
Zoning Reforms
Allow mixed-use development that places homes, shops, and workplaces closer together.
Complete Streets
Design roads that safely accommodate pedestrians, cyclists, and public transit users alongside cars.
What You Can Do: From Personal Actions to Community Advocacy
While system-level changes are crucial, individuals can also take steps to improve their environmental health:
Advocate
For complete streets, sidewalk improvements, and bike lanes in your community.
Choose
Housing in walkable neighborhoods when possible.
Support
Zoning changes that allow mixed-use development and accessible green spaces.
Engage
With local planning processes to ensure health considerations are part of development decisions.
The Path Forward: Building a Healthier Future
The growing understanding of how our surroundings shape our health represents a paradigm shift in public health. It moves beyond focusing solely on individual responsibility to acknowledge the powerful role of community design in creating—or hindering—opportunities for health.
As the research shows, interventions at the local, state, and federal level can help reduce health and safety risks in our environments and promote wellbeing 1 . From the walkability of our streets to the quality of our buildings, we have the knowledge and tools to create environments that naturally support healthier lives.
The science is clear: when we design communities that encourage movement, provide access to nature, minimize environmental hazards, and foster social connection, we're not just creating more pleasant places to live—we're building a foundation for better health for all.
The challenge now is to apply these insights through thoughtful policies, equitable planning, and a renewed commitment to creating built environments that actively promote, rather than accidentally undermine, our collective wellbeing.