Exploring urban design’s impact on physical activity: A participatory photovoice study across socioeconomically diverse neighborhoods

Abstract

Urban design significantly influences the physical activity (PA) behaviors of residents, impacting public health and well-being. This study examines how the built environment, social structures, economic conditions, and political context shape PA behaviors in three socioeconomically diverse neighborhoods in Bilbao, Spain. Using the Photovoice method, forty-one participants documented and discussed urban design features that affect their PA, fostering deep community engagement. A thematic analysis of 117 photographs identified four overarching factors influencing PA across all socioeconomic groups: 1) availability and quality of urban spaces for PA; 2) walkability and pedestrian infrastructure; 3) perceived safety and security; and 4) management of community assets. These factors were shaped by public space accessibility, topography, traffic-pedestrian interactions, and the extent of community involvement in urban planning. The study highlights the importance of inclusive, participatory approaches in urban planning to address health disparities and promote active, sustainable communities. Participants suggested specific interventions such as improving pedestrian infrastructure, enhancing safety measures, and increasing community-led management of shared assets to encourage active living. By emphasizing the role of social policies and community engagement, these findings provide a foundation for policymakers to develop strategies that promote equitable access to active living environments for all residents. While the study's insights are context-specific to Bilbao, they offer valuable lessons for similar urban settings, highlighting the potential of community-based approaches in fostering healthier and more inclusive cities.