Abstract
Public spaces could promote health equity by providing a place for people to engage in physical activity. Whereas most studies show a positive association between public spaces and physical activity, there are still mixed results, especially in low- and middle-income countries. The objectives of this mixed-methods study were: (i) to assess the quantitative association between access to public spaces and physical activity; (ii) to assess the modification of the association by public spaces quality, area-level walkability, and social stratifiers; (iii) to explain the quantitative results using qualitative data. Quantitative data were obtained with a household survey in two arid-climate Mexican cities in 2017-2018. physical activity was measured with the Global Physical Activity Questionnaire. Access to public spaces was measured in buffers centered on survey blocks, walkability with area-level indicators, and public spaces quality with the Physical Activity Resources Assessment. Qualitative data were obtained with semi-structured interviews and neighborhood observation. No quantitative association between access to public spaces and physical activity was found, as well as no interactions between access to public spaces and other variables. Walkability was positively associated with physical activity. Qualitative analysis showed that local public spaces were rarely used by adults because they were perceived as small, unequipped, unattractive, and unsafe. The results shed light on the relationship between public spaces and physical activity, highlighting the improvements in design and upkeep of public spaces that are necessary to achieve their potential health benefit.
Highlights
Insufficient physical activity is a major risk factor for death and disability, but more than 50% of adults are physically inactive worldwide 1
The promotion of physical activities is important for public health, and public spaces could be significant for this, providing people with a place for engaging in physical activity, and a destination to walk to or through 2
As the key quantitative result was the null association between access to public spaces and physical activity, we aimed to explain it with the results of the qualitative component
Summary
Insufficient physical activity is a major risk factor for death and disability, but more than 50% of adults are physically inactive worldwide 1. There are still mixed results, and some researchers have reported lower physical activity levels among those living closer to public spaces [3,5,6,7]. These contrasting results might be explained by characteristics that modify the relationship between public spaces and physical activity, including the public space quality 2. The number and kind of available facilities and amenities could be significant 10, and a previous study showed that the presence of more facilities was positively associated with the probability of visiting public spaces and engaging in physical activity there 12. Safety is a significant aspect, frequently mentioned in the literature as an obstacle to the use of public spaces [8,10]
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