An essential characteristic of a healthy and sustainable city is a physically active population. Effective policies for healthy and sustainable cities require evidence-informed quantitative targets. We aimed to identify the minimum thresholds for urban design and transport features associated with two physical activity criteria: at least 80% probability of engaging in any walking for transport and WHO's target of at least 15% relative reduction in insufficient physical activity through walking. The International Physical Activity and the Environment Network Adult (known as IPEN) study (N=11 615; 14 cities across ten countries) provided data on local urban design and transport features linked to walking. Associations of these features with the probability of engaging in any walking for transport and sufficient physical activity (≥150 min/week) by walking were estimated, and thresholds associated with the physical activity criteria were determined. Curvilinear associations of population, street intersection, and public transport densities with walking were found. Neighbourhoods exceeding around 5700 people per km2, 100 intersections per km2, and 25 public transport stops per km2 were associated with meeting one or both physical activity criteria. Shorter distances to the nearest park were associated with more physical activity. We use the results to suggest specific target values for each feature as benchmarks for progression towards creating healthy and sustainable cities.

Centre for Urban Transitions Swinburne University of Technology and Baker Heart and Diabetes Institute Melbourne VIC Australia

College of Health Solutions Senior Global Futures Scientist Julie Ann Wrigley Global Futures Laboratory Arizona State University Phoenix AZ USA

Department of Landscape Architecture and Environmental Planning Natural Learning Initiative College of Design North Carolina State University Raleigh NC USA

Department of Movement and Sports Sciences Faculty of Medicine and Sports Sciences Ghent University Ghent Belgium

Department of Sports Science and Clinical Biomechanics University of Southern Denmark Odense Denmark

Department of Urban Planning and Design Urban Form Lab University of Washington Seattle WA USA

Department of Urban Planning and Spatial Analysis Sol Price School of Public Policy University of Southern California Los Angeles California USA

Department of Urban Studies and Planning University of California San Diego CA USA

Faculty of Physical Culture Palacký University Olomouc Olomouc Czech Republic

Health Research Institute University of Canberra Canberra ACT Australia

Healthy Liveable Cities Lab RMIT University Melbourne VIC Australia

Healthy Liveable Cities Lab RMIT University Melbourne VIC Australia; School of Population Health The University of Western Australia Perth WA Australia

Herbert Wertheim School of Public Health and Human Longevity Science University of California San Diego CA USA

Human Potential Centre School of Sport and Recreation Auckland University of Technology Auckland New Zealand

Mary MacKillop Institute for Health Research Australian Catholic University Melbourne VIC Australia; Herbert Wertheim School of Public Health and Human Longevity Science University of California San Diego CA USA

Mary MacKillop Institute for Health Research Australian Catholic University Melbourne VIC Australia; School of Public Health The University of Hong Kong Hong Kong Hong Kong Special Administrative Region China

Melbourne Centre for Cities University of Melbourne Melbourne VIC Australia

Prevention Research Center Brown School Washington University in St Louis St Louis MO USA

Prevention Research Center Brown School Washington University in St Louis St Louis MO USA; Graduate Program in Urban Management Pontifical Catholic University of Parana Curitiba Brazil

School of Medicine at Universidad de los Andes Bogotá Colombia

School of Public Policy and Urban Affairs Northeastern University Boston MA USA

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