Inactivity is one of the major causes of morbidity and mortality in economically developed countries. Physical activity has been shown to have a significant positive effect on health and well-being, preventing and treating cardio-respiratory diseases, diabetes, osteoporosis, and obesity, as well as depression and anxiety. Although the above facts are widely known, engaging sedentary people in exercise has been difficult in practice. This thesis explores the potential of urban design to provide and encourage inclusive, natural, pleasant, easily accessible exercise incorporated into walking for all income, age, physical ability and occupational groups as part of their daily travels through the city. While most of the past research on the effect of the built environment on physical activity has focused on quantity, this work also considers quality of physical activity, particularly more natural and diverse movement involving the whole body, similar to hiking. It draws on existing scientific knowledge from other disciplines, such as physiology and sociopsychology, to balance the effectiveness of the exercise with accessibility and attractiveness for people with a wide range of physical abilities. This ‘Active Urbanism’ concept employs shapes and surfaces – such as cobblestones, steppingstones, steep slopes, large steps, and balancing beams – placed on urban routes to encourage people to walk more and with a greater variety of movements, leading to greater health benefits.

The biokinetic theme determines the health benefits for individuals, whilst the sociological theme relates to the potential proportion of the population reached and the best ways to achieve this reach. Both aspects are important for estimating and maximizing the overall potential benefit to population health. Interventions aimed at the whole population may have small effect sizes at the individual level, but have very wide reach, leading to substantial overall impact on the population. The findings of this research demonstrate the nature, range and reach of health benefits associated with Active Urbanism and how it can be applied to the design of urban environments. Methodologically, the thesis also reveals that a multidisciplinary approach is important when it comes to the practice of designing and implementing healthy environments – a topic that has gained growing attention in recent decades.