Low-carbon built environments and cardiometabolic health: a systematic review of Australian studies

Australian cities offer potential for public health impact through low-carbon built environment design interventions, given their high per capita carbon footprint and with car use being a large proportion of transport mode share. Certain neighbourhood built environment features have been shown to influence uptake of active travel (walking and cycling), and thus may have beneficial associations with cardiometabolic health outcomes, such as obesity and type 2 diabetes. This systematic review synthesised Australian evidence on associations between low-carbon built environment attributes (green space and those promoting active transport) and cardiometabolic health in adults. Six databases were systematically searched; 33 articles met the inclusion criteria and 22 were included in a meta-analysis. We found strong evidence for an association of higher levels of walkability with lower risk of overweight/obesity, while there was some evidence linking higher land use mix and supportive walking/cycling infrastructure with lower overweight/obesity risk. Australian policy and advocacy efforts favouring more walkable neighbourhoods (compact, dense, and mixed-use) may have dual benefits for population health and the sustainability of cities. These findings highlight the importance of urban planning and public health practitioners working together to achieve healthy and sustainable cities for all.