The Nursing and Health Promotion research group examined the urban design of three Bilbao neighbourhoods from the perspective of their inhabitants for the purpose of detecting which elements hamper and which encourage physical activity. The participatory study detected that the availability and quality of green areas, multi-purpose facilities and pedestrian spaces are key elements in making the population active.

The World Health organisation classifies sedentary behaviour in today’s society as a global public health problem. Urban environments constitute one of the main challenges with respect to physical inactivity, given that 31% of the population in European cities, for example, is sedentary.

In this context, the Nursing and Health Promotion research group proposed analysing how Bilbao’s urban design influences the physical activity of its inhabitants: “We conducted a participatory study in collaboration with residents in three socioeconomically diverse neighbourhoods and confirmed that the urban environment has a significant impact on people’s activity behaviours. We saw that the influencing factors are the availability and quality of spaces for physical activity, the perception of safety, pedestrian infrastructure and the management of community resources,” explained the researcher Ainara San Juan.

The EHU group opted for a research method known as Photovoice, in which the residents themselves were the ones who used photographs to document the elements they felt facilitated or hindered physical activity. People from Deusto, Uribarri and San Francisco took part, and 117 images per neighbourhood were analysed. “We wanted to gather the citizens’ perspectives. So the results are not deductions made by the research team, but based on the conclusions drawn by the residents themselves following in-depth discussions. That makes the final message all the more significant,” said San Juan.

Firstly, in terms of availability and quality of spaces for physical activity, the research results indicate that the environments rated most highly by the citizens are green areas and multi-purpose facilities. In other words, instead of places that are highly specialised for a single activity, spaces that can be used for different functions are considered to be more suitable. Even so, the UPV/EHU researcher added that “the participants stressed that using and managing these places properly is just as important as having them available. They emphasised the importance of offering activities and maintaining the facilities properly. They also highlighted the importance of accessibility, because having suitable spaces for physical activity is of little use if they are difficult to reach, which is the case in neighbourhoods with steep slopes, for example.

Very closely linked to accessibility, the study also concluded that one of the main concerns of the population is pedestrian mobility. Regarding problems caused by slopes, they set great store by moving walkways and urban lifts that facilitate and ensure equality of opportunity for citizens with mobility difficulties. However, the residents pointed out that attention should be paid to other aspects that make pedestrian areas difficult to navigate and, consequently, prevent people from being active. They cited narrow, poorly paved or poorly lit pavements and terraces or other obstacles that reduce the space for walking.

The research also highlighted the fact that the perception of safety is another important issue in the population’s ability to lead an active life. Although vandalism and anti-social behaviour were mentioned in some cases, overall, the study participants cited traffic as the main cause of the sensation of insecurity in Bilbao. “In all the neighbourhoods they mentioned the challenges posed by the coexistence of vehicles and pedestrians. They pointed out that traffic limits the space available for physical activity, as it often leads to pedestrians, cyclists, children in the park, joggers, etc. having to share areas and these interactions generate incidents and insecurity,” explained San Juan.

Importance of involving citizens in urban planning

Those who collaborated in the study consider it important to take citizen participation into account when decisions are made regarding community resources related to mobility. San Juan explained that “although the residents feel that the authorities are doing things, they want to be taken more into consideration because they believe that this would respond to the real needs of the community; that would allow actions that do not address the priorities of each neighbourhood to be avoided, or relevant information for making improvements to be obtained”.

Indeed, the researcher believes that one of the strongest points in the work carried out is that they managed to connect citizens with the authorities: “The methodology used is not only participatory but also has a social component. It is not restricted to generating scientific knowledge but seeks social transformation. In this case, the needs identified throughout the process were translated into specific policy recommendations and were passed on directly to the heads of the authorities through several citizen science sessions. The most powerful thing is that, as a university, we acted as intermediaries to ensure that the message from the public reached its intended audience.”

Further information

Ainara San Juan is in the EHU's Public Health PhD Programme and this article is part of her thesis in which she explores the relationship between the urban environment and physical activity from the citizens’ perspective. Leyre Gravina belongs to the Department of Nursing, leads the Nursing and Health Promotion research group, and is co-supervising the PhD work together with the urban health expert Manuel Franco.

The results of the research on the relationship between the urban environment and physical activity in Bilbao are available on a web page where photos and videos of the process are also included.

Bibliographic reference

Ainara San-Juan-Escudero, Sendoa Ballesteros-Pena, Irrintzi Fernandez-Aedo, Silvia Caballero Sanchez, Julia Fernandez-Alonso, Pedro Gullon, Manuel Franco, Leyre Gravina

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

Landscape and Urban Planning

DOI: 10.1016/j.landurbplan.2025.105334