Multiple environmental characteristics including walkability, greenspace, area-level socioeconomic status, and home gardens were positively associated with physical activity across different intensity levels in Bulgaria's five largest cities, with associations remaining robust after accounting for air pollution and noise.
Key Findings
Results
Walkability was positively associated with multiple forms of physical activity including vigorous physical activity, moderate-to-vigorous physical activity, and walking.
Both objective and perceived walkability showed positive associations with walking
Objective walkability was positively associated with vigorous physical activity and moderate-to-vigorous physical activity
The study used a cross-sectional survey of 4640 adults conducted in 2023 across Bulgaria's five most populous cities
Physical activity was measured using the short form of the International Physical Activity Questionnaire (IPAQ)
Results
Greenspace availability was positively associated with vigorous physical activity, moderate-to-vigorous physical activity, and walking.
Greenspace was measured objectively within 300m and 1000m buffers around participants' neighborhoods
Medium and high levels of greenspace were positively associated with walking
Both low and high perceived greenspace (compared to medium) were positively associated with vigorous physical activity and moderate-to-vigorous physical activity
Medium/high levels of objective greenspace were positively associated with walking
Results
Area-level socioeconomic status (SES) was positively associated with vigorous physical activity and walking.
Area-level SES was included as an objective neighborhood measure
Both low and high area-level SES were positively associated with walking compared to reference category
Area-level SES was positively associated with time spent in vigorous physical activity
SES was measured at the neighborhood level rather than at the individual level
Results
Presence of a home garden was positively associated with vigorous physical activity, moderate-to-vigorous physical activity, and walking.
Home garden presence was self-reported by participants
Home gardens were associated with all three measured categories of physical activity: vigorous, moderate-to-vigorous, and walking
This was one of several environmental characteristics examined in the study
The study examined home gardens alongside objective neighborhood measures and perceived environmental characteristics
Results
Perceived bluespace was positively associated with vigorous physical activity and moderate-to-vigorous physical activity, while objective bluespace availability was positively associated with moderate-to-vigorous physical activity.
Bluespace was measured both objectively (within 300m and 1000m buffers) and through self-reported perception
Perceived bluespace showed positive associations with both vigorous and moderate-to-vigorous physical activity
Objective bluespace availability was positively associated with moderate-to-vigorous physical activity
Bikeability (perceived) was positively associated with vigorous physical activity
Results
Air pollution (fine particulate matter) and road traffic noise were unexpectedly positively associated with certain forms of physical activity.
Fine particulate matter (PM2.5) was one of the objective environmental measures linked to participants' neighborhoods
Road traffic noise was also measured objectively as part of the environmental assessment
The positive associations between air pollution/noise and physical activity were described as 'unexpected'
Associations between other environmental characteristics and physical activity remained robust after accounting for air pollution and noise
Methods
The study examined multiple environmental characteristics jointly alongside individual perceptions to assess their combined associations with physical activity.
The cross-sectional survey included 4640 adults across Bulgaria's five most populous cities in 2023
Objective measures included neighborhood walkability, PM2.5, road traffic noise, area-level SES, and greenspace/bluespace within 300m and 1000m buffers
Perceived measures included walkability, bikeability, greenspace, and bluespace
Physical activity was assessed across different intensity levels: vigorous, moderate-to-vigorous, and walking
What This Means
This research suggests that where people live significantly shapes how physically active they are. Researchers surveyed 4,640 adults living in Bulgaria's five largest cities in 2023 and found that neighborhoods with better walkability, more green spaces (like parks), access to water features (bluespace), and higher socioeconomic status tended to have residents who were more physically active. Having a home garden was also linked to higher levels of physical activity across all intensity categories measured—vigorous exercise, moderate-to-vigorous activity, and walking. These patterns held true whether the environmental features were measured objectively using maps and sensors, or reported subjectively by participants based on their own perceptions.
A surprising finding was that higher levels of air pollution (fine particulate matter) and road traffic noise were unexpectedly positively associated with some types of physical activity. The researchers note this was unexpected but emphasize that the positive associations between beneficial environmental features and physical activity remained strong even after accounting for these factors. This suggests the health-promoting qualities of walkable, green neighborhoods are not simply cancelled out by the presence of urban stressors like noise and pollution.
This research suggests that city planning and urban design decisions—such as building more walkable streets, expanding parks and green spaces, and improving access to natural water features—could meaningfully support higher levels of physical activity among urban residents. The findings are particularly relevant for cities in Eastern Europe and similar contexts where such research has been limited, and they provide evidence that investments in urban environmental quality may have public health benefits through promoting more active lifestyles.
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Dzhambov A, Burov A, Markevych I, Kostadinov K, Dimitrova D, Helbich M, et al.. (2026). Environmental characteristics and physical activity: A cross-sectional study in Bulgaria's five largest cities.. International journal of hygiene and environmental health. https://doi.org/10.1016/j.ijheh.2026.114816