What are effective city-led public health policies to reduce sedentary behaviour in urban youth?

Abstract

Abstract Sedentary behaviour increases substantially during the transition from childhood to adolescence and is associated with poorer health outcomes (Habyarimana et al., 2025). In dense urban environments, opportunities for physical activity among youth are shaped by environmental factors such as access to green space, transportation infrastructure, and community programming (Liu et al., 2024; Squillacioti et al., 2023). These factors are further influenced by socioeconomic inequities. For instance, youth from marginalised communities often face a greater exposure to factors that may promote sedentary behaviours (Alliott et al., 2022; Salvo et al., 2023). Preadolescents and early adolescents are particularly affected because their independent mobility and access to recreational spaces are often constrained. Municipal public health units require clear, policy-relevant evidence to identify effective interventions that reduce sedentary behaviour while addressing health inequities. The aim of this rapid review was to provide an evidence synthesis of municipal-led and public health interventions that reduce sedentary behaviour among pre- and early adolescents living in urban environments similar to the city of Toronto in Canada and produce a policy-relevant evidence brief to inform municipal public health planning. A variety of municipal-led public health interventions were identified in this rapid review. Interventions most consistently associated with long-term optimal reductions in sedentary time were those that modified the built environment. For instance, effective initiatives included improving access to parks, active transport infrastructure, and traffic reduction measures. Cities can play a substantial role in improving the public health of urban youth. Evidence supports the use of multi-component and context-sensitive strategies that integrate built environment changes and physical activity programming.