Author's School

Brown School

Author's Department

Social Work


English (en)

Date of Award

Summer 9-21-2023

Degree Type


Degree Name

Doctor of Philosophy (PhD)

Chair and Committee

Ross Brownson

Committee Members

Deborah Salvo


Over the past three decades, Latin America has undergone major demographic, lifestyle, and epidemiological transitions. These rapid transitions are relevant contributors to social and health inequities in the region. Physical inactivity is a known risk factor for several adverse health outcomes, including Type 2 diabetes, coronary heart disease, and site-specific cancers (breast, ovarian, endometrial, and colon). Latin America has the highest prevalence of physical inactivity among all global regions, with one in every three Latin Americans being physically inactive. Research exploring the link between urban policies, built environment characteristics, and physical activity has grown over the past two decades. Nevertheless, the available evidence from the region suggests essential differences in the mechanisms through which urban policy and built environments influence population patterns of physical activity relative to what we know for high-income countries (HIC) settings. Latin America comprises low-to-middle-income countries and is home to six megacities, which face unique and complex health and social challenges. However, most of this evidence stems from something other than megacities in the region but from small to mid-sized cities. Additionally, although the available studies have contributed to the literature, there remain several substantial methodological limitations related to research questions, methods, study designs, and frameworks developed for HICs that need to be culturally and contextually appropriate for conducting studies in the region. This study focuses on Mexico City’s metropolitan area, which has over 20 million inhabitants. Through an interdisciplinary urban health lens, this dissertation aims to contribute to generating contextually relevant Research by following the ‘necessity-vs-choice-based models of the physical activity framework.’ the relationship between macro-level factors (urban policy and urban environment) and physical activity patterns in Mexico City, a Latin American megacity, was explored through three independent but interrelated studies. This study contributed to filling research gaps in understanding how macro-level factors influence physical activity in a Latin American megacity. The first study explores the relationship between objectively measured built environment characteristics and accelerometer-based physical activity among adults in Mexico City, finding consistent results with previous studies and moderating effects that have not been previously studied. The second study investigates the impact of two system-level shocks on the ridership patterns of the city's public bicycle-sharing system (Ecobici), highlighting missed opportunities for promoting cycling, especially among women. The last study introduces a tool to assess the physical activity policy misalignment and facilitate the examination of the “policy-to-practice disconnect” between the national and subnational (city) levels across the policy process. A pilot study in Mexico complements this study to test the feasibility and applicability of the tool in this country. Overall, these studies contribute to understanding the urban environment, policies, and active and sustainable transportation in Mexico City.

Available for download on Thursday, December 19, 2024