Access to public open space is important to increase leisure-time walking (LTW) in high-income countries, but there is little evidence in middle-income countries. We conducted a cross-sectional analysis to examine the relationship between LTW and the presence of different public open spaces (parks, bike paths, and squares) and the mix of these recreational destinations near the homes of adults participating in the Sao Paulo Health Survey (n = 3145). LTW was evaluated by a questionnaire. We delineated buffers (500, 1000, and 1500 m) from the geographic coordinates of the adults’ residential addresses using a geographic information system. We used multilevel logistic regression taking account of clustering by census tracts and households, and with adjustment for social, demographics, and health characteristics. The main results showed that the presence of at least two recreational destinations within a 500-m buffer of participants’ homes were associated with an increased odds of LTW compared with no destinations present (OR = 1.65; 95% CI 1.09–2.55). No associations were found for destinations further away. These results support actions outlined in the new urban plan for Sao Paulo city and could be used to highlight the importance access to a mix of public open spaces to promote physical activity in megacities of middle-income countries.

Cities that support cycling for transportation reap many public health benefits. However, the prevalence of this mode of transportation is low in Latin American countries and the association with facilities such as bike paths and train/subway stations have not been clarified. We conducted a cross-sectional analysis of the relationship between bike paths, train/subway stations and cycling for transportation in adults from the city of Sao Paulo. We used data from the Sao Paulo Health Survey (n = 3145). Cycling for transportation was evaluated by a questionnaire and bike paths and train/subway stations were geocoded using the geographic coordinates of the adults’ residential addresses in 1500-m buffers. We used multilevel logistic regression, taking account of clustering by census tract and households. The prevalence of cycling for transportation was low (5.1%), and was more prevalent in males, singles, those active in leisure time, and in people with bicycle ownership in their family. Cycling for transportation was associated with bike paths up to a distance of 500 m from residences (OR (Odds Ratio) = 2.54, 95% CI (Confidence interval) 1.16–5.54) and with the presence of train/subway stations for distances >500 m from residences (OR = 2.07, 95% CI 1.10–3.86). These results are important to support policies to improve cycling for transportation in megacities such as Sao Paulo.

The study investigated availability and food sources in urban areas using elements of the NOVA food classification system, adopted by the Brazilian Dietary Guidelines, in a Brazilian municipality. In addition, the study also aimed to identify inequalities in the geographical distribution of food retailers that commercialize healthy and/or unhealthy foods. This cross-sectional study was performed in the municipality of Jundiai in the State of São Paulo, Brazil. Data from within-store audit and geographic data were used to characterizing the nutrition community environment. The mean was calculated for food items available in each of the four NOVA groups for each audited food retailer. The mean of food items available in each of the four NOVA groups for each audited food retail were calculated. The density and proportion of different types of food retailers were georeferenced. The supermarkets, medium market stores, and grocery stores presented the highest availability of unprocessed foods as well as ultra-processed foods. Establishments that sold primarily unprocessed foods and included a fruits and vegetables section at the entrance of the store had a greater availability of healthy foods, but their density in the territory was low compared to establishments that prioritized the sale of ultra-processed foods and sold ultra-processed foods in the checkout area. Especially in middle- and low-income areas, the concentration of food retailers with priority sale of ultra-processed products is reaches 22 times higher than the sale of unprocessed or minimally processed foods. The study supported the identification of regions where it was necessary to improve access to equipment that marketed unprocessed foods as a priority.

Ozone events in South America might be triggered by increasing air temperatures and dry conditions, leading to vulnerable population exposure. The current air quality standards and attention levels in São Paulo state, Brazil, are 40% higher and 25% higher, respectively, than the limits recommended by the World Health Organization (WHO). We simulated an extreme ozone event in the São Paulo megacity using the Weather Research and Forecast/Chemistry model during an extreme event characterized by positive anomalies of air temperature and solar radiation. Results were evaluated using the different air quality limits from São Paulo state and the WHO, also with socioeconomic vulnerability data from the Brazilian census and cost analysis for the public health system from the extreme episode. More than 3 million people in vulnerability conditions, such as low income and families with an above-average percentage of children, live in areas where ozone concentrations exceeded the attention levels of the WHO during the episode, which is ignored by the lenient SP state environmental laws. WHO air quality guidelines must be adopted urgently in developing nations in order to provide a more accurate basis for cost analysis and population exposure, particularly the for vulnerable population groups.

O presente estudo se propôs a caracterizar os diferentes tipos de equipamentos de varejo de alimentos presentes no ambiente alimentar e descrever sua distribuição no território segundo indicadores sociodemográficos. Para tanto, foram utilizados dados secundários do município de Jundiaí-SP. Foram verificadas a variedade e a densidade dos equipamentos de varejo, segundo dados sociodemográficos da região. Foram construídos mapas georreferenciados para ilustrar a distribuição espacial dos varejos de alimentos no município. Foi verificada uma maior concentração de varejos de alimentos nas áreas centrais da cidade. Nas áreas periféricas, com menor renda e menor escolaridade, foram encontradas maiores concentrações de pequenos comércios varejistas em relação aos Supermercados/Hipermercados. Em áreas com melhores indicadores sociodemográficos foram encontradas maiores concentrações de equipamentos varejistas do tipo padarias. Outros varejos de alimentos como feiras-livres, açougues e feiras direto do produtor concentraram-se nas áreas centrais da cidade. Concluiu-se que falta de variedade de locais que ofereçam alimentos in natura e minimamente processados em bairros periféricos podem levar a população a ter que enfrentar obstáculos para seguir as recomendações do Guia Alimentar para a População Brasileira e alcançar uma dieta saudável.

Air pollution is associated to poor urban mobility conditions, as in the megacity of São Paulo. Three scenarios of policies of driving restrictions were simulated using the WRF/Chem model, to assess the impacts on ozone pollution and the consequences for environmental justice: urban toll, sustainable transition, and vehicle free zone. Results show that the urban toll leads to a decrease of 20 µg.m-3 in maximum 8-hour ozone averages and the prevention of six hours of exceedances of the air quality standard. Sustainable transition was the most promising scenario, with a decrease of 50 µg.m-3 and avoiding 22 hours of exceedances. The vehicle free zone did not show any advantages. For the implementation of adequate public transport systems, massive investments are required, in order to achieve better air quality with the greatest environmental justice possible, aiming towards the protection of human health along with a more democratic access to the urban spaces.