Enhancing the Socioecological Model to Integrate Equity and Planetary Health: A Framework for Understanding Complex...

Physical activity is a major contributor to population health, yet opportunities for active living are inequitably distributed due to social and structural determinants of health. Climate change, urbanization, and social inequalities influence whether individuals engage in physical activity out of necessity or as a free choice.

We present an Enhanced Socioecological Model integrating planetary health and the necessity-choice continuum into the classic socioecological framework, providing a tool to assess large-scale interventions originating outside the health sector. After critically synthesizing the Ecological Model of Active Living, the Social Determinants of Health, and the Planetary Health framework, we applied enhanced socioecological model to 2 national affordable-housing programs-Brazil's Minha Casa, Minha Vida and the US Choice Neighborhoods Initiative.

A review of peer-reviewed studies, policy documents, and program reports reveals that peripheral Minha Casa, Minha Vida developments exacerbate necessity-driven mobility through inadequate transit and infrastructure thereby heightening climatic and social vulnerabilities. Conversely, Choice Neighborhoods Initiative's in situ, mixed-income redevelopment fosters choice-driven activity via transit connectivity, green space, and community amenities.

The Enhanced Socioecological Model offers a unifying framework for guiding future research and policy interventions, advancing equitable, climate-resilient urban development while promoting public health.