One thing I see, is that people in urban environments typically opt-in to exercise (like voluntarily going on a run). Whereas those in more rural areas have more physical demanding jobs and responsibilities.
I’m an urban-based desk jockey who exercises a lot but it doesn’t really compare to my more rurally-based friends who are on their feet working blue collar jobs 5 days a week.
Suburbanites who are only active while engaging in intentional exercise because they need to get in their car to go anywhere are in the worst situation.
This is true. We have nowhere to go on foot. In every direction we have roads, private property and that's it.
If we walk we risk automobile/pedestrian injury, unless we'd prefer to risk trespassing charges. This is also the full selection of kids' choices, btw.
I grew up in an environment where these where my choices and it was terrible, it's a big part of why I've made "being able to go anywhere on foot" a goal.
When I lived in suburbs, I had to go out of my way to get even 6K steps in a whole day.