Neighborhood Urban Profiles and Health Outcomes: Findings from the HORUS project in Rijeka, Croatia

This paper examines the relationships among urban environments, health behaviors and noncommunicable diseases (NCDs). This study is grounded in contemporary urban health theory and builds explicitly on the UrbWellth model, complemented by the WHO framework on social determinants of health and the Dahlgren–Whitehead model. Together, these frameworks emphasize that health outcomes emerge from interactions between urban morphology, environmental stressors, social context, and individual characteristics rather than from linear causal pathways. As a part of the HORUS project (GA No. 101136516), a cross-sectional survey on health behaviors was conducted in Rijeka, Croatia, between March and July 2024 among 2,448 adults. Neighborhoods in the city of Rijeka (N = 34) were characterized using a multidimensional set of urban determinant indicators capturing density, pedestrian infrastructure, service accessibility, traffic-related noise exposure, topography, green space availability, and economic activity. A cluster analysis was used to identify distinct urban neighborhood typologies that reflect real-world configurations of urban morphology and environmental conditions. Differences in health behaviors and outcomes, including physical activity, diet (ultra-processed food consumption), smoking status, alcohol use, overweight status, diabetes status, cardiovascular disease status, and mental health status, were examined between neighborhood typologies using binary logistic regression models adjusted for sociodemographic variables. Compared with residents of the peri-urban cluster, residents of the inner-city/coastal cluster had lower odds of nonactive commuting, poor sleep, eating ultra-processed food and being overweight. These findings support the use of urban environmental evidence to identify priority neighborhoods and inform locally tailored prevention strategies within HORUS, particularly those targeting active mobility, healthy eating, and weight-related risk.

Key messages

• Neighborhood urban profiles where associated with active commuting, sleep, ultra-processed food consumption, and overweight, even after adjusting for sociodemographic.

• Urban characteristics can inform development of targeted and tailored NCD prevention interventions.