Creating healthy street environments to encourage physical activity is an effective strategy against non-communicable diseases exacerbated by rapid urbanization globally. Developing countries face more significant health challenges than developed ones. However, existing research predominantly focuses on the perspective of developed countries. To address the health challenges in developing nations, studies should not only draw on the findings from developed countries but also clearly define unique research processes and pathways. Consequently, this study conducts a comparative analysis between China, representing developing countries, and developed nations, using databases like China National Knowledge Infrastructure (CNKI) and Web of Science (WOS) and tools such as Citespace, Bicomb, and Statistical Package for the Social Sciences (SPSS) to explore research hotspots, developmental trajectories, thematic categories, and trends. The findings reveal a shift in developed countries from macro-material to micro-environmental elements under multidisciplinary scrutiny, while future topics may include street space evaluations and psychological healing. In China, research has been dominated by different disciplines at various stages, starting with medical attention to chronic disease prevention, which then shifted to traffic engineering’s focus on constructing green travel environments, and finally expanded to disciplines like landscape architecture examining the impact of street environment elements on pedestrian behavioural perceptions. Future themes will focus on promoting elderly health and urban health transport systems. Generally, research in developed countries exhibits a “bottom-up” approach, with practical issues at a “post-evaluation” stage, primarily based on the “socio-ecological model” and emphasizing multidisciplinary collaboration. Chinese research shows a “top-down” characteristic, driven by national policies and at a “pre-planning” stage, integrating theories such as Maslow’s hierarchy of needs and attention restoration theory, with relatively loose disciplinary cooperation. Overall, research is shifting from macro to human-centric scales and is progressively utilizing multi-source and multi-scale big data analysis methods. Based on this, future research and development recommendations are proposed for developing countries, with China as a representative example.
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