Urban living conditions shape health through interlocking environmental exposures, infrastructure constraints, and behavioral opportunities. This paper examines how perceived environmental conditions vary across the Attica Region and how these differences plausibly translate into unequal cardio-respiratory and mental health burdens. A cross-sectional online survey (April–June 2022) captured responses from 1,883 residents across the seven regional units of Attica (Central Sector, North Sector, South Sector, West Sector, Piraeus, East Attica, West Attica). The Central Sector emerged as the most environmentally constrained urban setting: respondents reported the highest perceived density, very high perceived traffic burden, elevated noise disturbance and the highest perceived atmospheric pollution The Central Sector also showed the weakest cycling environment despite relatively high walking/cycling frequency compared with several peripheral units. Piraeus and the West Sector also concentrated multiple stressors. Across Attica, 60% reported walkable access to green space, yet meaningful inequalities appeared by unit; public participation was low, with only ~8% reporting that their opinion had been requested for health-benefiting changes. Associations between unit of residence and key environmental conditions were consistently significant, with effect sizes ranging from small-to-moderate overall and strongest for bicycle-lane availability. Findings support an environmental-planning interpretation: exposures and protective resources cluster geographically, reinforcing health inequities.

Keywords: Urbanization, Environmental health, Quality of life, Cities, Regions, Environment, Society.