“I like seeing people, different cultures, and hearing different music”: Exploring adolescent perspectives of inclusive and healthy high-rise and dense urban environment designs

• Due to urbanization more young people will live in high-rises and dense urban areas. • We explored teen perspectives (n = 22) of healthy high-rise and dense area designs. • Social, cultural sites; unique places; and multipurpose designs supported health. • Crowded places, weak social connectivity, and poor transport designs abated health. • Urban designers might consider social/cultural activity sites, connectivity designs. As countries continue to urbanize, an increasing number of adolescents will live in densely populated urban areas, often residing in high-rise buildings. Despite these trends, many high-rises, and their surrounding areas, sparsely consider the needs of adolescents. This results in urban environments that are often ill-suited to sufficiently support the health and development of adolescents. In the present study, we conducted geo-logged and participant-led go-along interviews lasting between 40–120 min and travelling ∼ 1 km, from July-December 2023 to explore how adolescents (13–18 years; n = 22) perceived the inclusiveness and health-promoting qualities of high-rise and densified urban environments. We employed Gehl’s Inclusive Healthy Place Framework (IHPF) to inform our abductive thematic analysis and frame our ensuing discussions via its four guiding principles (i.e., context, process, design and program, sustain). Our findings outline 11 distinct themes highlighting the importance of desirable social and cultural activity options, meaningful local sites, and diversity in the local active use designs and spaces. Conversely, adolescents expressed worries regarding weak social connectivity, poor sanitation, lacking place legibility, and ‘anti-social’ designs. We discuss specific implications for urban design, planning, and health audiences regarding building (e.g., communal space) and neighborhood (e.g., streetscapes with patios) design.