Public health and city planning are highly interconnected; however, the nexus between the urban state of buildings and sidewalks and corresponding public and urban health issues is lacking in Greece. In a case study in Athens, Greece, we evaluated unsafe buildings, facades, balconies, and sidewalks during a 15-year follow-up. We manually inspected (a) if the building/location’s condition had worsened and (b) any effective intervention by the state. Of the 400 initially selected buildings, 251 nonoverlapping buildings were analyzed. Overall, ~20% of the buildings posed a subjectively perceived severe risk for collapse, 35% had near-to-fall objects, and 45% had other minor issues. Fifteen years later, ~85% of the buildings were at the same or higher risk of complete or partial fall, and in only 15% had the risk of collapse been reduced or removed by private or public intervention. We detected uneven and dangerous parts of sidewalks hindering walkability and increasing the risk of falling or tipping. Our assessment revealed that Athens’ historical center harbors plausible safety and health risks for pedestrians and dwellers due to entire or partial building collapse and poor-condition sidewalks, which can potentially act as stress factors. Collectively, the issue of near-collapse buildings and risky sidewalks as an urban health determinant appears neglected by municipal authorities in their urban planning priorities; thus, future studies are needed in the field.
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