Are healthy fitness routines only possible in certain living environments

Yes and no. no because you can work out if you are poor and live in a box and yes because obviously you can't work out if you live on Mars :)

The answer is true.  People in other countries might not have a good and healthy fitness routine as the people in america do.  An example would be:  They probably don't have exercise equipment and a good diet because of where they live...so it all depends on where you live in the world.