Maternal and Child Health Journal

, Volume 16, Supplement 2, pp 258–267 | Cite as

Associations Between Neighborhood Characteristics and Physical Activity Among Youth Within Rural–Urban Commuting Areas in the US

  • Laurin Kasehagen
  • Ashley Busacker
  • Debra Kane
  • Angela Rohan


The association among rural–urban communities, neighborhood characteristics, and youth physical activity is inconsistent in the literature. We used data from the 2007 National Survey of Children’s Health, for youth aged 10–17 years (n = 45,392), to examine the association between physical activity and neighborhood characteristics, after adjusting for known confounders. We also examined the association between physical activity and neighborhood characteristics within seven levels of Rural–Urban Commuting Areas (RUCAs) that depict a continuum from isolated rural to dense urban communities. Attainment of a minimum physical activity level differed by RUCA (P = 0.0004). In adjusted, RUCA-specific models, the presence of parks was associated with attaining a minimum physical activity level in only one of the seven RUCAs (adjusted odds ratio: 3.49; 95 % confidence interval: 1.55, 7.84). This analysis identified no association between youths’ minimum physical activity attainment and neighborhood characteristics in unstratified models; and, RUCA-specific models showed little heterogeneity by rural–urban community type. Although this analysis found little association between youth physical activity and neighborhood characteristics, the findings could reflect the crude categorization of the neighborhood amenities (sidewalks, parks, recreation centers) and detracting elements (litter, dilapidated housing, vandalism) and suggests that simple measurement of the presence of an amenity or detracting element is insufficient for determining potential associations with reaching minimum levels of physical activity. By exploring neighborhood characteristics and features of neighborhood amenities within the context of well-defined community types, like RUCAs, we can better understand how and why these factors contribute to different levels of youth physical activity.


Rural–urban commuting area Neighborhood Physical activity Child Adolescent 


  1. 1.
    U. S. Department of Health and Human Services. (1996). Physical activity and health: A report of the surgeon general. Atlanta, GA: USDHHS; Centers for Disease Control and Prevention; National Center for Chronic Disease Prevention and Health Promotion; Office on Smoking and Health.Google Scholar
  2. 2.
    Warburton, D. E., Nicol, C. W., & Bredin, S. S. (2006). Health benefits of physical activity: The evidence. CMAJ: Canadian Medical Association Journal, 174(6), 801–809. doi: 10.1503/cmaj.051351.PubMedCrossRefGoogle Scholar
  3. 3.
    U. S. Department of Health and Human Services. (2008). 2008 physical activity guidelines for Americans (pp. 15–20). Atlanta, GA: USDHHS, ODPHP. Retrieved September 6, 2012 from
  4. 4.
    American Academy of Pediatrics; Council on Sports Medicine and Fitness; & Council on School Health. (2006). Active healthy living: Prevention of childhood obesity through increased physical activity. Pediatrics, 117(5), 1834–1842. doi: 10.1542/peds.2006-0472.CrossRefGoogle Scholar
  5. 5.
    U. S. Department of Agriculture, & U. S. Department of Health, Human Services. (2005). Dietary guidelines for Americans (pp. 19–22). Washington, DC: U.S. Government Printing Office.Google Scholar
  6. 6.
    Centers for Disease Control and Prevention. (2010). Youth risk behavior surveillance—United States, 2009. MMWR. Morbidity and Mortality Weekly Report, 59(SS-5), 25–26.Google Scholar
  7. 7.
    Centers for Disease Control and Prevention. (2011). Physical activity levels of high school students—United States, 2010. MMWR. Morbidity and Mortality Weekly Report, 60(23), 773–777.Google Scholar
  8. 8.
    Centers for Disease Control and Prevention. (2012). Youth risk behavior surveillance—United States, 2011. MMWR. Morbidity and Mortality Weekly Report, 61(SS-4), 35–36.Google Scholar
  9. 9.
    Dunton, G. F., Kaplan, J., Wolch, J., Jerrett, M., & Reynolds, K. D. (2009). Physical environmental correlates of childhood obesity: A systematic review. Obesity Reviews, 10(4), 393–402. doi: 10.1111/j.1467-789X.2009.00572.x.PubMedCrossRefGoogle Scholar
  10. 10.
    Gordon-Larsen, P., Nelson, M. C., Page, P., & Popkin, B. M. (2006). Inequality in the built environment underlies key health disparities in physical activity and obesity. Pediatrics, 117(2), 417–424. doi: 10.1542/peds.2005-0058.PubMedCrossRefGoogle Scholar
  11. 11.
    Tucker, P., Irwin, J. D., Gilliland, J., He, M., Larsen, K., & Hess, P. (2009). Environmental influences on physical activity levels in youth. Health & Place, 15(1), 357–363. doi: 10.1016/j.healthplace.2008.07.001.CrossRefGoogle Scholar
  12. 12.
    Babey, S. H., Hastert, T. A., Yu, H., & Brown, E. R. (2008). Physical activity among adolescents. When do parks matter? American Journal of Preventive Medicine, 34(4), 345–348. doi: 10.1016/j.amepre.2008.01.020.PubMedCrossRefGoogle Scholar
  13. 13.
    Oliver, M., Witten, K., Kearns, R. A., Mavoa, S., Badland, H. M., Carroll, P., et al. (2011). Kids in the city study: Research design and methodology. BMC Public Health, 11, 587. doi: 10.1186/1471-2458-11-587.PubMedCrossRefGoogle Scholar
  14. 14.
    Yousefian, A., Ziller, E., Swartz, J., & Hartley, D. (2009). Active living for rural youth: Addressing physical inactivity in rural communities. Journal of Public Health Management and Practice, 15(3), 223–231. doi: 10.1097/PHH.0b013e3181a11822.PubMedGoogle Scholar
  15. 15.
    Committee on Environmental Health. (2009). The built environment: Designing communities to promote physical activity in children. Pediatrics, 123(6), 1591–1598.CrossRefGoogle Scholar
  16. 16.
    Oreskovic, N. M., Kuhlthau, K. A., Romm, D., & Perrin, J. M. (2009). Built environment and weight disparities among children in high- and low-income towns. Academic Pediatric, 9(5), 315–321. doi: 10.1016/j.acap.2009.02.009.CrossRefGoogle Scholar
  17. 17.
    Oreskovic, N. M., Winickoff, J. P., Kuhlthau, K. A., Romm, D., & Perrin, J. M. (2009). Obesity and the built environment among Massachusetts children. Clinical Pediatrics (Phila), 48(9), 904–912. doi: 10.1177/0009922809336073.CrossRefGoogle Scholar
  18. 18.
    Witten, K., Hiscock, R., Pearce, J., & Blakely, T. (2008). Neighbourhood access to open spaces and the physical activity of residents: A national study. Preventive Medicine, 47(3), 299–303. doi: 10.1016/j.ypmed.2008.04.010.PubMedCrossRefGoogle Scholar
  19. 19.
    Belanger, M., Gray-Donald, K., O’Loughlin, J., Paradis, G., & Hanley, J. (2009). Influence of weather conditions and season on physical activity in adolescents. Annals of Epidemiology, 19(3), 180–186. doi: 10.1016/j.annepidem.2008.12.008.PubMedCrossRefGoogle Scholar
  20. 20.
    Huston, S. L., Evenson, K. R., Bors, P., & Gizlice, Z. (2003). Neighborhood environment, access to places for activity, and leisure-time physical activity in a diverse North Carolina population. American Journal of Health Promotion, 18(1), 58–69.PubMedCrossRefGoogle Scholar
  21. 21.
    Jago, R., Baranowski, T., Zakeri, I., & Harris, M. (2005). Observed environmental features and the physical activity of adolescent males. American Journal of Preventive Medicine, 29(2), 98–104. doi: 10.1016/j.amepre.2005.04.002.PubMedCrossRefGoogle Scholar
  22. 22.
    Wilson, D. K., Lawman, H. G., Segal, M., & Chappell, S. (2011). Neighborhood and parental supports for physical activity in minority adolescents. American Journal of Preventive Medicine, 41(4), 399–406. doi: 10.1016/j.amepre.2011.06.037.PubMedCrossRefGoogle Scholar
  23. 23.
    Boslaugh, S. E., Luke, D. A., Brownson, R. C., Naleid, K. S., & Kreuter, M. W. (2004). Perceptions of neighborhood environment for physical activity: Is it “who you are” or “where you live”? Journal of Urban Health, 81(4), 671–681. doi: 10.1093/jurban/jth150.PubMedCrossRefGoogle Scholar
  24. 24.
    Gordon-Larsen, P., McMurray, R. G., & Popkin, B. M. (2000). Determinants of adolescent physical activity and inactivity patterns. Pediatrics, 105(6), E83.PubMedCrossRefGoogle Scholar
  25. 25.
    Belanger, M., Gray-Donald, K., O’Loughlin, J., Paradis, G., Hutcheon, J., Maximova, K., et al. (2009). Participation in organised sports does not slow declines in physical activity during adolescence. The International Journal of Behavioral Nutrition and Physical Activity, 6, 22. doi: 10.1186/1479-5868-6-22.PubMedCrossRefGoogle Scholar
  26. 26.
    Ries, A. V., Voorhees, C. C., Gittelsohn, J., Roche, K. M., & Astone, N. M. (2008). Adolescents’ perceptions of environmental influences on physical activity. American Journal of Health Behavior, 32(1), 26–39. doi: 10.5555/ajhb.2008.32.1.26.PubMedCrossRefGoogle Scholar
  27. 27.
    Boone-Heinonen, J., Evenson, K. R., Song, Y., & Gordon-Larsen, P. (2010). Built and socioeconomic environments: Patterning and associations with physical activity in U.S. adolescents. The International Journal of Behavioral Nutrition and Physical Activity, 7, 45. doi: 10.1186/1479-5868-7-45.PubMedCrossRefGoogle Scholar
  28. 28.
    Boone-Heinonen, J., & Gordon-Larsen, P. (2011). Life stage and sex specificity in relationships between the built and socioeconomic environments and physical activity. Journal of Epidemiology and Community Health, 65(10), 847–852. doi: 10.1136/jech.2009.105064.PubMedCrossRefGoogle Scholar
  29. 29.
    Badland, H., & Schofield, G. (2006). Understanding the relationship between town size and physical activity levels: A population study. Health & Place, 12(4), 538–546. doi: 10.1016/j.healthplace.2005.08.007.CrossRefGoogle Scholar
  30. 30.
    Sandercock, G., Angus, C., & Barton, J. (2010). Physical activity levels of children living in different built environments. Preventive Medicine, 50(4), 193–198. doi: 10.1016/j.ypmed.2010.01.005.PubMedCrossRefGoogle Scholar
  31. 31.
    Blumberg, S. J., Foster, E. B., Frasier, A. M., Satorius, J., Skalland, B. J., Nysse-Carris, K., et al. (2012). Design and operation of the National Survey of Children’s Health, 2007. Vital and Health Statistics, 1(55), 1–149.Google Scholar
  32. 32.
    Strong, W. B., Malina, R. M., Blimkie, C. J., Daniels, S. R., Dishman, R. K., Gutin, B., et al. (2005). Evidence based physical activity for school-age youth. Journal of Pediatrics, 146(6), 732–737. doi: 10.1016/j.jpeds.2005.01.055.PubMedCrossRefGoogle Scholar
  33. 33.
    Morrill, R., Cromartie, J., & Hart, G. (1999). Metropolitan, urban, and rural commuting areas: Toward a better depiction of the United States settlement system. Urban Geography, 20(8), 727–748.CrossRefGoogle Scholar
  34. 34.
    WWAMI Rural Health Research Center. (2012). Rural-urban commuting area codes. Retrieved September 6, 2012, from
  35. 35.
    Centers for Disease Control and Prevention. (2012). About BMI for children and teens. Retrieved September 5, 2012, from
  36. 36.
    American Academy of Pediatrics. Committee on Public Education. (2001). American Academy of Pediatrics: Children, adolescents, and television. Pediatrics, 107(2), 423–426.CrossRefGoogle Scholar
  37. 37.
    Pedlow, S., Luke, J. V., & Blumberg, S. J. (2007). Multiple imputation of missing household poverty level values from the National Survey of Children with Special Health Care Needs, 2001, and the National Survey of Children’s Health, 2003. Hyattsville, MD: National Center for Health Statistics.Google Scholar
  38. 38.
    Ding, D., Sallis, J. F., Kerr, J., Lee, S., & Rosenberg, D. E. (2011). Neighborhood environment and physical activity among youth a review. American Journal of Preventive Medicine, 41(4), 442–455. doi: 10.1016/j.amepre.2011.06.036.PubMedCrossRefGoogle Scholar
  39. 39.
    Allison, K. R., Dwyer, J. J., Goldenberg, E., Fein, A., Yoshida, K. K., & Boutilier, M. (2005). Male adolescents’ reasons for participating in physical activity, barriers to participation, and suggestions for increasing participation. Adolescence, 40(157), 155–170.PubMedGoogle Scholar
  40. 40.
    Babey, S. H., Brown, E. R., & Hastert, T. A. (2005). Access to safe parks helps increase physical activity among teenagers. Policy Brief/UCLA Center for Health Policy Research, PB2005-10, 1–6.Google Scholar
  41. 41.
    Liu, J., Bennett, K. J., Harun, N., & Probst, J. C. (2008). Urban-rural differences in overweight status and physical inactivity among us children aged 10–17 years. The Journal of Rural Health, 24(4), 407–415. doi: 10.1111/j.1748-0361.2008.00188.x.PubMedCrossRefGoogle Scholar
  42. 42.
    Kaczynski, A. T., Potwarka, L. R., & Saelens, B. E. (2008). Association of park size, distance, and features with physical activity in neighborhood parks. American Journal of Public Health, 98(8), 1451–1456. doi: 10.2105/AJPH.2007.129064.PubMedCrossRefGoogle Scholar
  43. 43.
    Boone-Heinonen, J., Casanova, K., Richardson, A. S., & Gordon-Larsen, P. (2010). Where can they play? Outdoor spaces and physical activity among adolescents in U.S. urbanized areas. Preventive Medicine, 51(3–4), 295–298. doi: 10.1016/j.ypmed.2010.07.013.PubMedCrossRefGoogle Scholar
  44. 44.
    Boone-Heinonen, J., Popkin, B. M., Song, Y., & Gordon-Larsen, P. (2010). What neighborhood area captures built environment features related to adolescent physical activity? Health & Place, 16(6), 1280–1286. doi: 10.1016/j.healthplace.2010.06.015.CrossRefGoogle Scholar
  45. 45.
    Nichol, M., Janssen, I., & Pickett, W. (2010). Associations between neighborhood safety, availability of recreational facilities, and adolescent physical activity among Canadian youth. Journal of Physical Activity & Health, 7(4), 442–450.Google Scholar
  46. 46.
    Slater, S. J., Ewing, R., Powell, L. M., Chaloupka, F. J., Johnston, L. D., & O’Malley, P. M. (2010). The association between community physical activity settings and youth physical activity, obesity, and body mass index. Journal of Adolescent Health, 47(5), 496–503. doi: 10.1016/j.jadohealth.2010.03.017.PubMedCrossRefGoogle Scholar
  47. 47.
    Singh, G. K., Siahpush, M., & Kogan, M. D. (2010). Neighborhood socioeconomic conditions, built environments, and childhood obesity. Health Affairs (Millwood), 29(3), 503–512. doi: 10.1377/hlthaff.2009.0730.CrossRefGoogle Scholar
  48. 48.
    Blumberg, S. J., & Luke, J. V. (2007). Coverage bias in traditional telephone surveys of low-income and young adults. Public Opinion Quarterly, 71(5), 734–749.CrossRefGoogle Scholar
  49. 49.
    Blumberg, S. J., Luke, J. V., Davidson, G., Davern, M. E., Yu, T. C., & Soderberg, K. (2009). Wireless substitution: State-level estimates from the National Health Interview Survey, January–December 2007. National Health Statistics Reports, 16(14), 1–13.Google Scholar
  50. 50.
    National Association for Sport and Physical Education. (2008). Comprehensive school physical activity programs: Position statement. Retrieved September 6, 2012, from
  51. 51.
    Dalton, M. A., Longacre, M. R., Drake, K. M., Gibson, L., Adachi-Mejia, A. M., Swain, K., et al. (2011). Built environment predictors of active travel to school among rural adolescents. American Journal of Preventive Medicine, 40(3), 312–319. doi: 10.1016/j.amepre.2010.11.008.PubMedCrossRefGoogle Scholar
  52. 52.
    Kim, J., Liu, J., Colabianchi, N., & Pate, R. R. (2010). The effect of perceived and structural neighborhood conditions on adolescents’ physical activity and sedentary behaviors. Archives of Pediatrics and Adolescent Medicine, 164(10), 935–942. doi: 10.1001/archpediatrics.2010.167.PubMedCrossRefGoogle Scholar
  53. 53.
    Rossen, L. M., Pollack, K. M., Curriero, F. C., Shields, T. M., Smart, M. J., Furr-Holden, C. D. M., et al. (2011). Neighborhood incivilities, perceived neighborhood safety, and walking to school among urban-dwelling children. Journal of Physical Activity & Health, 8(2), 262–271.Google Scholar

Copyright information

© Springer Science+Business Media New York (outside the USA)  2012

Authors and Affiliations

  • Laurin Kasehagen
    • 1
    • 2
  • Ashley Busacker
    • 1
  • Debra Kane
    • 1
  • Angela Rohan
    • 1
  1. 1.Division of Reproductive HealthCenters for Disease Control and PreventionAtlantaUSA
  2. 2.Department of Pediatrics, Section on Child Health Policy and CityMatCHUniversity of Nebraska Medical CenterOmahaUSA

Personalised recommendations