The Role of Neighborhood Economic Context on Physical Activity Among Children in Poverty: Results from the Geographic Research on Wellbeing (GROW) Study

Background and Purpose:

Although physical activity is important for child health, only 42% of children aged 6-11 in the United States meet physical activity recommendations (60 or more minutes of moderate- or greater-intensity activity on 5 of 7 days), and children in low (vs. high) economic status families are less likely to engage in physical activity. In addition to the family level, neighborhood economic context, measured by poverty concentration and income inequality, has been hypothesized to influence child physical activity. However, it is unknown whether the influence of neighborhood economic context on child physical activity varies according to family economic context. The present study thus investigates whether neighborhood poverty and income inequality are associated with physical activity among a population-based sample of poor children.

Methods:

The Geographic Research on Wellbeing study (2012-2013) is a follow-up survey of 3,016 mothers who participated in California’s Maternal and Infant Health Assessment survey during 2003-2007. The survey included approximately 80 questions regarding demographic, socioeconomic, neighborhood-related, and health-related characteristics, pertaining to themselves and their children aged 4-10 years. The independent variable was neighborhood (i.e., census tract) economic context (4 categories: low poverty (LP) and high income inequality (HII); LP and low income inequality (LII); high poverty (HP) and LII; and HP and HII). The two dependent variables were (1) sufficient physical activity (engagement in physical activity on 5 days or more per week vs. less); and (2) insufficient physical activity (engagement in physical activity on 2 days or less per week vs. more). Log-binomial regression, estimated by the SAS GENMOD procedure, was used to estimate a relative risk (RR) for the two physical activity outcomes after controlling for age, gender, race/ethnicity, maternal marital status, and maternal education level.

Results:

One half of poor children reported sufficient physical activity, and 25% showed insufficient physical activity. Two thirds of the children lived in neighborhoods with HP and HII, followed by neighborhoods with HP and LII (15%), neighborhoods with LP and LII (15%), and neighborhoods with LP and HII (6%). Children who resided in neighborhoods with HP and LII were more likely to engage in sufficient physical activity than were children residing in neighborhoods with LP and HII (RR=1.62, p < .05). Children who resided in (a) neighborhoods with LP and LII (RR=0.59, p < .05), (b) neighborhoods with HP and LII (RR=0.54, p < .05), or (c) neighborhoods with HP and HII (RR=0.66, p < .05) were significantly less likely to report insufficient physical activity than those in neighborhoods with LP and HII.

Conclusion/implications:

Findings support the hypothesis that neighborhood economic context is a social barrier to physical activity among poor children. Interestingly, children in neighborhoods with LP and HII were the most vulnerable to insufficient physical activity among the 4 types of neighborhoods. This finding suggests that increasing physical activity among children in neighborhoods with LP and HII should be a high policy priority. Further research is needed to explore the mechanisms by which neighborhood economic context affects child physical activity.