Abstract
Background: Rural U.S. adults’ prevalence of meeting physical activity (PA) guidelines is lower than urban adults, yet rural-urban differences in environmental influences of adults’ PA are largely unknown. The study’s objective was to identify rural-urban variations in environmental factors associated with the prevalence of adults meeting PA guidelines. Methods: County-level data for non-frontier counties (n = 2697) were used. A five-category rurality variable was created using the percentage of a county’s population living in a rural area. Factor scores from Factor Analyses (FA) were used in subsequent Multiple Linear Regression (MLR) analyses stratified by rurality to identify associations between environmental factor scores and the prevalence of males and females meeting PA guidelines. Results: FA revealed a 13-variable, four-factor structure of natural, social, recreation, and transportation environments. MLR revealed that natural, social, and recreation environments were associated with PA for males and females, with variation by sex for social environment. The natural environment was associated with PA in all but urban counties; the recreation environment was associated with PA in the urban counties and the two most rural counties. Conclusions: Variations across the rural-urban continuum in environmental factors associated with adults’ PA, highlight the uniqueness of rural PA and the need to further study what succeeds in creating active rural places.
Highlights
Female physical activity (PA) was associated with the natural environment (β = −31, p 0.01), social environment (β = −24, p 0.01), and recreation environment (β = 0.33, p 0.01)
Negative associations are seen for natural environment factors in all levels of rurality (β −36 to −46; all p 0.01) except the Urban counties
Findings from this study address a critical research gap highlighted in reviews of the literature [9,10] by identifying variations in the strength of environmental factors associated with meeting PA guidelines across the rural-urban continuum, using objective measures for—and an inclusive definition of—“environment” elucidated by Sallis and colleagues in their seminal work [6]
Summary
The percentage of adults meeting combined aerobic and muscle-strengthening PA guidelines is 31% lower among rural residents compared to urban residents [3]. This deficit exists despite evidence of greater relative increases of meeting PA guidelines from 2008 to 2017 among rural adults (47.4%) compared to urban adults (30.4%) overall. Rural U.S adults’ prevalence of meeting physical activity (PA) guidelines is lower than urban adults, yet rural-urban differences in environmental influences of adults’ PA are largely unknown. The study’s objective was to identify rural-urban variations in environmental factors associated with the prevalence of adults meeting PA guidelines. Analyses (FA) were used in subsequent Multiple Linear Regression (MLR) analyses stratified by rurality to identify associations between environmental factor scores and the prevalence of males and females meeting PA guidelines. The natural environment was associated with PA in all but urban counties; the recreation environment was associated with PA in the urban counties and the two most rural counties
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