Abstract
Standardized physical fitness monitoring provides a more accurate proxy for youth health when compared with physical activity. Little is known about the utilization of broad-scale individual-level youth physical fitness testing to explore health disparities. We examined longitudinal trends in population-level fitness for 4th-12th grade New York City youth during 2006/7-2016/17 (average n = 510,293 per year). Analyses were performed in 2019. The primary outcome was whether or not youth achieved sex-/age-specific performance levels (called the Healthy Fitness Zone) on the aerobic capacity, muscular strength and muscular endurance tests using the NYC FITNESSGRAM. The Cooper Institute’s most recent Healthy Fitness Zone criteria were applied to all tests and years. Prevalence estimates were weighted, accounted for school clustering, adjusted for student-level sociodemographics, and run by sociodemographic subgroups and year. The overall prevalence for meeting 3 Healthy Fitness Zones increased from 15.5% (95%CI: 13.9%-17.0%) in 2006/7 to 23.3% (95%CI: 22.2%-24.4%) in 2016/17 for students in grades 4–12. Fitness for all student groups increased over time, although Hispanic and non-Hispanic black girls consistently had the lowest prevalence of meeting 3 Healthy Fitness Zones as compared to all other race/sex subgroups. Also, 9th-12th graders had a lower prevalence of meeting 3 Healthy Fitness Zones as compared to 4th-8th graders. Given forecasted sharp increases in cardiovascular disease prevalence, routine youth fitness surveillance using standardized, criterion referenced methods can identify important fitness disparities and inform interventions.
Highlights
Just 25% of United States (US) youth are reported to meet national physical activity guidelines including at least 60 minutes of daily physical activity for children ages 6 and older [1]
Data were drawn from the New York City (NYC) FITNESSGRAM dataset, NYC Department of Education (DOE)’s citywide fitness assessment based on the FitnessGram1, and jointly managed by NYC DOE and Department of Health and Mental Hygiene (DOHMH)
Consistent with prior analyses of longitudinal NYC FITNESSGRAM data and assessments of youth health-related fitness levels [26,27,28], this study reports on PACER, curl-up and pushup test data, which are valid and reliable measures of aerobic capacity, abdominal and upper body strength and endurance, respectively [9]
Summary
Just 25% of United States (US) youth are reported to meet national physical activity guidelines including at least 60 minutes of daily physical activity for children ages 6 and older [1]. Low youth physical activity corresponds to low physical fitness, including near failing grades on criterion-referenced health-related fitness standards for US children and adolescents [6,7]. Physical fitness can be defined as a state reflecting one’s ability to perform physical activity or exercise that is related to both present and future health [8,9]. Reduced fitness is strongly correlated with noncommunicable chronic conditions in childhood and adulthood, including cardiovascular disease, type 2 diabetes, metabolic syndrome, dementia and Alzheimer disease, breast and colon cancer, and disability later in life [10]. Disparities persist in youth fitness attainment across race, poverty, and sex [11,12,13], therein predicting persistent inequities for chronic conditions into adulthood [14]
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