Youth Sport Participation By Metropolitan Status: 2018-2019 National Survey Of Children’s Health (NSCH)

Abstract

Youth sport participation in rural populations is understudied, including minimal information being available on how participation rates vary by urbanicity. This information is crucial for identifying demographic groups within different levels of urbanicity that may need additional support to increase sport participation. PURPOSE: To examine the association between metropolitan statistical area (MSA) status and sport participation among American youth ages 6-17. METHODS: This cross-sectional study used data from the 2018-2019 National Survey of Children’s Health. Weighted prevalence statistics were computed for sport participation by MSA status (living in an MSA, yes/no), overall and by child sex and age. Modified Poisson regression was used to estimate incidence rate ratios (IRR) for non-MSA versus MSA youth, before and after adjusting for special health care needs, race/ethnicity, income, and parent education. RESULTS: The final sample included 30,029 children [11.6 years (SD = 0.4), 51.4% female, 49.0% White). About 56% participated in sport in the past year. Sport participation prevalence was lower outside of (versus within) MSAs [53.6% (95% CI: 51.1%-56.0%) versus 56.0% (95% CI: 54.7%-57.3%)]. Among youth ages 6-11, those in non-MSAs (versus MSAs) were less likely to participate in sport [IRR 0.92 (95% CI: 0.86-0.99)], which was non-significant after adjustment. In adjusted models, youth ages 12-17 in non-MSAs (versus in MSAs) were more likely to participate in sport [aIRR 1.07 (95% CI: 1.00-1.15)]. This association was stronger for older males [aIRR 1.12 (95% CI: 1.02-1.23)]. CONCLUSIONS: There was a negative association between living in a non-MSA and sport participation. However, in adjusted models, non-MSA youth were more likely to participate. The relationship between MSA status and sport participation may be largely driven by factors (e.g., household income) that affect children’s ability to participate in sport. Efforts promoting youth sport should focus on reducing cost-related barriers to increase participation regardless of household income.