Approximately 20% of the U.S. population lives in rural areas. In some countries, the percentage of people dwelling in rural areas is even greater. In the U.S., childhood obesity is more common in rural areas and rural residents lack access to opportunities to engage in routine physical activity. Based on this, it is commonly believed rural youth are less active than their urban peers. However, urban residence is also associated with an increasingly sedentary lifestyle. Rural and urban areas differ in environmental, demographic, and social variables that influence PA behaviors. Yet despite these differences, comparisons of youth PA levels between rural and urban locales are conflicting, with no consistent indication of greater or lesser PA levels in one locale versus the other. To inform public health policy and eliminate health disparities, investigations into differences in PA levels due to locale are warranted. Therefore, the purpose of this study was to systematically review published articles comparing youth PA between rural and urban locales.
Methods
The review identified articles that compared PA between rural and urban youth. Inclusion criteria were: articles in English; included both rural and urban youth; and reported comparisons for one or more of the following four outcomes – PA, physical education and sport participation rates, and sedentary behaviors. Random effects standardized mean effects sizes (Hedge's g) were computed on each outcome separately.
Analysis/Results
Of a total of 80 articles located, 18 met the inclusion criteria, comprising a total of 112,793 youth. Overall, rural children had higher rates of PA (g = 0.13, 95%CI 0.05 to 0.20) and lower rates of sedentary behaviors (g =
-0.17, 95%CI -0.25 to -0.09) in comparison with urban children. There were no significant differences between rural and urban children regarding physical education or sports participation
Conclusions
Although it is commonly believed rural children are less physically active than urban children, this study indicates rural children have modestly higher rates of physical activity and lower levels of sedentary behaviors. Yet despite this, the differences between rural and urban are minimal. Therefore, public health efforts to combat childhood obesity and sedentary lifestyle are needed in both rural and urban areas. These interventions need to take into consideration the different factors involved in urban and rural locales such as demographic, environmental, and social factors which influence physical activity rates.
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