Prevalence and correlates of state and regional disparities in vigorous physical activity levels among US children and adolescents.

BACKGROUND: This study examines state and regional disparities in vigorous physical activity levels among US children age 6 to 17 years.

METHODS: The 2003 National Survey of Children's Health was used to calculate vigorous physical activity (VPA) and no days of vigorous physical activity (NVPA) prevalence by state and geographic region. Logistic and least squares regression were used to analyze geographic disparities.

RESULTS: Vigorous physical activity levels varied substantially across geographic areas, with the East Southcentral region of the US having the highest NVPA prevalence (13.4%) and the Pacific region the lowest prevalence (9.1%). Children in Georgia and Tennessee had 2.2 to 2.3 times higher odds and children in DC, Oklahoma, Arkansas, Indiana, Kentucky, Kansas, New Jersey, South Carolina, and Washington (adjusted prevalence>13.4%) had 1.8 to 2.0 times higher odds of NVPA than children in California (adjusted prevalence=8.4%). Adjustment for race/ethnicity, socioeconomic status, social capital, television viewing, sleep behavior, and parental physical activity doubled the magnitude of geographic disparities in vigorous physical activity levels. Area poverty, income inequality, and violent crime rates were independent predictors of VPA and NVPA.

CONCLUSIONS: Although individual and area-level socioeconomic factors are important predictors, substantial geographic disparities remain, with children in several Southern states having particularly high risks of NVPA.