Urban-Rural Disparity and Economic Geography Variation in the Likelihood of Meeting Physical Activity Recommendation–Results from the Study of Community Sports in China

Purpose. Maintaining physical activity (PA) has significant implications for health. According to the World Health Organization (WHO), adults aged 18–64 should engage in at least 150 to 300 minutes of moderate-intensity aerobic PA per week. However, urban-rural disparities and economic geography variations in PA levels have not received enough attention. This study aimed to examine these disparities in the likelihood of meeting PA recommendations by using data from the Study of Community Sports in China. Methods. This is a nationwide cross-sectional community-based study. A total of 5,000 participants were randomly selected using a multistage sampling strategy. They were asked to complete a survey including demographics data and PA levels. The data were analyzed using mixed-effects logistic regression to evaluate the association between urban-rural residency, economic geography regions, and the likelihood of meeting PA recommendations. Results. A total of 3,779 participants met the eligible criteria, and only 816 (21.6%) met the PA recommendation. The urban participants were more likely to meet the PA recommendation than their rural peers [OR (95% CI) of 1.72 (1.09, 2.71)]. The association remained significant among those aged ≥30 [OR = 2.53 (1.51, 4.24)] and those with the education of high school and below [OR = 1.88 (1.18, 1.77)], but not in their younger, and more-educated peers (P_interaction = 0.009 and 0.034, respectively). Compared with the east coastal residents, western ones had a greater chance of meeting the recommendation [OR = 2.68 (1.25, 5.74)]. The association was more prominent among the more-educated [OR = 3.89 (1.58, 9.57)] than the less-educated [1.90 (0.83, 4.35)](P_interaction <0.001), but not modified by age. Conclusion. Urban and western residents were more active than their rural and east coastal counterparts. Studies should carefully consider the interactions between age and education level with urbanization and region while evaluating PA levels. Moreover, policymakers should develop policies and programs according to urban-rural disparity and regional variations to shorten the gaps.