Prevalence of Meeting Aerobic, Muscle-Strengthening, and Combined Physical Activity Guidelines During Leisure Time Among Adults, by Rural-Urban Classification and Region - United States, 2020.
Level 4 - case-series / case-control
Cross-sectional survey analysis of national surveillance data.
PubMed 36701252 · doi:10.15585/mmwr.mm7204a1
What was done
Researchers analyzed 2020 National Health Interview Survey (NHIS) data for US adults aged 18 and older. Using multivariate logistic regression controlling for demographic characteristics, they evaluated the prevalence and odds of meeting federal aerobic, muscle-strengthening, and combined guidelines during leisure time across a four-category rural-urban classification and four US Census Bureau regions (Northeast, Midwest, South, and West).
What was found
Across all rural-urban classifications and regions, no more than 28% of adults met combined guidelines. Prevalence of meeting aerobic, muscle-strengthening, and combined guidelines was lowest in nonmetropolitan counties (38.2%, 21.1%, and 16.1%, respectively) and highest in the West region (52.1%, 35.3%, and 28.5%, respectively). Adults in the most rural category were significantly less likely to meet aerobic, muscle-strengthening, and combined guidelines compared to adults in each of the three other urban-rural categories (adjusted odds ratio [aOR] range: 0.68 to 0.89). Adults in medium and small metropolitan counties were less likely to meet guidelines than those in the two most urban categories (aOR range: 0.85 to 0.89). Compared to the West region, adults in the Northeast, Midwest, and South were less likely to meet guidelines (aOR range: 0.75 to 0.82).
Why it matters
These findings highlight persistent geographic and rural-urban disparities in physical activity across the United States. Identifying these gaps points to specific regional and rural populations that may benefit from targeted public health infrastructure and interventions.
Limits
The abstract does not state the total sample size. The cross-sectional design cannot establish causality. Physical activity measures were limited to self-reported leisure-time activity, excluding occupational, domestic, or transportation-related physical activity and introducing potential recall or social desirability bias.
Cited by
- context Approximately 80% to 90% of the United States population fails to meet standard resistance training guidelines.