James F. Sallis and Russell R. Pate
Tiffany J. Chen, Kathleen B. Watson, Shannon L. Michael, Jessica J. Minnaert, Janet E. Fulton, and Susan A. Carlson
Background: Healthy People 2030 includes objectives to increase meeting the aerobic physical activity guideline for ages 6–13 years (of ages 6–17 y, monitored by National Survey of Children’s Health [NSCH]) and grades 9 to 12 (mostly aged 14–18+ y, monitored by Youth Risk Behavior Survey [YRBS]). This study compares methodologies, prevalence, and patterns of meeting the guideline, particularly for overlapping ages 14–17 years. Methods: Nationally representative surveys, 2016–2017 NSCH (adult proxy report, 6–17 y) and 2015 and 2017 YRBS (self-report, grades 9–12), assess meeting the guideline of ≥60 minutes of daily moderate to vigorous physical activity. Prevalence and odds ratios were estimated by age group and demographics. Results: For youth aged 14–17 years, 17.4% (95% confidence interval [CI], 16.1–18.7; NSCH) and 27.0% (95% CI, 25.6–28.5; YRBS) met the guideline. 25.9% (95% CI, 24.8–27.2) aged 6–13 years (NSCH) and 26.6% (95% CI, 25.3–28.0) in grades 9 to 12 (YRBS) met the guideline. Across surveys, fewer females (P < .001) and Asian youth (P < .001 except among NSCH 14–17 y) met the guideline. Conclusions: Neither methodology nor estimates for meeting the aerobic guideline are similar across surveys, so age continuity between juxtaposed estimates should not be assumed by magnitude nor age for separate Healthy People 2030 youth physical activity objectives.
Geoffrey P. Whitfield, Eric T. Hyde, and Susan A. Carlson
Background: Adults should perform ≥150 minutes per week of moderate-intensity equivalent physical activity for substantial health benefits and >300 minutes per week for additional benefits. The authors analyzed 21 years of National Health Interview Survey data to better understand trends in aerobic physical activity participation among US adults. Methods: The authors estimated the annual prevalence (1998–2018) of self-reported leisure-time physical inactivity, insufficient activity, meeting only the minimal aerobic guideline, and meeting the high aerobic guideline overall and by selected characteristics. Prevalence differences between 1998 and 2018 were compared across subgroups and periods of significant change were identified using JoinPoint regression. Results: The prevalence of inactivity decreased from 40.5% (1998) to 25.6% (2018) while the prevalence of meeting the high aerobic guideline increased from 26.0% to 37.4%. Increases in meeting the high guideline were similar across age groups, racial/ethnic groups, levels of education, and Census regions. Increases in insufficient activity and meeting the minimal guideline were statistically significant but of relatively small magnitude. Conclusions: The prevalence of inactivity decreased and meeting the high aerobic guideline increased overall and for all subgroups from 1998 to 2018. Physical activity promotion strategies may aim to continue these trends while also narrowing persistent disparities in participation across subgroups.
Kathleen B. Watson, Geoffrey P. Whitfield, Stacey Bricka, and Susan A. Carlson
Background: New or enhanced activity-friendly routes to everyday destinations is an evidence-based approach for increasing physical activity. Although national estimates for some infrastructure features surrounding where one lives and the types of nearby destinations are available, less is known about the places where individuals walk. Methods: A total of 5 types of walking trips (N = 54,034) were defined by whether they began or ended at home (home based [HB]) and trip purpose (HB work, HB shopping, HB social/recreation, HB other, and not HB trip) (2017 National Household Travel Survey). Differences and trends by subgroups in the proportion of each purpose-oriented trip were tested using pairwise comparisons and polynomial contrasts. Results: About 14% of U.S. adults reported ≥1 walking trip on a given day. About 64% of trips were HB trips. There were few differences in prevalence for each purpose by subgroup. For example, prevalence of trips that were not HB decreased significantly with increasing age and increased with increasing education and household income. Conclusions: Given age-related and socioeconomic differences in walking trips by purpose, planners and other professionals may want to consider trip origin and destination purposes when prioritizing investments for the creation of activity-friendly routes to everyday destinations where people live, work, and play.