Adolescents’ physical activity: cross-national comparisons of levels, distributions and disparities across 52 countries

Abstract

BackgroundDespite global concerns regarding physical inactivity, limited cross-national evidence exists to compare adolescents’ physical activity participation. We analysed data from 52 high- and low-middle income countries, with activity undertaken inside and outside of school in 2015. We investigated gender and socioeconomic disparities, and additionally examined correlations with country-level indices of physical education (PE) curriculum time allocation, wealth, and income inequality.MethodsWe compared adolescents’ reported activity levels inside and outside of school using nationally representative cross-sectional data from 52 high- and low-middle income countries (N = 347,935)—the Programme for International Student Assessment (PISA) in 2015. Students reported average attendance (days/week) in PE classes, and the days/week engaged in moderate activity (MPA) and vigorous activity (VPA) outside of school. We also compared gender and socioeconomic disparities, and additionally examined correlations with purported determinants—country-level estimates of PE curriculum time allocation, wealth, and income inequality.ResultsAverage activity levels differed substantially both between and within regions, with potentially important differences in distributions identified—such as a bimodal distribution in the U.S. and Canada in PE. Males were more active than females, as were those from households with higher rather than lower household wealth; these disparities were modest for PE, but higher for moderate and vigorous activity outside school—there was strong evidence for heterogeneity in the magnitude of these disparities (e.g., I2 > 95% for gender differences across all countries). PE class attendance was positively correlated with PE curriculum time allocation (rho = 0.36); activity outcomes were inconsistently associated with country-level wealth and income inequality.ConclusionsOur findings reveal extensive cross-country differences in adolescents’ physical activity; in turn, these highlight policy areas that could ultimately improve global adolescent health, such as the incorporation of minimum country-level PE classes, and the targeting of gender and socioeconomic disparities in activity conducted outside of school. Our findings also highlight the utility of educational databases such as PISA for use in global population health research.

Income-based inequalities in self-reported moderate-to-vigorous physical activity among adolescents in England and the United States: comparisons from two cross-sectional surveys

“…Likewise, the evidence of inequalities presented here broadly agree with systematic reviews [29], findings for vigorous-intensity activity among children in the UK [30], and US findings for physical activity [31], inactivity [21], recreational activity [20], active transportation [28] and cardiorespiratory fitness [32]. Our findings also agree with worldwide studies for levels of activity outside-of-school [24] and for activity frequency [33].…”

“…We decided, a-priori, to conduct gender-stratified analyses due to expected differences in MVPA levels and inequalities in these as reported in the literature [20,24]. All analyses accounted for the complex survey designs, including the geographical clustering of participants in primary sampling units.…”

The Health Of Us Adolescent Athletes During Covid-19 Related School Closures And Sport Cancellations

“…Females with worse physical activity scores is a particular concern as females have demonstrated even worse physical activity levels outside of school physical activity than males in previous studies. 39 We readily acknowledge that the sex differences we report may not be solely due to the cancellation of in-person school attendance and the cancellation of sports. Experts have stated that factors such as a lack of social interaction, increased economic uncertainty and social media access may all play a role in affecting the health of young individuals during the COVID-19 pandemic.…”

Changes of Physical Activity and Ultra-Processed Food Consumption in Adolescents from Different Countries during Covid-19 Pandemic: An Observational Study

“…A high percentage of school going adolescents are estimated to be insufficiently physically active worldwide [6], with a significant variation between countries [4,5]. Documenting and understanding these differences are important to identify countries and corresponding policies associated with the determinants of physical activity levels [5].…”

“…Among these habits, the practice of physical activity is one of the most important ones. Yet, physical inactivity is common among adolescents and sedentary behaviors in this stage of life have been negatively associated with physical, mental, and social health adverse outcomes [5]. Currently, the WHO estimates that 3 out of 4 adolescents do not meet the minimum recommendations for physical activity [6].…”