Fair play? Participation equity in organised sport and physical activity among children and adolescents in high income countries: a systematic review and meta-analysis

Abstract

Background Physical activity and sport have numerous health benefits and participation is thought to be lower in disadvantaged children and adolescents. However, evidence for the disparity in physical activity is inconsistent, has not been reviewed recently, and for sport has never been synthesised. Our aim was to systematically review, and combine via meta-analyses, evidence of the socioeconomic disparities in physical activity and sport participation in children and adolescents in high income countries. Methods We conducted searches of five electronic databases using physical activity, sport, and socioeconomic disparity related terms. Two independent reviewers assessed 21,342 articles for peer-reviewed original research, published in English that assessed socioeconomic disparities in physical activity and sport participation in children and adolescents. We combined evidence from eligible studies using a structural equation modelling approach to multilevel meta-analysis. Results From the 104 eligible studies, we meta-analysed 163 effect sizes. Overall, children and adolescents living in higher socioeconomic status households were more likely to participate in sport (OR: 1.87, 95% CIs 1.38, 2.36) and participated for a longer duration (d = 0.24, 95% CIs 0.12, 0.35). The socioeconomic disparity in the duration of sport participation was greater in children (d = 0.28, 95% CIs 0.15, 0.41) compared with adolescents (d = 0.13, 95% CIs − 0.03, 0.30). Overall, children and adolescents living in higher socioeconomic status households were more likely to meet physical activity guidelines (OR: 1.21, 95% CIs 1.09, 1.33) and participated for a longer duration (d = 0.08, 95% CIs 0.02, 0.14). The socioeconomic disparity in the duration of total physical activity between low and high socioeconomic status households was greater in children (d = 0.13, 95% CIs 0.04, 0.21) compared with adolescents (d = 0.05, 95% CIs − 0.05, 0.15). There was no significant disparity in leisure time physical activity (d = 0.13, 95% CIs − 0.06, 0.32). Conclusions There was evidence of socioeconomic disparities in sport participation and total physical activity participation among children and adolescents. Socioeconomic differences were greater in sport compared to total physical activity and greater in children compared with adolescents. These findings highlight the need importance of targeting sport programs according to socio-economic gradients, to reduce inequities in access and opportunity to organised sport.

Organized Sports Participation Among Children Aged 6–17 Years: United States, 2020

“…Sports team participation has been associated with increased levels of physical activity (1) and improved physical and mental health among children and adolescents (2,3). Disparities in sports participation have been found across age, sex, race, disability, and socioeconomic subgroups (4)(5)(6). This report describes national estimates of parent-reported organized sports participation during the past 12 months among children aged 6-17 years.…”

Neighborhood-level socioeconomic factors moderate the association between physical activity and relative age effect: a cross-sectional survey study with Japanese adolescents

“…Socioeconomic factors were not directly associated with sports participation and physical activity. Previous studies have shown that adolescents demonstrate weaker association between socioeconomic factors and sports participation and physical activity duration than preschool children [ 13 ]. In Japan, most secondary school students belong to school activity clubs, which are generally scheduled after school.…”

“…Socioeconomic status (SES), such as parents' income and education level, is one of the factors that influences adolescents' sports participation and physical activity [10][11][12][13]. Adolescents with low SES are less likely to participate in sports and to engage in physical activity than adolescents with high SES.…”

A socio-ecological approach to reduce the physical activity drop-out ratio in primary care-based patients with type 2 diabetes: the SENWI study protocol for a randomized control trial

“…Studies reporting dropout from long-term PA programmes show that people with low education and socioeconomic status have a higher prevalence than their counterparts [14]. Moreover, a previous qualitative study identified that not only social inequity [32,33] but also having non-negotiable kinship needs (e.g. family care) may effect treatment adherence [34].…”

“…political decision-making) may have more influence on PA routinization than patients' motivation and knowledge [34,36]. Yet, ineffective primary care-based PA recommendations may enhance socioeconomic barriers and health inequity in T2DM patients [32,33].…”