Urban-Rural Differences in Children’s and Adolescent’s Physical Activity and Screen-Time Trends Across 15 Years

Abstract

Background Urban and rural areas have been experiencing major demographic and structural changes, characterized by an aging population in rural areas and a growth of cities in number and size. However, it is poorly researched how children’s physical activity and screen time developed in urban and rural areas. To address this deficit, we investigated physical activity and screen-time trends in Germany’s pediatric population across four urbanicity levels (rural, small town, medium-sized town, city). Method We obtained weighted data at three cross-sectional timepoints between 2003 and 2017, representative for Germany’s child and adolescent population. Physical activity and screen time were self-reported. We analyzed trends using a structural equation modeling framework for the overall sample and calculated interactions between the trends and age and gender, respectively. Results In total, 12,161 children and adolescents between 4 and 17 years participated in the study. Children and adolescents in rural areas experienced a downward trend in total physical activity. Outdoor play and leisure-time physical activity decreased across all areas, with the strongest decline in rural areas. Computer and gaming time increased across all areas except for cities, with the sharpest increase in rural areas. The decline in outdoor play and the incline in computer and gaming time were driven by adolescents. Females showed stronger increases in computer and gaming time than males. Conclusion Our findings suggest that in a representative sample of children and adolescents in Germany, detrimental trends in children’s physical activity and screen time occur at a higher rate in rural areas compared with urban environments. This provides critical information for health policy: While all children and adolescents should be targeted for physical activity promotion, a special focus should be on tailoring interventions for rural areas to prevent and mitigate inequalities in physical activity across urban and rural areas.

A Study on the Correlation between Physical Activity and Physical Fitness Index of Chinese Adolescents

“…The research by Roemmich JN et al [21] showed that urban adolescents are more actively involved in PA, with a participation rate of 77.8%, while rural adolescents are only 22.2%. The results of the study by Nigg C et al [22] indicated that urban adolescents are more actively involved in PA and have a relatively more adequate level of PA. The differences in PA between urban and rural adolescents may be due to various factors.…”

Comparison of Estonian Schoolchildren’s Physical Activity and Fitness Indicators before and after the COVID-19 Pandemic’s Period of Restricted Mobility

“…The smallest changes occurred among 16–17-year-old girls and 14–15-year-old boys, where no significant shift in the reduction of hours spent outdoors was observed. Nigg et al (2022) also noted a decrease in the time spent outdoors among adolescents and, at the same time, an increase in screen time [ 15 ]. Distance learning during the restrictions caused by the COVID-19 pandemic also contributed to the increase in screen time and, therefore, to the decrease in outdoor time.…”

“…It is encouraging to observe that, according to the HBSC (Health Behaviour in School-aged Children) study, the physical activity levels among school children have been relatively stable in recent years [ 12 , 13 ]; meanwhile, boys are more likely to meet the recommended daily physical activity levels than girls, and younger school students (11 years old) are more physically active than older ones (15 years old) [ 12 , 13 , 14 ]. Additionally, over the past two decades, leisure time physical activity has declined among both rural and urban children, with a particularly significant decrease in the time rural children spend outdoors [ 15 ]. At the same time, the sedentary screen time for both rural and urban children has increased [ 13 , 15 , 16 ], and this in turn limits physical activity [ 17 ].…”

“…Additionally, over the past two decades, leisure time physical activity has declined among both rural and urban children, with a particularly significant decrease in the time rural children spend outdoors [ 15 ]. At the same time, the sedentary screen time for both rural and urban children has increased [ 13 , 15 , 16 ], and this in turn limits physical activity [ 17 ]. Excessive screen time and reduced physical activity contribute to weight gain [ 18 ] and various health issues like back pain [ 16 ] and depressive symptoms [ 19 ].…”

Development and reliability testing of an audit toolbox for the assessment of the physical activity friendliness of urban and rural environments in Germany

“…Although there is no significant difference in the total levels of physical activity of adults living in rural and those living in urban areas, adults in rural areas have lower levels of transport-related physical activity, which can be explained by longer travel distances to workplaces, shops, and other facilities and destinations ( 34 , 60 , 61 ). While older studies have found higher levels of physical activity in children and adolescents in rural compared to urban areas in Germany, a more recent one revealed stronger declines of total physical activity and outdoor play in rural areas, which may be a result of a lack of opportunities ( 62 – 65 ).…”