Research: Health and Physical Activity

Physical activity rates among children have declined over the past two decades, which is a concerning trend carrying multiple implications. Regular physical activity is crucial for youth development and leads to improved bone health, weight status, cardiorespiratory and muscular fitness, cognition, and reduced risk of anxiety and depression (U.S. DHHS, 2018). Yet, less than one-quarter (24 percent) of children 6-17 years of age do not engage in at least 60 minutes of daily physical activity as recommended in the Physical Activity Guidelines for Americans (U.S. DHHS, 2018; U.S. Report Card Research Advisory Committee, 2022). Youth of color, youth with disabilities, girls, and adolescent-age youth are even less likely to attain recommended physical activity levels. (U.S. Report Card Research Advisory Committee, 2022). In particular, physical activity rates remain higher for boys than girls, and higher for White students than for African-American and Hispanic students (U.S. DHHS, 2020).

Activity levels for many children have declined, due in part to a built environment that is unsafe for walking and bicycling, reduced physical education in school, and increased popularity of sedentary leisure-time activities. Safe Routes to School can create environmental, policy, and behavioral changes that increase physical activity and promote the health of both children and adults.  Articles summarized in this section address the overall health benefits of physical activity, specifically walking to and from school, as well as the impact that increased physical activity opportunities have on health trends in the U.S.  There is also a growing body of research included here to support the improved social and emotional health implications Safe Routes to School and active transportation on youth development.

Research Highlights:

  • Children who walk to school get three times as much moderate to vigorous physical activity during their walk to school than during recess (Cooper et al., 2010). Children walk more when they live on more walkable routes with more open green space and less exposure to road traffic (Gallimore et al., 2011; Rahman, et al., 2011; Lamber et al., 2009).
  • Implementation of Safe Routes to School initiatives like Walking School Buses have demonstrated improved rates of walking to school, increased daily moderate-to-vigorous physical activity, and support healthy weight (Quarles, 2012; Mendoza et al., 2011; Mori et al., 2012; Kong et al., 2010).
  • Research demonstrates that children who walk or bicycle to school have higher daily levels of physical activity and better cardiovascular fitness than do children who do not actively commute to school (Mendoza et al., 2011; Davison, et al., 2008; Østergaard et al., 2012).
  • One study suggests that a 5% increase in neighborhood walkability is associated with 32.1% more minutes devoted to physically active travel and about one-quarter point lower body mass index (0.228) (Frank, et al., 2006).
  • Living in a walkable community has been associated with increased prevalence of healthy weight in adolescents (Slater et al., 2013).
  • Perceptions of safety and attractiveness impact a neighborhood’s walkability (Project for Public Space, 2016Ussery et al., 2017).  
  • There are gender, racial, and class disparities in how much people walk. Compared to affluent and primarily White neighborhoods, low-income neighborhoods and communities of color are perceived as less attractive and safe because of crime (Ussery et al., 2017).   
  • Investing in bike lanes is an investment in public health. People bike more when the built environment supports bicycling by including bike lanes, bike racks, and traffic calming (Dill et al., 2013Hipp et al., 2013Winters et al., 2016).
  • In addition to more bike infrastructure and road engineering improvements to make bicycling safer, bicycle education is important (Pion et al., 2016).
  • US metro areas with greater multi-modal transportation options (i.e., walking, bicycling, public transit) have better public health outcomes. People make healthier lifestyle choices, have more quality leisure time, exercise more, and live longer (Meehan et al., 2017; Frederick et al., 2017).
  • Students can build stronger friendships and relationships through walking and biking together. Based on a CDC evaluation of 145 informants from 184 walking school bus programs from 2017 to 2018, every additional walking school bus trip per week was related to a 21 percent increase in the odds of experiencing less bullying (Carlson et al., 2020).
Research
Motor and Cognitive Performance of Overweight Preschool Children

Gross and fine motor skills and cognitive performance in obese and overweight children were compared to healthy weight children. Participants were 1,543 children (797 boys and 746 girls) ages 43 to 84 months, attending childcare centers in Munich, Germany.

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Physical Activity and Obesity Mediate the Association Between Childhood Motor Function and Adolescents' Academic Achievement
  • Obesity and physical inactivity may have a negative impact on cognitive function and academic achievement. This prospective study investigated whether childhood motor function predicts later academic achievement via physical activity, fitness, and obesity.
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Physical Fitness, Academic Achievement, and Socioeconomic Status in School-Aged Youth

This study examined the association between physical fitness and academic achievement and determined the influence of socioeconomic status (SES) on the association between fitness and academic achievement in school-aged youth.

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Estimated Energy Expenditures for School-Based Policies and Active Living

This research review considered how policy and built environment could impact energy expenditure in youth.

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Neighborhood Design for Walking and Biking
Physical Activity and Body Mass Index

Neighborhood designs often relate to physical activity and to body mass index (BMI). The authors wanted to find out if neighborhood walkability/bikeability relates to BMI and obesity risk and whether moderate-to-vigorous physical activity (MVPA) account for some of the relationship?

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Public Health and the Green Building Industry: Partnership Opportunities for Childhood Obesity Prevention

This special review article touches on a number of key built environment issues leveraged by the Safe Routes to School program to improve childhood health and prevent obesity. 

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Smart Growth Community Design and Physical Activity in Children

The purpose of the study was to assess whether living in a smart growth community was associated with increased neighborhood-centered leisure-time physical activity in children aged 8–14 years, compared to residing in a conventional community (i.e., one not designed according to smart growth principles).

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Unwalkable Neighborhoods, Poverty, and the Risk of Diabetes Among Recent Immigrants to Canada Compared with Long-Term Residents

This study was designed to examine whether residents living in neighborhoods that are less conducive to walking or other physical activities are more likely to develop diabetes and, if so, whether recent immigrants are particularly susceptible to such effects.

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Walkable Communities and Adolescent Weight

Neighborhood design features have been associated with health outcomes, including the prevalence of obesity. This study examined the association between walkability and adolescent weight in a national sample of public secondary school students and the communities in which they live.

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Smart Use of Community Resources: An Interactive Lesson for Public Schools on Joint Use Agreements

The need for safe play spaces in communities across the United States is more important than ever (ChangeLab Solutions, 2012).