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
Changes in the Percentage of Students Who Walk or Bike to School – United States, 1969 and 2001

Data from the 1969 and 2001 National Household Transportation Survey report that a smaller percentage of students lived within 1 mile of school in 2001 than in 1969.

Research
Investment in Safe Routes to School Projects: Public Health Benefits for the Larger Community

This study estimates of the amount of land area and population in the United States that could be affected by Safe Routes to School programs, and examines the types of locations where such improvements are likely to affect the greatest number of people and the improvements it could have on the larger community.

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Systematic Review of Active Commuting to School and Children’s Physical Activity and Weight

The recent decline in children's active commuting (walking or biking) to school has become an important public health issue. Recent programs have promoted the positive effects of active commuting on physical activity (PA) and overweight. However, the evidence supporting such interventions among schoolchildren has not been previously evaluated.

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Increasing Access to Places for Physical Activity Through a Joint Use Agreement: A Case Study in Urban Honolulu

The purpose of this article is to present a case study of In-Motion, a JUA pilot project of the City and County of Honolulu Department of Parks and Recreation (DPR) implemented at Farrington High School (FHS) in Honolulu, Hawaii.

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Effects of Weight on Children’s Educational Achievement
  • Results suggest that, in general, children who are overweight or obese have achievement test scores that are about the same as children with average weight.
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Exercise and Children’s Intelligence, Cognition, and Academic Achievement

This study reviews the literature that examines the effects of exercise on children’s intelligence, cognition, or academic achievement.

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Overweight is Associated with Decreased Cognitive Functioning Among School-age Children and Adolescents

This study examines the associations between academic performance, cognitive functioning, and increased BMI in a nationally representative sample of children.

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Physical Education, School Physical Activity, School Sports, and Academic Performance

Data analyzed in this study indicate that additional curricular emphasis on physical education may result in small absolute gains in grade point average and strongly suggest a relative increase in performance per unit of academic teaching time.

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Interventions to Promote Walking: Systematic Review

This study assesses the effects of interventions to promote walking in individuals and populations by conducting a systematic review of published and unpublished reports in any language identified by searching 25 electronic databases, by searching websites, reference lists, and existing systematic reviews, and by contacting experts.

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Small Changes in Dietary Sugar and Physical Activity as an Approach to Preventing Excessive Weight Gain: The America on the Move Family Study

Two small lifestyle changes, as promoted by the America on the Move initiative, in diet (to eliminate 100 kcal/day) and physical activity (to walk an additional 2000 steps/day), could be useful for addressing childhood obesity by preventing excess weight gain in families.