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
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.

Research
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.

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Estimating the Number of Children Who Can Walk to School

National estimates suggest that 14%-19% of children walk to school while state and local estimates suggest that 4% to 20% of children walk to school.

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The Relationship Between Relative Weight and School Attendance Among Elementary Schoolchildren

This study examines the relationship between relative weight and school attendance among 1,069 fourth to sixth graders from nine elementary schools in the inner city of Philadelphia, PA.

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Environment, Obesity, and Cardiovascular Disease Risk in Low-Income Women

Financially disadvantaged populations are more likely to live in communities that do not support healthy choices. This paper investigates whether certain characteristics of the built environment are associated with obesity or coronary heart disease (CHD) risk among uninsured low-income women.

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Estimating the Energy Gap Among US Children: A Counterfactual Approach

By quantifying the magnitude of energy imbalance responsible for the increase in body weight among US children, this study looks to provide salient targets for population intervention.

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Prevalence of Obesity and Overweight in the United States: 1999-2004

In 2003-2004, 17.1% of US children and adolescents were overweight.

Research
Many Pathways from Land Use to Health

This article examines single-use, low-density land use patterns and reports that a 5% increase in neighborhood walkability is associated with: