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).
Bicycling Policy Indirectly Associated with Overweight/Obesity


Policies and infrastructure that support commuting by bicycle are linked with lower rates of overweight and obesity among adults in large U.S. cities.

Journal Article, Research
Supporting Public Health Priorities:
Recommendations for Physical Education and Physical Activity Promotion in Schools – Progress in Cardiovascular Diseases

Key Takeaway: Walking and biking to school is an important part of multi-component comprehensive school physical activity programs (CSPAPs).

Acute Exercise Facilitates Brain Function and Cognition in Children Who Need It Most
An ERP Study of Individual Differences in Inhibitory Control Capactity

The study examined the effects of moderate-intensity aerobic exercise on aspects of cognitive control in two groups of children categorized by higher- and lower-task performance.

Fitness, Fatness, and Academic Performance in Seventh-Grade Elementary School Students

Background:  In addition to the benefits on physical and mental health, cardiorespiratory fitness has shown to have positive effects on cognition. This study aimed to investigate the relationship between cardiorespiratory fitness and body weight status on academic performance among seventh-grade students.

Physical Activity and Cognition in Adolescents: A Systematic Review

Purpose: To perform a systematic review of the evidence on the associations between physical activity and cognition by differentiating between academic and cognitive performance measures. Second-generation questions regarding potential mediators or moderators (i.e., sex, age and psychological variables) of this relationship were also examined.

The Association Between Physical Fitness and Academic Achievement in Texas State House Legislative Districts
An Ecologic Study

Background: The association of physical fitness with cognitive function in children and adolescents is unclear. The purpose of this ecological study was to describe the association between academic achievement, body mass index, and cardiovascular fitness in a large sample of elementary, middle, and high school students in Texas.

The Importance of Physical Activity and Aerobic Fitness for Cognitive Control and Memory in Children


  • We review literature that examines the association among physical activity, aerobic fitness, cognition, and the brain in elementary school children (ages 7-10 years).

Background:  Physical inactivity has been shown to increase the risk for several chronic diseases across the lifespan. However, the impact of physical activity and aerobic fitness on childhood cognitive and brain health has only recently gained attention.

Acute Aerobic Exercise: An Intervention for the Selective Visual Attention and Reading Comprehension of Low-Income Adolescents

Background:  There is a need for feasible and research-based interventions that target the cognitive performance and academic achievement of low-income adolescents.

Active Commuting to School in Mexican Adolescents
Evidence from the Mexican National Nutrition and Health Survey

Background: Travel to school offers a convenient way to increase physical activity (PA) levels in youth. We examined the prevalence and correlates of active commuting to school (ACS) in a nationally representative sample of Mexican adolescents. A secondary objective was to explore the association between ACS and BMI status.