Preventing Chronic Disease | Rural–Urban Differences in Objective and Subjective Measures of Physical Activity: Findings From the National Health and Nutrition Examination Survey (NHANES) 2003–2006 - CDC
Rural–Urban Differences in Objective and Subjective Measures of Physical Activity: Findings From the National Health and Nutrition Examination Survey (NHANES) 2003–2006
Jessie X. Fan, PhD; Ming Wen, PhD; Lori Kowaleski-Jones, PhD
Suggested citation for this article: Fan JX, Wen M, Kowaleski-Jones L. Rural–Urban Differences in Objective and Subjective Measures of Physical Activity: Findings From the National Health and Nutrition Examination Survey (NHANES) 2003–2006. Prev Chronic Dis 2014;11:140189. DOI: http://dx.doi.org/10.5888/pcd11.140189
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Abstract
Introduction
Lower levels of physical activity among rural relative to urban residents have been suggested as an important contributor to rural–urban health disparity; however, empirical evidence is sparse.
Lower levels of physical activity among rural relative to urban residents have been suggested as an important contributor to rural–urban health disparity; however, empirical evidence is sparse.
Methods
We examined rural–urban differences in 4 objective physical activity measures (2 intensity thresholds by 2 bout lengths) and 4 subjective measures (total, leisure, household, and transportation) in a nationally representative sample of participants in the National Health and Nutrition Examination Survey (NHANES) 2003–2006. The sample comprised 5,056 adults aged 20 to 75 years. Rural-Urban Commuting Area (RUCA) codes were matched with NHANES subjects to identify urban status and 2 types of rural status. Rural–urban and within–rural differences in physical activity were estimated without and with controls for demographic and socioeconomic variables.
We examined rural–urban differences in 4 objective physical activity measures (2 intensity thresholds by 2 bout lengths) and 4 subjective measures (total, leisure, household, and transportation) in a nationally representative sample of participants in the National Health and Nutrition Examination Survey (NHANES) 2003–2006. The sample comprised 5,056 adults aged 20 to 75 years. Rural-Urban Commuting Area (RUCA) codes were matched with NHANES subjects to identify urban status and 2 types of rural status. Rural–urban and within–rural differences in physical activity were estimated without and with controls for demographic and socioeconomic variables.
Results
Rural residents were less active than urban residents in high-intensity long bout (2,020 counts per minute threshold and 10 miniutes or longer bout length) accelerometer-measured physical activity (42.5 ± 6.2 min/wk vs 55.9 ± 2.8 min/wk) but the difference disappeared with a lower-intensity threshold (760 counts per minute). Rural residents reported more total physical activity than urban residents (438.3 ± 35.3min/wk vs 371.2 ± 12.5 min/wk), with differences primarily attributable to household physical activity. Within rural areas, micropolitan residents were less active than residents in smaller rural areas. Controlling for other variables reduced the size of the differences.
Rural residents were less active than urban residents in high-intensity long bout (2,020 counts per minute threshold and 10 miniutes or longer bout length) accelerometer-measured physical activity (42.5 ± 6.2 min/wk vs 55.9 ± 2.8 min/wk) but the difference disappeared with a lower-intensity threshold (760 counts per minute). Rural residents reported more total physical activity than urban residents (438.3 ± 35.3min/wk vs 371.2 ± 12.5 min/wk), with differences primarily attributable to household physical activity. Within rural areas, micropolitan residents were less active than residents in smaller rural areas. Controlling for other variables reduced the size of the differences.
Conclusion
The direction and significance of rural–urban difference in physical activity varied by the method of physical activity measurement, likely related to rural residents spending more time in low-intensity household physical activity but less time in high-intensity physical activity. Micropolitan residents were substantially less active than residents in smaller rural areas, indicating that physical activity did not vary unidirectionally with degree of urbanization.
The direction and significance of rural–urban difference in physical activity varied by the method of physical activity measurement, likely related to rural residents spending more time in low-intensity household physical activity but less time in high-intensity physical activity. Micropolitan residents were substantially less active than residents in smaller rural areas, indicating that physical activity did not vary unidirectionally with degree of urbanization.
Acknowledgments
This research was supported by the National Institute of General Medical Sciences of the National Institutes of Health (NIH) under award number R01CA140319-01A1. The funding agency had no involvement in study design, data analysis, interpretation of results, or decision to submit this article for publication. The fındings and conclusions in this article are those of the authors and do not necessarily represent the views of NIH and the Research Data Center (RDC), National Center for Health Statistics, CDC. The authors thank Drs Xingyou Zhang, Fahui Wang, Heidi Hanson, and staff of the RDC for their data support and technical assistance.
Author Information
Corresponding Author: Jessie X. Fan, PhD, Department of Family and Consumer Studies, University of Utah, 225 S 1400 E AEB 228, Salt Lake City, UT 84112-0080. Telephone: 801-581-4170. E-mail: fan@fcs.utah.edu.
Author Affiliations: Ming Wen, Lori Kowaleski-Jones, University of Utah, Salt Lake City, Utah.
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