ArticlePreventive medicine2026
A cross-sectional analysis of disparities in neighborhood physical activity environments across the urban-rural Spectrum in the contiguous United States.
Article in Preventive medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesNeighborhood physical activity environments (PAEs), including built, facility, natural, and civic environments, support active living but are inequitably distributed. We examined racial/ethnic and socioeconomic disparities in PAEs and described variations by urbanicity.
methodsWe used population-weighted multivariable ordinary least squares regression with urbanicity and county fixed effects (2018; 69,889 contiguous United States census tracts) to estimate associations between standardized PAE indicators across four dimensions (built, facilities, natural, social) and categorical racial/ethnic composition and neighborhood poverty. Sensitivity analyses compared models with and without county fixed effects and weighting; urbanicity-stratified models examined variations.
resultsNon-Hispanic Black and Hispanic tracts had lower land-use mix (β = -0.53; -0.31), fewer fitness centers (β = -0.51; -0.60), lower green space (β = -0.08; -0.33), and higher pollution (β = 0.18; 0.38) than non-Hispanic White tracts. High-poverty tracts had greater road and intersection density (β = 0.29; 0.36), fewer fitness centers (β = -0.15), lower green space (β = -0.23), and lower civic engagement (β = -0.97). Their 95% confidence intervals excluded 0. Associations were generally larger in urban and suburban areas. County fixed effects reversed walkability advantages for non-Hispanic Black tracts.
conclusionsFindings underscore the need for equitable environmental investment that supports active living.
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