Physical activity levels of children living in different built environments

Objective. To review the available literature assessing differences in physical activity levels of children living in different built environments classified according to land use within developed countries. Methods. A systematic review of published literature up to March 2009. Online searches of five databases yielded 18 studies which met inclusion criteria. Studies provided data on n = 129446, 5-18 years old (n = 117544 from the United States). Results. From 13 assessments of differences in physical activity between rural and urban children one showed that rural children were significantly more active than urban children. In studies where the built environment was sub-divided further, suburban and small town children showed the highest levels of physical activity, followed by rural, then urban children. Differences in types of physical activity undertaken were evident, showing that rural children spent more time outdoors, involved in unstructured play compared with urban children. These findings were mainly restricted to children <13 years old. Conclusions. The literature does not show major differences in the physical activity levels between children from rural or urban areas. Where studied, the suburban built environment appears most conducive to promoting physical activity. Further research should use at least a trilateral division of the built environment and should also account for socioeconomic status, racial factors and seasonal effects. (C) 2010 Elsevier Inc. All rights reserved.