INTRODUCTION: Rural-urban inequalities in China have been widening over the past few decades. Compared to their urban counterparts, rural residents may encounter various barriers to equal opportunities to effectively engage in physical activity. This study examines the rural-urban disparity in physical activity, proximity and satisfaction with local exercise facilities.
METHODS: An in-person survey was conducted in 29 counties of 10 Chinese provinces in 2012. Five thousand questionnaires were administered by trained staff with a completion rate of 82.1%. The complete sample includes 1661 rural and 2446 urban residents. Eight dichotomous outcome measures were used, pertaining to leisure-time physical activity engagement; proximity to the nearest exercise facility from home; satisfaction level with the quantity, variety, fee levels, opening hours, and daily management and services of nearby exercise facilities; and satisfaction level with the local public sports service system. Nearest-neighbor matching was performed to match rural residents with urban residents by observed individual sociodemographics, including gender, age, education level and residential province. Pearson's χ2 test was used to assess the difference in sociodemographics and outcome measures between rural and urban residents before and after matching.
RESULTS: Before nearest-neighbor matching, the frequency distributions of age and education level are significantly different between rural and urban residents (both p<0.0001). After matching, the differences in the frequency distributions between rural and urban residents become statistically non-significant for all observed sociodemographics: gender (p=0.170), age (p=0.934), education level (p=0.244) and residential province (p=1.000). Compared to their matched urban counterparts, rural residents are 8.1% (p<0.0001) more likely to be physically inactive in their leisure time and 5.8% (p=0.005) less likely to live within 30-minute walking distance to the nearest exercise facility. Rural residents are 15.7%, 15.7%, 8.6%, 13.5% and 14.7% more likely to be unsatisfied with the quantity, variety, fee levels, opening hours, and daily management and services of nearby exercise facilities, and 16.1% more likely to be unsatisfied with the local public sports service system than matched urban residents (all p<0.0001).
CONCLUSIONS: Substantial rural-urban disparities tend to be present in leisure-time physical activity, proximity to the nearest exercise facility, and satisfaction level with exercise facilities and the public sports service system. Policy interventions are warranted to improve the accessibility and affordability of local exercise facilities in rural areas as a way to promote physical activity among Chinese rural residents and reduce disparities.
