Several review papers have summarised the evidence for an association between children and adolescent’s physical activity levels and neighbourhood opportunities to exercise. The majority, including a recent ‘review of reviews’, have concluded that the presence of facilities and clubs for physical activity and sports is positively associated with more
activity (Davison and Lawson, 2006, de Vet et al., 2011, Limstrand, 2008, Sallis et al., 2000). Many of the studies used perceptions of facilities rather than objective measures. A positive association between parks and playgrounds and physical activity levels was also found (Limstrand, 2008).
Studies published more recently confirm this positive relationship between activity levels and the presence of facilities and parks. For example, in a New-Zealand based study Utter et al. (2006) found that students who perceived that there were certain facilities (a park, skateboard ramp, sports field, swimming pool, gym, or bicycle track) in their area were significantly more likely to perform regular vigorous activity, independent of age, gender, ethnicity, and SES. Another study found that those who used recreation centres were more active than those who did not. However as this study asked about use rather than
availability, it could be that more active people were more likely to attend the centres and this could have resulted in the association with activity being observed, rather than because the recreation centres themselves were responsible for raising activity levels (Gordon- Larsen et al., 2000). Adolescents who said there was nothing to do in their neighbourhood were significantly less likely to be active (Utter et al., 2006).
Quality in addition to the physical presence of facilities is important; dilapidated buildings and poor quality or unsafe equipment could all discourage the use of facilities. One study found physical activity was associated with better quality facilities but not with the quantity of facilities available (Romero, 2005). Physical accessibility is another
consideration (Sallis and Glanz, 2006). Facilities could be geographically close to home but individuals may be discouraged from travelling to them because of busy traffic, a lack of street lighting, or high levels of crime for example. Social norms could be important in influencing whether children in a neighbourhood use the facilities on offer although few studies have included measures of this (de Vet et al., 2011). In the US, ethnicity has also been found to play a role in accessibility due to some resources being dominated by individuals of a particular ethnic group which deters people of other ethnic groups from using them (Leventhal and Brooks-Gunn, 2000). Costs and opening times could also be barriers for some neighbourhood residents. In a study of adolescents living in a low- income area, few reported difficulties with physical access to facilities, however more than half reported that their parents would not pay fees to access facilities, and many wrongly thought there were entrance fees to facilities which were actually free (Romero, 2005).
It has been hypothesised that perceptions of neighbourhood safety, objective measures of crime, and measures of disorder could influence activity levels. Road safety could be important, particularly for young children, in a parent’s decision to allow their child to access facilities in the neighbourhood themselves and for making a neighbourhood pleasant to walk and play in. Only a few studies have examined measures of road safety and activity levels in children thus making firm conclusions difficult. However the
presence of pavements, low levels of traffic, and access to crossings have been shown to be positively associated with increased levels of physical activity (Limstrand, 2008).
Increasing levels of crime (measured objectively) were associated with lower levels of activity in adolescents in most of the small number of studies that have examined this measure (Ferreira et al., 2006). For example, Gordon-Larsen et al. (2000) found that those in the highest crime areas were significantly less active than those in the lowest crime areas. Objective measures of neighbourhood deprivation have not been included in many studies, but one found it to be associated with lower activity levels in 11-12 year old girls but not boys (Brodersen et al., 2005).
Many more studies have included perceived measures of safety. The vast majority of these studies found no association between child or adolescent activity levels and parental or child-reported perceptions of safety (Davison and Lawson, 2006, Ferreira et al., 2006). For example, Motl et al. (2006) did not find any direct effects between safety and activity levels. However, this could be partly due to the fact that there was little variation in perceptions of safety within the sample, with the girls in the study generally feeling that their neighbourhoods were safe. It is possible that safe neighbourhoods do not promote physical activity, rather that unsafe areas may deter it. A study by Utter et al. (2006) did find an association; those who said they felt safe in their neighbourhood were significantly more active than those who did not. Perceptions of safety can differ by ethnicity; in one study White girls in urban areas felt it was safer to walk/jog alone than White girls in rural areas but there was no difference between Black girls in the two settings (Felton et al.,
2002). In this study the White urban girls reported the highest levels of neighbourhood
safety and they were also the group with the highest activity levels, however the association between perceptions of neighbourhood safety and activity levels was not formally tested.
US-based studies have examined neighbourhood disorder and found mixed results. In one study, lower levels of activity were reported by adolescents who lived in an area with more physical (e.g. graffiti, litter) and social (e.g. people selling drugs) disorder (Molnar et al., 2004). A further study found pleasant neighbourhood aesthetics to be associated with increased activity in adolescents (Mota et al., 2005). However Romero et al. (2001) found that perceptions of hazards in the neighbourhood were not significantly associated with perceptions of safety, and that those who perceived more hazards in the neighbourhood were actually more likely to be active. Perceptions that a facility was in a safe place or that it was safe to walk to it were not significantly associated with activity levels in fully
adjusted models.
The lower levels of physical activity in residents of more socially deprived areas could be partly explained by less access to places to be active than those in more affluent areas. It has been hypothesised that low-income neighbourhoods have fewer resources for physical activity, and that any facilities present will be of lower quality than those in more affluent areas (Romero, 2005). In addition, residents of poorer areas may have limited resources to access facilities that cost money, or to travel to those located further afield (Lamb et al., 2010). Objective, country-wide studies of the distribution of neighbourhood facilities for physical activity have been conducted in Scotland, the US, and New Zealand. In Scotland, after adjustment for urbanicity the most affluent and most deprived areas had the lowest mean number of total facilities, and middle income areas the highest. The type of facility differed by neighbourhood deprivation; the most deprived neighbourhoods had the fewest private facilities, whereas the most affluent neighbourhoods had the fewest public facilities (Lamb et al., 2010). This study then examined total number of facilities within cities by neighbourhood deprivation; in Aberdeen and Dundee the most deprived areas had the lowest mean number of facilities per 1000 residents, whereas those in middle income areas tended to have the most. However in Edinburgh and Glasgow total number of facilities did not differ significantly by neighbourhood deprivation. Although total number of facilities did not vary, the type may have; a further Glasgow study found that affluent areas had more tennis courts, bowling greens and private swimming pools, but deprived areas had more public sports centres and public swimming pools (Macintyre et al., 2008).
In New Zealand, median travel time to the nearest park and sports or leisure facility was lower in more deprived neighbourhoods than in more affluent ones, although travel time to the nearest beach was highest for the most disadvantaged communities (Pearce et al.,
2007). In the US, neighbourhood median income was positively associated with the likelihood of a neighbourhood having each of the four types of physical activity facility considered (physical fitness facilities, membership sports clubs, dance facilities and public golf courses) (Powell et al., 2006). In addition, these facilities were significantly less likely to be in neighbourhoods with high proportions of African Americans or Hispanics, and were more likely to be found in suburban as opposed to urban areas. In a further US study which examined ‘community recreational spaces’, a higher neighbourhood poverty rate was associated with lower availability of sports areas, parks/green spaces and bike paths. Areas with higher proportions of African Americans had fewer sports areas, parks/green spaces and public pools/beaches. In contrast, neighbourhoods with higher concentrations of Hispanics had greater availability of all types of recreational space. All facilities combined, areas with lower poverty rates, lower proportions of African
Americans, and higher proportions of Hispanics had more recreational spaces (Powell et al., 2004). However another US study of girls reported no significant difference in access to parks and gyms by ethnicity or neighbourhood type. However in this study all of the girls (whether Black or White, or living in urban or rural areas) reported relatively low availability of play grounds, parks and gyms close to home (Felton et al., 2002).
Play areas (i.e. outdoor areas with play equipment such as swings and slides) may be important for activity in children, particularly for those without a private garden at home. In Glasgow there was a linear increase in the mean number of play areas with increasing neighbourhood deprivation (Ellaway et al., 2007). However a quality audit of a sample of play areas in Glasgow found that equipment was often poorer in more deprived areas (McAdam, 2010). Furthermore, in a focus group children in deprived areas reported more barriers to play, and these were of a more serious nature than those reported by children in more affluent neighbourhoods (barriers included vandalism, misuse of equipment, and safety from injury and strangers) (McAdam, 2010). A qualitative study of Glasgow residents cited social cohesion, integration and inclusion to be important in their decision of whether or not to use urban parks (Seaman et al., 2010).
Therefore the majority of studies have examined the physical presence of facilities rather than accessibility or quality (Powell et al., 2006). It is unclear whether perceived or objective measures are most important in determining behaviour. There may be facilities in a neighbourhood that residents do not perceive to be close to home; a study of parks in
Glasgow found poor agreement between measured and self-reported distance from home (Macintyre et al., 2008).