Association between Natural Resources for Outdoor Activities and Physical Inactivity: Results from the Contiguous United States

Abstract

Protected areas including national/state parks and recreational waters are excellent natural resources that promote physical activity and interaction with Nature, which can relieve stress and reduce disease risk. Despite their importance, however, their contribution to human health has not been properly quantified. This paper seeks to evaluate quantitatively how national/state parks and recreational waters are associated with human health and well-being, taking into account of the spatial dependence of environmental variables for the contiguous U.S., at the county level. First, we describe available natural resources for outdoor activities (ANROA), using national databases that include features from the Protected Areas Database, NAVSTREETS, and ATTAINSGEO 305(b) Waters. We then use spatial regression techniques to explore the association of ANROA and socioeconomic status factors on physical inactivity rates. Finally, we use variance analysis to analyze ANROA's influence on income-related health inequality. We found a significantly negative association between ANROA and the rate of physical inactivity: ANROA and the spatial effect explained 69%, nationwide, of the variation in physical inactivity. Physical inactivity rate showed a strong spatial dependence-influenced not only by its own in-county ANROA, but also by that of its neighbors ANROA. Furthermore, community groups at the same income level and with the highest ANROA, always had the lowest physical inactivity rate. This finding may help to guide future land use planning and community development that will benefit human health and well-being.

Keywords: community health; physical inactivity; protected areas; spatial autocorrelation; spatial lag model.

Figure 1

Geographic Distributions of Contiguous U.S. Natural Resources for Outdoor Activities.

Figure 2

Classification of ANROA for the Contiguous U.S. Counties.

Figure 3

Geographic Distributions of Average Age-Adjusted Physical Inactivity Rate in Contiguous U.S. Counties (2008 to 2011; rates were grouped by natural breaks classification).

Figure 4

Average Age-adjusted Rate of Physical Inactivity among ANROA and Income Groups (Group A: low income pop < 20%; Group B: 20% < low income pop < 50%; Group C: low income pop > 50%. Error bar indicates 95% confidence interval; the classification of ANROA is consistent with Figure 2).