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Meta-Analysis
. 2020 Jun;10(1):010410.
doi: 10.7189/jogh.10.010410.

Are people in the bush really physically active? A systematic review and meta-analysis of physical activity and sedentary behaviour in rural Australians populations

Carlos Ivan Mesa Castrillon  1 , Paula R Beckenkamp  1 , Manuela L Ferreira  2 , Jose A Michell  1   2   3   4   5 , Vania Alice de Aguiar Mendes  3 , Georgina M Luscombe  4 , Emmanuel Stamatakis  5 , Paulo Henrique Ferreira  1
Affiliations
Meta-Analysis

Are people in the bush really physically active? A systematic review and meta-analysis of physical activity and sedentary behaviour in rural Australians populations

Carlos Ivan Mesa Castrillon et al. J Glob Health. 2020 Jun.

Abstract

Background: Physical inactivity is a major risk factor for non-communicable disease and premature mortality. People who live in rural settings are usually regarded as more physically active than those living in urban areas, however, direct comparisons between these populations are scarce. We aimed to summarise the prevalence of physical inactivity and sedentary behaviour in rural settings in Australia, compared to urban counterparts.

Methods: We searched six databases (AMED, Embase, Medline; CINAHL, SPORTDiscus; and RURAL) and identified 28 observational studies that investigated the levels of physical inactivity and/or sedentary behaviour in adults aged 18 years and over in rural Australia. Random effects meta-analysis was used to generate pooled prevalence estimates.

Results: Physical inactivity was four percentage points (95% confidence interval (CI) = 0.4 to 8) higher in rural populations compared to urban populations. There was a one percentage point (95% CI = -3 to 5) prevalence difference of physical activity in the rural populations. Rural populations reported on average 7.8 hours of sedentary time per day (95% CI = 5 to 10) and the prevalence of high levels of sedentary behaviour (≥to 8 hours per day) was 7% (95% CI = -8 to -7) greater in urban areas compared to rural areas.

Conclusions: People living in rural areas are just as physically inactive as people who live in urban areas. Our findings challenge the popular views that rural lifestyles result in people engaging more frequently in physical activity. Public health campaigns promoting physical activity in rural settings are just as necessary as in urban settings.

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Conflict of interest statement

Conflict of interest: The authors completed the ICMJE Unified Competing Interest form (available upon request from the corresponding author), and declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow diagram.
Figure 2
Figure 2
Forest plot of the prevalence of physical inactivity of the rural population.
Figure 3
Figure 3
Forest plot of the prevalence of physical inactivity of the urban population.
Figure 4
Figure 4
Prevalence of physical inactivity in Australia. Panel A. Forest plot of the prevalence difference of physical inactivity of the rural vs urban population. Panel B. Forest plot showing a sensitive analysis of the prevalence difference of physical inactivity of the rural vs urban population including only studies that used Active Australia Survey or IPAQ.
Figure 5
Figure 5
Forest plot of the prevalence of physical activity of the rural population.
Figure 6
Figure 6
Forest plot of the prevalence of physical activity of the urban population.
Figure 7
Figure 7
Prevalence of physical activity in Australia. Panel A. Forest plot of the prevalence difference of physical activity of the rural vs urban population. Panel B. Forest plot showing a sensitive analysis of the prevalence difference of physical activity of the rural vs urban population including only studies that used active Australia or IPAQ.
Figure 8
Figure 8
Prevalence of sedentary behaviour in rural Australia. Panel A. Forest plot of the prevalence of rural population reporting sedentary behaviour. Panel B. Forest plot showing a sensitive analysis of the prevalence of sedentary behaviour in rural population only with studies that defined sedentary behaviour as spending 8 hours sitting per day.
Figure 9
Figure 9
Forest plot of the prevalence of urban population reporting sedentary behaviour.
Figure 10
Figure 10
Forest plot of the prevalence difference of rural vs urban population reporting sedentary behaviour.
Figure 11
Figure 11
Forest plot of pooling of overall average of hours per day in sedentary time measured with accelerometer in rural population.
Figure 12
Figure 12
Forest plot of prevalence difference of physical inactivity of less remote vs more remote population.
Figure 13
Figure 13
Forest plot of prevalence difference of physical activity of remote vs very remote population.
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