Associations between the Neighborhood Socio-Spatial Environment and Physical Activity Correlates in Primary School Children: A Cross-Sectional Analysis

Objectives: Physical activity (PA) promotion in primary school children is a public health priority, but social inequalities need to be considered. However, empirical evidence to social inequalities in children´s PA is ambiguous. This study aimed to explore PA and PA correlates of primary school children depending on the neighborhood socio-spatial environment (NSSE) based on a socio-ecological model (SEM). Methods: 1st grade primary school children (n=556, 48% girls) were examined cross-sectionally. Children’s PA and PA correlates were assessed with a parent questionnaire. The NSSE was classified into low (LD), partial (PD), and high deprivation (HD) operationalized by an urban development index. Data were analyzed using analysis of variance, Chi2, and post-hoc tests. Key results: Primary school children from HD neighborhoods were significantly less involved in organized PA, received less instrumental parental support, and were exposed to neighborhood environments perceived less supportive to PA compared to children from LD and PD neighborhoods. Furthermore, mothers from HD neighborhoods reported lower engagement in exercise-related PA. Conclusions: PA and PA correlates of primary school children differed depending on the NSSE mainly to the disadvantage of children living in HD neighborhoods. Social inequalities are reflected in multiple levels of a SEM ranging from domain-specific PA to parental and environmental correlates. Future health promotion initiatives could use the NSSE as an indicator to address social inequalities in PA among primary school children in urban areas.