Urban-rural Disparities In Health-relrated Physical Fitness (hrpf) Level Among Korean Older Adults: The National Fitness Award 2011-2024

PURPOSE: This study examines the disparities in health-related physical fitness (HRPF) levels among older adults across different geographical settings in Korea. METHODS: Using data from the National Fitness Award (2011-2024), we compare HRPF indicators among older adults residing in rural areas (population < 50,000), urban cities (population < 500,000), and big municipal cities (population > 500,000). Key health indicators such as hypertension, obesity, and fitness tier level were analyzed to understand the influence of residential areas on fitness and health outcomes. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for each HRPF outcome. Fitness tiers were classified as Tier 1 (high), Tier 2 (moderate), Tier 3 (low), and none, with rural areas as the reference group. RESULTS: Compared to urban cities, rural residents had slightly lower odds of hypertension (OR = 0.895, 95% CI = 0.866-0.924) but were less likely to engage in fitness activities across all tiers (Tier 1: OR = 0.823, 95% CI = 0.77-0.88; Tier 2: OR = 0.722, 95% CI = 0.69-0.756; Tier 3: OR = 0.792, 95% CI = 0.763-0.823). Moreover, rural residents had higher odds of being overweight (OR = 1.167, 95% CI = 1.134-1.201) and obese (OR = 1.285, 95% CI = 1.203-1.373), with lower fitness level (Tier 1: OR = 0.744, 95% CI = 0.699-0.791; Tier 2: OR = 0.67, 95% CI = 0.642-0.7; Tier 3: OR = 0.764, 95% CI = 0.738-0.792) compared to big municipal city. CONCLUSION: Findings indicate significant urban-rural disparities in HRPF among older adults. Rural residents generally show lower fitness levels and higher odds of obesity across all tiers compared to their urban and big municipal city counterparts, despite slightly lower risks of hypertension. These results underscore the need for targeted interventions in rural areas to enhance fitness engagement and address obesity risks among older populations. Supported by: Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2024S1A5C3A02043877)