Social Vulnerability and Leisure-Time Physical Activity in the United States From 2020 to 2022: An Unaltered Crisis Within a Crisis.

Background: No leisure time physical activity (NO-LTPA) continues to be a leading behavioral driver of poor health outcomes in the United States. The current investigation explores the relationship between, short term, longitudinal changes in social vulnerability and NO-LTPA within the context of culturally distinct U.S. regions.

Methods: We merged county-level data on physical inactivity prevalence, the Social Vulnerability Index (SVI), and the American Nations regional cultures schematic.

Results: The prevalence of NO-LTPA was significantly higher: 1) In American Nations Group 1 in both 2020 and 2022; and 2) During 2022 in both American Nation Groups. The overall SVI score was significantly higher in American Nations Group 1 in both 2020 and 2022 but there were no significant differences in either group from 2020 to 2022. There were 1161 U.S. counties (i.e., 37%) that had a decrease in NO-LTPA from 2020 to 2022 (mean reduction = -1.7 ±1.5) compared to 1970 U.S. counties that has no change or an increase in NO-LTPA from 2020 to 2022 (mean increase = 2.0 ±1.6). The difference in 2020 to 2022 change in SVI was statistically significant (-0.8 ±0.50 vs 0.04 ±0.51, P < .001) between counties with a decrease in NO-LTPA compared to those with no change or an increase.

Discussion: These current findings indicate the SVI-NO-LTPA crisis within a crisis continues to be a factor in the U.S. The fact that there was a statistical signal between SVI and NO-LTPA change indicates improving the former may likewise improve the latter.