Urban context, socioeconomic status, and adolescent physical activity: qualitative findings from Madrid and Bilbao

Urban and social environments strongly shape adolescents' opportunities to engage in physical activity, with inequalities in socioeconomic status, infrastructure and neighbourhood conditions creating uneven access. This study explored the determinants underlying unequal participation in physical activity among adolescents in Madrid and Bilbao.

A constructivist qualitative case study informed by grounded theory was conducted in secondary schools in Madrid and Bilbao between February 2022 and April 2024. Schools were selected from neighbourhoods with differing socioeconomic profiles. Fieldwork included thirty six semi structured interviews and twenty-four focus groups, analysed through open, axial and selective coding supported by Atlas.ti.

Four major thematic categories were identified: 1) Household socioeconomic conditions as a determinant of physical activity; 2) The role of the educational community in shaping physical activity engagement; 3) Perceived insecurity, the appropriation of public space and gender; 4) Urban realities and their influence on physical activity practices. Distinct patterns emerged between Madrid and Bilbao, linked to urban structure, the use of sports facilities, and accessibility.

Economic, spatial and social inequalities limit equitable access to physical activity. The findings underscore the need for context sensitive policies that integrate socioeconomic and urban factors and strengthen the role of schools in reducing adolescent health inequalities.