How environmental health burdens shape physical activity patterns: age-specific evidence from OECD countries

Despite widespread acknowledgment of physical activity's (PA) benefits, inactivity remains a significant public health challenge, exacerbated by environmental and socioeconomic factors. This study investigates how environmental health burdens-specifically air pollution and smoking-related disease burdens-alongside socioeconomic conditions shape PA patterns across different life stages in OECD countries.

Using cross-sectional data from 38 OECD countries, age-stratified beta regression models examined the determinants of PA prevalence among adolescents (ages 11-17), adults (ages 18-69), and older adults (ages 70+). Independent variables included air pollution-related and smoking-related Disability-Adjusted Life Years (DALYs), Body Mass Index (BMI), GDP per capita, urbanization, internet penetration, access to sports facilities, healthcare expenditure, and average annual working hours. Data imputation techniques ensured dataset completeness, supported by auxiliary demographic variables. Robustness checks included multicollinearity assessments, non-linear tests, and sensitivity analyses.

Adolescents exhibited relatively high PA rates, positively influenced by urbanization only when socioeconomic contexts were considered (β=0.119, p=0.031). Adult PA was significantly boosted by greater access to sports facilities (β=0.172, p=0.019), while internet penetration negatively impacted activity levels marginally (β=-0.126, p=0.068). For older adults, PA increased notably with better sports facility access (β=0.178, p=0.001) but declined with higher air pollution-related (β=-0.128, p=0.028) and smoking-related DALYs (β=-0.097, p=0.027), as well as increased internet penetration (β=-0.143, p=0.030).

Determinants of PA vary markedly across age groups and include significant interactions with environmental and socioeconomic factors. Urbanization enhances adolescent PA contingent on supportive environments. In adults and older adults, infrastructure such as sports facilities proves essential, though environmental health burdens significantly limit activity in older populations. Age-specific, environmentally informed public health strategies and infrastructural interventions are critical to sustainably promoting PA across life stages.