Similar perceived availability but lower use of physical activity spaces among Chilean adults with disabilities

Adults with disabilities are less physically active than the general population, yet the environmental point at which this disparity emerges is rarely identified in national surveillance. We examined perceived availability, use, and barriers to the use of physical activity spaces among Chilean adults with and without disabilities, and estimated the association of disability with physical inactivity and with non-use of available spaces.

Cross-sectional analysis of the 2024 National Survey of Physical Activity and Sports Habits (ENAFyD), a probabilistic national sample of adults in Chile (n = 8,653). Self-reported disability was classified into mutually exclusive categories (sensory only, physical only, cognitive only, multiple types, other only, none) and cross-classified with perceived availability of spaces near the home, their use, reported barriers among non-users, and the survey physical activity index. Group differences were tested with weighted Poisson regression with robust variance, reported as crude prevalence ratios (PR) with 95% confidence intervals and p values; adjusted models included sex, age group, and socioeconomic status, selected a priori as confounders using a directed acyclic graph.

The weighted prevalence of disability was 9.3%. Perceived availability of spaces did not differ between groups (92.1% vs. 91.4%; crude PR 1.01; 95% CI 0.99-1.03; p = 0.478). However, among adults with available spaces, only 29.9% (95% CI 25.4-34.8) of those with disabilities used them, compared with 42.7% (40.8-44.6) of those without (crude PR for non-use 1.22; 1.16-1.29; p < 0.001). The largest differential barriers were distance or difficulty of access (14.0% vs. 7.7%; PR 1.82; 1.44-2.31) and lack of companionship (25.9% vs. 16.8%; PR 1.54; 1.31-1.80). In adjusted models, disability was associated with physical inactivity (PR 1.22; 1.11-1.33) and with non-use of available spaces (PR 1.14; 1.08-1.20), with the largest estimate among adults reporting multiple disability types (PR 1.47; 1.35-1.60).

In Chilean adults, the disability gap in physical activity is concentrated in the use of spaces rather than in their perceived availability, and access- and companionship-related barriers were more frequently reported by non-users with disabilities. Policies should prioritize the usability of existing spaces, through accessibility, safe access, and social support, alongside new construction.