Relationship between perceived neighborhood safety and physical activity among youth with a mental/emotional/behavioral condition

Background: Physical activity is an important part of promoting child health and development. Decreasing levels of physical activity among children is a growing public health concern as the prevalence of childhood obesity has increased. Children with mental/emotional/behavioral (MEB) conditions are a vulnerable population disproportionately affected by obesity. Perceived neighborhood safety is one factor that has been related to physical activity. Methods: Data from the 2007 National Survey of Children's Health were used to model the relationship of perceived neighborhood safety and presence of an MEB condition on the likelihood that a child met recommendations for adequate physical activity (≥ 3 days/week). Results: 18.8% of children aged 6-17 years had ever had an MEB condition, and were more likely than children with no history of an MEB condition to have inadequate physical activity (27.4% vs. 21.6%, p<0.0001) and live in a perceived unsafe neighborhood (83.5% vs. 87.1%, p=0.0003). After controlling for demographic factors in a weighted logistic regression model, there was an interaction effect between history of an MEB condition and neighborhood safety (p<0.0001). There was a significant difference by MEB status among children living in a safe neighborhood (aOR=1.6), but no difference among children living in an unsafe neighborhood. Conclusion: Safe communities can help support healthy behaviors. For children living in safe neighborhoods, the absence of MEB conditions was predictive of increased physical activity. Understanding the community context and its relationship to mental health is critical to the implementation of place-based interventions to have a widespread public health impact.