What are the determinants of physical activity for people in the Southern region?

Adequate physical activity is a major contributor to a healthy living and prolonging life. The disparity in physical activity (PA) remains varied across the geographic areas, with the highest inactivity in South. To reduce the disparity, it needs to investigate the specific details of factors that each region faces. Objectives: determine the individual and environmental determinants of PA for people in the southern area. Method: data from 2007 BRFSS was obtained and linked with external environmental data sources from US Census Bureau, USDA, and NORSIS databases. A two-level logistic regression was analyzed. Outcome variable is meeting PA (yes / no). Individual-level variables include demographic, socio-economic, lifestyle, and health status. Environmental-level variables as a county scale include physical activity built environments (the combination of resources availability per capita of local facilities, green areas, and outdoor activities), socio-economic contexts, natural amenity, crime rate, and the level of urbanization. Results: At the individual level, White, male, consuming more fruits and vegetables, more satisfied with life, higher income, higher education, better health, and younger are significantly positive with meeting PA. At the county level, built environments, natural amenity, and percentage of people with higher education are significantly positive with the meeting PA. Cross-level interaction effect reveal that the association between built environments and PA is significantly decreased for people with low education compared to those with high education. To promote PA for people in the Southern area, this study emphasizes that promoting physical activity built environments and supporting education to the residents need to be accomplished.