Interplay between air pollution, built environment, and MVPA: Perceptions of children and youth in India

Background: Air pollution can limit participation in physical activity and exacerbate non-communicable disease risk; however, the relationship between child and youth perceptions of air pollution and moderate to vigorous physical activity (MVPA) are not fully understood in low and middle-income countries (LMICs).

Purpose: The objective of this study was to understand the relationship between child and youth perceptions of air pollution, built environment, and MVPA across rural and urban regions in India.

Methods: This cross-sectional, observational study was conducted during the Coronavirus disease lockdown in India in 2021. The study implemented a multi-stage stratified random sampling method involving urban and rural schools in five Indian states across 28 different cities and villages. Using Google Forms, children and youth (N=1042) self-reported information on various factors, including MVPA, and perception of air pollution and built environment. The sample was divided based on gender (male and female), geographic location (urban and rural), and age cohorts (5–10 years, 11–13 years, and 14–17 years), resulting in eight multiple linear regression models.

Results: After adjusting for age, gender, and location, a significant association was found between the perception of air pollution and MVPA levels. Similarly, the perception of a high crime rate was associated with lower MVPA levels.

Conclusions: These findings emphasize the importance of addressing air pollution and improving the built environment to facilitate outdoor active living among children and youth.

Practical Implications: Air pollution, in this age of climate emergency, is a significant challenge in LMICs. This is the first to investigate the association between child and youth perceptions of air pollution and MVPA in both urban and rural regions of India – an approach that can be replicated in other LMICs to develop active living policies that mitigate air pollution.

Funding: This research was supported by the Canada Research Chairs Program.