Family Car Ownership: Driving Inactivity in Young People? Cross-Sectional and Longitudinal Analyses in the International Children's Accelerometry Database

Background: Ubiquitous car ownership may affect children’s activity and health. We assessed the cross-sectional and longitudinal associations between household car ownership and children’s daily time spent sedentary (SED) and in moderate to vigorous physical activity (MVPA). Methods: Pooled cohort data were from the International Children’s Accelerometry Database. Outcome measures were average daily accelerometer-measured SED and MVPA (in minutes per day). Exposures were household car ownership (none, 1, and ≥2) and change in car ownership. Associations were examined using multivariable mixed-effects linear regression. Results: Mean age of participants (N = 4193) was 10.4 years (SD = 2.0), 53.4% were girls, and mean follow-up duration (N = 1333) was 3.3 years (SD = 1.1). Cross-sectionally, household car ownership was associated with higher SED (vs none: 1 car: β = 14.1 min/d, 95% CI, 6.7–21.5; ≥2 cars: 12.8, 95% CI, 5.3–20.4) and lower MVPA (vs none: 1 car: β = –8.8, 95% CI, −11.9 to −5.7; ≥2 cars: β = –8.8, 95% CI, −12.0 to −5.7). Associations were stronger in boys than girls and in children from lower socioeconomic backgrounds (SED only). Prospectively, there were no associations with increased car ownership. Reductions in household car ownership (of which 93.1% had ≥ 2 cars at baseline) were associated with a greater reduction in MVPA (vs no change: β = −8.4, 95% CI, −13.9 to −3.0) but not SED. Conclusions: Children in households with car access were more SED and less active than those without. Losing access to a second car was associated with greater decreases in MVPA, potentially related to losing access to activity-enabling environments. Reducing car access and use are important public health targets (eg, reducing air pollution), but their potential impact on children’s activity opportunities should be mitigated.