Rate of physical activity and community health: Evidence from U.S. counties

Background: Although previous studies supported the health benefits of physical activity, these studies were limited to individual-level research designs. Building upon a social-ecological model, we examined the relationship between physical activity and community health-the health status of a defined group of people-while accounting for the potential endogeneity of physical activity to health. Methods: We obtained U.S. county-level data from the 2012 Behavioral Risk Factor Surveillance System survey and the 2014 County Health Ranking Database. We first conducted an ordinary least squares (OLS) regression analysis to examine the relationship between the rate of physical activity and community health measured by the average perceived health score for each county. We then conducted a 2-stage least squares (2SLS) regression analysis to investigate this relationship after accounting for potential endogeneity. Results: Results from the OLS analysis indicated that the rate of physical activity was positively associated with community health. Results from the 2SLS analysis confirmed that the physical activity rate remained positively associated with community health. Conclusions: In line with the social-ecological model, our findings provide the first evidence for the health benefits of county-level physical activity. Our results support extant research that has shown relationships between physical activity and individual-level, health-related outcomes.