Walking for recreation and transport in urban and rural South Australian adults

Background: Physical activity participation is poor in people living in rural areas compared to their urban counterparts. Walking is an effective way of achieving the recommended levels of physical activity. Transport and recreational walking participation may differ between urban and rural settings and we need to better understand these differences to develop effective strategies for increasing participation.
Aim: This study aimed to describe the differences in recreational and transport walking between urban and rural/remote South Australia.
Methods: Data were collected using a computer-assisted telephone interview from randomly selected adults aged ≤18 years. Respondents were asked to report the number of times and minutes walked in a week for recreation or transport. Area of residence was stratified using Accessibility/Remoteness Index of Australia regions (major city, inner regional, outer regional and remote/very remote). Data were analysed using negative binomial regression controlling for socioeconomic status, age and body mass index.
Results: Of the N=4004 respondents, average age was 47.8 ± 18.5 years, 51.1% were female, 70.9% lived in the major city, 14.6% in Inner Regional, 10.8% in Outer Regional and 3.6% in remote/very remote areas. Overall 38.7% of respondents reported no recreational walking and 47.5% reported no transport walking. For recreation walking, relative to major city, the number of times walked was lower for only remote/very remote residents (IRR 0.74 [95%CI 0.59-0.92] p<0.01). When analysed by sex, this difference was only observed for men (IRR 0.538 [95%CI 0.39-0.73] p<0.001). For transport walking, relative to major city, the number of times walked was less for inner regional (IRR 0.74 [95%CI 0.67-0.85, p<0.001) and outer regional (IRR 0.64 [95%CI 0.56-0.74] p<0.001) only. These differences were seen in men and women.
Conclusion: A high proportion of respondents reported no walking for recreation or transport and differences between urban and regional populations were observed, particularly for transport walking. Area of residence did not play a role in recreational walking participation for women, which may be a reflection of more active employment roles for men in rural areas. Physical activity participation in rural areas is complex and more research is needed to understand this populations needs.