Government support, community recreation facilities and physical activity in China: a cross-sectional socio-ecological analysis

Background: In the context of rising non-communicable diseases (NCDs) Chinese authorities emphasise the need for local governments to provide public sports services to support physical activity. Methods: Employing a socio-ecological theoretical framework, and drawing on a hierarchical dataset synthesised from the China Health and Nutrition Survey (CHNS),China Stock Market & Accounting Research Database (CSMAR) and Wind Financial Terminal from 2015, multi-level analysis of the association between provincial government expenditure on culture, sports and media from 12 provinces, the recreation facilities provided by 287 communities and physical activity of n= 10,305 individuals is explored. The number of, and time allocated to, physical activities undertaken as well as their METs equivalent in relation to World Health Organisation (WHO) guidelines are investigated. Results: Controlling for a large set of individual confounders, the results show community recreation facilities and provincial government expenditure have a significant positive association with physical activity participation that exceeds health guidelines. Conclusions: The results confirm the importance of government support for sport, and the provision of community sport and physical activity facilities in China. This has implications for public health policy generally including in the Western context. It remains however, that the cultural context of engagement also needs further consideration.