Lifestyle behaviors affect health at the individual and community levels. Physical activity, cessation of smoking and alcohol consumption, and dietary control improve health1. Physical activity refers to all movements that require energy consumption by skeletal muscles, including occupational and housekeeping activities, commuting, and leisure activities such as play2,3. A lack of physical activity causes obesity and chronic diseases, including cardiovascular disease, high blood pressure, type 2 diabetes, osteoporosis, and certain cancers3–5. Physical inactivity is associated with chronic diseases such as hypertension, diabetes, hyperlipidemia, and metabolic syndrome3–5. Today, although the need for physical activity is recognized, opportunities are decreasing given the increasing urbanization of modern society3.
The US Centers for Disease Control in the “Guide to Community Preventive Services” recommend increasing accessibility to exercise spaces to enhance physical activity6. In Korea, the Ministry of Health and Welfare in the “Physical Activity Guide for Koreans” recommends appropriate physical activity throughout the life cycle7. Moderate physical activity refers to an activity performed at 3.0–to 5.9-fold higher-than-resting intensity; such activity generally scores 5–6 when activities are scored from 1 to 10. Regular moderate physical activity improves the musculoskeletal, cardiovascular, respiratory, and endocrine systems, affording many health benefits8. According to the Organization for Economic Cooperation and Development report of 2017, the average rate of moderate physical activity in OECD countries in 2016 was 66.5%9; the value published by Statistics Korea was 47.8%10. However, that rate decreased to 57.1% in 2014, 51.0% in 2015, and 47.8% in 201610.
Social ecological theory suggests that participation in physical activity is influenced by personal characteristics, as well as the compositional, social, and natural environments11–15. In particular, physical activity during leisure time can be affected by geographic location, socioeconomic status, the natural environment, cost, and accessibility16–22. Accessibility is influenced principally by “distance”, “time”, and “quantity”, all of which determine the type of exercise23–26. The greater the accessibility to sports facilities in residential areas, the higher the participation in physical activity; awareness of exercise facilities differs according to the extent of individual physical activity27,28. In addition, personal traits, such as a positive attitude toward exercise, influenced participation in physical activity29.
Recent studies indicated that “accessibility” in general influences physical activity, thus not only the objective accessibility to public sports facilities28. In addition, the general characteristics and subjective perceptions of the built environment significantly influenced physical activity; such activity varied by the socioeconomic status of the residents30,31. Although various authors have explored the associations among the perception, accessibility, and the physical activities of sports facilities, few have evaluated how personal perceptions of exercise facility accessibility affect moderate physical activity in Korea. Accordingly, we examined the association between accessibility to exercise facilities and moderate physical activity using national community health survey data from Korea.