{"doi":"10.64898/2025.12.16.25342402","title":"Place, Population, and Inequality: A Cross-Sectional National Analysis of Disparities in Neighborhood Physical Activity Environments Across the Urban–Rural Spectrum","abstract":"Objectives: Neighborhood physical activity environments (PAEs)-including walkability, recreational facilities, green space, and civic infrastructure-support active living and population health but are often inequitably distributed. This study examines racial/ethnic and socioeconomic disparities in neighborhood PAEs and assesses variation by urbanicity. Methods: We used population-weighted ordinary least squares regression models with county fixed effects using the latest available 2018 data from 69,889 census tracts in the contiguous United States. Models assessed associations between racial/ethnic and poverty composition and four PAE dimensions-built, physical facilities, natural, and social environments. Sensitivity analyses compared models with and without county fixed effects and population weighting. Urbanicity-stratified models examined disparities across urban, suburban, town, rural, and mixed settings. Results: Non-Hispanic White and low-poverty populations had greater access to PAEs across all domains, except that low-poverty populations lived in areas with lower walkability. Disparities were largest in urban and suburban areas. Rural high-poverty populations had more natural resources but less infrastructure and civic support. County-fixed effects reversed the walkability advantages for non-Hispanic Black observed in unadjusted models. Conclusions: PAE disparities disproportionately affect racial/ethnic minority and high-poverty populations, especially in urban areas. Findings support equity-focused, context-specific interventions for environmental justice in health policy.","journal":"medRxiv","year":2025,"id":585570,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9394,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":444100,"name":"Neng Wan","orcid":"0000-0001-8214-9164","position":1,"is_corresponding":false},{"id":391106,"name":"Ming Wen","orcid":"0000-0001-6397-3473","position":2,"is_corresponding":false},{"id":1421339,"name":"Ning Xiong","orcid":"0000-0003-3289-7919","position":0,"is_corresponding":true}],"reference_count":30,"raw_metadata":null,"created_at":"2026-07-19T02:59:24.273134Z","pmid":"41445608","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}