Associations Between Neighborhood Opportunity and Indicators of Physical Fitness for New York City Public School Youth.

Fewer than 1/4th of US children and adolescents meet physical activity (PA) guidelines, leading to health disparities that track into adulthood. Neighborhood opportunity may serve as a critical modifiable factor to improve fitness attainment and reduce these disparities. We drew data from the Child Opportunity Index to examine associations between neighborhood indicators of opportunity for PA and multiple fitness indicators among New York City public school youth. Multilevel generalized linear mixed models were used to estimate the overall and sex-stratified associations between neighborhood indicators (green space, healthy food, walkability, commute time) and indicators for physical fitness [curl-ups, push-ups, Progressive Aerobic Cardiovascular Endurance Run (PACER), sit-and-reach] using the New York City FITNESSGRAM data set. The analytic sample [ = 299,839; median (interquartile range) age = 16 (12-17)] was 50.1% female, 37.5% Hispanic, 26.2% non-Hispanic Black, and most (69.5%) qualified for free/reduced price school meals. Neighborhood indicators were positively associated with higher values of indicators for physical fitness. The strongest associations were observed between walkability and both BMI and PACER, and commute time with BMI, push-ups, and PACER. For example, walkability had the greatest magnitude of effects for BMI and muscular strength and endurance (BMI: : -0.75, 95% confidence interval, CI: -1.01 to -0.49; PACER: : 1.98, 95% CI: 1.59 to 2.37), and particularly for girls compared with boys (BMI, girls: : -0.91, 95% CI: -1.22 to -0.66); BMI, boys: : -0.56, 95% CI: -0.86 to -0.25); PACER, girls: : 2.11, 95% CI: 1.68 to 2.54; push-ups, boys: : 1.71, 95% CI: 1.31 to 2.12). Neighborhood indicators were associated with multiple measures of youth fitness. Continued research on neighborhood opportunity and youth fitness may better inform place-based public health interventions to reduce disparities.