Geographic and Urban–Rural Differences in Walking for Leisure and Transportation

Published:October 18, 2018DOI:


      Walking can serve many purposes, such as transportation (to get some place) or leisure (for fun, relaxation, or exercise); therefore, it provides many opportunities for people to be physically active. This study examines geographic and urban–rural differences in walking in the U.S.


      Adult respondents (aged ≥18 years) to the 2015 National Health Interview Survey reported participation in and time spent (minutes per week) walking for transportation and leisure in the past week. In 2017, prevalence and time spent walking (among walkers) for any, leisure, and transportation walking were estimated by nine expanded regions and urban–rural designation.


      Prevalence of any walking ranged from 50.8% (East South Central) to 72.4% (Pacific); for leisure walking 43.9% (East South Central) to 60.6% (Pacific); and transportation walking 17.8% (East South Central) to 43.5% (New England). Among walkers, mean minutes spent walking per week ranged from 77.4 (East South Central) to 101.6 (Pacific); for leisure walking 70.5 (West South Central) to 85.9 (Mountain); and for transportation walking 47.4 (East South Central) to 66.4 (Middle Atlantic). Overall, there were urban–rural differences in prevalence of walking; however, differences depended on walking purpose and expanded region. Time spent walking was similar in urban and rural areas.


      Regional differences in walking prevalence and time spent walking exist. Urban–rural differences in prevalence of walking differ based on region and purpose; however, rural areas had a lower prevalence of walking than urban areas regardless of purpose in southern regions. Opportunities exist to improve walking, particularly among southern regions with a focus on rural areas.
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        • HHS
        2008 Physical Activity Guidelines for Americans.
        HHS, Washington, DC2008
        • Physical Activity Guidelines Advisory Committee
        Physical Activity Guidelines Advisory Committee Report.
        HHS, Washington, DC2008
      1. HHS. Healthy People 2020: Data 2020. Accessed July 13, 2017.

        • HHS
        Step It Up! The Surgeon General's Call to Action to Promote Walking and Walkable Communities.
        HHS, Office of the Surgeon General, Washington, DC2015
        • Morris JN
        • Hardman AE
        Walking to health.
        Sports Med. 1997; 23: 306-332
        • Paul P
        • Carlson SA
        • Carroll DD
        • Berrigan D
        • Fulton JE
        Walking for transportation and leisure among U.S. adults—National Health Interview Survey 2010.
        J Phys Act Health. 2015; 12: S62-S69
        • Kruger J
        • Ham SA
        • Berrigan D
        • Ballard-Barbash R
        Prevalence of transportation and leisure walking among U.S. adults.
        Prev Med. 2008; 47: 329-334
        • Lee C
        • Moudon AV
        Correlates of walking for transportation or recreation purposes.
        J Phys Act Health. 2006; 3: S77-S98
        • Tudor-Locke C
        • Ham SA
        Walking behaviors reported in the American Time Use Survey 2003–2005.
        J Phys Act Health. 2008; 5: 633-647
        • McKenzie B.
        Modes Less Traveled—Bicycling and Walking to Work in the United States: 2008–2012.
        U.S. Census Bureau, New York2014
        • Yang Y
        • Diez-Roux AV
        Walking distance by trip purpose and population subgroups.
        Am J Prev Med. 2012; 43: 11-19
        • Polzin S
        • Pisarski A
        Commuting in America 2013: The National Report on Commuting Patterns and Trends.
        American Association of State Highway and Transportation Officials, Washington, DC2015
        • U.S. Department of Transportation, Federal Highway Administration, 2009
        National Household Travel Survey.
        (Accessed May 4,)
        • Pucher J
        • Buehler R
        • Merom D
        • Bauman A
        Walking and cycling in the United States, 2001–2009: evidence from the National Household Travel Surveys.
        Am J Public Health. 2011; 101: S310-S317
        • Martin SL
        • Kirkner GJ
        • Mayo K
        • et al.
        Urban, rural, and regional variations in physical activity.
        J Rural Health. 2005; 21: 239-244
        • Reis JP
        • Bowles HR
        • Ainsworth BE
        • et al.
        Nonoccupational physical activity by degree of urbanization and U.S. geographic region.
        Med Sci Sports Exerc. 2004; 36: 2093-2098
        • Saelens BE
        • Sallis JF
        • Frank LD
        Environmental correlates of walking and cycling: findings from the transportation, urban design, and planning literatures.
        Ann Behav Med. 2003; 25: 80-91
        • Saelens BE
        • Handy SL
        Built environment correlates of walking: a review.
        Med Sci Sports Exerc. 2008; 40: S550-S566
        • Anderson TJ
        • Saman DM
        • Lipsky MS
        • Lutfiyya MN
        A cross-sectional study on health differences between rural and non-rural U.S. counties using the County Health Rankings.
        BMC Health Serv Res. 2015; 15: 441
        • Singh GK
        • Siahpush M
        Widening rural-urban disparities in life expectancy, U.S., 1969–2009.
        Am J Prev Med. 2014; 46: e19-e29
      2. Centers for Disease Control and Prevention (CDC), National Center for Health Statistics, 2015. Survey description, National Health Interview Survey. Documentation/NHIS/2015/srvydesc.pdf. Published 2016. Accessed July 13, 2017.

      3. Centers for Disease Control and Prevention (CDC), National Center for Health Statistics. National Health Interview Survey. Accessed July 17, 2017.

      4. U.S. Department of Commerce Economics and Statistics Administration, U.S. Census Bureau. Census Regions and Divisions of the United States. Published 2013.

        • Cohen RA
        • Martinez ME
        • Zammitti EP
        Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, 2015.
        National Center for Health Statistics, 2016
        • Holahan J
        • Buettgens M
        • Carroll C
        • Dorn S
        The cost and coverage implications of the ACA Medicaid expansion: national and state-by-state analysis.
        (Published 2012. Accessed September 25,)
        • Ratcliffe M
        • Burd C
        • Holder K
        • Fields A
        Defining rural at the U.S. Census Bureau: American Community Survey and Geography Brief.
        U.S. Department of Commerce Economics and Statistics Administration, U.S. Census Bureau, 2016
        • Go AS
        • Mozaffarian D
        • Roger VL
        • et al.
        Heart disease and stroke statistics–2014 update: a report from the American Heart Association.
        Circulation. 2014; 129: e28
        • Myers CA
        • Slack T
        • Martin CK
        • Broyles ST
        • Heymsfield SB
        Regional disparities in obesity prevalence in the United States: a spatial regime analysis.
        Obesity. 2015; 23: 481-487
        • Paul P
        • Carlson SA
        • Fulton JE
        Walking and the perception of neighborhood attributes among U.S. adults, 2012.
        J Phys Act Health. 2017; 14: 36-44
        • Whitfield GP
        • Carlson SA
        • Ussery EN
        • et al.
        Environmental supports for physical activity, National Health Interview Survey—2015.
        Am J Prev Med. 2018; 54: 294-298
        • Carlson SA
        • Paul P
        • Kumar G
        • et al.
        Prevalence of Complete Streets policies in U.S. municipalities.
        J Transp Health. 2017; 5: 142-150
        • Sugiyama T
        • Neuhaus M
        • Cole R
        • Giles-Corti B
        • Owen N
        Destination and route attributes associated with adults’ walking: a review.
        Med Sci Sports Exerc. 2012; 44: 1275-1286
        • Karsch H
        • Hedlund J
        • Tison J
        • Leaf W
        Review of studies on pedestrian and bicyclist safety, 1991–2007 (Report No. DOT HS 811 614).
        National Highway Traffic Safety Administration, Washington, DC2012
        • Carlson SA
        • Watson KB
        • Paul P
        • Schmid TL
        • Fulton JE
        Understanding the demographic differences in neighborhood walking supports.
        J Phys Act Health. 2017; 14: 253-264
        • Boone-Heinonen J
        • Gordon-Larsen P
        • Guilkey DK
        • Jacobs DRJr
        Popkin BM. Environment and physical activity dynamics: the role of residential self-selection.
        Psychol Sport Exerc. 2011; 12: 54-60
        • Myers D.
        Peak millennials: three reinforcing cycles that amplify the rise and fall of urban concentration by millennials.
        Hous Policy Debate. 2016; 26: 928-947
      5. U.S. Department of Transportation, Federal Highway Administration. Small Town and Rural Multimodal Networks; 2016.

        • National Physical Activity Society
        Stories from Small Towns: America Paves the Way for Connected Citizens, Health, and Town Pride.Atlanta, GA;.
        • Loh TH
        • Walljasper J
        • Sonenklar D
        • Mills K
        • Levinger D
        Active Transportation Beyond Urban Centers: Walking and Bicycling in Small Towns and Rural America.
        Rails-to-Trails Conservancy, Washington, DC2012