Evolving disparities in exercise-related physical activity among Chinese children and adolescents: evidence from a national repeated cross-sectional analysis, 2014–2022

BackgroundGlobal studies show low levels of physical activity (PA) among children and adolescents, yet evidence on long-term national trends and subgroup disparities in China is limited. This study examined exercise-related PA trends among Chinese children and adolescents from 2014 to 2022 and explored temporal changes in subgroup disparities.MethodsA national repeated cross-sectional analysis was conducted using data from five waves (2014–2022) of the China Family Panel Studies (CFPS), including 16,223 observations from 7,982 children and adolescents aged 10–18 years. Exercise-related PA time was assessed using self-reported frequency and duration; ≥60 min/day was an exploratory threshold, not WHO guideline adherence. Survey-weighted descriptive statistics, categorical-wave comparisons, interaction tests, and age-adjusted logistic regression models examined overall trends and disparities by school level, gender, income, urban–rural residence, and region.ResultsBetween 2014 and 2018, unadjusted weighted average daily PA time among Chinese children and adolescents increased by 3.0 min/day (95% CI, 0.1, 6.0), although this small difference was not robust in sensitivity analyses. From 2020 to 2022, PA increased by 10.2 min/day (95% CI, 7.5, 12.9). Gender-based differences in PA remained consistently significant throughout, with boys being more active than girls. Gender differences varied by wave; regional variation was less consistent in sensitivity analyses. The primary analysis did not support changing disparities by school level, urban–rural residence, or income. Males, children from higher-income families, and urban residents had higher adjusted odds of reporting ≥60 min/day of exercise-related PA.ConclusionExercise-related PA among Chinese children and adolescents increased between 2020 and 2022. The questionnaire change in 2020 limits interpretation of the 2018–2020 difference. Targeted policies should continue to promote PA, especially for children from low-income families. Efforts should also consider demographic-specific strategies to address persistent inequalities in PA participation.