Geospatial and Sociodemographic Variability in Youth Sport Participation: 2021–2022 National Survey of Children’s Health

PURPOSE: This cross-sectional study used data from the 2021-2022 National Survey of Children's Health to examine the sociodemographic characteristics associated with youth sport (YS) participation in the United States by state among youth 6 to 17 yr of age. The study also examined state-level associations between YS participation and meeting physical activity (PA) guidelines. METHODS: A logistic regression model evaluated the associations of sociodemographic characteristics of age, sex, race/ethnicity, household income, special healthcare needs (SHCN) status, and health insurance type with YS participation by state. Rao-Scott chi-square tests computed by state determined whether YS participation was associated with meeting PA guidelines. RESULTS: The analytic sample included 64,535 youth. Approximately 51% reported past-year YS participation (range = 39.8%-64.6% across states). Household income was significantly associated with YS participation for 43 states. Youth from lower-income households had lower odds of participating in sport than youth from higher-income households (odds ratio range = 0.24-0.49). In 35 states, youth with SHCN had lower odds of participating in sport than youth without SHCN (odds ratio range = 0.35-0.72). Race/ethnicity and age were significantly associated with YS participation in 13 and 7 states, respectively, and the sociodemographic subgroups more likely to participate varied by geographic location. YS participation was significantly associated with meeting PA guidelines in 20 states. CONCLUSIONS: YS is a critical developmental setting for youth. Youth with lower incomes and SHCN were consistently less likely to participate in sport than their peers. Associations between other sociodemographic characteristics (e.g., race/ethnicity) and YS participation varied geospatially, highlighting the need for state-specific approaches to improve YS so that all youth have opportunities to participate.