Physical activity, screen time and pediatric health-related quality of life in the Mississippi Delta


Background: The association of physical activity (PA) and screen time (ST) on health-related quality of life (HRQOL) among predominantly low-income children in the Mississippi Delta region has not been previously described. Methods: We performed a cross-sectional survey to assess health risks from a representative sample of the population ≥3 years old in the Delta Region of Arkansas, Louisiana, and Mississippi. Linear models were utilized to examine Pediatric Quality of Life Inventory (PedsQL) scores based on reported PA and ST. Results: Median age of the 371 participants was 9.8 years, 57% were African American, and 26% had annual household income ≤$14,999. Overall, 262 (75%) were categorized as physically active and 48% reported >2 hours ST per day. Children reporting exercising 5 - 7 days per week had significantly better PedsQL total score (84.3 vs 80.8; p < 0.05) and physical function subscale score (91.5 vs 85.6; p < 0.01) compared to inactive children. The relationship between PA and improved HRQOL was stronger among white children and children with total household income ≥$15,000. High ST (>2 hours per day) did not significantly impact HRQOL. Conclusions: Findings suggest that PA among children living in the Mississippi Delta was related to higher HRQOL; however, the positive effects of PA on HRQOL may be less for minority and low-income children.

Share and Cite:

Perry, T. , Moore, P. , Redwine, K. , Robbins, J. and Weber, J. (2012) Physical activity, screen time and pediatric health-related quality of life in the Mississippi Delta. Open Journal of Preventive Medicine, 2, 105-111. doi: 10.4236/ojpm.2012.21015.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Janssen, I. and Leblanc, A.G. (2010) Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. International Journal of Behavioral Nutrition and Physical Activity, 7, 40. doi:10.1186/1479-5868-7-40
[2] Bize, R., Johnson, J.A. and Plotnikoff, R.C. (2007) Physical activity level and health-related quality of life in the general adult population: A systematic review. Preventive Medicine, 45, 401-415. doi:10.1016/j.ypmed.2007.07.017
[3] Sagatun, A., Sogaard, A.J., Bjertness, E., Selmer, R. and Heyerdahl, S. (2007) The association between weekly hours of physical activity and mental health: A three-year follow-up study of 15-16-year-old students in the city of Oslo, Norway. BMC Public Health, 7, 155. doi:10.1186/1471-2458-7-155
[4] Sanchez-Lopez, M., Salcedo-Aguilar, F., Solera-Martinez, M., Moya-Martinez, P., Notario-Pacheco, B. and Martinez-Vizcaino, V. (2009) Physical activity and quality of life in schoolchildren aged 11 - 13 years of Cuenca, Spain. Scandinavian Journal of Medicine & Science in Sports, 19, 879-884. doi:10.1111/j.1600-0838.2008.00839.x
[5] Shoup, J.A., Gattshall, M., Dandamudi, P. and Estabrooks, P. (2008) Physical activity, quality of life, and weight status in overweight children. Quality of Life Research, 17, 407-412. doi:10.1007/s11136-008-9312-y
[6] US Department of Health and Human Services (2008) Physical activity guidelines for Americans.
[7] American Academy of Pediatrics (2001) Children, adolescents, and television. Pediatrics, 107, 423-426. doi:10.1542/peds.107.2.423
[8] Andersen, R.E., Crespo, C.J., Bartlett, S.J., Cheskin, L.J. and Pratt, M. (1998) Relationship of physical activity and television watching with body weight and level of fatness among children: Results from the Third National Health and Nutrition Examination Survey. Jama, 279, 938-942. doi:10.1001/jama.279.12.938
[9] Hardy, L.L., Denney-Wilson, E., Thrift, A.P., Okely, A.D, and Baur, L.A. (2010) Screen time and metabolic risk factors among adolescents. Archives of Pediatrics & Adolescent Medicine, 164, 643-649. doi:10.1001/archpediatrics.2010.88
[10] Pagani, L.S., Fitzpatrick, C., Barnett, T.A. and Dubow, E. (2010) Prospective associations between early childhood television exposure and academic, psychosocial, and physical well-being by middle childhood. Archives of Pediatrics & Adolescent Medicine, 164, 425-431. doi:10.1001/archpediatrics.2010.50
[11] Carlson, S.A., Fulton, J.E., Lee, S.M., Foley, J.T., Heitzler, C. and Huhman, M. (2010) Influence of limit-setting and participation in physical activity on youth screen time. Pediatrics, 126, e89-e96. doi:10.1542/peds.2009-3374
[12] (2004) Self-reported health of residents of the Mississippi Delta. Journal of Health Care for the Poor and Underserved, 15, 645-662. doi:10.1353/hpu.2004.0056
[13] Pearson, T.A. and Lewis, C. (1998) Rural epidemiology: Insights from a rural population laboratory. American Journal of Epidemiology, 148, 949-957.
[14] Smith, J., Lensing, S., Horton, J.A., et al. (1999) Prevalence of self-reported nutrition-related health problems in the lower Mississippi Delta. The American Journal of Public Health, 89, 1418-1421. doi:10.2105/AJPH.89.9.1418
[15] Centers for Disease Control and Prevention (2009) Estimated county-level prevalence of diabetes and obesity— United States, 2007. Morbidity and Mortality Weekly Report (MMWR), 58, 1259-1263.
[16] Champagne, C.M., Bogle, M.L., McGee, B.B., et al. (2004) Dietary intake in the lower Mississippi delta region: Results from the foods of our delta study. Journal of the American Dietetic Association, 104, 199-207. doi:10.1016/j.jada.2003.11.011
[17] Stuff, J.E., Casey, P.H., Szeto, K.L., et al. (2004) Household food insecurity is associated with adult health status. Journal of Nutrition, 134, 2330-2335.
[18] Casey, P.H., Szeto, K.L., Robbins, J.M., et al. (2005) Child health-related quality of life and household food security. Archives of Pediatrics & Adolescent Medicine, 159, 51-56. doi:10.1001/archpedi.159.1.51
[19] Varni, J.W., Seid, M. and Kurtin, P.S. (2001) PedsQL 4.0: Reliability and validity of the Pediatric Quality of Life Inventory version 4.0 generic core scales in healthy and patient populations. Medical Care, 39, 800-812. doi:10.1097/00005650-200108000-00006
[20] Varni, J.W., Limbers, C.A. and Burwinkle, T.M. (2007) Impaired health-related quality of life in children and adolescents with chronic conditions: A comparative analysis of 10 disease clusters and 33 disease categories/severities utilizing the PedsQL 4.0 Generic Core Scales. Health and Quality of Life Outcomes, 5, 43. doi:10.1186/1477-7525-5-43
[21] Eisenmann, J.C., Bartee, R.T. and Wang, M.Q. (2002) Physical activity, TV viewing, and weight in US youth: 1999 Youth Risk Behavior Survey. Obesity Research, 10, 379-385. doi:10.1038/oby.2002.52
[22] Kann, L., Kinchen, S.A., Williams, B.I., et al. (2000) Youth risk behavior surveillance—United States, 1999. MMWR Surveillance Summaries, 49, 1-32.
[23] Bickel, G., Nord, M., Price, C., Hamilton, W. and Cook, J. (2000) Measuring food security in the United States. Guide to measuring household food security. Alexandria, VA: US Department of Agriculture.
[24] Bogle, M., Stuff, J., Davis, L., et al. (2001) Validity of a telephone-administered 24-hour dietary recall in telephone and non-telephone households in the rural Lower Mississippi Delta region. Journal of the American Dietetic Association, 101, 216-222. doi:10.1016/S0002-8223(01)00056-6
[25] US Department of Agriculture ARS. Continuing survey of food intakes by individuals 1994-1996, 1998. CD-ROM (2000).
[26] Gordon-Larsen, P., Nelson, M.C., Page, P. and Popkin, B.M. (2006) Inequality in the built environment underlies key health disparities in physical activity and obesity. Pediatrics, 117, 417-424. doi:10.1542/peds.2005-0058
[27] Humbert, M.L., Chad, K.E., Spink, K.S., et al. (2006) Factors that influence physical activity participation among high- and low-SES youth. Qualitative Health Research, 16, 467-483. doi:10.1177/1049732305286051
[28] Gomez, J.E., Johnson, B.A., Selva, M. and Sallis, J.F. (2004) Violent crime and outdoor physical activity among inner-city youth. Preventive Medicine, 39, 876-881. doi:10.1016/j.ypmed.2004.03.019
[29] Babey, S.H., Hastert, T.A., Yu, H. and Brown, E.R. (2008) Physical activity among adolescents. When do parks matter? American Journal of Preventive Medicine, 34, 345-348. doi:10.1016/j.amepre.2008.01.020
[30] Tester, J.M. (2009) The built environment: Designing communities to promote physical activity in children. Pediatrics, 123, 1591-1598. doi:10.1542/peds.2009-0750
[31] Papakostas, G.I., Petersen, T., Mahal, Y., Mischoulon, D., Nierenberg, A.A. and Fava, M. (2004) Quality of life assessments in major depressive disorder: A review of the literature. General Hospital Psychiatry, 26, 13-17. doi:10.1016/j.genhosppsych.2003.07.004
[32] Sapin, C., Fantino, B., Nowicki, M.L. and Kind, P. (2004) Usefulness of EQ-5D in assessing health status in primary care patients with major depressive disorder. Health and Quality of Life Outcomes, 2, 20. doi:10.1186/1477-7525-2-20
[33] Sobocki, P., Ekman, M., Agren, H., et al. (2007) Health-related quality of life measured with EQ-5D in patients treated for depression in primary care. Value Health, 10, 153-160. doi:10.1111/j.1524-4733.2006.00162.x
[34] Salmon, J., Timperio, A., Telford, A., Carver, A. and Crawford, D. (2005) Association of family environment with children’s television viewing and with low level of physical activity. Obesity Research, 13, 1939-1951. doi:10.1038/oby.2005.239
[35] Brener, N.D., Kann, L., McManus, T., Kinchen, S.A., Sundberg, E.C. and Ross, J.G. (2002) Reliability of the 1999 youth risk behavior survey questionnaire. Journal of Adolescent Health, 31, 336-342.
[36] Brener, N.D., Kann, L., McManus, T., Kinchen, S.A., Sundberg, E.C. and Ross, J.G. (2002) Reliability of the 1999 youth risk behavior survey questionnaire. Journal of Adolescent Health, 31, 336-342. doi:10.1016/S1054-139X(02)00339-7

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.