Discussion
Among U.S. women of reproductive age, approximately one fourth reported leisure-time activity meeting both aerobic and muscle-strengthening physical activity guidelines during 2022 and 2024. These findings align with a CDC National Center for Health Statistics data brief that found that 28.7% and 22.7% of women aged 18–34 and 35–44, respectively, met both physical activity guidelines in 2020 (3). Although the national prevalence of meeting physical activity guidelines has increased in recent decades (4), this report’s estimates suggest that significant differences in level of leisure-time physical activity exist among women of reproductive age, with differences by race and ethnicity, age, and educational attainment. White women, younger women, and those with more educational attainment reported higher prevalences of engaging in sufficient or high moderate-to-vigorous aerobic physical activity, engaging in any muscle-strengthening physical activity, and meeting both physical activity guidelines. These findings are consistent with those from previous research findings that leisure-time physical activity participation is lower among Black and Hispanic adults than among White adults and among those with less educational attainment than among those with more educational attainment (4).
Some groups with lower leisure-time physical activity participation, including Hispanic and Black adults and those with less educational attainment, also experience higher rates of chronic disease–associated morbidity and mortality (5,6). Given that physical activity can help to prevent or mitigate chronic diseases (1), focused interventions that increase physical activity, particularly among these groups, could help reduce preventable differences in health outcomes.
Physical activity also has numerous maternal health benefits, including lowering risk of preeclampsia and gestational diabetes (1,2). Safely increasing physical activity among women of reproductive age could be an important strategy for improving these and other pregnancy-related outcomes, including reducing the length of labor and postpartum recovery (1,2). Evidence suggests most adults maintain or reduce leisure-time physical activity as they age; therefore, establishing physical activity habits during early adulthood might attenuate decreases later in life (7).
Approximately one half of women of reproductive age did not participate in any muscle-strengthening activities, highlighting opportunities to promote this beneficial activity. Approximately one in four women reported activity meeting aerobic physical activity guidelines only, whereas approximately one in 15 reported activity meeting muscle-strengthening physical activity guidelines only, suggesting that moderate-to-vigorous aerobic physical activity might be more accessible or prioritized over muscle-strengthening activity. This might be related to barriers specific to muscle-strengthening activity, such as accessing weights or resistance bands, knowing proper techniques, or social perceptions (8). Incorporating muscle-strengthening activity into existing aerobic physical activity programs might increase participation in muscle-strengthening activity.
In the United States, access to physical activity opportunities and resources varies, with marked differences in open space, safely walkable neighborhoods, group exercise opportunities, gym equipment, and resources (e.g., free time, childcare, and social support), necessitating health promotion strategies that consider social and structural factors (9,10). Active People, Healthy Nation, CDC’s national initiative to improve physical activity by 2027, promotes evidence-based strategies, including communications campaigns designed for different levels of educational attainment, to increase physical activity and address related differences in health outcomes. Tailored approaches (e.g., creating safe and convenient places for physical activity in underserved areas, including rural and low income counties, and developing walking groups or buddy systems (1)), might help address physical activity differences.
Limitations
The findings in this report are subject to at least three limitations. First, this cross-sectional study uses self-reported physical activity data, which are potentially subject to recall or social desirability bias. Second, NHIS asks about leisure-time physical activity only and does not account for other types (e.g., occupational physical activity), potentially underestimating participation in physical activity. Finally, smaller sample sizes, (e.g., among American Indian and Alaska Native women) might have limited statistical power to identify differences among groups. Reliability of estimates was not assessed, and some estimates might be unstable.
Implications for Public Health Practice
Nearly three fourths (74.9%) of U.S. women of reproductive age do not meet both physical activity guideline recommendations. Significant differences in meeting recommendations by race and ethnicity, age, and educational attainment underscore the value of addressing possible barriers to physical activity among specific groups, which could be an important strategy for improving health outcomes and reducing related differences in outcomes.
