Neighborhood Social Determinants of Health Patterns and Youth Sports Participation: Evidence from the ABCD Study

PURPOSE: Participation in sports contributes substantially to children's physical health, psychological well-being, and cognitive development. Despite national initiatives to increase youth sports participation, inequities remain. Socioeconomic disadvantage, racial and ethnic minority status, and other social determinants of health (SDOH) are associated with lower engagement. However, most research addresses isolated factors rather than cumulative neighborhood-level SDOH. This study identified neighborhood SDOH profiles and examined their associations with sports participation. METHODS: Baseline data of 9400 children from 9 to 10 yr in the Adolescent Brain Cognitive Development Study were analyzed. Eighty-two neighborhood indicators spanning seven SDOH domains were aggregated into domain scores, with higher scores reflecting more advantaged conditions. Hierarchical agglomerative clustering identified neighborhood SDOH profiles. Associations between cluster membership and sports participation were examined using regression models adjusted for age, sex, race and ethnicity, parental education, and household income. Outcomes included the total number of sports and qualitative indices by sport skill type (open vs closed) and context (team vs individual). RESULTS: Four neighborhood profiles were identified, ranging from high affluence to urban high-risk environments. Children from disadvantaged clusters participated in fewer sports. Those in the most deprived neighborhoods played approximately 1.5 fewer sports than peers in affluent areas ( P < 0.01) and had reduced odds (open-skill or team sport participation odds ratios approximately 0.35-0.37, P < 0.01). Associations were attenuated after adjustment for individual- and family-level socioeconomic factors, with disparities remaining significant primarily in moderately advantaged and highly socioeconomically deprived neighborhoods. CONCLUSIONS: Distinct neighborhood social conditions are associated with differences in youth engagement in organized sports. These findings underscore the importance of considering structural and community-level factors when examining disparities in youth sports participation.