Movement inequities: How Race, Class, and Gender Shape Access and Participation in Sport and Rehabilitation

Physical activity is a critical component of health and longevity, yet access to high-quality movement experiences, through sport, in early childhood and adolescence is unevenly distributed across social groups [1,2]. For girls and women – particularly those with marginalized race, class, and gender identities – early inequities in physical activity contribute to physical and psychosocial disparities later in life [3-5]. Using an intersectional approach, we identify who is allowed to participate in sport and thus who has increased opportunities to develop physical literacy. Lower rates of physical activity among girls leads to increased risk for developing low bone density, cardiovascular disease, musculoskeletal injuries, and chronic pain as women age [6,7]. Girls and women of color, in particular, are less likely to meet recommended physical activity levels, putting them at increased risk for sedentary-related cardiometabolic conditions [8]. Many girls and women from socioeconomically disadvantaged communities are also less likely to access necessary rehabilitative care [9]. Psychosocial consequences associated with physical inactivity (e.g., depression, reduced social connection, impaired cognitive functioning, elevated stress vulnerability) further compound these health disparities [10,11]. As such, we argue that inequitable access to physical activity, through sport, functions as one upstream determinant of health and highlights the need for early intervention. Ensuring that all girls and women have meaningful opportunities to move is essential to improving health outcomes across the lifespan. Fewer childhood and early adolescence movement experiences can influence the prevalence and severity of conditions and responsiveness to treatment in adulthood. We offer evidence-based strategies for practitioners to reframe physical activity and exercise through sport access as a rehabilitation and health equity priorities.