Prevalence of insufficient daily physical activity and its association with health indicators among Chinese primary and secondary school students: a cross-sectional study

Objective Based on an epidemiological investigation of 2-h of daily physical activity among primary and secondary school students across China's seven major administrative regions, this study analyzes the association between social support and cognitive factors, thereby providing recommendations for policy formulation. Methods A cross-sectional study was conducted using random cluster sampling across seven Chinese administrative regions from May to July 2025. Data were collected using standardized scales measuring physical activity levels, achievement of the daily 2-h physical activity target, academic stress, and health cognition. Statistical analyses, including descriptive statistics, chi-square tests, and multivariable logistic regression, were performed using SPSS 26.0. Results (1) The prevalence of insufficient 2-h daily physical activity showed significant differences across various demographic variables (all p < 0.001). Higher prevalence rates were observed among students in rural areas (30.50%), private schools (29.41%), boarding students (30.03%), and those with lower frequency of reunions with parents. (2) Key risk factors identified included lack of health cognition, low perceived value of physical activity, lack of sports facilities, insufficient allocated physical education time, and lack of access to smart devices. (3) Significant urban-rural/regional disparities were found regarding access to smart devices ( t = 3.142, p = 0.002) and academic stress levels ( t = 2.499, p = 0.012). Conclusion Health cognition, resource availability, and time allocation are significant factors associated with the insufficiency of daily 2-h physical activity among Chinese primary and secondary school students. The education department has increased the guarantee of student system construction, and has implemented differentiated management for higher grades.