Abstract
Background/aims: Physical activity plays a critical role in preventing non-communicable diseases (NCDs), yet disparities persist across populations. In Indonesia, rapid urbanization may contribute to differences in physical activity patterns between rural and urban residents.
Objective: This study aimed to examine the association between rural–urban residence and levels of vigorous and moderate physical activity among Indonesian adults using nationally representative data.
Methods: A cross-sectional study was conducted using data from the 2023 Indonesia Health Survey (SKI), involving 711,286 respondents aged ≥15 years. Physical activity was categorized into vigorous and moderate levels. Data were analyzed using chi-square tests and multivariable logistic regression to estimate crude and adjusted odds ratios (OR) with 95% confidence intervals (CI), controlling for age, sex, education, occupation, and wealth index.
Results: Rural residents were more likely to engage in vigorous physical activity compared to urban residents (52.9% vs. 47.1%; OR = 0.685; 95% CI: 0.678–0.692; p < 0.001). After adjustment, urban residence remained negatively associated with vigorous activity (AOR = 0.72; 95% CI: 0.70–0.74). Conversely, urban residents were slightly more likely to engage in moderate activity (AOR = 1.05; 95% CI: 1.03–1.07). These findings indicate a shift from occupational to lifestyle-based activity in urban populations.
Conclusion: Significant rural–urban disparities in physical activity persist in Indonesia. Urban populations are less engaged in vigorous activity, highlighting the need for targeted public health interventions. Policies promoting active urban living—such as improving access to green spaces, supporting active transportation, and encouraging community-based exercise programs—are essential to reduce physical inactivity and mitigate the growing burden of NCDs.

Key words: Heavy Physical Activity; Moderate Physical Activity; Rural/urban; SKI 2023