We aimed to investigate the association of the presence of public PA facilities near the household and participation in public programs of PA with leisure-time PA as well as whether income and educational level could moderate this association, using a nationally representative sample of Brazilian adults. Our main findings were that the presence of public PA facilities near the household and participation in public PA programs were associated with higher leisure-time PA among all quintiles of income and educational level. However, these associations were more pronounced among the lowest quintiles of educational level and income.
Our findings confirm that the presence of public PA facilities near the household and participation in public PA programs are associated with a higher leisure-time PA practice as reported in previous findings [12, 13, 18, 19]. Although both correlates were associated with higher leisure-time PA across all quintiles of income and educational level, the association was stronger in the lowest educational level group. These findings highlight that PA policies should be more decisive for PA promotion among the poorest as the opportunities for PA practice are lower in this group .
There are marked PA inequalities especially in the leisure-time domain, in which people with higher educational level and income present higher PA practice [7, 8]. In this sense, the increases in leisure-time PA levels over the years in Brazil is somewhat contrasting with the also increasing socioeconomic inequalities in the practice of leisure-time PA . Considering the context of inequalities in leisure-time PA and the more decisive role of public PA facilities and participation in public PA programs, it is noteworthy that a higher proportion of people in the highest quintile of educational level and income reported the presence of public PA facilities near the household. This finding is consistent with previous Brazilian finding  as well as from other countries  and underscore the urgent need to address disparity and inequality in presence of PA facilities in low-income areas and disadvantaged regions of Brazil.
Our findings highlight that the building and revitalization of public PA facilities such as parks and recreational centers for PA practice need to be prioritized in areas with lower socioeconomic development. Despite the association with PA, the proximity to public PA facilities could also be positive for well-being and quality of life . However, a frequent consequence of revitalization is the increasing gentrification and hygienisation in the surrounding areas, which could cause an urban displacement of people with lower socioeconomic conditions from the revitalized areas to areas without public facilities [23, 24]. Some actions could help to avoid gentrification, such as involving the community in the planning of the revitalizations as well as creating measures to avoid the real estate speculation throughout the surrounding areas .
Also, the expansion of community health programs for the stimulation of PA should be prioritized, especially in deprived areas. Although Brazil has a large program that includes PA professionals in primary health care (Multidisciplinary Primary Care Teams), the distribution of the units with PA interventions is unequal considering different geographical regions . The supervised PA promoted by the different programs already proved to be effective, even in highly deprived areas, such as in “favelas” [14, 27]. Also, both the building of public PA facilities and the stimulation of community health programs for the stimulation of PA should be taken together. For example, analyzing data from the same Brazilian National Survey (adjusting for the same confounders), participants living in areas with a public PA facility near the household were 268% (OR:3.69; 95%CI:3.03–4.50) more likely to participate in public PA programs, highlighting that most of the programs occurs in public PA facilities. In this sense, building PA facilities in more deprived regions would also contribute to the expansion and engagement of people with lower socioeconomic status in public PA programs. In addition, considering the difference observed between the frequency of public PA facilities, leisure-time PA and participation in public PA programs across categories of educational level and income, further investigations are needed in order to identify strategies to optimize the use of public PA facilities.
The strength of our study is including a large nationally representative sample of Brazilian adults with data on PA, proximity to public PA facilities, income and educational level. However, our findings should be inferred in light of possible limitations. First, our study has a cross-sectional design and causal relations should be avoided. Second, our findings were based on self-reported measures, which can present bias. Third, the levels of participation in public PA programs were considerably low, which is a reflection of the low coverage of health programs involving physical education professionals, which may have reduced the sampling power. However, up to the moment, there is no feasible method to estimate domains of PA in large population studies. Also, both perceived and objectively-assessed built environmental characteristics are associated with PA .
In conclusion, we found participation in public PA programs and presence of public PA facilities near the household to be associated with higher leisure-time PA and the associations are stronger in the group with lower educational level. Our findings suggest that presence of public PA facilities and participation in public PA programs are built environmental correlates that could be relevant for designing effective public health intervention for reducing social inequalities in leisure-time PA among adults in low-income areas of Brazil. Future studies should evaluate whether revitalization and the building of open spaces in areas of lower socioeconomic conditions could increase leisure-time PA among people with lower socioeconomic status.