Pathways to play: Race, neighborhood safety, and other correlates of outdoor play in early childhood.

Outdoor play contributes to children's development and well-being, yet engagement in outdoor play has declined and there is some evidence of disparities in outdoor play across sociodemographic groups. This study examined individual, family, and community factors associated with outdoor play among children (3-5 years) in the United States. Using structural equation modeling, we analyzed cross-sectional data from 35,178 parents in the National Survey of Children's Health. Outdoor play was significantly negatively associated with race and ethnicity (Asian, Black or African American, Hispanic, and multiracial relative to non-Hispanic White children), urbanicity, household income, and screen time. It was positively associated with neighborhood safety, daycare usage, and child health. The racial and ethnic disparities were partly mediated by neighborhood safety and socioeconomic factors, although significant direct associations remained. Contrary to expectations, urbanicity did not moderate the association between income and outdoor play. These findings underscore the importance of multilevel influences on early childhood play. Future research should integrate neighborhood-level and surveillance data to better understand how safety, environmental hazards, and access contribute to disparities. Community-level interventions that reduce structural barriers and improve equitable access to safe outdoor spaces may increase outdoor play and support healthy child development.