Patterns of Physical Activity and Depressive Symptoms Among Korean Adults: A Descriptive Cross-Sectional Analysis of the 2023 Korea Community Health Survey

Abstract

Background/Objectives: Depression has increased substantially in Korea following the COVID-19 pandemic, with prevalence reaching 7.3% in 2023, the highest level in a decade, raising urgent concerns about widening mental health disparities. Although physical activity (PA) is associated with reduced depressive symptoms, nationally representative post-pandemic evidence from Korean adults remains limited. This study descriptively examined patterns of PA participation and depressive symptoms across key sociodemographic groups using 2023 Korea Community Health Survey (KCHS) data. Methods: We analyzed cross-sectional data from 228,249 adults aged ≥19 years in the 2023 KCHS. Depressive symptoms were measured using nine PHQ-9 items (1–4 on Likert scale). PA was assessed as the number of days per week (0–7) of moderate (MPA) and vigorous (VPA) physical activity according to KCHS operational definitions. All analyses incorporated complex survey features (strata, clusters, weights). Group differences were examined using design-corrected t-tests and ANOVA. Results: Women, adults aged 60 years or older, bereaved individuals, and those with lower educational attainment reported higher depressive symptom levels (p < 0.001). PA participation was higher among men, younger adults, married individuals, and those with higher education. Depressive symptom scores decreased with increasing PA frequency, with the lowest levels observed among adults active 5–7 days per week. Although mean differences were modest (0.02–0.12 points on the four-point scale; η2 < 0.06), these steady population-level gradients provide meaningful baseline information for understanding post-pandemic mental health patterns in Korea. Conclusions: Although individual-level differences were small (η2 < 0.06), the population-level gradients are important for monitoring mental health disparities in post-pandemic Korea. Women, older adults, bereaved individuals, and lower-education groups represent key high-burden populations. Future studies should employ longitudinal designs, objective PA measures, and confounder-adjusted models to clarify mechanisms and directionality, and evaluate the effectiveness of community-based PA interventions.