The Play Deficit: Public Health’s Untold Crisis

I am sitting on a patch of grass under a massive weeping willow. My friends and I are intricately braiding fallen branches, creating what will soon become a crown. We begin sectioning off the hanging branches, creating rooms in our castle. No sooner does the game begin than we emerge from under the tree hand in hand, laughing and running toward our next adventure.

–me, age 7


Does this type of play still exist for children? Can you imagine childhood without opportunities to play? Many of the adults I encounter speak fondly of their childhoods and recall play as a key component of their lives. So why is it that we adults quickly sacrifice children’s opportunities to play in the name of achievement, safety, or changing times?

The health of a society should be measured by the health of its play. The play of a healthy society should be rich and varied: imaginative, dramatic, physical, cooperative, solitary. Children—in urban, suburban, and rural areas—should have ample and easy access to safe and stimulating outdoor play spaces: creeks, woods, adventure playgrounds, pocket parks. Caregivers and parents should feel comfortable allowing children the time, independence, and freedom to play in their neighborhoods. Kids should be safe playing outside. Play should be afforded the same importance as math and reading, valued as truly integral to curriculum, as the foundation of learning. Cities, neighborhoods, and housing should be designed to support and sustain play throughout the life span.


This post is the first in a new series of posts from Danielle Marshall of KaBOOM!  In coming months, Danielle will be exploring other issues related to the Play Deficit and its impact on health and public policy.


A playful society is filled with problem-solving, resiliency, communication, and exploration of acceptable boundaries and risk. Play promotes all these faculties, and more. For those who believe play is a luxury, I urge them to consider their own childhoods. As children, we changed the rules of a game midstride; we negotiated who would play the role of Mommy, Daddy, or the family pet; we spent days running, jumping, and climbing, engaging our bodies in a series of escalating challenges. While hard at play, we unwittingly built the cognitive, social-emotional, and physical skills which continued to support us as we made the transition to adulthood.

Yet, a current Play Deficit exists. It is the very real decline in child-driven, unstructured play in U.S. society, and it has critical implications for the physical and developmental health of children and adolescents as well as the health of communities. Signs of the Play Deficit can be found almost everywhere.

Recess minutes are shrinking in many American schools, a frequent consequence of intense focus on high-stakes school testing. One-fifth of schools do not provide regular recess to students in all grades (1), and students in low-income or high-minority enrollment schools are disproportionately affected. Schools with over 75 percent of students on free or reduced lunch receive, on average, 19.75 minutes of recess each day, and schools with over 50 percent minority enrollment receive, on average, 21.8 minutes of recess. Compare this to the almost 30 minutes daily in schools with less than 6 percent minority enrollment and less than 35 percent of students on free or reduced lunch, and the disparity becomes remarkably clear (2). This would be less troubling if children were freely playing more outside of school—at home, in neighborhoods, in recreation centers, in front yards, at parks, in nearby streams and woods. But they aren’t.

Children’s media usage has soared in the past two decades, with the average American child engaging in 7 hours 38 minutes of media use each day (3). At the same time, the American Academy of Pediatrics recommends that children under the age of two avoid screen media entirely and that older children limit it. Birth to 24 months is the period during which the human brain conducts most of its development in response to environmental stimuli, and according to Zero to Three: The National Center for Infants, Toddlers, and Families, “brain development is ‘activity-dependent,’ meaning that the electrical activity in every circuit—sensory, motor, emotional, cognitive—shapes the way that circuit gets put together.” (4) Screen time drastically reduces engagement in those activities—such as talking, playing, dancing, singing—that promote neural development.

Furthermore, older children’s out-of-school time increasingly is structured in a trend termed the “professionalization of parenting” by Dr. Kenneth Ginsburg. This is not to say that organized activities have no place nor benefit in a child’s life, but growing emphasis on packing children’s schedules with music lessons, sports clinics, and arts classes detracts from critical downtime for parent-child interaction and free play, possibly contributing to stress and anxiety in the lives of highly-scheduled children and families. Parents themselves are barraged by messages that “good” parenting includes rigorous and early preparation for children’s higher education, reinforcing the expectation that “successful” parenting involves a variety of scheduled extracurricular activities.

This is paired with drastically diminished “freedom to roam” for today’s children. A study conducted by Dr. Lia Karsten in Amsterdam in 2003, which realistically can be compared to trends noted among American youth, revealed that children’s range to roam had been severely restricted since the 1950s and experienced more parental constraints (5). Among factors contributing to this restricted range are parental perceptions of safety. Whether real or imagined, such perceptions boast consequences, one of which is less time engaged in free outdoor play. Likewise, real documented safety concerns exist in certain communities due to violence or environmental factors. Lack of access to safe play spaces—whether it take the form of neighborhood violence, lack of sidewalks and walkability, or old or unsafe equipment—create barriers to play. All too often, as is the case with access to health care, socioeconomic equity of access to play does not exist. The nation’s poorest are often the most negatively impacted, the most likely to be shortchanged in this respect, too.

We are doing our society an injustice. The benefits of play far outweigh any advantage created by reducing children’s time and access to play. Research focused on play behavior in animals reveals “a strong positive link between brain size and playfulness.” (6) Play can be therapeutic, is linked to healing processes, and helps children cope with traumas such as war and natural disaster (7). The reverse? Rising diagnosis of attention and mental disorders, rising obesity rates, skyrocketing obesity-related health problems, increases in stress and anxiety, increases in bullying and aggression. Sound familiar?

So where do we go from here? If we allow the decline of play to continue, we will encounter ramifications on a far greater scale. In addition to rising rates of obesity and type 2 diabetes, as well as behavioral challenges in the classroom, play deprivation has been linked to atypical social behavior. Research completed by Dr. Stuart Brown concluded that a lack of play or abnormal play was a feature in the childhoods of 90 percent of convicted murderers profiled (8). Lack of Play is a thread woven through contemporary society, with repercussions that follow suit. Decisions made within families, within communities, by governments, in schools, in the medical and public health communities, and amongst legislators affect the state of play, which in turn affects the state of people.

I certainly don’t want to imply that we’re creating a nation of murderers, but the implications of a play-free world are truly troubling. Luckily, a growing coalition of organizations and people recognize the importance of play to public health, not just physical health but mental health and well-being. Innovative solutions are implemented or advanced every day by community advocates who rally to create city task forces on play, joint-use agreements between school districts and parks departments, cities that close down streets for play, pediatricians who prescribe play for a host of ailments, housing authorities that integrate play-friendly design, principals who incorporate increased play breaks and recess into daily school life, and citizens who demand access to safe play spaces and who join forces to create access or spaces where none exist.

The typical American childhood has radically changed, often to the detriment of children and society. In upcoming posts, I will chronicle innovative thinkers and initiatives that are using play to catalyze positive change. I invite you to shape the conversation surrounding play’s relationship to public health and to share your experiences and opinions about why play matters to the health and well-being of our society.


1) School Health Policies and Program Studies (October 2007). Physical Activity. Retrieved October 28, 2010, from
2) National Center for Education Statistics, Fast Response Survey System (FRSS) (2005). Foods and Physical Activity in Public Elementary Schools: 2005. FRSS 87. U.S. Department of Education.
3) Rideout, Foehr, and Roberts (2010). Generation M2: Media in the Lives of 8- to 18-Year-Olds. Kaiser Family Foundation.
4) Zero to Three: National Center for Infants, Toddlers, and Families (n.d.). Retrieved October 30, 2010, from
5) Karsten, L. (2005). It All Used to be Better? Different Generations on Continuity and Change in Urban Children’s Daily Use of Space. Children’s Geographies, 3 (3), 275-290.
6) Furlow, Bryant (2001, June). Play’s the Thing. New Scientist. 2294.
7) Frost, J. (2005). Lessons from disasters: Play, work and the creative arts. Childhood Education, 82, 2-7.
8) Brown, Stuart (2009). Play: How It Shapes the Brain, Opens the Imagination, and Invigorates the Soul. New York: Penguin.


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Director of Community Engagement, KaBOOM!