The study by the Saskatoon Health Region says only 16.4 per cent of Grade 5 to 8 students are getting the optimal amount of physical activity.
But when broken down by neighbourhood, students at low-income schools came in at a dismal 6.3 per cent.
The study also says rural schools need to include a focus on the negative effects of drinking.
It found that students in rural areas reported they had tried drinking more frequently than all low, middle or upper income children in the city.
The findings are based on responses from 4,314 students in city schools and 1,469 students from rural Saskatoon in the winter and spring of 2011.