•The proportion of school-aged children and adolescents in China who engage in recommended levels of physical activity (PA), in or outside of school time, has been declining for decades.•Current PA promotion policies for Chinese schools are primarily "stand-alone" approaches and their efficacy appears limited.•Re-evaluating the problem from a comprehensive social-ecological perspective within a public health model offers greater potential for developing effective and culturally appropriate interventions to increase PA among Chinese youth.•If the goals of Healthy China 2030, including the prevention of the early onset of chronic diseases among Chinese children and adolescents, are to be met by reversing the trend of declining PA, careful consideration of this new paradigm is imperative.
© 2019 Published by Elsevier B.V. on behalf of Shanghai University of Sport.