Abstract
BackgroundSocial inequalities in health can be explained in part by the social patterning of leisure-time physical activity, such as non-participation in sports. This study is the first to explore whether absolute and relative educational inequalities in sporting inactivity among adults have changed in Germany since the early 2000s.MethodsData from four cross-sectional national health surveys conducted in 2003 (n = 6890), 2009 (n = 16,418), 2010 (n = 17,145) and 2012 (n = 13,744) were analysed. The study population was aged 25–69 years in each survey. Sporting inactivity was defined as no sports participation during the preceding 3 months. The regression-based Slope Index of Inequality (SII) and Relative Index of Inequality (RII) were calculated to estimate the extent of absolute and relative educational inequalities in sporting inactivity, respectively.ResultsSporting inactivity was consistently more prevalent in less-educated groups. The overall prevalence of sporting inactivity declined significantly over time. However, the decline was observed only in the high and medium education groups, while no change was observed in the low education group. Both absolute and relative educational inequalities in sporting inactivity were found to have widened significantly between 2003 (SII = 0.30, 95% CI = 0.25–0.35; RII = 2.08, 95% CI = 1.83–2.38) and 2012 (SII = 0.41, 95% CI = 0.37–0.45; RII = 3.44, 95% CI = 3.03–3.91). Interaction analysis showed that these increases in inequalities were larger in the younger population under the age of 50 than among the elderly.ConclusionsThe findings suggest that the gap in sports participation between adults with high and low educational attainment has widened in both absolute and relative terms because of an increase in sports participation among the better educated. Health-enhancing physical activity interventions specifically targeted to less-educated younger adults are needed to prevent future increases in social inequalities in health.
Highlights
Social inequalities in health can be explained in part by the social patterning of leisure-time physical activity, such as non-participation in sports
The decline in the crude sporting inactivity prevalence was observed only in the high and medium education groups, while there was no significant trend in men and women with low education
In summary, this study provides evidence that the prevalence of sporting inactivity declined in the German adult population between 2003 and 2012, but that the educational gap in sporting inactivity persisted and even widened during this period
Summary
Social inequalities in health can be explained in part by the social patterning of leisure-time physical activity, such as non-participation in sports. This study is the first to explore whether absolute and relative educational inequalities in sporting inactivity among adults have changed in Germany since the early 2000s. In Germany and most other European countries, a higher level of leisure-time physical activity including sports activity is associated with higher social position among adults [5,6,7,8]. Higher education can promote sports participation through several individual and social factors, such as self-efficacy, outcome expectancies, financial resources, social networks, and environmental conditions such as neighbourhood safety [10]. Educational differences in physical activities during leisure time, such as sports activity, have been found to partly explain social inequalities in health outcomes [11]. Narrowing the educational gap in health-enhancing physical inactivity has the potential to reduce social inequalities in health
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