Abstract
BackgroundUnderstanding socioeconomic disparities in physical activity is important, given its contribution to overall population-wide health and to health disparities. Existing studies examining trends in these disparities have focused exclusively on physical activity during leisure-time and have not investigated the potential moderators of socioeconomic disparities in physical activity. Using self-reported data from the US National Health and Nutrition Examination Survey (NHANES) 2007 to 2016 for 29,039 adults aged 20 years and over we examined education-related disparities in overall (total) moderate-to-vigorous intensity physical activity, and in its sub-components, recreational (leisure-time) and non-recreational (active transportation and work) activity. We also examined if education-related disparities in physical activity were moderated by age, gender, and race/ethnicity.MethodsLogistic regression models were used to evaluate disparities in physical activity according to education group and their moderation across age, gender, race/ethnicity, and time-period.ResultsOverall activity levels (% ≥150 min/week) were highest amongst highly educated adults, yet contrasting education-related disparities were found for recreational and non-recreational activities (active transportation and work), favoring the highest- and lowest-educated groups respectively. Within each domain of activity, associations were moderated by age and race/ethnicity, and by gender for work-based activity. The net result was that education-related disparities in total activity were substantially larger in older adults (P < 0.001) and amongst women (P < 0.001). For example, the estimated difference in the probability of being active in the highest versus the lowest educational groups was 23.1% (95% CI: 19.1, 27.2) amongst those aged ≥60 years, yet 10.8% (95% CI: 7.1, 14.6) amongst those aged 20–39.ConclusionsEducation-related disparities in physical activity persisted from 2007 to 2016. Our results suggest that understanding and addressing these disparities requires assessment of their multiple domains, and identification of the demographic sub-groups for which the disparities are more or less pronounced.
Highlights
Understanding socioeconomic disparities in physical activity is important, given its contribution to overall population-wide health and to health disparities
Age, gender and race/ethnicity were strongly associated with highest educational attainment: the proportion of adults achieving some college / associate degree or higher was lowest amongst older adults, and was highest amongst women and Non-Hispanic whites (P for χ2-tests all < 0.001; see Additional file 1)
Leisure-time The proportion of adults categorized as active (≥150 min/week) in the leisure-time domain differed by age, gender and race/ethnicity: activity levels were highest amongst younger adults, men, and Non-Hispanic whites (P for χ2-tests all < 0.001; see Additional file 2)
Summary
Understanding socioeconomic disparities in physical activity is important, given its contribution to overall population-wide health and to health disparities. Existing studies examining trends in these disparities have focused exclusively on physical activity during leisure-time and have not investigated the potential moderators of socioeconomic disparities in physical activity. We examined if education-related disparities in physical activity were moderated by age, gender, and race/ethnicity. Gender, and race/ethnicity arguably represent the most important non-modifiable characteristics that may moderate socioeconomic disparities in physical activity, and understanding this may be informative for policy development. It is unknown whether any moderation of socioeconomic disparities in physical activity has changed over the last decade
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