Geographical Variations in the Environmental Determinants of Physical Inactivity among U.S. Adults.

Ruopeng An,Xinye Li,Ning Jiang

doi:10.3390/ijerph14111326

Abstract

Physical inactivity is a major modifiable risk factor for morbidity, disability and premature mortality worldwide. This study assessed the geographical variations in the impact of environmental quality on physical inactivity among U.S. adults. Data on county-level prevalence of leisure-time physical inactivity came from the Behavioral Risk Factor Surveillance System. County environment was measured by the Environmental Quality Index (EQI), a comprehensive index of environmental conditions that affect human health. The overall EQI consists of five subdomains—air, water, land, social, and built environment. Geographically weighted regressions (GWRs) were performed to estimate and map county-specific impact of overall EQI and its five subdomains on physical inactivity prevalence. The prevalence of leisure-time physical inactivity among U.S. counties was 25% in 2005. On average, one standard deviation decrease in the overall EQI was associated with an increase in county-level prevalence of leisure-time physical inactivity by nearly 1%. However, substantial geographical variations in the estimated environmental determinants of physical inactivity were present. The estimated changes of county-level prevalence of leisure-time physical inactivity resulted from one standard deviation decrease of the overall EQI ranged from an increase of over 3% to a decrease of nearly 2% across U.S. counties. Analogous, the estimated changes of county-level prevalence of leisure-time physical inactivity resulted from one standard deviation decrease of the EQI air, water, land, social, and built environment subdomains ranged from an increase of 2.6%, 1.5%, 2.9%, 3.3%, and 1.7% to a decrease of 2.9%, 1.4%, 2.4%, 2.4%, and 0.8% across U.S. counties, respectively. Given the substantial heterogeneities in the environmental determinants of physical inactivity, locally customized physical activity interventions are warranted to address the most concerning area-specific environmental issue.

Highlights

Physical inactivity is a major modifiable risk factor for morbidity, disability and premature mortality worldwide [1]
Data on county-level prevalence of leisure-time physical inactivity came from the Centers for Disease Control and Prevention (CDC)’s County Data Indicators (CDIs) [9]
The estimated changes of county-level prevalence of leisure-time physical inactivity resulted from one standard deviation decrease of the overall Environmental Quality Index (EQI) ranged from an increase of over 3% to a decrease of nearly 2% across U.S counties (Table 4)

Summary

Introduction

Physical inactivity is a major modifiable risk factor for morbidity, disability and premature mortality worldwide [1]. Physical activity promotion serves as a key public health strategy [2]. Four in five American adults fail to meet guidelines-recommended physical activity levels [3]. While traditional perspective mainly blamed individuals themselves for their sedentary lifestyle, increasing attention has been shifted to the environmental determinants of health behavior—how political, economic, ecological, and social contexts in which people are born, live, work and age impact their physical activity [4]? Availability and proximity of parks, bike lanes and recreational. Res. Public Health 2017, 14, 1326; doi:10.3390/ijerph14111326 www.mdpi.com/journal/ijerph

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Discussion

Conclusion