Mapping the Prevalence of Physical Inactivity in U.S. States, 1984-2015

Hajo Zeeb,Xiaoling Xiang,Yan Yang,Hai Yan,Ruopeng An

doi:10.1371/journal.pone.0168175

Abstract

BackgroundPhysical inactivity is a leading cause of morbidity, disability and premature mortality in the U.S. and worldwide. This study aimed to map the prevalence of physical inactivity across U.S. states over the past three decades, and estimate the over-time adjusted changes in the prevalence of physical inactivity in each state.MethodsIndividual-level data (N = 6,701,954) were taken from the 1984–2015 Behavioral Risk Factor Surveillance System (BRFSS), an annually repeated cross-sectional survey of state-representative adult population. Prevalence of self-reported leisure-time physical inactivity was estimated by state and survey year, accounting for the BRFSS sampling design. Logistic regressions were performed to estimate the changes in the prevalence of physical inactivity over the study period for each state, adjusting for individual characteristics including sex, age, race/ethnicity, education, marital status, and employment status.ResultsThe prevalence of leisure-time physical inactivity varied substantially across states and survey years. In general, the adjusted prevalence of physical inactivity gradually declined over the past three decades in a majority of states. However, a substantial proportion of American adults remain physically inactive. Among the 50 states and District of Columbia, 45 had over a fifth of their adult population without any leisure-time physical activity, and 8 had over 30% without physical activity in 2015. Moreover, the adjusted prevalence of physical inactivity in several states (Arizona, North Carolina, North Dakota, Utah, West Virginia, and Wyoming) remained largely unchanged or even increased (Minnesota and Ohio) over the study period.ConclusionsAlthough the prevalence of physical inactivity declined over the past three decades in a majority of states, the rates remain substantially high and vary considerably across states. Closely monitoring and tracking physical activity level using the state physical activity maps can help guide policy and program development to promote physical activity and reduce the burden of chronic disease.

Highlights

Physical inactivity is a leading cause of morbidity, disability and premature mortality in the U
Detailed information about the Behavioral Risk Factor Surveillance System (BRFSS) including questionnaires, sampling design and survey datasets can be found on its web portal
During 1984–2010, the BRFSS was administered over landline telephones alone; whereas since 2011, refinement to the BRFSS sampling schemes has been made to include data received from cell phone users as well, which facilitates the inclusion of a broader demographic and provides a more comprehensive reflection of the nation’s health status

Summary

Introduction

Physical inactivity is a leading cause of morbidity, disability and premature mortality in the U. Promoting physical activity has long been a public health priority [2]. 4 in 5 U.S adults do not meet recommended levels of physical activity guidelines [3]. Various programs such as provision of economic incentives [4], mass media campaigns [5], point-of-decision prompts [6], neighborhood built environment remodeling [7], social network interventions [8], etc., have been employed to promote active living. Existing programs addressing sedentary behavior and physical inactivity have only limited success in facilitating long-term behavior modification and maintenance [9, 10]. This study aimed to map the prevalence of physical inactivity across U.S states over the past three decades, and estimate the over-time adjusted changes in the prevalence of physical inactivity in each state

Objectives

Methods

Results

Conclusion