Physical Activity According to Diabetes and Metropolitan Status, U.S., 2020 and 2022

Abstract

IntroductionPhysical activity (PA) can reduce morbidity and mortality among adults with diabetes. While rural disparities in PA exist among the general population, it is not known how these disparities manifest among adults with diabetes. MethodsData from the 2020 and 2022 National Health Interview Survey were analyzed in 2023 to assess prevalence of meeting aerobic and muscle-strengthening recommendations according to the 2018 Physical Activity Guidelines for Americans during leisure time. PA prevalence was computed by diabetes status, type of PA, and urban/rural residence (large central metro, large fringe metro, medium/small metro, and non-metro). Logistic regression models were used to estimate prevalence and prevalence ratios of meeting PA recommendations by urban/rural residence across diabetes status. ResultsAmong adults with diabetes in non-metro counties, only 23.8% met aerobic, 10.9% met muscle-strengthening, and 6.2% met both PA recommendations. By contrast, among adults with diabetes in large fringe metro counties, 32.1% met aerobic, 19.7% met strengthening, and 12.0% met both guidelines. Multivariable adjusted prevalence of meeting muscle-strengthening recommendations was higher among participants with diabetes in large fringe metro compared to large central metro counties (PR=1.27; 95% CI 1.03-1.56). Among those without diabetes, adjusted prevalence of meeting each recommendation or both was lower in non-metro and small/medium metro compared to large central metro counties. ConclusionsAdults with diabetes are less likely to meet the PA recommendations than those without, and differences exist according to urban/rural status. Improving PA among rural residents with diabetes may mitigate disparities in diabetes-related mortality.