Abstract
BackgroundPeople with a low socioeconomic status (SES) are more likely to be physically inactive than their higher status counterparts, however, the mechanisms underlying this socioeconomic gradient in physical inactivity remain largely unknown. Our aims were (1) to investigate socioeconomic differences in recreational walking among older adults and (2) to examine to what extent neighbourhood perceptions and individual cognitions regarding regular physical activity can explain these differences.MethodsData were obtained by a large-scale postal survey among a stratified sample of older adults (age 55–75 years) (N = 1994), residing in 147 neighbourhoods of Eindhoven and surrounding areas, in the Netherlands. Multilevel logistic regression analyses assessed associations between SES (i.e. education and income), perceptions of the social and physical neighbourhood environment, measures of individual cognitions derived from the Theory of Planned Behaviour (e.g. attitude, perceived behaviour control), and recreational walking for ≥10 minutes/week (no vs. yes).ResultsParticipants in the lowest educational group (OR 1.67 (95% CI, 1.18–2.35)) and lowest income group (OR 1.40 (95% CI, 0.98–2.01)) were more likely to report no recreational walking than their higher status counterparts. The association between SES and recreational walking attenuated when neighbourhood aesthetics was included in the model, and largely reduced when individual cognitions were added to the model (with largest effects of attitude, and intention regarding regular physical activity). The assiation between poor neighbourhood aesthetics and no recreational walking attenuated to (borderline) insignificance when individual cognitions were taken into account.ConclusionBoth neighbourhood aesthetics and individual cognitions regarding physical activity contributed to the explanation of socioeconomic differences in no recreational walking. Neighbourhood aesthetics may explain the association between SES and recreational walking largely via individual cognitions towards physical activity. Intervention and policy strategies to reduce socioeconomic differences in lack of recreational walking among older adults would be most effective if they intervene on both neighbourhood perceptions as well as individual cognitions.
Highlights
People with a low socioeconomic status (SES) are more likely to be physically inactive than their higher status counterparts, the mechanisms underlying this socioeconomic gradient in physical inactivity remain largely unknown
Explaining the 'SES – no recreational walking' association As presented in Table 3, the sex- and age-adjusted odds ratios (OR) to do no recreational walking for the lowest educational group
Explaining the 'neighbourhood aesthetics- no recreational walking' association The association between neighbourhood aesthetics and no recreational walking reduced to non-significance when individual cognitions were taken into account, the OR for no recreational walking among those finding their neighbourhood unattractive remained elevated
Summary
People with a low socioeconomic status (SES) are more likely to be physically inactive than their higher status counterparts, the mechanisms underlying this socioeconomic gradient in physical inactivity remain largely unknown. Several studies have shown that a higher prevalence of unhealthy behaviours among lower socioeconomic groups contribute to the explanation of socioeconomic inequalities in health [3,4,5]. Among those behaviours is physical activity, as people with a low SES are more likely to be physically inactive than their higher status counterparts [6,7]. In the few studies that have attempted to explain socioeconomic differences in physical inactivity, physical environmental factors (e.g. poor neighbourhood aesthetics, safety issues, access to facilities [9,10]), social environmental factors (e.g. social participation [11]), and individual cognitions (e.g. self-efficacy or perceived behaviour control [9]) have been identified as potential explanatory factors
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