Abstract
BackgroundThis study systematically reviewed the evidence pertaining to socioeconomic inequalities in different domains of physical activity (PA) by European region.MethodsStudies conducted between January 2000 and December 2010 were identified by a systematic search in Pubmed, Embase, Web of Science, Psychinfo, Sportdiscus, Sociological s, and Social Service s. English-language peer-reviewed studies undertaken in the general population of adults (18–65 years) were classified by domain of PA (total, leisure-time including sport, occupational, active transport), indicator of socioeconomic position (education, income, occupation), and European region. Distributions of reported positive, negative, and null associations were evaluated.ResultsA total of 131 studies met the inclusion criteria. Most studies were conducted in Scandinavia (n = 47). Leisure-time PA was the most frequently studied PA outcome (n = 112). Considerable differences in the direction of inequalities were seen for the different domains of PA. Most studies reported that those with high socioeconomic position were more physically active during leisure-time compared to those with low socioeconomic position (68% positive associations for total leisure-time PA, 76% for vigorous leisure-time PA). Occupational PA was more prevalent among the lower socioeconomic groups (63% negative associations). Socioeconomic differences in total PA and active transport PA did not show a consistent pattern (40% and 38% positive associations respectively). Some inequalities differed by European region or socioeconomic indicator, however these differences were not very pronounced.ConclusionsThe direction of socioeconomic inequalities in PA in Europe differed considerably by domain of PA. The contradictory results for total PA may partly be explained by contrasting socioeconomic patterns for leisure-time PA and occupational PA.
Highlights
Socioeconomic inequalities in morbidity and mortality are well-documented [1,2]
These 131 studies reported on 105 study populations and 447 unique associations between a socioeconomic position (SEP) indicator and physical activity (PA) outcome (Table 1)
In most studies the response was higher than 60% but approximately one quarter of the studies did not report any response percentage
Summary
Socioeconomic inequalities in morbidity and mortality are well-documented [1,2]. Differences in health behaviours play an important role in these inequalities [3]. To the higher prevalence of smoking in lower socio-economic groups [4,5], evidence suggests that the higher obesity rates are of major importance to health inequalities [6,7,8,9]. Obesity levels in Europe are rising rapidly; the prevalence of obesity has tripled since the 1980s [10]. European regions are thought to be in a different stage of the obesity epidemic; when the level of economic development increases, the proportion of positive associations between socioeconomic position (SEP) and overweight and obesity decreases and the proportion of negative association increases [6,7]. No systematic review of the evidence of socio-economic differences in PA in Europe has been published to date. This study systematically reviewed the evidence pertaining to socioeconomic inequalities in different domains of physical activity (PA) by European region
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