European Health Interview Survey Research Articles

Cross-national data on informal caregivers of older people with long-term care needs in the European population: time for a more coordinated and comparable approach.

To promote long-term care policies for older adults, accurate mapping of the often invisible and insufficiently recognized role of their informal caregivers is needed. This paper measures the prevalence of informal caregivers in the European population, illustrates current difficulties in gathering unequivocal information on this topic and deals with the scientific and policy implications of the problem. Using the European Health Interview Survey (EHIS), the European Quality of Life Survey (EQLS) and the Study on Health and Ageing in Europe (SHARE), the current difficulties in gathering unequivocal information on this topic are illustrated. In most countries, the share of informal caregivers varies, sometimes markedly, among the three surveys. As for the sex of caregivers, while confirming the well-known higher prevalence of caregivers among women than among men, large variations emerge across the three surveys in most countries in respect of the two sexes. The takeaway message of the paper is that it is urgent to promote international concerted action in gathering comprehensive informal caregiving information and/or exploring in greater depth the different intercultural understandings of informal care itself.

Quality of life and associated factors on employees of a public university working remotely during the COVID-19 pandemic.

Introduction:The pandemic caused by the severe acute respiratory syndrome coronavirus 2 imposed restrictions to movement, generating new work dynamics especially in the education sector, where remote working has become the rule. The overlapping of work-related and domestic tasks and the fear of the virus generated an additional burden to workers, with unknown effects on their quality of life.Objectives:To estimate the quality of life of employees of the education sector who were working remotely during the pandemic caused by the severe acute respiratory syndrome coronavirus 2 and identify associated factors.Methods:This is a cross-sectional study performed with a sample of 317 government employees of a federal university between August 25 2020 and September 11 2020. Standardized questionnaires concerning sociodemographic and economic aspects were constructed using the Google Forms tool. The European Health Interview Survey - Quality of Life 8-item index was used to assess quality of life. Multiple linear regression was used to check for associations between variables using quality of life scores as outcome (alpha value of 5%). This research proposal was approved by the National Research Ethics Commission, with a Certificate of Presentation for Ethical Appreciation No. 33636220.1.0000.0056.Results:The European Health Interview Survey - Quality of Life 8-item index resulted in mean adjusted scores of 3.5 ± 1.9. Quality of life was independently associated with age (β = 0.01, 95% confidence interval 0.00 to 0.02, p = 0.015), physical activity (β = 0.19, 95% confidence interval 0.00 to 0.38, p = 0.049), smoking habits (β = 0.54, 95% confidence interval 0.19 to 0.88, p = 0.002), having a dedicated workspace (β = 0.14, 95% confidence interval 0.02 to 0.26, p = 0.023), performing housework (β =-0.20, 95% confidence interval-0.32 to-0.08, p < 0.001), financial difficulties (β =-0.26, 95% confidence interval-0.40 to-0.12, p < 0.001), and the impact of social distancing at work (β =-0.33, 95% confidence interval-0.47 to-0.19, p < 0.001).Conclusions:The level of quality of life within the sample was reasonable; it was higher among older participants who were physically active and did not smoke, and lower when the socioeconomic situation was unfavorable. This highlights the importance of constructing support strategies while the effects of the pandemic linger.

Health-Enhancing Physical Activity in Europe-Combined Aerobic Physical Activity and Muscle-Strengthening Exercise Guideline Adherence Among 280,605 Adults From 28 European Countries.

Compared with engaging in aerobic physical activity (aerobic PA; eg,walking, running, cycling) or muscle-strengthening exercise (MSE; eg,weight/resistance training) alone, epidemiological evidence suggests that combining both is linked to better health. However, the assessment of both PA modes is rare in health surveillance. This article provides the first multicountry study on the descriptive epidemiology of combined moderate to vigorous PA-MSE guideline adherence. Data were drawn from the European Health Interview Survey wave 2 (2013-2014), comprising samples from 28 European countries (n = 280,605). Self-reported aerobic PA and MSE were assessed using the validated European Health Interview Survey Physical Activity Questionnaire. The authors calculated the weighted proportions meeting the health-enhancing PA guideline (aerobic PA ≥ 150min/wk and MSE ≥ 2 sessions/wk). Poisson regression assessed the prevalence ratios for meeting the combined guideline across sociodemographic factors and by country. A total of 15.0% met the health-enhancing PA guideline. The lowest prevalence was from respondents from Southern and Central European countries (Romania, Poland, and Croatia, range: 0.5%-5.7%). Poorer self-rated health, older age, lower income, being female, and being obese had a lower likelihood of meeting the combined guideline. Most European adults do not meet the health-enhancing PA guideline that includes both aerobic PA and MSE.

Socijalno-ekonomske determinante rodnih razlika u samoproceni zdravlja kod starije populacije

Introduction: Self-reported health status is considered one of the highly significant indicators of general health and overall quality of life. Aim: to examine whether there are gender differences in self-reported health status among the older population depending on the socioeconomic determinants. Methods: The analysis was carried out based on the data collected from the fourth National Health Survey of the population of Serbia, which was designed as a cross-sectional study. The research was conducted in accordance with the methodological guidelines and research instruments of the European Health Interview Survey. Results: A statistically significant correlation was observed between gender and the self-reported health status of the respondents. Women were significantly more likely to report poor self-rated health (27.8%), whereas men reported better self-rated health (21.3%). The results of the multivariate logistic regression analysis showed that poor self-rated health status among women was more likely to be affected by age, educational level, and region, whereas age and economic status were significant factors associated with poor self-rated health status among men. Conclusion: Taking into consideration the fact that the advantages of increased life expectancy will achieved only if these extra years of life gained through increased longevity are spent in good health, the importance of conducting additional research on gender differences is more than evident, particularly in terms of providing meaningful insight into the development of action plans devised to deal with gender differences in health status, simultaneously promoting healthy and active aging for both men and women.

Mental health, functioning, and quality of life in employees who worked in the office vs. from home during the first wave of COVID-19 in Brazil.

Coronavirus disease 2019 (COVID-19) was declared a global pandemic early in 2020, followed by a period during which governments imposed strict social distancing measures to slow transmission. However, most essential services remained open, and those working in offices faced a higher risk of infection compared to those working at home. We compare the occurrence and potential determinants of mental health outcomes, functioning, and quality of life (QoL) in a subset of a sample of Brazilian individuals who worked from home and a subset who worked in the office during the first wave of COVID-19. Data were collected during the first wave of COVID-19, using an online survey to assess sociodemographic and clinical variables, functioning with the Digital Functioning Assessment Short Test (D-FAST), QoL with the European Health Interview Surveys QoL instrument (EUROHIS-QOL), depression with the Patient-Reported Outcomes Measurement Information System (PROMIS) depression instrument, anxiety with the PROMIS anxiety instrument, and stress symptoms with the Impact of Event Scale-Revised (IES-R) in a large sample comprising individuals who worked in offices (n = 1685) or worked from home (n = 1,338). Analysis revealed that depressive and post-traumatic stress symptoms were less prevalent in individuals who worked from home and showed that they had higher functioning and QoL than those working in the office. Individuals who worked in the office were younger, more likely to be female, had lower household income, had low educational level, and were more likely to be unmarried than the home working group. Our findings support the notion of the negative impact of the COVID-19 pandemic on mental health in both office workers and those working from home. However, the group who worked from home seem to be more resilient with fewer psychiatric symptoms and better functioning.

Reliability and Validity of Slovenian Versions of IPAQ-SF, GPAQ, and EHIS-PAQ for Assessing Physical Activity and Sedentarism of Adults.

Health policies rely on physical activity (PA) and sedentary behavior data collected through PA questionnaires (PAQs). Validity of international PAQs varies among countries. Therefore, it is important to know the validity of the national versions of the PAQs to properly evaluate the results. We conducted a validation study of the Slovenian versions of the International PAQ Short Form (IPAQ-SF), the Global PAQ (GPAQ), and the PAQ used in the European Health Interview Survey (EHIS-PAQ) on 306 healthy adults. The most valid and reliable constructs in all tested were sedentary behavior and vigorous PA (VPA), however the criterion validity of these constructs was low (Spearman’s ρ 0.38–0.45 for sedentary behavior and 0.34–0.42 for VPA). Moderate to vigorous PA (MVPA) had low validity (0.26–0.29) despite being used as a standard measure of PA behavior. Participants over-reported MVPA for 17 to 156 min and underreported the sedentary behavior for more than two hours. The test-retest study found high reliability for sedentary behavior (0.69–0.81) and low to moderate reliability for PA behavior (0.42–0.76). The Slovenian versions of the observed PAQs are a useful tool for national PA surveillance, but for qualitative assessment of individual health-related PA behavior they should be combined with accelerometer-based devices.

Low Levels of Influenza Vaccine Uptake among the Diabetic Population in Spain: A Time Trend Study from 2011 to 2020

(1) Background: In this work, we aim to describe influenza vaccine uptake among the diabetic population in Spain to assess the time trend from 2011 to 2020 and identify predictors of vaccine uptake among diabetes patients. (2) Methods: We conducted a descriptive cross-sectional study using the European Health Interview Survey for Spain (2014 and 2020) and the Spanish National Health Surveys (2011 and 2017). The independent variables analysed included socio-demographic characteristics, health-related variables and lifestyle variables. We matched each participant with diabetes with a non-diabetic participant based on age, sex, place of residence and year of survey. (3) Results: The overall coverage among diabetic adults was 52.1% compared to 40.6% for matched participants without diabetes (p < 0.01). The vaccine uptake among adults with diabetes was 52.6% in 2011, 54.38% in 2014 and 53.4% in 2017. The adjusted OR of having been vaccinated in 2020, with respect to 2011, was not significant at 0.87 (95% CI: 0.72–1.06). Factors such as being male, higher age, being affected by respiratory disease or cancer and being physically active were identified as positive predictors for influenza vaccination uptake, while smoking was a negative predictor. (4) Conclusions: The influenza vaccine uptake is below desirable levels among the adult diabetic population in Spain and has not improved from 2011 to 2020. More efforts should be made to increase influenza vaccine uptake in this high-risk group, especially for women, those aged 18–64 years, without other high-risk conditions and smokers.

Income inequalities, social support and depressive symptoms among older adults in Europe: a multilevel cross-sectional study

This study analysed the association between income inequality and depression from a multilevel perspective among older adults in Europe, including an examination of the role of social support. The data came from Eurostat’s European Health Interview Survey (EHIS). Selected participants were aged 65 years or above (n = 68,417) and located in 24 European countries. The outcome variable (depression) was measured using the eight-item Patient Health Questionnaire (PHQ-8). The resulting dataset included individual-level (level-1) and aggregate-level (level 2) exposure variables. Level-1 included income quintiles and social support as exposure variables and sex, age, living alone, limitation in activities of daily living and general activity limitation as control variables. Level 2 included the Gini coefficient, healthcare expenditure and dependency ratio. A multilevel linear regression analysis was performed with maximum likelihood (ML) estimation. All the income quintiles from 1 to 4 showed higher average scores for depression than quintile 5 (the highest). Higher social support scores were associated with lower scores for depression. An interaction was found between income quintile and social support, with higher levels of social support associated with lower scores for depression in quintiles 1 and 2. Higher Gini coefficient scores were associated with higher scores for depression. A significative random slope for social support was also found, meaning that the relationship between social support and depression differed across countries. No significant interaction was found between the Gini coefficient and social support. The study findings suggest that more unequal societies provide a less favourable context for the mental health of older adults. There are also significant country-dependent differences in terms of the relationship between support and mental health among older adults.

Gender differences in weight status and early school leaving in Italy

AbstractIn Italy, there are gender and geographical differences on early school leaving, obesity and physical activity among young adults (18–24 year olds). We examine whether weight status (overweight/obesity) is associated with a higher probability that a young adult is an early school leaver using Italian data based on the second wave of the European Health Interview Survey. Our results show that body mass index, which is the main proxy of weight status, positively affects the probability of being an early leaver. Being male increases the probability of being an early leaver in all macro‐areas, although the coefficient is higher in southern regions than in northern and central regions. Furthermore, we address the endogeneity problem, in which physical activity is used as an instrument of weight status to capture the possible endogeneity between weight status and the probability of early school leaving. Our results show that weight status is a better predictor of early school leaving for females than for males and is a better predictor for females living in northern and central regions than for females living in southern regions. These results suggest that females could benefit more than males from policies promoting physical activity and, more broadly, healthier lifestyles, at both the physical and the educational level; furthermore, these policies should be more aimed at females living in the northern and central regions where the less widespread phenomenon of overweight/obesity underlines the higher psychological distress of overweight/obese females.

Prevalence of Major Depressive Episode in 27 European Countries

Abstract Background Information about the prevalence of current Major Depressive Episode (MDE) across European countries is essential for its monitoring and for the development of evidence- based mental health policies. The aims were to: 1) estimate the prevalence of MDE by country in Europe; and 2) assess variations in prevalence between countries. Methods Data from participants of 27 countries that completed the questionnaire of the second wave of the European Health Interview Survey (EHIS-2) were analysed (n = 258,888). The prevalence of MDE was quantified using the Patient Health Questionnaire-8 (PHQ-8) with a cut-off score of ≥ 10. Prevalence and 95% Confidence Intervals (CI) were estimated for each country. Variation in prevalence (country vs the rest) was evaluated using bivariable and multivariable negative binomial regression models considering the specific country as the main explanatory variable. From these models, crude Prevalence Ratios (PR) and adjusted Prevalence Ratios (aPR) were obtained. Results The overall prevalence of current MDE in Europe was 6.38% (6.24%-6.52%). The country with the lowest prevalence was the Czech Republic (2.58%, 2.14%-3.02%) and the country with highest prevalence Iceland (10.33%, 9.33%-11.32%). In all the countries (except for Finland and Croatia) prevalence was higher in women than in men. The countries with the highest aPR were Germany (aPR: 1.80, 95% CI: 1.71-1.89) and Luxembourg (aPR: 1.50, 95% CI: 1.35-1.66), while Slovakia (aPR: 0.28, 95% CI: 0.24-0.33) and the Czech Republic (aPR: 0.32, 95% CI: 0.27-0.38) exhibited the lowest aPR. Conclusions Considerable variability in the prevalence of MDE by country in Europe was observed without a clear pattern. These results serve as baseline for monitoring the prevalence of MDE at a European level and suggest a need for developing preventive strategies against depression, particularly in those countries identified with the highest prevalence. Key messages The results of this study show that the overall prevalence of MDE is high (6.38%), with important variation across countries (ranging from 2.58% in the Czech Republic to 10.33% in Iceland). The results found could serve as a reference for the monitoring of MDE in Europe and for the development of screening and preventive strategies both at European level as well as at a country level.

Nutritional risk factors in Hungarian elderly-Biomarker2019 survey

Abstract In Hungary, about a quarter of the population is over the age of 60 and their proportion is projected to increase considerably within a few decades. According to the 2009 and 2014 European Health Interview Survey data, 87% of Hungarian older adults suffer from at least one non-communicable disease (NCD). Many of the NCDs are associated with poor nutrition. Reliable data on nutritional status of this age group is scarce. The Biomarker2019 survey provides comprehensive data on the nutritional status of this vulnerable age group. The cross-sectional survey was carried out in western Hungary. Participants aged ≥60y were selected from non-institutionalized patients of general practitioners' practicing in Western Hungary (n = 200). Data collection involved a questionnaire, physical examinations, three-day dietary record, and a collection of biological samples (fasting blood and 24-hour urine). 77% of the participants had high blood pressure diagnosed by a physician. 85% of men and 76% of women were overweight or obese, according to the BMIs. The mean proportion of energy from fat was higher (men: 39 E%, women: 37 E%), that from carbohydrates was lower in men (43 E%) than recommended, while it was adequate in women (47 E%). The mean protein intake was adequate in both sexes. Cholesterol intake was 433 mg/day for men and 317 mg/day for women, both higher than the Hungarian recommendations. The fiber intake was 23.8 g/day for men and 23.6 g/day for women, both below the recommended values. Based on the estimates of salt intake from 24-hour urine, 90% of participants had a higher salt intake than recommended. Nutritional risk factors predisposing to the development of NCDs were identified in the sample. The results of the study contributed to the development of a food-based dietary guideline tailor made to the Hungarian elderly population (60+ Health - Dietary Guideline for the Elderly), its dissemination to the target audience has been started. Key messages The identification of nutritional risk factors in a sample of older adults contributed to the development of a new food-based dietary guideline for the elderly population. The results can form the basis of further public health interventions.

ROLE OF SEX AND GENDER IN ACCESS TO CARE AND CARDIOVASCULAR COMPLICATIONS OF INDIVIDUALS WITH DIABETES MELLITUS

ROLE OF SEX AND GENDER IN ACCESS TO CARE AND CARDIOVASCULAR COMPLICATIONS OF INDIVIDUALS WITH DIABETES MELLITUS

Impact of Policies in Nutrition and Physical Activity on Diabetes and Its Risk Factors in the 28 Member States of the European Union.

Since healthy eating and physically active lifestyles can reduce diabetes mellitus (DM) risk, these are often addressed by population-based interventions aiming to prevent DM. Our study examined the impact of nutritional and physical activity policies, national diabetes plans and national diabetes registers contribute to lower prevalence of DM in individuals in the member states of the European Union (EU), taking into account the demographic and socioeconomic status as well as lifestyle choices. Datasets on policy actions, plans and registers were retrieved from the World Cancer Research Fund International’s NOURISHING and MOVING policy databases and the European Coalition for Diabetes report. Individual-based data on DM, socioeconomic status and healthy behavior indicators were obtained via the European Health Interview Survey, 2014. Our results showed variation in types and numbers of implemented policies within the member states, additionally, the higher number of these actions were not associated with lower DM prevalence. Only weak correlation between the prevalence of DM and preventive policies was found. Thus, undoubtedly policies have an impact on reducing the prevalence of DM, its increasing burden could not be reversed which underlines the need for applying a network of preventive policies.

Decreasing mental well-being during the COVID-19 pandemic: A longitudinal study among Danes before and during the pandemic

The COVID-19 pandemic has had a huge impact on people's lives and may influence mental health in the general population. In a unique representative Danish longitudinal study, we examined mental well-being measured just before and during the COVID-19 pandemic. The Danish Health and Wellbeing Survey is the Danish contribution to the European Health Interview Survey. In this study, we included the wave from autumn 2019, which we re-invited in the autumn 2020. The study population consisted of 4,234 persons. The main outcome was mental well-being measured by the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS). Linear and logistic regression models were conducted to evaluate change in SWEMWBS between 2019 and 2020. The SWEMWBS distribution was similar in 2019 and 2020, although the distribution moved to lower scores in 2020 compared to 2019. Mean SWEMWBS decreased significantly from 25.5 in 2019 to 24.6 in 2020 corresponding to a mean change of −1.0 (95%CI, −1.1. to −0.8). The proportion with low SWEMWBS increased from 16.5% in 2019 to 20.1% in 2020 (p < 0.001). The mean change was similar for men and women and for different age groups. The most negative development was observed among persons without depression or long-standing illnesses at baseline and among persons with higher educational level. Among persons with depression SWEMWBS increased. As expected, mental well-being significantly decreased in the adult Danish population during the COVID-19 pandemic. However, somewhat more unexpectedly, the decrease was most pronounced among persons without depression or long-standing illnesses and among higher educated groups.

German Health Update (GEDA 2019/2020-EHIS) - Background and methodology.

Between April 2019 and September 2020, 23,001 people aged 15 or over responded to questions about their health and living conditions for the German Health Update (GEDA 2019/2020-EHIS). The results are representative of the German resident population aged 15 or above. The response rate was 21.6%. The study used a questionnaire based on the third wave of the European Health Interview Survey (EHIS), which was carried out in all EU member states. EHIS consists of four modules on health status, health care provision, health determinants, and socioeconomic variables. The data are collected in a harmonised manner and therefore have a high degree of international comparability. They constitute an important source of information for European health policy and health reporting and are made available by the Statistical Office of the European Union (Eurostat). They also form the basis of the Federal Health Reporting undertaken in Germany. Data collection began in April 2019, just under a year before the beginning of the SARS-CoV-2 pandemic, and continued into its initial phase, as of March 2020. As such, data from the current GEDA wave can also be used to conduct research into the health impact of the SARS-CoV-2 pandemic.

Prevalence and Correlates of Muscle-Strengthening Activity Participation in Croatia: A Cross-Sectional Study in a National Representative Sample of 4561 Adults.

The World Health Organization recommends adults to engage in muscle-strengthening activity (MSA) at least two times per week. The aim of this study was to determine the prevalence and correlates of MSA in Croatian adults. We analysed self-reported data collected among 4561 Croatians aged ≥18 years within the European Health Interview Survey (EHIS wave 2). We calculated the weighted prevalence of meeting the MSA guidelines, and odds ratios for different population groups, adjusted for a range of sociodemographic and lifestyle variables in a multivariable logistic regression analysis. The prevalence of meeting the MSA guidelines was 8.0% (95% CI: 7.2, 8.8) in the overall sample, 5.4% (95% CI: 4.5, 6.4) among females, and 10.9% (95% CI: 9.6, 12.3) among males. We found significantly lower odds of meeting the MSA guidelines for females, older age groups, inhabitants of sparsely populated areas, those with a low education level, obese individuals, and those who did not rate their health as “very good” (p < 0.05 for all). The vast majority of Croatian adults do not meet the MSA guidelines. Public health initiatives to promote MSA in Croatia should focus on females, seniors, sparsely populated areas, people with low education, obese individuals, and those with impaired health.

Weight Status and Depression in Italy: Evidence from the Second Wave of the European Health Interview Survey

This study tests the association between weight status and depression in Italy using the Second Wave of the European Health Interview Survey (EHIS2) microdata, which also provide information on weight/height and eight depressive symptoms. Using a probit regression, the empirical results show a strong positive association between weight status, proxied by body mass index, and sleep troubles and eating disorders, with females suffering more than males. In addition, low interest is negatively associated with medium and high sources of income, while depressive mood and sense of failure are negatively associated with employment status. Individuals in midlife (45–54 years old) suffer from all depressive symptoms more than those in other age classes, with females suffering more than males, with the exception of low interest and depressive mood. Furthermore, individuals with a higher level of education have a lower likelihood of suffering from all depressive symptoms. These findings suggest that policies aimed at reducing obesity rates could also reduce new and emerging types of depressive symptoms correlated with overweight/obesity, such as sleep troubles and eating disturbances. JEL: J24, I12, I1, C25

Investigating unmet need for healthcare using the European Health Interview Survey: a cross-sectional survey study of Luxembourg

ObjectivesWe investigate the prevalence of unmet need arising from wait times, distance/transportation and financial affordability using the European Health Interview Survey. We explore associations between individual characteristics and the probability...

A Cluster Analysis of Risk Factors for Cancer across EU Countries: Health Policy Recommendations for Prevention.

Cancer burden in the European Union (EU) is increasing and has stimulated the European Commission (EC) to develop strategies for cancer control. A common “one size fits all” prevention policy may not be effective in reducing cancer morbidity and mortality. The goal of this paper is to show that EU member states are not homogenous in terms of their exposure to risk factors for cancer (i.e., lifestyle, socio-economic status (SES), air pollution, and vaccination). Data from a variety of sources including Eurostat, the UNESCO Institute for Statistics, the European Health Interview Survey, Eurobarometer, and the European Environment Agency were merged across years 2013–2015 and used to develop a cluster analysis. This work identified four patterns of cancer prevention behaviors in the EU thus making it possible to group EU members states into four distinct country clusters including: sports-engaged countries, tobacco and pollutant exposed nations, unhealthy lifestyle countries, and a stimulant-enjoying cluster of countries. This paper finds that there is a need for closer collaboration among EU countries belonging to the same cluster in order to share best practices regarding health policy measures that might improve cancer control interventions locally and across the EU.

The epidemiology of muscle-strengthening activity among adolescents from 28 European countries.

This study aimed to describe the prevalence and socio-demographic and lifestyle-related correlates of muscle-strengthening activity (MSA; strength/resistance training, sit-ups/push-ups, etc.) among a large sample of European adolescents. Data were drawn from the European Health Interview Survey Wave 2 (2013-2014), including 8818 adolescents (15-17 years) from 28 European countries. Self-reported MSA was assessed using a previously validated survey item. Population-weighted prevalence ratios were calculated for (a) 'none' (0 days/week), (b) 'insufficient MSA' (1-2 days/week) or (c) 'sufficient MSA' (⩾3 days/week). Generalised linear models using Poisson regression with robust error variance were used to calculate the prevalence ratios for adolescents reporting sufficient MSA by socio-demographic/lifestyle characteristics and by European region. Overall, 19.4% (95% confidence interval (CI) 18.3-20.7) reported sufficient (⩾3 days/week) MSA and 57.9% (95% CI 56.4-59.6) reported none. Females, adolescents from Southern and Eastern European regions, those not meeting the aerobic guideline and adolescents classified as overweight were significantly associated with a lower likelihood of reporting sufficient MSA, independent of other characteristics. The majority of European adolescents do not meet the MSA guidelines. Future large-scale MSA public-health interventions should target female and currently inactive adolescents, as well as those from Southern and Eastern European regions.