Leisure-time Physical Inactivity Research Articles

Identifying the health benefits of city bike infrastructure expansion policy

ABSTRACT The aim of this study was to understand how policy actions implemented by city governments to improve infrastructure within the built environment can in turn influence healthy behaviors and population health. The authors investigated the associations between policy actions implemented by city governments to improve biking infrastructure and multiple health outcomes including leisure-time physical inactivity, obesity and coronary heart disease (CHD). In addition, this study tested if bike use for commuting and leisure-time physical activity were mediators between policy actions to improve biking infrastructure and health outcomes, and whether the health effects of bike infrastructure were different in cities of different population density. We merged local sustainability survey data with city-level chronic disease measures for the largest cities in the U.S. (n = 457). Results from regressions using Ordinary Least Squares estimation and mediation tests showed policies implemented to improve biking infrastructure were associated with lower prevalence of leisure-time physical inactivity, obesity and CHD. These relationships were most notable in medium-density cities (1,500–3,000/sq. mi). Moreover, leisure-time physical activity and active commuting mediated the relationship between bike infrastructure improvement policies and health outcomes. This study demonstrated the value of a policy-based intervention in enhancing population health.

Racial/Ethnic Differences in Physical Activity in a Low-Income Sample in Texas.

National data reveal that the age-adjusted prevalence of leisure-time physical inactivity is higher among Blacks and Hispanics compared with Whites. However, these estimates do not consider nonleisure physical activity (PA). Also, race/ethnicity in these findings may by confounded by socioeconomic status disparities in PA. Here, we examine racial/ethnic differences in multiple measures of PA within a lower socioeconomic status sample. Participants in the current cross-sectional study (n = 1526 adults, aged ≥ 18y) were recruited from Supplemental Nutrition Assistance Program-Education classes (nutrition education classes that target low-income people) in Texas. Self-report data were obtained using survey questionnaires in spring and fall 2018. PA outcomes of 4 different intensities were assessed: mean daily time spent walking, engaging in moderate and vigorous PA, and sitting. Additional PA-related measures included use and awareness of community PA resources. Linear regression models examined racial/ethnic differences in the 4 PA outcomes after adjusting for participant gender, age, household composition measures, and various socioeconomic status measures. In this low-income sample, Hispanic and Black participants spent 6 to 9 more minutes per day walking and engaging in moderate and vigorous PA compared with White/other participants (P < .05 for each measure). Conversely, White/other participants reported spending 82 more minutes sitting per day than Black and Hispanic participants (P < .01). Overall, Black participants were most likely to utilize community PA resources and report ease of engaging in exercise. Together, these results reveal greater engagement in PA by racial/ethnic minorities in low-income communities compared with Whites. Our results have implications for tailoring PA programming to these communities.

Magnitude of risk factors for chronic noncommunicable diseases in adolescents and young adults in Brazil: A population-based study.

Estimate the magnitude and factors associated with risk factors for chronic noncommunicable diseases in adolescents and young adults in Brazil. Cross-sectional study that analyzed data from the 2019 National Health Survey. The population of interest was adolescents and young adults aged 15 to 24 years. Data were collected through individual interviews during home visits. Dependent variables included major risk factors for chronic noncommunicable diseases. Demographic and socioeconomic characteristics were used as independent variables. Multiple Poisson regression models were used to assess the relationship between independent variables and risk factors. A total of 10,460 individuals (5,001 men and 5,459 women) were included. Regardless of sex, the most prevalent risk factors were insufficient fruit and vegetable consumption (92.6%) and leisure-time physical inactivity (43.3%). The prevalence rates of tobacco smokers, alcohol consumption once a month or more, and alcohol abuse were 8.9%, 28.7%, and 18.5%, respectively. Regular consumption of soft drinks and/or artificial juices was described by 17.2%. The prevalence of overweight was 32.5%. Young adults, males, and individuals with lower educational levels, of black race/skin color, with lower household income, and residents of urban areas had a higher prevalence for most risk factors. Differences in the determinants were found for some factors. Inequalities between Brazilian regions were recorded for seven of the nine factors analyzed. The most socioeconomically developed regions had the highest prevalence of most risk factors. The high magnitude of risk factors indicates a potential increase in the burden of chronic noncommunicable diseases in a future scenario for Brazil.

Poor Sleep Quality and Working From Home Influence the Prevalence of Leisure Time Physical Inactivity During the COVID-19 Pandemic: COVID-Inconfidentes Study.

The aim of the study is to explore possible associations according to quality of sleep and work from home (WFH) with physical inactivity (PI) during the COVID-19 pandemic. This is a cross-sectional study in two Brazilian cities (>18 years), by probability sampling. Leisure-time physical activity was self-reported and classified according to guidelines. Sleep was by applying the Pittsburgh Sleep Quality Index. Work from home was classified as: total WFH or no WFH. A total of 1750 adults were analyzed, 69.1% were physically inactive, 51.9% had poor sleep quality, and 79.8% were not in WFH. PI was associated with poor sleep quality and non-WFH. Compared with those who reported WFH and good sleep quality, those who reported non-WFH and poor sleep quality had 4 times the prevalence of PI. Poor sleep quality, and not WFH, is associated with leisure PI. These factors combined increase the probability of PI.

Cardiovascular burden and unemployment: A retrospective study in a large population-based French cohort.

The specific effect of unemployment on cardiovascular health relatively to the effects of social position and work environment is still unclear. To clarify this effect, the associations between current or past unemployment and the prevalence of common cardiovascular risk factor and events were tested using multiple logistic regression models with adjustment for both social position and prior work environment. The analyses were performed in a population-based French cohort (CONSTANCES) that included 131,186 adults enrolled between 2012 and 2021. Participants who were unemployed at inclusion (n = 8278) were overexposed to non-moderate alcohol consumption, smoking, leisure-time physical inactivity and depression (odds ratios (ORs) from 1.19 to 1.58) whereas those who have been unemployed at least once in the past (n = 19,015) were additionally overexposed not only to the previous risk factors but also to obesity, diabetes and sleep disorders (ORs from 1.10 to 1.35). These latter were also more exposed to non-fatal myocardial infarction and peripheral arterial disease (ORs of 1.44 and 1.47 respectively), overexposures that persisted after further adjustment for cardiovascular risk factors (ORs of 1.36 and 1.33). The overexposures to risk factors and cardiovascular events were both dependent on the duration of past unemployment. They were equally observed in participants with low social position or bad work environment. These results suggest that unemployment increases cardiovascular risk independently from social position and work environment with a cumulative effect over time. The effect of unemployment could add up to those of low social position and bad work environment during lifetime to further increase cardiovascular risk. They also suggest that long-term unemployment increases the prevalence of cardiovascular events through pathways including but not limited to overexposure to common risk factors.

Age, skin color, self-rated health, and depression associated with co-occurrence of obesogenic behaviors in university students: a cross-sectional study.

The university context plays an important role in the health-disease process since students are potentially vulnerable to obesogenic behaviors that can influence long-term health. To estimate the prevalence of and factors associated with the co-occurrence of obesogenic behaviors among university students. This was a cross-sectional study at a Brazilian public university. This study was conducted with all university students in the first and second semesters of 2019 at Universidade Federal de Ouro Preto, Minas Gerais, Brazil. Data were collected between April and September 2019, using a self-administered questionnaire. The outcome was the co-occurrence of obesogenic behaviors, measured as the sum of three risk behaviors: inadequate eating practices, leisure-time physical inactivity, and sedentary behavior. A Venn diagram was used to evaluate the simultaneous occurrence of risk behaviors. Pearson's chi-square test and multivariate logistic regression were used for statistical analyses. A total of 351 students participated in the study. Inadequate eating practices constituted the most prevalent isolated risk behavior (80.6%), which was also the most prevalent when combined with sedentary behavior (23.6%). University students aged 20 years or younger, with non-white skin color, poor self-rated health, and symptoms of depression had increased chances of simultaneous occurrence of obesogenic behaviors. These findings highlight the importance of developing and implementing actions to reduce combined obesogenic behaviors in the university environment. Institutions should focus on creating an environment that promotes health-protective behaviors such as physical activity and healthy eating.

COVID-Inconfidentes: how did COVID-19 and work from home influence the prevalence of leisure-time physical inactivity? An analysis of before and during the pandemic

BackgroundThe COVID-19 pandemic has brought drastic changes to the lives of the global population. The restrictions imposed by government agencies impacted the daily lives of citizens, influencing several health behaviors, such as physical activity (PA). Thus, the present study aimed to assess the prevalence of physical inactivity (PI) and its associated factors before and during the COVID-19 pandemic.MethodsA population-based household seroepidemiological survey was conducted in two Brazilian municipalities located in the state of Minas Gerais, in which 1750 volunteers were interviewed between October and December 2020. Face-to-face interviews were conducted using a structured questionnaire in an electronic format. The moments considered for the PI analysis were M0 (before the pandemic), M1 (from March to July 2020), and M2 (from October to December 2020). Descriptive statistics and univariate and multivariate logistic regression were used to examine the factors associated with PI before (M0) and during the pandemic (M1 and M2).ResultsThe prevalence of PI was higher in the first months of the pandemic (M1) (67.3%; 95% confidence interval (CI): 62.4–71.9) than in the months from October to December 2020 (M2) (58.7%; 95% CI: 52.8–64.3); however, at both times (M1 and M2), PI was more prevalent than in the period before the pandemic started (M0) (39.7%; 95% CI: 35.6–43.8). Individuals who were overweight, obese, and had low educational levels were more likely to be physically inactive. At both M1 and M2, individuals who worked at a work from home were less likely to have PI.ConclusionsThe results suggest that the COVID-19 pandemic negatively influenced PA, substantially increasing the prevalence of PI. The determinants associated with PI were education, body mass index, and work from home.

Quantification of disparities in the distribution of lifestyle and metabolic risk factors, prevalence of non-communicable diseases and related mortality: the Belgian Health Interview Surveys 1997–2018

ObjectivesComprehensively measure the trends in health disparities by sociodemographic strata in terms of exposure to lifestyle and metabolic risks, and prevalence and mortality of non-communicable diseases (NCDs) during the last...

Sociodemographic disparity in health-related behaviours and dietary habits among public workers in China: a cross-sectional study

ObjectiveWe aimed to estimate the distribution of health-related behaviours and dietary habits by sociodemographics among public workers in China.DesignCross-sectional study.SettingA representative sample was obtained from 10 government-run institutions in Hunan...

Participation in Leisure-Time Aerobic Physical Activity Among Adults, National Health Interview Survey, 1998-2018.

Adults should perform ≥150minutes per week of moderate-intensity equivalent physical activity for substantial health benefits and >300minutes per week for additional benefits. The authors analyzed 21 years of National Health Interview Survey data to better understand trends in aerobic physical activity participation among US adults. The authors estimated the annual prevalence (1998-2018) of self-reported leisure-time physical inactivity, insufficient activity, meeting only the minimal aerobic guideline, and meeting the high aerobic guideline overall and by selected characteristics. Prevalence differences between 1998 and 2018 were compared across subgroups and periods of significant change were identified using JoinPoint regression. The prevalence of inactivity decreased from 40.5% (1998) to 25.6% (2018) while the prevalence of meeting the high aerobic guideline increased from 26.0% to 37.4%. Increases in meeting the high guideline were similar across age groups, racial/ethnic groups, levels of education, and Census regions. Increases in insufficient activity and meeting the minimal guideline were statistically significant but of relatively small magnitude. The prevalence of inactivity decreased and meeting the high aerobic guideline increased overall and for all subgroups from 1998 to 2018. Physical activity promotion strategies may aim to continue these trends while also narrowing persistent disparities in participation across subgroups.

Inatividade física no lazer e transtornos mentais comuns em trabalhadores da Atenção Primária à Saúde

Objetivo: Avaliar a associação entre inatividade física no lazer (IFL) e transtornos mentais comuns (TMC) entre trabalhadores(as) da Atenção Primária à Saúde (APS). Métodos: Estudo transversal, realizado com amostra aleatória de 2.136 trabalhadores(as) da APS de municípios do estado da Bahia. O questionário de coleta de dados incluiu características sociodemográficas e ocupacionais, hábitos de vida e o Self-Reporting Questionnaire. Procedeu-se análise multivariada, com uso da Regressão de Poisson com variância robusta. Resultados: Identificaram-se prevalências de 22,6% para TMC e 48,2% para IFL. Na análise bivariada, houve maior prevalência de TMC naqueles com IFL (p&lt;0,001), sexo feminino (p=0,015), menor nível de escolaridade (p=0,001) e renda (p&lt;0,001), nos Agentes Comunitários de Saúde (p&lt;0,001), com tempo de trabalho de cinco anos ou mais (p=0,040) e com comportamento sedentário no lazer (assistir TV e/ou ouvir rádio) (p=0,025). Evidenciou-se incremento da prevalência de TMC entre aqueles com IFL (53%), com tempo de trabalho na unidade maior ou igual a cinco anos (20%) e cujas atividades no seu tempo de lazer eram assistir TV e ouvir rádio (30%). Na análise múltipla, a associação entre IFL e TMC manteve-se significante (RP: 1,36; IC95%: 1,11-1,65), ajustando-se pelas variáveis confundidoras. Conclusão: A IFL é importante fator determinante da ocorrência de TMC entre trabalhadores(as) da APS, com influência de características da organização e processo de trabalho e outros hábitos de vida no lazer nessa relação.

Work-related physical and psychosocial risk factors cluster with obesity, smoking and physical inactivity

ObjectiveThis study investigated associations between the co-existence of multiple types of work-related psychosocial and physical risk factors, and (1) obesity; (2) smoking; and (3) leisure-time physical inactivity. It also aimed to identify sociodemographic characteristics related to clustering of work-related risk factors and lifestyle factors.MethodsCross-sectional data on work-related risk factors (e.g., decision authority and repetitive movements) and lifestyle was measured using a standardized questionnaire among 52,563 Dutch workers in health care, services, manufacturing and public sector. Multiple-adjusted logistic regression models assessed associations between the co-existence of multiple types of psychosocial and physical risk factors and lifestyle factors. Additionally, logistic regression models related age, gender and educational level to clustering of risk factors and lifestyle factors.ResultsThe co-existence of multiple types of work-related psychosocial risk factors was associated with higher odds of smoking and being physically inactive. For example, workers exposed to three psychosocial risk factors had a 1.55 times higher odds of being physically inactive (95%CI: 1.42–1.70) compared to unexposed workers. A higher number of physical risk factors was also significantly associated with higher odds of smoking and obesity. The co-existence of multiple types of physical risk factors was not associated with higher odds of physical inactivity. Clustering of work-related risk factors and at least one unhealthy lifestyle factor occurred in particular among workers with low educational level.ConclusionsResults imply that interventions are needed that focus on workers with a low educational level and address work-related physical and psychosocial risk factors as well as lifestyle.

Healthy lifestyle behaviors and the periodicity of mammography screening in Brazilian women

Introduction:Certain behaviors have been associated with health promotion, including mammography screening, in women worldwide.Objective:The objective of this study was to determine whether there is an association between the periodicity of mammography screening and healthy lifestyle behaviors in Brazilian women employed at a public university in Bahia, Brazil.Methods:A total of 635 women of 50–69 years of age at the time of the interview, from the Brazilian Longitudinal Study of Adult Health cohort who were resident in Bahia, participated in the study. Data were collected using a multidimensional questionnaire that included questions on participants’ sociodemographic characteristics and health-related behaviors (smoking, alcohol consumption, leisure-time physical activity and diet) and another questionnaire that dealt with risk factors and breast cancer screening. Measures of association were calculated using simple and multivariate logistic regression.Results:The practice of physical activity, not smoking, moderate alcohol consumption and a healthy diet were the health behaviors most adopted by the women who had last had a mammogram ⩽2 years previously (which is in line with the interval recommended by the Brazilian Ministry of Health). A statistically significant association was found between a lapse of ⩾3 years since last undergoing mammography screening and excessive alcohol consumption, while a borderline association was found between the same screening interval and leisure-time physical inactivity.Conclusion:There was an association between lifestyle risk behaviors and a longer time interval between mammography screenings. The present results contribute to the debate on the use of mammography, lifestyle behaviors and health promotion among women.

Economic burden of physical inactivity in hospitalizations due to dementia: a Brazilian nationwide study.

Our study aimed at determining the economic burden of leisure-time physical inactivity in hospitalizations due to dementia in Brazil. In this national-wide descriptive study, we used secondary data from the Brazilian Health Informatics Department and from the latest Brazilian National Health Survey (2013). Rate of hospitalization and economic cost were extracted from 2013. Leisure-time physical inactivity prevalence was used to estimate its population attributable fraction for dementia. Outcomes were stratified into sex (man/woman), age groups (< 50, 50-59, 60-69, 70-79, 80+), ethnicity (white, black, mixed race, other), and region (South, Southeast, North, Northeast, and Central). In 2013, 3,724 people were hospitalized due to dementia in Brazil resulting in a total cost of BRL 17,971,833.85 (USD 7,673,973.05). More than half of cost among men was spent with individuals younger than 59 years, white and mixed-race, and from Southeast region. Proportion of cost was higher in women older than 60 years and white. In 2013, 37% of all hospitalization from dementia in Brazil were attributable to physical inactivity, with values reaching 42.9% and 43.8% for men and women aged 80 or older, respectively. Physical inactivity cost BRL 6,994,254.75 (USD 2,986,546.78) in 2013 on hospitalizations due to dementia in Brazil. Higher attributable-cost was found for patients younger than 50 years and women older than 80. Strategies to preserve the quality of life of these patients are needed to reduce the burden for the patients, their family, and on the healthcare system.

Diabetes Control Is Associated with Environmental Quality in the U.S.

Background: Environmental parameters, including built and sociodemographic environments, can impact diabetes control (DC). Indeed, epidemiological studies have associated specific environmental factors with DC; however, the impact of multidimensional environmental status has not been assessed. Methods: The Environmental Quality Index (EQI) is a comprehensive quantitative metric that captures five environmental domains. DC was defined as the proportion of adults aged 20+ years with a previous diabetes diagnosis, high fasting blood glucose, and/or elevated hemoglobin A1c (HbA1c) who currently do not have high fasting blood glucose or elevated HbA1c. We conducted county-level analyses of age-adjusted DC prevalence rates for 2004-2012 in association with EQI for 2006-2010 and domain-specific indices using random intercept multilevel linear regression models clustered by state and controlled for county-level rates of obesity and physical inactivity. Analyses were stratified by rural-urban strata and results are reported as prevalence rate differences (PRD) with 95% confidence intervals (CIs) comparing highest quintile/worst environmental quality to lowest quintile/best environmental quality. Findings: The association of DC with cumulative environmental quality is negative after controlling for obesity and leisure time physical inactivity for all counties (PRD -0.32,95% CI:-0.38,-0.27). This suggests that rates of DC worsen as environmental quality declines. While overall environmental quality exerts effects on DC that vary across the rural-urban spectrum, poor sociodemographic and built environmental factors are associated with decreased DC nationally. Interpretation: These data suggest that improvements in environmental quality mediated by larger scale policy and practice interventions may improve glycemic control and reduce the morbidity and mortality arising from hyperglycemia. Funding Statement: This work was supported by the National Institutes of Health [P30 DK092949 to JSJ (via the Chicago Center for Diabetes Translational Research), P30 ES027792 (ChicAgo Center on Health and EnvironmenT), and R01 ES028879 (to RMS)], the American Diabetes Association [1-17-JDF-033 to RMS], and the U.S. Environmental Protection Agency [EP-17-D-000063 to JSJ]. A.K.K. supported in part by an appointment to the Internship/Research Participation Program at Office of Research and Development (Center for Public Health & Environmental Assessment), U.S. Environmental Protection Agency, administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the U.S. Department of Energy and the U.S. Environmental Protection Agency. Declaration of Interests: The authors do not have any conflicts of interest pertinent to this manuscript.

Socioeconomic status and self-perceived barriers to leisure time physical activity in Finnish Roma

Abstract Introduction Finnish Roma are at unequal socioeconomic position compared to the main population. Inequality has a key impact on the well-being and lifestyles of the Roma. The main aim of this study was to examine the prevalence of leisure time physical activity (LTPA) in the Finnish Roma. In addition, we investigated the relationship between socioeconomic factors and self-perceived barriers to leisure time physical activity to leisure time physical inactivity. Methods This study was based on cross-sectional data on the Roma Wellbeing Study (Roosa) collected in 2017-2018 (n = 365). Data of the study was collected by a long or a short questionnaire, with structured interview or completed by the respondent. The subsample of this study was limited to adult Roma living in Finland, identifying themselves with Roma culture (n = 344; men n = 134 and women n = 210). The data was analyzed by cross-tabulation, χ2-test and using logistic regression analysis. Men's and women's results are presented separately as odds ratios (OR) and with 95% confidence intervals (CI). Results In this study 46.7% of men and 64.3% of women did not engage leisure time physical activity. The self-perceived barriers to leisure time physical activity differ between men and women. Common barriers were lack of motivation, fatigue and low mood. In men, self-perceived barriers to leisure time physical activity were also illness or injury, lack of money and exercise guidance. In women, other self-perceived barriers were lack of exercise skills, suitable exercise group and form of exercise. Conclusions The low prevalence of leisure time physical activity in the Finnish Roma calls for actions. The socioeconomic inequalities and differences between men's and women's self-perceived barriers to leisure-time physical activity should be taken into account in measures to promote physical activity. Key messages In this study, nearly half of the Finnish Roma men and three out of five women did not engage in leisure time physical activity. The socioeconomic inequalities and self-perceived barriers to leisure time physical activity between Finnish Roma men and women should be taken into account in measures to promote physical activity.

Socioeconomic determinants of health and county-level variation in cardiovascular disease mortality: An exploratory analysis of Georgia during 2014-2016.

Since cardiovascular disease (CVD) represents the leading cause of death in the state of Georgia, we sought to describe the relationship between socioeconomic determinants of health (SDH) and CVD-related mortality in Georgia using publicly available population health and economic data. A multivariate regression model was estimated to examine physical inactivity, median household income, health insurance status, urban–rural status, and air quality on CVD mortality in Georgia between 2014 and 2016. We find that the median household income and annual average ambient concentrations of PM2.5 were the most significant factors in explaining CVD mortality. Lower levels of median household income and higher concentrations of PM2.5 were associated with higher CVD mortality rates. Leisure-time physical inactivity, health insurance status, and urban–rural status were not associated with worsened CVD-related mortality. As such, policies and interventions aimed at improving socioeconomic status in Georgia should be explored in an effort to positively impact CVD outcomes. Furthermore, this exploratory study could be extended for all counties in the U.S.

Providing Sports Venues on Mainland China: Implications for Promoting Leisure-Time Physical Activity and National Fitness Policies.

Leisure-time physical activity (LTPA) has been well documented as having substantial health benefits. The 2014 Chinese Fitness Survey Report stated that a lack of physical activity (PA) spaces is the most important non-human factor, leading to 10% of leisure-time physical inactivity in people aged 20 and above. We investigated the provision of sports venues in China and discussed the development of sports venues and national fitness policies in the context of promoting LTPA and public health. We analyzed information from China’s most recent sport venue census, the Sixth National Sports Venues Census, conducted in 2013. The number of sports venues increased between 2000 and 2013, with an inflection point around the year 2008. At the end of 2013, there were 12.45 venues for every 10,000 residents, and the per capita area was 1.46 m2. However, numbers were still small compared with the United States and Japan. The percentages of full-time access, part-time access and membership venues were 51.5%, 14.3% and 34.2% respectively. Only half of sports venues were fully open to the public, meaning that the realized number and area per capita could be even lower. A lack of sports venues forces people who want to engage in PA to occupy other urban spaces that are not planned and designed for PA. Urban parks had 119,750 fitness station facilities (3.32% of the total), and 2366 urban fitness trails (19.24%), with a combined length of 6450 km (32.91%). On average, urban and rural areas had 13.17 and 10.80 venues per 10,000 persons, and 1.83 m2 and 0.97 m2 per capita. The urban-rural gap in sports venues exactly embodies some aspects of the “urban-rural dual structure” in China’s society. Measures to promote PA should focus on new and existing sports venues. In the policy making process, Chinese governments need to pay attention to the potential impact of related, external factors such as the gap between the urban and the rural and the potential advantage of indoor venues against summer heat and air pollution.

Leisure-Time Physical Inactivity's Association With Environmental, Demographic, and Lifestyle Factors in the United States.

This study examined the effects of environmental, demographic, and lifestyle factors on leisure-time physical inactivity (LTPI). Analyses were based on county-level data in the contiguous United States. Statistical methods included simple regression, univariate, and multivariate 2-level organizational models (mixed models), and the intraclass correlation coefficient. Higher average daily maximum air temperature was directly and indirectly (through smoking and obesity) positively associated with LTPI. Higher average fine particulate matter was positively associated with LTPI. Higher precipitation was negatively associated with LTPI. Altitude (≥1500m) was associated with lower LTPI, directly because of better physical health at higher altitude and indirectly through temperature, fine particulate matter, precipitation, poverty, smoking, and obesity. Urban dwelling had direct and indirect (through poverty) negative associations with LTPI. Poverty had direct and indirect (through smoking and obesity) associations with LTPI. Smoking, poverty, and black race were each positively associated with LTPI. The association between black race and LTPI was explained by poverty. Modifying influences of gender, precipitation, and altitude were identified. The significant effects of temperature, fine particulate matter, precipitation, altitude, urban dwelling, poverty, smoking, and obesity on LTPI were both direct and indirect, and sex, precipitation, and altitude modified many of these associations.

Associations of physical activity with positive mental health: A population-based study

IntroductionThe relationship between physical activity (PA) and positive mental health (PMH) has been studied mainly by either concentrating on total PA or focusing on leisure time PA. This study investigated whether total PA and PA domains of leisure time, commuting and occupational PA and screen time sitting at home were associated with PMH. MethodsThe study used a national population study, the FinHealth 2017 Study that included the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) as a measurement for PMH. Of all (n = 10305, of whom 10247 were eligible) invited, 58.1% (5952) participated in health examination and were given a questionnaire including the WEMWBS. A total of 5337 (52.1% of the eligible sample, 89.7% of the health examination participants) returned the questionnaire. The WEMWBS scale was adequately completed by 5090 participants (55.6% women, mean age 55.5 years). Low, moderate and high level of PMH categories were formed. Leisure time, occupational and commuting PA domains were assessed separately and together as a total PA index. Also, screen time sitting at home was measured. Binary logistic regression models were utilized to estimate the odds ratios for having low PMH compared with moderate PMH and separately for having high PMH compared with moderate PMH. The models were estimated both with and without adjustment for potential confounders. ResultsPhysical inactivity (total PA) was associated with lower levels of PMH. Some of the PA domains were strongly associated with low PMH; leisure time physical inactivity and long screen time sitting at home were strongly related to higher odds of low PMH. Commuting PA was associated with high PMH. ConclusionsThe study highlights the importance of PA with relation to PMH among adults. Especially, physical inactivity was strongly associated with low PMH. As low levels of PMH can potentially present a risk for mental ill-health, this study suggests it is important to increase PA among the least active population.