Low-income Counterparts Research Articles

Healthcare workers' knowledge, attitudes, and practices towards cardiovascular disease prevention: a multi-national cross-sectional study

Abstract Introduction Prior studies have shown that improved primordial prevention of cardiovascular disease (CVD) may significantly delay its onset. Healthcare workers (HCWs) are well-placed to influence healthy lifestyle habits for CVD prevention. However, it is unclear how well HCWs fare in this role given the multiple demands on their time in clinical practice. Purpose We sought to understand the CVD prevention knowledge, attitudes and practices (KAPs) of HCWs across 25 nations. Insights gained could help inform efforts to optimise CVD prevention by HCWs. Methodology: Data was collected via an anonymous, online questionnaire which consisted of pre-validated CVD prevention and smoking cessation subscales adapted from the Preventive Medicine Attitudes and Activities Questionnaire (PMAAQ). The subscales have been previously validated in a study population of primary care residents in the US, demonstrating validity and reliability. Results 668 HCWs (60% doctors, 28% nurses, 12% medical students) from 25 nations responded to the survey. Overall, 74.86% of HCWs routinely assessed patients’ cardiovascular (CV) risk profiles in clinical practice. 65.65% of HCWs counselled patients who were asymptomatic for CVD on tangible lifestyle changes to improve their CV risk profiles, while 68.22% of HCWs did so when patients were overweight. Of note, only 51.26% of HCWs implemented comprehensive smoking cessation interventions for their patients. Practising HCWs demonstrated higher levels of CVD prevention promotion than medical students in all aspects (Fig 1b), except for self-reported importance of CVD risk factor counselling in primary prevention (Tukey HSD diff: 0.31, p-value: 0.051). Among practising HCWs, there were no significant differences in their promotion of CVD prevention across varying lengths of clinical practice. HCWs from higher income nations[1] tended to fare worse than their lower income counterparts in the promotion of CVD prevention (Fig 1a). Conclusion A large multi-national survey reveals significant gaps in the promotion of CVD prevention by HCWs, highlighting key differences in CVD prevention practices based on national income status. The results also demonstrate significant differences between medical students and practising HCWs’ CVD prevention behaviours, highlighting the role of continuing education for the promotion of long-term positive CVD prevention clinical practices amongst HCWs. Further efforts may target the medical education of early-career HCWs, especially in higher income nations. [1] National income level is defined as per the World Bank's classification, with the exception of Taiwan which is not classified as an independent nation under the World Bank. However, Taiwan is still labelled as a high income nation as her GNI (US$33,565) fits the criterion of the World Bank's definition of a high income nation (GNI per capita of >US$13,846).Table 1:Participant demographicsFigure 1a and 1b

Impact of household income on acute decompensated heart failure outcomes: national representative sample

Abstract Background The clinical outcomes of ADHF have been extensively studied; however, the impact of household income still needs to be better understood. This study aimed to elucidate the relationship between household income and outcomes in patients with ADHF. Methods This national retrospective cohort study used data from the 2016-2020 National Inpatient Database, focusing on patients admitted with ADHF. We stratified the cohort into two groups based on the median household income: below $50k and above $86k. The selection criteria included patients aged ≥ 18 years diagnosed with ADHF, excluding those with incomplete income data. The primary outcome was all-cause inpatient mortality, with a length of stay (LOS) and total hospital charges as secondary outcomes. Statistical analysis employed logistic and linear regressions adjusted for confounders, with the significance level set at p<0.05. We accounted for missing data using multiple imputation analyses. Results 1,123,024 patients admitted with ADHF met the inclusion criteria. We divided the groups into two cohorts: low-income (64%, N=718,735) and high-income (36%, N=404,289). No increase in mortality was identified (adjusted aOR: 1.05; p = 0.212). The study revealed that high-income patients had marginally longer average LOS (5.62 days vs. 5.35 days, p < 0.0001) and higher hospital charges ($62,512.46 vs. $49,440.14, p < 0.0001) compared to their low-income counterparts. Low-income patients exhibited a higher prevalence of hypertension and obesity, whereas high-income individuals were more affected by atrial fibrillation and hyperlipidemia (hypertension and obesity, p < 0.0001; atrial fibrillation, p < 0.0001). Conclusion In this national retrospective cohort of patients admitted for ADHF over five years, income did not affect mortality. However, LOS and total charges were affected by the median household income.

THE IMPACT OF SOCIAL FACTORS ON MEDICAL TERMINOLOGY: LANGUAGE VARIATION ACROSS DIFFERENT PATIENT GROUPS

This study explores the impact of social factors on the comprehension of medical terminology across diverse patient groups. Focusing on education level, socioeconomic status, and cultural background, the research employs a mixed-methods approach, combining surveys and interviews with 300 participants. Findings reveal significant disparities in understanding; those with higher education and income levels demonstrate better comprehension compared to their lower-income counterparts. Cultural influences further complicate communication, often leading to misunderstandings. The results underscore the necessity for healthcare providers to adopt culturally competent communication strategies and use plain language to enhance patient understanding and engagement in their healthcare.

“ChatGPT seems too good to be true”: College students’ use and perceptions of generative AI

This study investigates how U.S. college students (N = 1001) perceive and use ChatGPT, exploring its relationship with societal structures and student characteristics. Regression results show that gender, age, major, institution type, and institutional policy significantly influenced ChatGPT use for general, writing, and programming tasks. Students in their 30s–40s were more likely to use ChatGPT frequently than younger students. Non-native English speakers were more likely than native speakers to use ChatGPT frequently for writing, suggesting its potential as a support tool for language learners. Institutional policies allowing ChatGPT use predicted higher use of ChatGPT. Thematic analysis and natural language processing of open-ended responses revealed varied attitudes towards ChatGPT, with some fearing institutional punishment for using ChatGPT and others confident in their appropriate use of ChatGPT. Computer science majors expressed concerns about job displacement due to the advent of generative AI. Higher-income students generally viewed ChatGPT more positively than their lower-income counterparts. Our research underscores how technology can both empower and marginalize within educational settings; we advocate for equitable integration of AI in academic environments for diverse students.

Inequality in dental flossing behavior among Korean adults based on household income levels.

The aim of this study was to estimate the association between household income and dental flossing. This cross-sectional study investigated the impact of household income on flossing among 9,391 adults aged 30+ with ≥20 natural teeth, utilizing data from the seventh Korea National Health and Nutrition Examination Survey (2016-2018). Outcome measures included flossing (yes/no), with income categorized into 4 levels: lowest, medium to low, medium to high, and highest. Logistic regression, adjusted for age, gender, brushing frequency, recent dental exams, periodontitis, smoking, and alcohol use, was employed to evaluate the influence of socioeconomic status on oral hygiene practices. In the highest income group, flossing was 62.6% more prevalent than in the lowest income group (adjusted odds ratio [aOR], 1.63; 95% CI, 1.27 to 2.08). The strongest association between income levels and flossing was observed in individuals aged ≥70 years (aOR, 3.64; 95% CI, 1.86 to 7.11), with a decreasing strength of association in the 60s (aOR, 1.72; 95% CI, 1.05 to 2.84) and 50s age groups (aOR, 1.69; 95% CI, 1.07 to 2.68). Higher-income women demonstrated a higher frequency of flossing than their lower-income counterparts (aOR, 1.67; 95% CI, 1.24 to 2.23). Higher-income individuals without periodontitis were more likely to floss (aOR, 1.64; 95% CI, 1.23 to 2.18), and among those with periodontitis, flossing was significantly associated only with the highest income category (aOR, 1.64; 95% CI, 1.10 to 2.44). The findings of this study indicate a significant correlation between higher household income levels and an increased prevalence of flossing.

Lower taxes at all costs? Evidence from a survey experiment in four European countries

ABSTRACT It is commonly argued that citizens favour lower taxes, thereby exerting pressure for tax reductions that undermine the ability of governments to raise revenues. We argue that the ostensibly strong support for lower taxes is the result of survey measures that fail to account for fiscal trade-offs. An original survey experiment conducted in Germany, Italy, Spain, and the United Kingdom reveals that support for lower taxes declines significantly when this comes into conflict with other fiscal policy objectives, such as government spending, public debt, or other taxes. Overall, regressive changes receive less support than progressive reforms. At the individual level, preferences are shaped by self-interest and ideology, with ideology exerting a predominant influence. Notably, left-leaning, high-income voters exhibit an even stronger inclination to resist tax reductions compared to their low-income counterparts. Our findings challenge the assumption that tax cuts enjoy widespread popularity and suggest the potential for a progressive coalition against tax cuts, encompassing both low-income and affluent left-wing individuals.

The inequality of household carbon footprint in China: A city-level analysis

Climate change mitigation and carbon inequality reduction are of great significance to the sustainable development. Most of the existing studies on China's household carbon footprint inequality are at provincial level and lack in-depth analysis of cross-dimension of consumption categories. We calculated the carbon footprints in 309 city-level areas in China based on the multi-regional input-output table, and further explored the inequality of household carbon footprints from perspective of cross-dimension with Gini coefficient and Lorentz curve based on the China Family Panel Studies dataset. We found that although the carbon footprint inequality of different areas, income groups and family size were relatively high on the whole, the level of that in different consumption categories showed significant different characters. For instance, affluent demographics possess the requisite financial capacity to acquire luxury apparel, whereas economically disadvantaged cohorts predominantly procure garments at standard price points. This dynamic may engender heightened carbon disparity within the realm of clothing, with a proclivity for greater imbalances observed in high-income strata as opposed to their low-income counterparts. Specific measures for guiding residents to rationally consume luxury food and allocate educational resources, and advocate low-carbon travel to eliminate household carbon footprint inequality in China are proposed.

Factors associated with parental human papillomavirus vaccination intentions among adolescents from socioeconomically advantaged versus deprived households: a nationwide, cross-sectional survey

In the USA, HPV vaccine coverage is substantially lower among adolescents from high-income households compared to their low-income counterparts. We examined and compared the factors associated with parental HPV vaccination intentions between socioeconomically divergent groups. Data from unvaccinated and not fully HPV-vaccinated adolescents from the 2017-2021 National Immunization Survey (NIS)-Teen were analyzed. Socioeconomically advantaged vs. deprived groups were identified based on dichotomized income (material capital) and education (social capital). Parental intent to initiate and complete the HPV vaccine series was compared using bivariable analysis and the factors associated with lacking intent were identified. The 2017-2021 NIS-Teen included a total of 212,643 participants; the final analytical sample consisted of 105,958 adolescents (an estimated 10.3 million adolescents) who were unvaccinated or not fully vaccinated. In the advantaged group, 64.7% of parents of unvaccinated adolescents (equating to 2.4 million US adolescents) had no intention to initiate the HPV vaccine compared to 40.9% of parents in the deprived group (equating to 0.2 million adolescents) (P<0.0001; S>13.29). The most frequent reason for lacking intent in the advantaged group was 'safety concerns' (25.5%). In the deprived group, 'lack of knowledge', 'not recommended', and 'not needed' were common reasons (nearly 15% each). Lack of intent to complete the HPV vaccine series was higher in the advantaged group (43.9%; 1.1 million adolescents) compared to the deprived group (25.2%; 0.08 million adolescents) (P<0.0001; S>13.29). More than half in the advantaged group (58.4%) and over a third (37.1%) in the deprived group cited 'already up to date' as the main reason for not completing the HPV vaccine series. Lack of intent to initiate and complete the HPV vaccination series, particularly among socioeconomically advantaged parents is a significant barrier to achieving the national goal in the USA. The US National Institute on Minority Health and Health Disparities, the National Center for Advancing Translational Sciences, MUSC Hollings Cancer Center Seed funding, and the US National Cancer Institutes.

Death Anxiety Among Urban Middle Class: The Predictive Role of Income and Symbolic Money Attitudes

Terror management theory argues that money can function as an existential anxiety buffer. Therefore, the primary goal of this study ( N = 153) was to examine the relationship of income and symbolic money attitudes to death anxiety among middle-class individuals. In line with our predictions, results demonstrated that higher income earners experienced less death anxiety than their lower income counterparts. In addition, the more those living on low incomes regarded money as a symbol of power, the more prone to death anxiety they were. Low income and symbolic money attitudes, namely the evil and power dimensions, strongly contributed to death anxiety, with income serving as a moderator in the power dimension and death anxiety association: it was significant and positive only for those at greater risk of poverty. Personal income also seemed to play a crucial role in the connection between left–right self-placement and death anxiety, especially among male participants upon whom other people were financially dependent. Implications of these findings are discussed.

Income is not an equalizer: health development inequities by ethnoracial backgrounds in California kindergartners

BackgroundEarly childhood health development is positively associated with income, but the strength of this relationship with ethnoracial background remains unclear. This study examined the extent of health development inequities among California kindergarteners based on ethnoracial backgrounds and neighborhood-level income.MethodsThis cross-sectional study assessed health development inequities by analyzing neighborhood-level income, ethnoracial background, and health development data for California kindergarteners. Student-level data (n = 106,574) were collected through teacher report between 2010–2020 across 52 school districts and 964 schools. Student addresses were geocoded and linked to American Community Survey neighborhood income levels. Health development was measured using the Early Development Instrument, a population-level measure which includes physical health and well-being, social competence, emotional maturity, language and cognitive development, and communication skills and general knowledge domains. Outcomes included being “on-track” in each domain as well as overall health development.ResultsUsing a Generalized Estimation Equation with a log-link function, while accounting for interactions between ethnoracial background, income, and income-squared, we found significant health development inequities by ethnoracial background and neighborhood-level income. Regarding overall health development, as well as the physical, social and emotional domains, Black students had a lower likelihood of being on-track compared to the weighted average across income levels, whereas Asian students surpassed the weighted average. White students exhibited the steepest slope, and at the lowest income levels, their health development scores were akin to their Black and Hispanic/Latino/a low-income counterparts but resembled their Asian counterparts at higher income levels. For the general knowledge and communication domain, white students consistently had the highest likelihood of being on-track, while Hispanic/Latino/a students had the lowest likelihood across all income levels.ConclusionThis study examines health development inequities among California kindergarteners in diverse communities. Our analysis shows that the relationship between neighborhood-level income and kindergartners’ health development varies by domain and is weaker for students of color. Given the scarcity of population-level data on health development outcomes, these analyses offer valuable insights for identifying ecosystems necessitating support in promoting equitable early childhood health development.

Analyzing financial and economic development thresholds for carbon emission reduction: a dynamic panel regime-switching study across income levels

PurposeThis research investigates the threshold effects of the interplay between finance, development and carbon emissions across 97 countries, including 50 low-income and 47 high-income countries, during the period from 1991 to 2019.Design/methodology/approachEmploying various econometric modeling techniques such as dynamic linear regression, dynamic panel threshold regression and in/out of sample splitting, this study analyzes the data obtained from the World Bank's world development indicators.FindingsThe results indicate that low-income countries require a minimum financial development threshold of 0.354 to effectively reduce carbon emissions. Conversely, high-income countries require a higher financial development threshold of 0.662 to mitigate finance-induced carbon emissions. These findings validate the presence of a finance-led Environmental Kuznet Curve (EKC). Furthermore, the study highlights those high-income countries exhibit greater environmental concern compared to their low-income counterparts. Additionally, a minimum GDP per capita of US$ 10,067 is necessary to facilitate economic development and subsequently reduce carbon emissions. Once GDP per capita surpasses this threshold, a rise in economic development by a certain percentage could lead to a 0.96% reduction in carbon emissions across all income levels.Originality/valueThis study provides a novel contribution by estimating practical financial and economic thresholds essential for reducing carbon emissions within countries at varying levels of development.

“I Got it from my Mama:” The influence of working-class parents on young people’s cultural capital for success in school and work

In discussing what young people need in order to thrive in school and work environments, the existing education and workforce literature largely credits the types of social and cultural capital that are gained from middle-class upbringings, and rarely are working-class and low-income counterparts valued or considered conducive to achievement. In this research paper, we discuss how minoritized students from low-income homes described their first experiences in summer internships and their earliest memories related to work. Our student participants, 25 Bronx high school seniors, largely credited their guardians’ and family members’ work ethic (cultural capital) in working-class jobs as critical in their own motivational development. Our findings indicate that the experiences underrepresented youth have at home, through lessons and examples, lead to positive benefits and the development of certain forms of cultural capital, which can lead to academic success and occupational identity formation.

Emissões de carbono das famílias brasileiras por meio da POF e da matriz de insumo-produto

Abstract This study aims to comprehensively assess the carbon footprint of Brazilian households using data from the 2008 and 2018 Household Budget Survey (POF). Employing a hybrid Life Cycle Assessment methodology, our analysis reveals noteworthy insights. In 2008, households within the lower income bracket emitted approximately 4.04 tCO2e/year, decreasing to 3.81 tCO2e/year by 2018. Conversely, higher-income households emitted significantly more, with emissions of around 28.73 tCO2e/year in 2008, decreasing to 25.94 tCO2e/year by 2018 - almost seven times the emissions of their lower-income counterparts. Intriguingly, although constituting merely 2.47% of all families in 2018, the wealthiest households were responsible for 8.31% of total emissions, while the poorest, representing 24.25%, contributed to 11.97% of emissions. The imperative for affluent families, who exert a disproportionate environmental impact, lies in reconsidering consumption habits and actively seeking low-emission alternatives to curtail their carbon footprint.

The spatial distribution of businesses and neighborhoods: What industries match or mismatch what neighborhoods?

Using the Longitudinal Employer-Household Dynamic (LEHD) and American Community Survey (ACS), we evaluate the spatial relationship between businesses and neighborhoods through exploring the effects of homeownership rates on the job counts of businesses located at various distances to the neighborhoods. The effects of interest are evaluated for neighborhoods of different income levels and businesses of various types. To construct the spatial framework, we first cluster the businesses and then draw residential donut rings of different radii surrounding the business clusters. To control for any fixed locational and temporal features affecting the location choices of both households and businesses, we employ a fixed-effect (FE) identification strategy, where a positive (negative) coefficient suggests that the businesses match (mismatch) the neighborhoods with a higher concentration of homeowners. Our findings show that no industries mismatch the higher-income homeowners, whereas a mismatch exists between their lower-income counterparts and the industries of food and entertainment; the industries that match homeowners of both income groups include retail trade, whole trade, and education. In addition to these three sectors, health, professional services, and entertainment match the higher-income homeowners, whereas construction and transportation match the lower-income ones; for retail trade and whole trade, the matching occurs at a shorter distance between the lower income neighborhoods and businesses. Our results can assist the government in perfecting zoning regulations, developing subsidizing policies, and constructing affordable housing programs.

Residential relocations and changes in vehicle ownership

While the relationship between automobile ownership and the built environment is well established, less is known about how household relocations—specifically, moves between urban and suburban geographies—affect the likelihood of owning an automobile. Using the Panel Study of Income Dynamics and a refined neighborhood typology, I examine the relationship between inter-geography moves and transitions into and out of carlessness. Results suggest that among low-income households, urban-to-suburban movers have an increased likelihood of becoming car owners; those moving in the “opposite” direction—from suburban to urban neighborhoods—show a high propensity to transition into carlessness. Patterns among higher-income households, while similar, are more pronounced. In particular, higher-income carless households that make urban-to-suburban moves are far more likely to become car owners than their low-income counterparts. This highlights the ease with which higher-income households adjust their car ownership levels to suit their post-move neighborhoods. Higher-income suburban-to-urban movers are also more likely to transition into carlessness than low-income households. Importantly, however, only households at the bottom end of the “higher income” distribution have an increased propensity to become carless; suburban-to-urban movers with more financial resources maintain vehicle ownership rates similar to households that remain in the suburbs.

Income-based inequalities in self-reported moderate-to-vigorous physical activity among adolescents in England and the USA: a cross-sectional study

ObjectiveQuantify income-based inequalities in self-reported moderate-to-vigorous physical activity (MVPA) in England and the USA by sex.DesignPopulation-based cross-sectional study.Participants4019 adolescents aged 11–15 years in England (Health Survey for England 2008, 2012,...

The College Promise in Communities: Do Place-based Scholarships Affect Residential Mobility Patterns?

Place-based scholarships within the College Promise movement reduce the cost of college for students in particular places and often include incentives for families to live in places for a longer period of time to capture full program benefits. This financial incentive may change the residential mobility decisions of people living in and around Promise-targeted locations, potentially affecting a community’s composition and who can benefit from the scholarship. We use difference-in-differences with census tract-level data from the American Community Survey to assess whether the New Haven Promise, Say Yes Buffalo, or La Crosse Promise affect residential mobility based on household income, race/ethnicity, and age in their respective cities. We find evidence of overall in-migration due to program introduction, driven by the Say Yes Buffalo program, but corresponding decreases in those staying in treated Buffalo and La Crosse census tracts. Further, we find that White, high income residents are more likely to stay in New Haven to take advantage of the program. We also find a potential displacement effect in La Crosse for families with children, suggesting that originally targeted residents moved out the Promise-targeted areas, but that new families with children moved in as a result of the program. Overall, our short-term impacts suggest that since moving is expensive, higher income families are more likely to benefit from these programs than their lower income counterparts by having more control of whether, when, and where to move. Implications for communities and program (re)design are discussed.

Class-based differences in the use of (aggressive) humor: The mediating role of empathic concern

Recent research indicates that individuals’ social class (SC) is connected to a wide range of psychological outcomes. Nonetheless, the question of how SC is related to people's uses of humor during social interactions remains unexplored. Consequently, in this research, we tested whether a person's SC, as measured by both objective indices of material wealth (i.e., income and educational attainment) and subjective perceptions of one’ SC standing, is differentially related to affiliative and aggressive forms of humor. Study 1 (N = 156; 52.6% females) showed that there were no class-based differences in the use of affiliative humor, but provided preliminary support for a positive association between income and aggressive humor – even after controlling for age and gender. Study 2 (N = 201; 54.2% females) widely replicated these findings and revealed that the income-aggressive humor relationship was mediated by empathic concern. Overall, our results suggest that higher-income individuals, relative to their lower-income counterparts, tend to use aggressive humor more often because of their reduced others-oriented feelings of sympathy and compassion. To our knowledge, this research contains the first empirical evidence on the association of SC and the way in which individuals habitually use humor in their day-to-day lives.

A Case-Control Study Examining Disparities in Clinical Trial Participation Among Breast Surgical Oncology Patients.

BackgroundClinical trial participation among racial and ethnic minorities remains low despite national efforts. We sought to determine how participation in clinical trials by breast surgical oncology patients has changed over time and what characteristics are associated with participation. MethodsWomen with breast cancer enrolled in National Cancer Institute–sponsored, cooperative-group trials from 2000 to 2012 and who underwent oncologic surgery (n = 17 125) were compared with trial-eligible women in the National Cancer Database diagnosed in 2000–2012 (n = 792 719). Race-specific trial participation was plotted over time by income and reported as a proportion of the combined cohorts. Factors associated with trial participation were estimated using logistic regression; we report odds ratios (ORs) with 95% confidence intervals (CIs). A P value less than .05 was considered statistically significant for all analyses. All tests were two-sided.ResultsParticipation declined across all groups over time because of a decrease in the scale and number of trials. In 2000–2003, Asian–Pacific Islander (7.17%), Hispanic (3.48%), and white (7.13%) patients from the highest income group had higher participation than their lower-income counterparts (Asian–Pacific Islander: 3.95%; Hispanic: 2.67%; white: 5.96%), but by 2008–2012, only high-income white patients participated more than lower-income whites (0.32% vs 0.25%, all P < .01). Black (OR = 0.80, 95% CI = 0.75 to 0.85) and Hispanic (OR = 0.84, 95% CI = 0.77 to 0.92) patients were less likely to participate than whites, but there were statistically significant interactions between income and race and ethnicity, with high-income black patients being approximately 50% less likely to participate than lower-income blacks (all P < .001). ConclusionsMultifaceted interventions addressing the intersectionality of race, ethnicity, and other patient characteristics are needed to address persistent disparities in trial participation among breast surgical oncology patients.

Vigorous and moderate physical activity among overweight and obese adults in Malaysia: Sociodemographic correlates

BackgroundThis study examines the effects of sociodemographic factors on participation in vigorous and moderate physical activity and how they vary across bodyweight group (underweight, normal, overweight, obese I, obese II). MethodsThis study uses a nationally representative data with a sample of 10141 respondents. Bivariate and multivariate analyses are stratified by bodyweight group. The intensity of physical activity is measured using metabolic equivalent (MET). Vigorous physical activity has >6 MET, while moderate physical activity has ≤6 MET. ResultsSeveral important findings are noteworthy. First, age has a positive impact on moderate physical activity among obese I individuals but a negative impact on moderate physical activity among obese II individuals. Second, education is significant in determining participation in all intensity levels of physical activity among obese I individuals. Third, higher income obese II individuals spend less time in vigorous physical activity than their lower income counterparts. However, higher income overweight and obese I individuals spend less time in moderate physical activity compared with those who have lower income. Fourth, overweight, obese I and obese II males spend more time in vigorous and total physical activity than their female counterparts, but they allocate less time for moderate physical activity. ConclusionsIt appears that sociodemographic factors play an important role in determining participation in vigorous and moderate physical activity among overweight and obese adults. We conclude by discussing implications for policies directed towards promoting physically active lifestyle among overweight and obese adults who are unlikely to spend time in physical activity.