Inequalities in participation and time spent in moderate-to-vigorous physical activity: a pooled analysis of the cross-sectional health surveys for England 2008, 2012, and 2016

Abstract

Background Evidence is unclear on whether inequalities in average levels of moderate-to-vigorous physical activity (MVPA) reflect differences in participation, differences in the amount of time spent active, or both. Using self-reported data from 24,882 adults (Health Survey for England 2008, 2012, 2016), we examined gender-specific inequalities in these separate aspects for total and domain-specific MVPA. Methods Hurdle models accommodate continuous data with excess zeros and positive skewness. Such models were used to assess differences between income groups in three aspects: (1) the probability of doing any MVPA, (2) the average hours/week spent in MVPA, and (3) the average hours/week spent in MVPA conditional on participation (MVPA-active). Inequalities were summarised on the absolute scale using average marginal effects (AMEs) after confounder adjustment. Results Inequalities were robust to adjustment in each aspect for total MVPA and for sports/exercise. Differences between adults in high-income versus low-income households in sports/exercise MVPA were 2.2 h/week among men (95% confidence interval (CI): 1.6, 2.8) and 1.7 h/week among women (95% CI: 1.3, 2.1); differences in sports/exercise MVPA-active were 1.3 h/week (95% CI: 0.4, 2.1) and 1.0 h/week (95% CI: 0.5, 1.6) for men and women, respectively. Heterogeneity in associations was evident for the other domains. For example, adults in high-income versus low-income households were more likely to do any walking (men: 13.0% (95% CI: 10.3, 15.8%); women: 10.2% (95% CI: 7.6, 12.8%)). Among all adults (including those who did no walking), the average hours/week spent walking showed no difference by income. Among those who did any walking, adults in high-income versus low-income households walked on average 1 h/week less (men: − 0.9 h/week (95% CI: − 1.7, − 0.2); women: − 1.0 h/week (95% CI: − 1.7, − 0.2)). Conclusions Participation and the amount of time that adults spend in MVPA typically favours those in high-income households. Monitoring inequalities in MVPA requires assessing different aspects of the distribution within each domain. Reducing inequalities in sports/exercise requires policy actions and interventions to move adults in low-income households from inactivity to activity, and to enable those already active to do more. Measures to promote walking should focus efforts on reducing the sizeable income gap in the propensity to do any walking.

Relationships of Physical Activity and Diet Quality with Body Composition and Fat Distribution in US Adults

“…PA in the present study was not focused solely on recreational activities; it also considered activity at work and travel to and from places (21), which might have resulted in a higher average of weekly PA time particularly among respondents classified as meeting the PA recommendation. Nonetheless, our results are comparable to those previously published (12,40). The sample was restricted to adults aged 20 to 59, as DXA data were available only for respondents aged 59 years or younger for the data cycles used in the present study, so the findings cannot be generalized to older adults.…”

Determinants of physical activity among adults in the United Kingdom during the COVID‐19 pandemic: The DUK‐COVID study

“…If UK adults believed they had the physical opportunity and were motivated, they were more likely to have maintained or increased their PA during the lockdown. However, the majority of adults are not meeting the UK guidelines on PA and the prevalence of PA is substantially lower than national surveys prior to the pandemic (e.g., Scholes & Mindell, 2020). If the coronavirus continues to be an issue in the future, it will be critically important to identify ways to foster motivation for PA and to facilitate the opportunities for people to be physical active while adhering to public health protocol.…”

“…This is very similar to a report from Sport England (2020) in which 32% of English adults met these aerobic guidelines as of the last week in April 2020. In contrast, 63–66% of UK adults met the same guidelines between 2008 and 2018 (Scholes & Mindell, 2020; Sport England, 2018). Thus, the proportion of adults meeting these guidelines is substantially lower in the context of the COVID pandemic.…”

Are there gender based differences in participation and time spent in physical activity in Albania? Evidence from 2017-18 demographic and health survey

“…We include several socioeconomic and demographic covariates in modelling factors affecting participation and time spent in PA. The existing literature on factors affecting the decision to participate in PA guided the choice of these variables [17][18][19][20][21][22][23]45]. These factors include age categories in years; education levels; household economic status, marital status; urban/rural place of residence; 12 administrative regions; occupation status; the number of preschool and school-age children in the household; and lifestyle factors such as smoking, drinking habits, and healthy eating habits.…”