Socioeconomic Inequalities in Physical Activity and Sedentary Behaviour among the Chilean Population: A Systematic Review of Observational Studies

Abstract

Socioeconomic inequalities in physical (in)activity and sedentary behaviours are key mediators in obesity and health socioeconomic inequalities. Considering the high and uneven obesity rates in Chile, this review aims to systematically assess the socioeconomic inequalities in physical activity (PA) and sedentary behaviour (SB) among the Chilean population from different age groups. Peer-reviewed and grey literature were searched from inception until 31st December 2019 in PubMed, Scopus, PsycINFO, Web of Sciences and LILACS. Publications in English and Spanish, from observational studies that reported the comparison of at least one indicator of PA or SB between at least two groups of different socioeconomic positions (SEP), from the general Chilean population, were included. Data searches, screening, extraction, and quality assessment, using the Newcastle Ottawa Quality Assessment Scale for observational studies, were conducted by two independent researchers. Seventeen articles (from 16 studies) met the inclusion criteria (14 cross-sectional; two cohort). Across these, quality was considered low, medium and high for 19%, 69% and 13%, respectively. Results showed consistent evidence for a lower leisure-time PA and sitting time, and higher physical inactivity among adults from the lower, compared to the highest, SEP groups. Associations between SEP and total PA, moderate-to-vigorous PA, low PA, and transport and work-related PA were inconsistent. These findings provide insights to public health and physical activity researchers and policymakers aiming to reduce socioeconomic inequalities in PA and SB in Chile and other countries.

Refining index to measure physical activity inequality: which group of the population is the most vulnerable?

“…Previous studies have consistently reported that socio-economic inequality in PA was driven by income, education, and occupation differentials. Higher-SES individuals are more likely to have more opportunity to engage in recreational PA, whereas their lower-SES counterparts engaged mostly in work-related PA [ 16 , 18 ]. Among the higher-SES, inequality was mostly related to access to leisure PA, as increased income is generally correlated with increased work hours and reduced leisure time [ 4 ].…”

“…Urban–rural and regional disparities in PA have been documented worldwide. With regard to exposure to health promotion initiatives and access to PA amenities, urban dwellers and those who reside in the more developed regions of the world accumulated more PA minutes than their rural counterparts [ 1 , 6 , 16 – 18 ]. However, this study found PA inequality in all regions of Thailand, with the largest gaps in Bangkok.…”

“…Previous studies have consistently reported that gender inequality in PA occurs because the nature of sports and exercise favors males [ 16 , 18 ]. Females appeared to be at a natural disadvantage because the proportion who could comply with the recommended MVPA was consistently lower than their male counterparts, resulting in fewer minutes of MVPA [ 1 , 5 , 38 ].…”

“…Socio-economic inequality in PA also has been frequently reported. Individuals from lower SES (i.e., lower level of education) were more likely to engage in workrelated PA and have less opportunity for recreational PA compared to their higher-SES counterparts [16][17][18]. Regional disparities are reflected by a higher level of inactivity among Latin American, Central Asian, and northern-hemisphere countries [1].…”

Prevalence of non-alcoholic fatty liver disease and its association with lifestyle habits in adults in Chile: a cross-sectional study from the National Health Survey 2016–2017

“…Since Chile has the highest prevalence of excess body weight among the OECD countries, a substantial economic burden is expected in the following years (2,(37)(38)(39)(40) . Indeed, obesity-related conditions are major risk factors for death and disability (41) , reducing the country's Gross Domestic Product by 3•8 % per year (42) .…”