Research articleActive Transportation Increases Adherence to Activity Recommendations
Introduction
Disparities in health outcomes among different demographic groups are one of the greatest public health challenges of the United States.1 A major question concerning these disparities involves the relative contributions of individual health behaviors, interactions between individuals and the healthcare system, the consequences of differing demographic characteristics, such as race/ethnicity or socioeconomic status (SES), and the effects of environment on health.2, 3 Chronic diseases including diabetes, cardiovascular disease, and cancer at multiple sites are influenced by diet, weight, and physical activity. Levels of physical activity (PA), independent of diet and obesity, have been linked (mainly in observational studies) to diverse health outcomes including cardiovascular disease, diabetes, and cancer at several sites.4, 5, 6, 7 Understanding the associations between PA and demographic variables might help explain health disparities and account for the differing prevalence of obesity and other adverse health outcomes in different demographic groups.8
Data from national and regional surveys indicate that the prevalence of leisure-time physical activity (LTPA) or leisure-time physical inactivity (LTPI) among demographic groups parallel disparities in the prevalence of health conditions related to physical activity. For example, LTPI was more prevalent in African-American and Mexican-American men and women than non-Hispanic whites based on data from a nationally representative survey, and the prevalence of diabetes and cardiovascular disease are greater in these populations as well.9 Most past studies of physical activity prevalence have focused on LTPA and have demonstrated higher levels of LTPA in men, younger people, subjects with higher income, and those with higher education levels.10 Non–leisure-time PA occurs in the home, workplace, and for transportation. Several studies have documented levels of occupational PA in diverse populations.11, 12 Self-reported occupational PA is higher in those with less than 12 years education and younger people, and in lower-income respondents, non-Hispanic blacks, and Hispanics.11 However, few large health surveys address transportation behavior, and no large U.S. health survey allows a quantitative assessment of leisure, transportation, domestic, and occupational PA. The 2001 California Health Interview Survey (CHIS) does provide a unique opportunity to examine the potential contribution of transportation-related PA to overall PA for a large and diverse sample of California adults. This study focuses on the hypothesis that the inclusion of non–leisure-time walking and bicycling (NLTWB) may reduce the magnitude of apparent disparities in adherence to PA recommendations.
Section snippets
Methods
Data from the 2001 CHIS was used for this study; CHIS is a large (n =56,270 households) random-digit-dial telephone survey designed to give state- plus local-level estimates of the prevalence of diverse health indicators and health behaviors. The survey was administered in seven languages (English, Spanish, Mandarin, Cantonese, Vietnamese, Korean, and Khmer). The CHIS 2001 weighted response rate, based on the American Association for Public Opinion Research Response Rate 4 (RR4)13 was 37.7%
Results
Prevalence of adherence to physical activity (PA) recommendations based on LTPA and NLTWB are presented in Table 1 along with prevalence of none of the reported activity. The remainder of the respondents reported some LTPA or NLTWB. Overall, 28% of Californians reported no LTPA, and 59% reported no NLTWB. Several results are noteworthy. Adherence based on LTPA was greater in men than women, declined with age, increased with education and income level, and showed clear associations with
Discussion and Conclusions
Data from the 2001 CHIS shows that inclusion of NLTWB reduces, but does not eliminate, apparent disparities in adherence to recommendations concerning PA as a function of gender, age, race/ethnicity, income, and education. This result is relevant to the design and dissemination of public health messages concerning inactivity and its potential role as a contributor to obesity and other health disparities. For example, interventions aimed at populations reporting high levels of transportation
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2019, Journal of Nutrition Education and BehaviorCitation Excerpt :First, in a study of 6 countries, 2 of which contained this study's target population, Bauman et al41 found that more males than females engaged in LTPA in both Fiji (69.4% vs 41.1%) and Nauru (17.2% vs 3.5%). Second, Berrigan and colleagues44 reported that more Pacific Islander males than females (49.9% vs 34.2%) adhered to the LTPA. Third, Behrens et al38 also found that more Tongan males than females (11.1% vs none) met the PAG.
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