Socioeconomics inequities associated with different domains of physical activity: results of the National Health Survey 2019, Brazil

Cruz, Danielle Keylla Alencar; Silva, Kelly Samara da; Lopes, Marcus Vinicius Veber; Parreira, Fernanda Ramos; Pasquim, Heitor Martins

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Brasil

Epidemiologia e Serviços de Saúde

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Brasil

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Original Article • Epidemiol. Serv. Saúde 31 (spe1) • 2022 • https://doi.org/10.1590/SS2237-9622202200015.especial copy

Socioeconomics inequities associated with different domains of physical activity: results of the National Health Survey 2019, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To examine the socioeconomic indicators associated with engagement in physical activity (PA) in the leisure-time, transportation, domestic and occupational domains, in Brazilian adults.

Methods:

Cross-sectional study with secondary data from the National Health Survey (PNS), conducted in 2019. The factors associated with engagement in PA were analyzed using logistic regression.

Results:

The study involved 88,500 Brazilian adults with mean age of 45 ± 17.5 years old. Longer working hours [odds ratio (OR) = 0.74; 95%CI 0.66;0.82; > 40h vs. ≥ 20h] and female sex (OR = 0.67; 95%CI 0.63;0.71) were associated with lower chances of engaging in leisure-time PA. Higher income (OR = 3.20; 95%CI 2.79;3.67; > 5 vs. ≥ minimum wage) and education level (OR = 3.01; 95%CI 2.74;3.32 - complete higher education vs. incomplete elementary school) were positively associated with leisure-time PA.

Conclusion:

Socioeconomic correlates were strongly related to engagement in PA in Brazilian adults, suggesting a pattern of inequity marked by the need for survival, which is socially reproduced.

Keywords:
Cross-Sectional Studies; Motor Activity; Public Health; Social Determinants of Health; Descriptive Epidemiology; Socioeconomic Factors

Variables	% (95%CI)^a
Census classification
Urban	86.2 (86.0;86.4)
Rural	13.8 (13.7;14.0)
Per capita income (minimum wages)
Up to 1/2	22.0 (21.6;22.5)
> 1/2 to 1	29.2 (28.7;29.7)
> 1 to 2	28.2 (27.6;28.7)
> 2 to 3	9.1 (8.7;9.4)
> 3 to 5	6.4 (6.1;6.6)
> 5	5.2 (4.9;5.4)
Educaton
Incomplete elementary education	34.8 (34.2;35.3)
Complete elementary education	14.5 (14.1;14.9)
Complete high school	34.9 (34.4;35.5)
Complete higher education	15.8 (15.4;16.2)
Sex
Male	46.9 (46.3;47.4)
Female	53.2 (52.6;53.7)
Age groups (years)
18 to 24	13.9 (13.4;14.4)
25 to 39	29.2 (28.7;29.8)
40 to 59	35.3 (34.7;35.9)
≥ 60	21.6 (21.2;22.1)
Race/skin color
White	43.3 (42.7;43.8)
Black	11.5 (11.1;11.8)
Brown	43.8 (43.2;44.4)
Lives with a spouse
No	38.6 (38.0;39.2)
Yes	61.4 (60.8.0;62)
Work/employment status
In the labor force and occupied	61.3 (60.7;61.8)
In the labor force and unoccupied	5.3 (5.0;5.6)
Out of the labor force	33.5 (32.9;34.0)
Working hours ^b (hours per week)
Up to 20	12.9 (12.4;13.4)
21 to 30	10.5 (10.1;10.9)
31 to 40	33.1 (32.4;33.8)
> 40	43.5 (42.8;44.3)

Variables	% (95%CI)^a
Domestic
No	84.2 (83.8;84.6)
Yes	15.8 (15.4;16.3)
Occupational ^a
No	52.0 (51.2;52.8)
Yes	48.0 (47.2;48.8)
Transportation
No	50.4 (49.9;51.0)
Yes	49.6 (49.0;50.1)
Leisure time
No	59.5 (58.9;60.1)
Yes	40.5 (39.9;41.1)
Most frequent activity during leisure time
Does not engage in any	59.5 (58.9;60.1)
Walking/hiking	15.4 (15.0;15.8)
Running	2.2 (2.1;2.4)
Cycling	2.0 (1.8;2.2)
Weight training/muscle strengthening	8.6 (8.2;8.9)
Aerobics/academy gymnastics	3.2 (3.0;3.4)
Sports	8.2 (7.8;8.5)

Variables	PA domains
	Domestic	Transportation	Leisure time	Occupational^a
	OR^b (95%CI)^c	OR (95%CI)^c	OR (95%CI)^c	OR (95%CI)^c
Census classification
Urban	1.00	1.00	1.00	1.00
Rural	1.06 (0.97;1.14)	0.67 (0.63;0.71)	0.79 (0.75;0.85)	1.61 (1.49;1.74)
Per capita income (minimum wages)
Up to 1/2	1.00	1.00	1.00	1.00
> 1/2 to 1	0.95 (0.86;1.04)	0.77 (0.72;0.83)	1.24 (1.15;1.34)	0.85 (0.78;0.94)
> 1 to 2	1.03 (0.92;1.14)	0.61 (0.57;0.66)	1.58 (1.45;1.71)	0.79 (0.72;0.88)
> 2 to 3	0.99 (0.85;1.15)	0.54 (0.49;0.60)	2.09 (1.87;2.33)	0.71 (0.62;0.81)
> 3 to 5	0.94 (0.79;1.13)	0.54 (0.48;0.61)	2.39 (2.11;2.70)	0.61 (0.52;0.71)
> 5	0.67 (0.55;0.81)	0.51 (0.45;0.58)	3.20 (2.79;3.67)	0.54 (0.45;0.63)
Education
Incomplete elementary education	1.00	1.00	1.00	1.00
Complete elementary education	1.31 (1.18;1.46)	0.99 (0.92;1.07)	1.40 (1.28;1.52)	0.86 (0.77;0.95)
Complete high school	1.32 (1.21;1.45)	1.01 (0.94;1.07)	1.95 (1.82;2.09)	0.62 (0.56;0.67)
Complete higher education	1.21 (1.07;1.38)	0.84 (0.76;0.92)	3.01 (2.74;3.32)	0.38 (0.33;0.42)
Sex
Male	1.00	1.00	1.00	1.00
Female	2.85 (2.63;3.08)	1.21 (1.15;1.27)	0.67 (0.63;0.71)	0.66 (0.62;0.71)
Age group (years)
18 to 24	1.00	1.00	1.00	1.00
25 to 39	1.51 (1.32;1.71)	0.88 (0.80;0.96)	0.73 (0.67;0.80)	1.09 (0.97;1.24)
40 to 59	1.57 (1.38;1.78)	0.96 (0.87;1.05)	0.61 (0.56;0.67)	1.10 (0.97;1.24)
≥ 60	0.88 (0.76;1.02)	0.90 (0.82;1.00)	0.43 (0.39;0.48)	0.89 (0.76;1.04)
Race/skin color
White	1.00	1.00	1.00	1.00
Black	1.15 (1.02;1.28)	1.36 (1.25;1.47)	0.99 (0.91;1.08)	1.19 (1.07;1.32)
Brown	0.99 (0.92;1.07)	1.11 (1.05;1.17)	1.01 (0.96;1.07)	1.04 (0.96;1.12)
Lives with a spouse
No	1.00	1.00	1.00	1.00
Yes	1.34 (1.25;1.44)	0.79 (0.75;0.83)	0.91 (0.86;0.96)	1.01 (0.95;1.09)
Work status and working hours (hours per week)
Up to 20	1.00	1.00	1.00	1.00
21 to 30	0.82 (0.70;0.96)	0.90 (0.80;1.02)	0.95 (0.84;1.08)	1.34 (1.17;1.52)
31 to 40	0.72 (0.63;0.82)	0.72 (0.65;0.80)	0.82 (0.74;0.91)	1.41 (1.26;1.58)
> 40	0.71 (0.62;0.80)	0.70 (0.63;0.77)	0.74 (0.66;0.82)	1.71 (1.53;1.91)
Out of the labor force	0.73 (0.65;0.82)	0.44 (0.40;0.49)	0.87 (0.79;0.97)	-
In the labor force and unoccupied	1.26 (1.06;1.49)	0.70 (0.60;0.80)	0.97 (0.83;1.12)	-

Variables	Walking	Running	Cycling	Weight/Muscle training	Aerobics	Sports
Variables	OR^a (95%CI)^b	OR (95%CI)^b	OR (95%CI)^b	OR (95%CI)^b	OR (95%CI)^b	OR (95%CI)^b
Census classification
Urban	1.00	1.00	1.00	1.00	1.00	1.00
Rural	0.82 (0.76;0.90)	0.41 (0.30;0.55)	0.49 (0.36;0.68)	0.46 (0.39;0.55)	0.37 (0.29;0.47)	1.24 (1.10;1.38)
Per capita income (minimum wage)
Up to 1/2	1.00	1.00	1.00	1.00	1.00	1.00
> 1/2 to 1	1.29 (1.17;1.42)	1.20 (0.90;1.60)	1.31 (0.82;2.08)	1.66 (1.40;1.97)	1.33 (1.05;1.68)	0.88 (0.77;1.01)
> 1 to 2	1.54 (1.39;1.72)	1.81 (1.37;2.38)	1.42 (0.88;2.29)	2.67 (2.25;3.17)	2.02 (1.59;2.56)	0.94 (0.80;1.10)
> 2 to 3	1.85 (1.60;2.13)	2.46 (1.78;3.40)	1.52 (0.88;2.63)	4.26 (3.48;5.21)	3.43 (2.38;4.93)	1.03 (0.83;1.29)
> 3 to 5	2.05 (1.74;2.41)	3.12 (2.14;4.55)	1.91 (1.03;3.54)	5.07 (4.10;6.27)	3.55 (2.54;4.96)	1.16 (0.88;1.53)
> 5	2.11 (1.74;2.56)	5.22 (3.59;7.58)	2.39 (1.30;4.39)	8.65 (6.93;10.79)	4.54 (3.21;6.42)	1.54 (1.16;2.04)
Education
Incomplete elementary education	1.00	1.00	1.00	1.00	1.00	1.00
Complete elementary education	1.20 (1.07;1.34)	2.09 (1.45;3.01)	1.48 (1.13;1.94)	1.73 (1.41;2.11)	1.20 (0.91;1.60)	1.81 (1.55;2.11)
Complete high school	1.71 (1.56;1.87)	4.53 (3.39;6.07)	1.81 (1.36;2.41)	3.32 (2.84;3.87)	1.83 (1.43;2.34)	2.13 (1.85;2.45)
Complete higher education	2.24 (1.98;2.55)	8.75 (6.35;12.05)	2.29 (1.64;3.19)	6.04 (5.07;7.20)	2.73 (2.06;3.62)	2.93 (2.40;3.59)
Sex
Male	1.00	1.00	1.00	1.00	1.00	1.00
Female	1.12 (1.04;1.21)	0.29 (0.24;0.35)	0.30 (0.24;0.37)	1.01 (0.91;1.12)	3.90 (3.08;4.95)	0.08 (0.06;0.09)
Age group (years)
18 to 24	1.00	1.00	1.00	1.00	1.00	1.00
25 to 39	1.19 (1.00;1.42)	0.72 (0.56;0.94)	0.83 (0.58;1.20)	0.75 (0.64;0.87)	0.81 (0.64;1.04)	0.44 (0.38;0.51)
40 to 59	1.86 (1.57;2.21)	0.45 (0.34;0.58)	0.70 (0.51;0.97)	0.41 (0.35;0.48)	0.81 (0.63;1.04)	0.17 (0.14;0.20)
≥ 60	1.44 (1.20;1.73)	0.14 (0.09;0.22)	0.65 (0.43;0.97)	0.25 (0.21;0.30)	0.68 (0.50;0.92)	0.04 (0.03;0.05)
Race/skin color
White	1.00	1.00	1.00	1.00	1.00	1.00
Black	0.94 (0.83;1.05)	1.00 (0.77;1.29)	0.67 (0.48;0.93)	0.96 (0.81;1.12)	1.04 (0.81;1.33)	1.33 (1.14;1.55)
Brown	1.04 (0.97;1.13)	1.06 (0.89;1.27)	0.66 (0.51;0.84)	0.95 (0.86;1.06)	1.11 (0.94;1.31)	1.14 (1.02;1.29)
Lives with a spouse
No	1.00	1.00	1.00	1.00	1.00	1.00
Yes	1.06 (0.99;1.14)	0.98 (0.82;1.18)	1.23 (1.00;1.51)	0.70 (0.64;0.77)	1.02 (0.89;1.17)	0.94 (0.84;1.05)
Work status and working hours (hours per week)
Up to 20	1.00	1.00	1.00	1.00	1.00	1.00
21 to 30	0.90 (0.76;1.06)	1.15 (0.78;1.69)	0.74 (0.49;1.13)	1.06 (0.85;1.32)	1.05 (0.74;1.50)	0.83 (0.62;1.09)
31 to 40	0.67 (0.59;0.77)	1.17 (0.85;1.61)	0.83 (0.57;1.21)	0.94 (0.78;1.13)	0.89 (0.67;1.18)	0.81 (0.64;1.02)
> 40	0.65 (0.57;0.75)	0.98 (0.72;1.33)	0.66 (0.48;0.92)	0.85 (0.71;1.02)	0.76 (0.56;1.04)	0.70 (0.55;0.88)
Out of the labor force	0.95 (0.84;1.07)	0.94 (0.67;1.31)	0.60 (0.40;0.90)	0.87 (0.72;1.04)	1.03 (0.78;1.37)	0.62 (0.48;0.80)
In the labor force and unoccupied	1.12 (0.92;1.35)	1.25 (0.82;1.90)	0.43 (0.27;0.68)	1.09 (0.84;1.41)	1.03 (0.65;1.63)	0.74 (0.55;0.99)

Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 61 3315-3464, Fax: +55 61 3315-3464 - Brasília - DF - Brazil
E-mail: ress.svs@gmail.com

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[1] Correspondence
Danielle Keylla Alencar danielle.cruz@saude.gov.br