BACKGROUND:Understanding socioeconomic disparities in physical activity is important, given its contribution to overall population-wide health and to health disparities. Existing studies examining trends in these disparities have focused exclusively on physical activity during leisure-time and have not investigated the potential moderators of socioeconomic disparities in physical activity. Using self-reported data from the US National Health and Nutrition Examination Survey (NHANES) 2007 to 2016 for 29,039 adults aged 20 years and over we examined education-related disparities in overall (total) moderate-to-vigorous intensity physical activity, and in its sub-components, recreational (leisure-time) and non-recreational (active transportation and work) activity. We also examined if education-related disparities in physical activity were moderated by age, gender, and race/ethnicity. METHODS:Logistic regression models were used to evaluate disparities in physical activity according to education group and their moderation across age, gender, race/ethnicity, and time-period. RESULTS:Overall activity levels (% ≥150 min/week) were highest amongst highly educated adults, yet contrasting education-related disparities were found for recreational and non-recreational activities (active transportation and work), favoring the highest- and lowest-educated groups respectively. Within each domain of activity, associations were moderated by age and race/ethnicity, and by gender for work-based activity. The net result was that education-related disparities in total activity were substantially larger in older adults (P < 0.001) and amongst women (P < 0.001). For example, the estimated difference in the probability of being active in the highest versus the lowest educational groups was 23.1% (95% CI: 19.1, 27.2) amongst those aged ≥60 years, yet 10.8% (95% CI: 7.1, 14.6) amongst those aged 20-39. CONCLUSIONS:Education-related disparities in physical activity persisted from 2007 to 2016. Our results suggest that understanding and addressing these disparities requires assessment of their multiple domains, and identification of the demographic sub-groups for which the disparities are more or less pronounced.

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背景:了解体育活动中的社会经济差异很重要,因为它对整个人群的整体健康和健康差异做出了贡献。现有研究检查这些差异趋势的研究仅专注于休闲时间的体育活动,而没有调查体育活动中社会经济差异的潜在调节因素。使用2007年至2016年美国国家健康与营养调查(NHANES)的自我报告数据,对29,039名20岁及以上的成年人进行了调查,研究了总体(总计)中度至剧烈强度的体育活动以及它的子部分是娱乐活动(休闲时间)和非娱乐活动(主动运输和工作)活动。我们还检查了是否因年龄,性别和种族/民族而减轻了与体育锻炼有关的与教育有关的差异。
方法:采用逻辑回归模型根据教育人群和年龄,性别,种族/民族和时间段的差异来评估体育活动中的差异。
结果:受过高等教育的成年人的总体活动水平(%≥150分钟/周)最高,但在娱乐和非娱乐活动(主动运输和工作)中发现了与教育相关的差异,偏向于受过最高和最低教育组。在每个活动领域中,协会都是按年龄和种族/民族,以及按性别参加基于工作的活动进行管理的。最终结果是,与教育相关的总活动差异在老年人(P <0.001)和女性(P <0.001)中明显更大。例如,在60岁以上的人群中,最高和最低文化程度的人群活跃度的估计差异为23.1%(95%CI:19.1,27.2),而10.8%(95%CI:7.1,14.6) )在20-39岁之间。
结论:与体育活动有关的与教育有关的差异在2007年至2016年期间持续存在。我们的结果表明,了解和解决这些差异需要评估其多个领域,并确定差异明显的人口子群体。

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