A systematic review of the relationship between socio-economic position and physical activity

Abstract

Objective The aim of the present review was to examine epidemiological evidence to determine if there is strong evidence of a positive gradient of increasing physical activity across the socio-economic strata, and how relationships are affected by socio-economic measurement. Design Systematic review. Method A search of major databases was conducted to identify published studies that reported physical activity in relation to socio-economic position (SEP) in adults. Results Twenty-eight cross-sectional and five longitudinal studies met the inclusion criteria. Approximately half of these were American. Consequently education and income were most commonly used to represent SEP. The majority of studies were secondary analyses of existing health survey data, which could explain the generally large sample sizes and methodological weaknesses in physical activity and SEP measurement. There was consistent evidence of a higher prevalence or higher levels of leisure-time or moderate-vigorous intensity physical activity in those at the top of the socio-economic strata compared with those at the bottom. Evidence for positive gradients across the socio-economic strata was less consistent. Education produced the most stable relationships, less susceptible to confounding effects of ethnicity and the environment. Conclusion Those at the top of the socio-economic scale appear to perform more leisure-time activity than those at the bottom. Diverse and often crude physical activity and socio-economic measurement made it difficult to distinguish between artefact and true effect in a relationship with so many potential confounding influences. Further studies using up-to-date methods of socio-economic and physical activity measurement are necessary to further explore this relationship and its confounders.

A mass phenomenon: The social evolution of obesity

“…In any case, however, the original result that richer individuals are, ceteris paribus, less overweight is preserved. In line with the empirical observation the extended model predicts that richer people, on average, exercise more for weight loss (Gidlow et al, 2006).…”

Arterial hypertension and associated factors in patients submitted to myocardial revascularization

“…Possible explanations for the influence of the lower socioeconomic level on health conditions of the population fall on their lack of access to the health system, beyond the lower degree of information and understanding of the disease and their determinants (24) . In addition, studies have already shown the negative impact the lower socioeconomic level exerts on physical activity and adoption of a healthy diet (25) . In the present study, the socioeconomic variable was represented by the source of funding of patient surgery, dichotomized into the SUS and non-SUS groups, but association between this variable and arterial hypertension was not demonstrated.…”

Sociodemographic and behavioural correlates of weight status among women with children living in socioeconomically disadvantaged neighbourhoods

“…12,13 Studies have also shown that physical inactivity and poor nutrition are disproportionately experienced by those experiencing socioeconomic disadvantage. [14][15][16][17][18] Efforts to reduce the high prevalence of overweight and obesity among women with children who are socioeconomically disadvantaged are currently hindered by a lack of understanding of the aetiology of weight gain and obesity in this group. Although diets high in energy and fat and sedentary lifestyles are believed to be key behaviours in the aetiology of overweight and obesity among young women generally, 3,9,10 the relative contributions of these factors to weight gain in women with children, particularly those whose risk may be increased because of living in socioeconomically disadvantage neighbourhoods, are not well understood.…”