Equity impacts of interventions to increase physical activity among older adults: a quantitative health impact assessment

Abstract

Background: Behavioural interventions may increase social inequalities in health. This study aimed to project the equity impact of physical activity interventions that have differential effectiveness across education groups on the long-term health inequalities by education and gender among older adults in Germany. Methods: We created six intervention scenarios targeting the elderly population: Scenarios #1-#4 applied realistic intervention effects that varied by education (low, medium high). Under scenario #5, all older adults adapted the physical activity pattern of those with a high education. Under scenario #6, all increased their physical activity level to the recommended 300 min weekly. The number of incident ischemic heart disease, stroke and diabetes cases as well as deaths from all causes under each of these six intervention scenarios was simulated for males and females over a 10-year projection period using the DYNAMO-HIA tool. Results were compared against a reference-scenario with unchanged physical activity. Results: Under scenarios #1-#4, approximately 3589-5829 incident disease cases and 6248-10,320 deaths could be avoided among males over a 10-year projection period, as well as 4381-7163 disease cases and 6914-12,605 deaths among females. The highest reduction for males would be achieved under scenario #4, under which the intervention is most effective for those with a high education level. Scenario #4 realizes 2.7 and 2.4% of the prevented disease cases and deaths observed under scenario #6, while increasing inequalities between education groups. In females, the highest reduction would be achieved under scenario #3, under which the intervention is most effective amongst those with low levels of education. This scenario realizes 2.7 and 2.9% of the prevented disease cases and deaths under scenario #6, while decreasing inequalities between education groups. Under scenario #5, approximately 31,687 incident disease cases and 59,068 deaths could be prevented among males over a 10-year projection period, as well as 59,173 incident disease cases and 121,689 deaths among females. This translates to 14.4 and 22.2% of the prevented diseases cases among males and females under scenario #6, and 13.7 and 27.7% of the prevented deaths under scenario #6.

Estimating the impact of tax policy interventions on the projected number and prevalence of adults with type 2 diabetes in Germany between 2020 and 2040

“… 45 Another example is a web-based physical activity intervention which may avert approximately 8000 disease cases and 13 000 deaths among the population aged >55 years in Germany over a 10-year period. 46 Similar comparisons might be useful with regard to screening programs for people at high risk of type 2 diabetes and with regard to the effects of food labeling such as the Nutri-Score, which was recently introduced to Germany. 47…”

Evidenzbasierung in Primärprävention und Gesundheitsförderung: Methoden und Vorgehensweisen in 5 Forschungsverbünden

“…[ 14 ]) und einer Folgenabschätzung zur gesundheitlichen Chancengleichheit [ 15 ], die eine Modellierung und Quantifizierung erwarteter Gesundheitseffekte durch bewegungsförderliche Interventionen bei Älteren beinhaltete. Gesundheitliche Chancengleichheit wurde ebenfalls mittels Modellierung von Szenarien zu sozialen Unterschieden bei der Untersuchung der Interventionswirksamkeit aufgegriffen, wodurch konkrete Hinweise für eine angemessene Umsetzung der Erkenntnisse in Public-Health-Maßnahmen erarbeitet wurden [ 15 ]. Insgesamt konnte durch die intensive Abstimmung im Verbund ein Vorgehen umgesetzt werden, das die Komplexität der Förderung körperlicher Aktivität bei Älteren berücksichtigt und ein gemeinsames Lernen von Forschenden und Akteur*innen ermöglicht.…”

Socioeconomic disparities and inequality of mass sports participation: Analysis from Chinese General Social Survey 2010–2018

“…With the improvement of social and economic levels, human values gradually surpass the pursuit of a single economic dimension, and pay more attention to multi-dimensional experiences such as social, psychological and physical health ( 1 ). When health sociologists observe changes in perceptions, they find that socioeconomic factors such as social status, education and income level of individuals are closely related to the attainment of physical health ( 2 – 8 ). The inequality of sports participation caused by social class distinction has attracted scholars' attention.…”