Physical activity pattern, cardiorespiratory fitness, and socioeconomic status in the SCAPIS pilot trial — A cross-sectional study

Abstract

Living in a low socioeconomic status (SES) area is associated with an increased risk of cardiovascular events and all-cause mortality. Previous studies have suggested a socioeconomic gradient in daily physical activity (PA), but have mainly relied on self-reported data, and individual rather than residential area SES. This study aimed to investigate the relationships between residential area SES, PA pattern, compliance with PA-recommendations and fitness in a Swedish middle-aged population, using objective measurements. We included 948 individuals from the SCAPIS pilot study (Gothenburg, Sweden, 2012, stratified for SES, 49% women, median age: 58 years), in three low and three high SES districts. Accelerometer data were summarized into intensity-specific categories: sedentary (SED), low (LIPA), and medium-to-vigorous PA (MVPA). Fitness was estimated by submaximal ergometer testing. Participants of low SES areas had a more adverse cardiovascular disease risk factor profile (smoking: 20% vs. 6%; diabetes: 9% vs. 3%; hypertension: 38% vs. 25%; obesity: 31% vs. 13%), and less frequently reached 150 min of MVPA per week (67% vs. 77%, odds ratio [OR] = 0.61; 95% confidence interval [95% CI] = 0.46–0.82), from 10-minute bouts (19% vs. 31%, OR = 0.53, 95% CI = 0.39–0.72). Individuals in low SES areas showed lower PA levels (mean cpm: 320 vs. 348) and daily average MVPA (29.9 vs. 35.5 min), and 12% lower fitness (25.1 vs. 28.5 mL × min− 1 × kg− 1) than did those in high SES areas. Reduced PA and fitness levels may contribute to social inequalities in health, and should be a target for improved public health in low SES areas.

Socioeconomic Correlates and Determinants of Cardiorespiratory Fitness in the General Adult Population: a Systematic Review and Meta-Analysis

“…Studies [ 53 , 54 ] reporting on the association between CRF and residential area SES conducted multivariable regression analysis and observed that median VO 2 max increased and odds of low fitness (METs) decreased with higher residential area SES.…”

“…In this systematic review and meta-analysis of the association between SES and CRF in adults, evidence from 15 population-based studies from 8 different countries, shows that predominately higher SES is associated with increased CRF. Socioeconomic exposures, such as SES indices, composed of various SES indicators [ 50 , 52 ], and residential area SES [ 54 ], generally showed a positive relationship with CRF [ 41 , 53 ]. Studies using education level as an exposure, showed either a positive relationship between education and CRF [ 41 – 45 , 47 , 48 , 51 ] or a u-shaped relationship [ 46 , 49 , 50 ].…”

Physical activity levels objectively measured among older adults: a population-based study in a Southern city of Brazil

“…A recent study from Mexican found an inverse association between active life style and car use, and that lower SES groups walk, cycle or use public transport when commuting [ 32 ]. Another study suggested that lower socioeconomic groups were less active in MVPA which was closely related to the characteristics of their place of residence [ 33 ]. Thus, studies examining associations between physical activity and socioeconomic status should consider both the physical activity domains assessed as well as the locations where activity take place.…”

Socioeconomic status and cardiovascular risk factors in young adults: a cross-sectional analysis of a Brazilian birth cohort

“…Thus, due to their greater health awareness, they adhere better to the practice of physical activity. This may have contributed to the fact that their BMI values are lower, with consequent lower prevalences of obesity and higher HDL-cholesterol 27 .…”