Sociodemographic inequities associated with participation in leisure-time physical activity in sub-Saharan Africa: an individual participant data meta-analysis

Abstract

Background: Leisure-time physical activity (LTPA) is an important contributor to total physical activity and the focus of many interventions promoting activity in high-income populations. Little is known about LTPA in sub-Saharan Africa (SSA), and with expected declines in physical activity due to rapid urbanisation and lifestyle changes we aimed to assess the sociodemographic differences in the prevalence of LTPA in the adult populations of this region to identify potential barriers for equitable participation. Methods: A two-step individual participant data meta-analysis was conducted using data collected in SSA through 10 population health surveys that included the Global Physical Activity Questionnaire. For each sociodemographic characteristic, the pooled adjusted prevalence and risk ratios (RRs) for participation in LTPA were calculated using the random effects method. Between-study heterogeneity was explored through meta-regression analyses and tests for interaction. Results: Across the 10 populations (N = 26,022), 18.9% (95%CI: 14.3, 24.1; I 2 = 99.0%) of adults (≥ 18 years) participated in LTPA. Men were more likely to participate in LTPA compared with women (RR for women: 0.43; 95%CI: 0.32, 0.60; P < 0.001; I 2 = 97.5%), while age was inversely associated with participation. Higher levels of education were associated with increased LTPA participation (RR: 1.30; 95%CI: 1.09, 1.55; P = 0.004; I 2 = 98.1%), with those living in rural areas or self-employed less likely to participate in LTPA. These associations remained after adjusting for time spent physically active at work or through active travel. Conclusions: In these populations, participation in LTPA was low, and strongly associated with sex, age, education, self-employment and urban residence. Identifying the potential barriers that reduce participation in these groups is necessary to enable equitable access to the health and social benefits associated with LTPA.

Intensity Matters for Musculoskeletal Health: A Cross-Sectional Study on Movement Behaviors of Older Adults from High-Income Scottish and Low-Income South African Communities

“…The guidelines for older adults now consider movement behaviors throughout the day. Older adults' PA patterns and intensities are often dictated by socioeconomic status, with differences shown between low-to middle-income countries (LMICs) and high-income countries (HICs) [17][18][19]. In HICs, there is easier access to facilities for leisure-time activities that include gym-based exercise and sports [20], which are activities associated with higher PA intensities, particularly MVPA [21].…”

Sarcopenic Obesity in Africa: A Call for Diagnostic Methods and Appropriate Interventions

“…LMICs across Africa are in an ongoing state of economic and social transition, which has contributed to an increase in the aging population, alongside the added burden of poverty, obesity, and associated co-morbidities (17,18). Increasing urbanization is also accompanied by a reduction in levels of physical activity, increased sedentary behavior and nutritional deficiencies (19)(20)(21). These may occur throughout the life course, and act as risk factors for sarcopenic obesity (15,22,23).…”

Making the case for ‘physical activity security’: the 2020 WHO guidelines on physical activity and sedentary behaviour from a Global South perspective

“…Estelle Victoria Lambert , 1 Tracy Kolbe-Alexander, 1,2 Deepti Adlakha, 3 Adewale Oyeyemi, 4 Nana Kwame Anokye, 5 Shifalika Goenka, 6 Patricia Mogrovejo, 7 Deborah Salvo 8…”

“…Meanwhile, recreational PA is inaccessible for most in these settings. 6 As such, and with rapid urbanisation in LMICs, often into poverty, 7 we are required to view PA through the 'lens' of equity. This demands us to elevate the discussion for PA above health, and frame it as a basic human right that is central to sustainable development.…”