scholarly journals Adolescents’ physical activity: cross-national comparisons of levels, distributions and disparities across 52 countries

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
David Bann ◽  
Shaun Scholes ◽  
Meg Fluharty ◽  
Nikki Shure
Keyword(s):  
Physical Activity ◽  
Income Inequality ◽  
Time Allocation ◽  
Socioeconomic Disparities ◽  
Activity Levels ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
Low Middle Income Countries ◽  
Cross National

Abstract Background Despite global concerns regarding physical inactivity, limited cross-national evidence exists to compare adolescents’ physical activity participation. We analysed data from 52 high- and low-middle income countries, with activity undertaken inside and outside of school in 2015. We investigated gender and socioeconomic disparities, and additionally examined correlations with country-level indices of physical education (PE) curriculum time allocation, wealth, and income inequality. Methods We compared adolescents’ reported activity levels inside and outside of school using nationally representative cross-sectional data from 52 high- and low-middle income countries (N = 347,935)—the Programme for International Student Assessment (PISA) in 2015. Students reported average attendance (days/week) in PE classes, and the days/week engaged in moderate activity (MPA) and vigorous activity (VPA) outside of school. We also compared gender and socioeconomic disparities, and additionally examined correlations with purported determinants—country-level estimates of PE curriculum time allocation, wealth, and income inequality. Results Average activity levels differed substantially both between and within regions, with potentially important differences in distributions identified—such as a bimodal distribution in the U.S. and Canada in PE. Males were more active than females, as were those from households with higher rather than lower household wealth; these disparities were modest for PE, but higher for moderate and vigorous activity outside school—there was strong evidence for heterogeneity in the magnitude of these disparities (e.g., I2 > 95% for gender differences across all countries). PE class attendance was positively correlated with PE curriculum time allocation (rho = 0.36); activity outcomes were inconsistently associated with country-level wealth and income inequality. Conclusions Our findings reveal extensive cross-country differences in adolescents’ physical activity; in turn, these highlight policy areas that could ultimately improve global adolescent health, such as the incorporation of minimum country-level PE classes, and the targeting of gender and socioeconomic disparities in activity conducted outside of school. Our findings also highlight the utility of educational databases such as PISA for use in global population health research.

scholarly journals Physical activity in adolescence: cross-national comparisons of levels, distributions and disparities across 52 countries

2018 ◽  
Author(s):  
David Bann ◽  
Shaun Scholes ◽  
Meg Fluharty ◽  
Nikki Shure
Keyword(s):  
Physical Activity ◽  
Income Inequality ◽  
Time Allocation ◽  
Socioeconomic Disparities ◽  
Moderate Activity ◽  
Activity Levels ◽  
International Student Assessment ◽  
Country Level ◽  
Low Middle Income Countries ◽  
Cross National

AbstractIntroduction:Despite global concerns regarding physical inactivity, limited cross-national evidence exists to compare adolescents’ physical activity participation. We analysed 52 high- and low-middle income countries, with activity undertaken inside and outside of school in 2015. We investigated gender- and socioeconomic-disparities, and additionally examined correlations with country-level indices of physical education (PE) curriculum time allocation, wealth, and income inequality.Methods:We used the Programme for International Student Assessment (PISA), a nationally representative cross-sectional survey of 15-year-olds (N=347,935). Students reported average attendance (days/week) in PE classes, and the days/week engaged in moderate activity (MPA) and vigorous activity (VPA) outside of school. Both the mean and distributions of outcomes were evaluated, as were gender- and socioeconomic-disparities. Pearson’s correlations (r) between the physical activity outcomes and PE curriculum time allocation, wealth (indexed by GDP) and income inequality (indexed by the Gini coefficient) were calculated.Results:Activity levels inside and outside of school were higher in Eastern Europe than Western Europe, the Americas, and the Middle East/North Africa. Comparisons of average levels masked potentially important differences in distributions. For example, activity levels inside school showed a bimodal distribution in the US (mean PE class attendance 2.4 days/week; 41.3%, 6.3% and 33.1% of students attended PE classes on 0, 2 and 5 days/week respectively). In contrast, most other countries exhibited more centrally shaped distributions. Pro-male and pro-high socioeconomic disparities were modest for participation inside school, but higher for MPA and VPA outside of school. The magnitude of these also differed markedly by country. Activity in school was weakly positively correlated with PE curriculum time allocation (r=0.33); activity outside of school was strongly negatively correlated with income inequality (e.g. r=-0.69 for MPA).Conclusion:Our findings reveal extensive cross-country differences in adolescents’ physical activity; in turn, these highlight policy areas that could ultimately improve global adolescent health, such as the incorporation of minimum country-level PE classes, and the targeting of gender- and socioeconomic- disparities in activity conducted outside of school. Our findings also highlight the utility of educational databases such as PISA for use in global population health research.

scholarly journals Inequality in physical activity, global trends by income inequality and gender in adults

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Chastin SFM ◽  
J. Van Cauwenberg ◽  
L. Maenhout ◽  
G. Cardon ◽  
E. V. Lambert ◽  
...  
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Income Inequality ◽  
Physical Inactivity ◽  
World Health ◽  
Middle Income ◽  
Physical Activity Guidelines ◽  
Middle Income Countries ◽  
Country Level ◽  
The World

Abstract Background Physical inactivity is a global pandemic associated with a high burden of disease and premature mortality. There is also a trend in growing economic inequalities which impacts population health. There is no global analysis of the relationship between income inequality and population levels of physical inactivity. Methods Two thousand sixteen World Health Organisation’s country level data about compliance with the 2010 global physical activity guidelines were analysed against country level income interquantile ratio data obtained from the World Bank, OECD and World Income Inequality Database. The analysis was stratified by country income (Low, Middle and High) according to the World Bank classification and gender. Multiple regression was used to quantify the association between physical activity and income inequality. Models were adjusted for GDP and percentage of GDP spent on health care for each country and out of pocket health care spent. Results Significantly higher levels of inactivity and a wider gap between the percentage of women and men meeting global physical activity guidelines were found in countries with higher income inequality in high and middle income countries irrespective of a country wealth and spend on health care. For example, in higher income countries, for each point increase in the interquantile ratio data, levels of inactivity in women were 3.73% (CI 0.89 6.57) higher, levels of inactivity in men were 2.04% (CI 0.08 4.15) higher and the gap in inactivity levels between women and men was 1.50% larger (CI 0.16 2.83). Similar relationships were found in middle income countries with lower effect sizes. These relationships were, however, not demonstrated in the low-income countries. Conclusions Economic inequalities, particularly in high- and middle- income countries might contribute to physical inactivity and might be an important factor to consider and address in order to combat the global inactivity pandemic and to achieve the World Health Organisation target for inactivity reduction.

scholarly journals Prevalence and correlates of adherence to movement guidelines among urban and rural children in Mozambique: a cross-sectional study

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Taru Manyanga ◽  
Joel D. Barnes ◽  
Jean-Philippe Chaput ◽  
Peter T. Katzmarzyk ◽  
Antonio Prista ◽  
...  
Keyword(s):  
Physical Activity ◽  
Sleep Duration ◽  
Screen Time ◽  
Cross Sectional Study ◽  
Rural Children ◽  
Sectional Study ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries

Abstract Background Insufficient physical activity, short sleep duration, and excessive recreational screen time are increasing globally. Currently, there are little to no data describing prevalences and correlates of movement behaviours among children in low-middle-income countries. The few available reports do not include both urban and rural respondents, despite the large proportion of rural populations in low-middle-income countries. We compared the prevalence of meeting 24-h movement guidelines and examined correlates of meeting the guidelines in a sample of urban and rural Mozambican schoolchildren. Methods This is cross-sectional study of 9–11 year-old children (n = 683) recruited from 10 urban and 7 rural schools in Mozambique. Moderate- to vigorous-intensity physical activity (MVPA) and sleep duration were measured by waist-worn Actigraph GT3X+ accelerometers. Accelerometers were worn 24 h/day for up to 8 days. Recreational screen time was self-reported. Potential correlates of meeting 24-h movement guidelines were directly measured or obtained from validated items of context-adapted questionnaires. Multilevel multivariable logit models were used to determine the correlates of movement behaviours. Meeting 24-h movement guidelines was defined as ≥60 min/day of MVPA, ≤2 h/day of recreational screen time, and between 9 and 11 h/night of sleep. Results More rural (17.7%) than urban (3.6%) children met all three 24-h movement guidelines. Mean MVPA was lower (82.9 ± 29.5 min/day) among urban than rural children (96.7 ± 31.8 min/day). Rural children had longer sleep duration (8.9 ± 0.7 h/night) and shorter recreational screen time (2.7 ± 1.9 h/day) than their urban counterparts (8.7 ± 0.9 h/night and 5.0 ± 2.3 h/day respectively). Parental education (OR: 0.37; CI: 0.16–0.87), school location (OR: 0.21; CI: 0.09–0.52), and outdoor time (OR: 0.67; CI: 0.53–0.85) were significant correlates of meeting all three 24-h movement guidelines. Conclusions Prevalence and correlates of meeting movement guidelines differed between urban and rural schoolchildren in Mozambique. On average, both groups had higher daily MVPA minutes, shorter sleep duration, and higher recreational screen time than the 24-h movement guidelines recommend. These findings (e.g., higher than recommended mean daily MVPA minutes) differ from those from high-income countries and highlight the need to sample from both urban and rural areas.

scholarly journals Built environment correlates of physical activity and sedentary behaviour in older adults: A comparative review between high and low-middle income countries

2019 ◽  
Vol 57 ◽  
pp. 277-304 ◽  
Author(s):  
Claire Cleland ◽  
Rodrigo Siqueira Reis ◽  
Adriano Akira Ferreira Hino ◽  
Ruth Hunter ◽  
Rogério César Fermino ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Built Environment ◽  
Sedentary Behaviour ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Comparative Review

scholarly journals Protocol for a Multi-Level Policy Analysis of Non-Communicable Disease Determinants of Diet and Physical Activity: Implications for Low- and Middle-Income Countries in Africa and the Caribbean

2021 ◽  
Vol 18 (24) ◽  
pp. 13061
Author(s):  
Maylene Shung-King ◽  
Amy Weimann ◽  
Nicole McCreedy ◽  
Lambed Tatah ◽  
Clarisse Mapa-Tassou ◽  
...  
Keyword(s):  
Physical Activity ◽  
South Africa ◽  
Policy Development ◽  
Salt Intake ◽  
Communicable Disease ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
Promotion Of Physical Activity ◽  
Low And Middle Income

Non-communicable diseases (NCDs) are the leading cause of death globally. Despite significant global policy development for addressing NCDs, the extent to which global policies find expression in low-and-middle income countries’ (LMIC) policies, designed to mitigate against NCDs, is unclear. This protocol is part of a portfolio of projects within the Global Diet and Activity Research (GDAR) Network, which aims to support the prevention of NCDs in LMICs, with a specific focus on Kenya, Cameroon, South Africa and Jamaica. This paper outlines the protocol for a study that seeks to explore the current policy environment in relation to the reduction of key factors influencing the growing epidemic of NCDs. The study proposes to examine policies at the global, regional and country level, related to the reduction of sugar and salt intake, and the promotion of physical activity (as one dimension of healthy placemaking). The overall study will comprise several sub-studies conducted at a global, regional and country level in Cameroon, Kenya and South Africa. In combination with evidence generated from other GDAR workstreams, results from the policy analyses will contribute to identifying opportunities for action in the reduction of NCDs in LMICs.

Individual and Contextual Factors Associated With Maternal and Child Health Essential Health Services Indicators: A Multilevel Analysis of Universal Health Coverage in 58 Low & Middle-Income Countries

2021 ◽  
Author(s):  
Seun S. Anjorin ◽  
Abimbola A. Ayorinde ◽  
Oyinlola Oyebode ◽  
Olalekan A. Uthman
Keyword(s):  
Health Services ◽  
Universal Health Coverage ◽  
Demographic And Health Surveys ◽  
Health Coverage ◽  
Multinomial Regression ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
Low Middle Income Countries ◽  
Universal Health

Background: Universal health coverage (UHC) is part of the global health agenda to tackle the lack of access to essential health services (EHS). This study developed and tested models to examine the individual, neighbourhood and country-level determinants associated with access to coverage of EHS under the UHC agenda in low- and middle-income countries (LMICs). Methods: We used datasets from the Demographic and Health Surveys of 58 LMICs. Suboptimal and optimal access to EHS were computed using nine indicators. Descriptive and multilevel multinomial regression analyses were performed using R & STATA. Result: The prevalence of suboptimal and optimal access to EHS varies across the countries, the former ranging from 5.55% to 100%, and the latter ranging from 0% to 90.36% both in Honduras and Colombia, respectively. In the fully adjusted model, children of mothers with lower educational attainment (RRR 2.11, 95% credible interval [CrI] 1.92 to 2.32) and those from poor households (RRR 1.79, 95%CrI 1.61 to 2.00) were more likely to have suboptimal access to EHS. Also, those with health insurance (RRR 0.72, 95% CrI 0.59 to 0.85) and access to media (RRR 0.59, 95% CrI 0.51 to 0.67) were at lesser risk of having suboptimal EHS. Similar trends, although in the opposite direction, were observed in the analysis involving optimal access. The intra-neighbourhood and intra-country correlation coefficients were estimated using the intercept component variance; 57.50%% and 27.70% of variances in suboptimal access to EHS are attributable to the neighbourhood and country-level factors. Conclusion: Neighbourhood-level poverty, illiteracy, and rurality modify access to EHS coverage in LMICs. Interventions aimed at achieving the 2030 UHC goals should consider integrating socioeconomic and living conditions of people.

scholarly journals Active Commuting to School and Physical Activity Levels among 11 to 16 Year-Old Adolescents from 63 Low- and Middle-Income Countries

2020 ◽  
Vol 17 (4) ◽  
pp. 1276
Author(s):  
Miguel Peralta ◽  
Duarte Henriques-Neto ◽  
Joana Bordado ◽  
Nuno Loureiro ◽  
Susana Diz ◽  
...  
Keyword(s):  
Physical Activity ◽  
Middle Eastern ◽  
Age Groups ◽  
Activity Levels ◽  
Active Commuting ◽  
Middle Income ◽  
Middle Income Countries ◽  
Active Commuting To School ◽  
Physical Activity Levels ◽  
Low And Middle Income

Background: Global physical activity levels are low. Active commuting to school is a low-cost and sustainable behaviour that promotes adolescents’ physical activity levels. Despite its importance, data on low- and middle-income countries is scarce. This study aimed to assess the relationship between active commuting to school and physical activity (PA) levels among 11–16 years-old adolescents from 63 low- and middle-income countries and six world regions. Methods: Data were from the GSHS database. Participants were 187,934 adolescents (89,550 boys), aged 11–16 years-old, from 63 low- and middle-income countries. Active commuting to school and PA were self-reported as the number of days adolescents walked or cycled to school and engaged in physical activity for at least 60 min in the past 7 days. Results: Boys and girls who actively commuted to school presented higher prevalence of attaining the PA recommendations, but only for the 13–14 (boys: 16.6% versus 22.0%; girls: 9.8% versus 14.6%) and 15–16 (boys: 16.3% versus 21.6%; girls: 8.0% versus 14.0%) year-old age groups. Only for Oceania, Central Asian, Middle Eastern, and North African girls and Sub-Saharan African boys no difference was found in the prevalence of attaining the PA recommendations between those who actively commuted to school and those who did not. Boys who actively commuted to school were 42% (95% CI: 1.37, 1.46) more likely to achieve the PA recommendations, while girls were 66% (95% CI: 1.59, 1.73) more likely to achieve the PA recommendations. Conclusions: Active commuting to school is associated with the adolescents’ physical activity levels. However, it may have a lesser influence in helping younger adolescents attaining physical activity recommendations. Public health authorities should promote active commuting to school among adolescents in order to improve the PA levels and promote health.

Temporal Trends in Physical Activity: A Systematic Review

2009 ◽  
Vol 6 (5) ◽  
pp. 548-559 ◽  
Author(s):  
Alan G. Knuth ◽  
Pedro C. Hallal
Keyword(s):  
Physical Activity ◽  
Temporal Trends ◽  
Age Groups ◽  
Activity Levels ◽  
Middle Income ◽  
Time Activity ◽  
Middle Income Countries ◽  
Pubmed Database ◽  
Adolescents And Adults ◽  
Over Time

Background:In spite of all accumulated scientific knowledge on the benefits of physical activity (PA) for health, high rates of sedentary lifestyle are still observed worldwide. The aim of this study was to systematically review articles on temporal trends of PA and fitness, with emphasis on differences between children/adolescents and adults.Methods:An electronic search at the Medline/PubMed database was carried out using the following combination of keywords: temporal trends or trends or surveillance or monitoring and PA or exercise or physical fitness or motor activity or sedentary or fitness.Results:By using this strategy, 23,088 manuscripts were detected. After examination, 41 articles fulfilled all inclusion criteria, and were, therefore, included. The data currently available in the literature for adults shows that leisure-time activity levels tend to be increasing over time, while occupational-related PA is decreasing over time. Youth PA seems to be decreasing over time, including a lower level of activity in physical education classes. As a consequence, fitness levels are also declining.Conclusion:PA surveillance must be strongly encouraged in all settings and age groups. Special attention must be paid to low and middle-income countries, where PA surveillance is virtually inexistent.

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