Urban/Rural- and Income-Related Variations in Correlates of Physical Activity in U.S. Adults

1
Urban/Rural- and Income-Related Variations in
Correlates of Physical Activity in U.S. Adults

• Sharon E. Parks
• Robyn Housemann PhD, Ross Brownson PhD
• Prevention Research Center at
• Saint Louis University

2
Introduction

• Importance of physical activity to chronic
  disease
• link to heart disease, colon cancer, NIDDM,
  osteoporosis
• link to 14 (over 250,000) of premature U.S
  deaths/year
• McGinnis and Foege, 1993.
• Much research on racial and gender differences in
  physical activity
• Recent foci environment, SES, intra-personal and
  interpersonal factors and urban/rural dwelling

3
Introduction

• Wilcox et.al 2000
• Analyzed urban/rural differences in physical
  activity for ethnically diverse, women, ages 40
  and older
• Significant findings
• Urban- age, barriers, social support
• Rural- age, barriers, social support, race,
  education, enjoyable scenery, not seeing others
  exercise
• Will these differ depending upon SES and in a
  sample containing men?

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Methods-Sampling

• National Physical Activity Survey
• Cross-sectional
• Random-digit dialing
• Modified BRFSS sampling
• Over-sampled lower income zip codes
• Included 1,818 men and women

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Methods- Instrumentation

• Questionnaire ascertained
• Environmental characteristics
• Social support
• Personal barriers
• Participation in physical activity

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Methods- Analyses

• Dependent variable - meets/doesnt meet
  recommendations for P.A. based on new BRFSS
  questions
• U.S. Census categories - urban, suburban, rural
• Income breaks - less than 20K (lower) and 20K
  or more (higher)
• Multivariate-adjusted (age, gender, education,
  race) ORs and 95 CIs calculated

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Results-Overall
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Results-Overall Urban/Rural Patterns

• Large urban/rural and income variations found in
  participants reporting
• Places to exercise neighborhood streets, parks,
  shopping malls
• Personal barriers fear of injury, being in poor
  health, disliking exercise
• Social support encouragement from relatives
  important for P.A

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Results-Environment/Access Associations

• Places to exercise strongly related to P.A. among
  urban, higher income and suburban, lower income
  participants
• Parks increased likelihood of lower income,
  suburban participants to meet recommendations
  14.5 times
• Access to an indoor gym was related to P.A. for
  suburban residents (OR5.0)

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Results-Environment/Access Associations

• Evidence of a dose-response relationship
  between number of places to exercise and
  likelihood to meet recommendations for all
• For example, ORs for urban, higher income
• 0 places1.00
• 1 place 1.14
• 2 places2.11
• 3 places3.87
• 4 places5.63

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Results-Social Support Associations

• Encouragement from friends related to P.A. among
  urban and suburban lower income and rural, higher
  income participants
• Encouragement from relatives related to P.A.
  among suburban higher income participants

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Results-Personal Barriers Associations

• Evidence of a dose-response between number or
  barriers reported and likelihood to meet
  recommendations
• For example, ORs for urban, lower and higher
  income combined
• 0 barriers1.00
• 1 barrier 0.66
• 2 barriers0.42
• 3 barriers0.38

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Limitations

• Cross-sectional data
• Data collected via telephone survey
• Survey conducted only in English
• Some survey questions not examined for validity
  and reliability

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Conclusions

• Income level is probably more important than
  urban/rural dwelling in predicting adults
  likelihood to be physically active
• Many significant relationships that emerged here
  were not previously examined among urban and
  rural residents

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Implications

• Areas of emphasis for community-based physical
  activity research and intervention design
• For example, enablers and barriers may differ
  substantially between lower and higher income
  urban and rural areas
• Issues in research likely to show variation
  between specific communities

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Future Work

• Longitudinal studies needed
• Determine influence of dwelling/income related
  differences in determinants on adoption and
  maintenance of physical activity
• For the full article see

Parks SE, Housemann RA, Brownson RC. Differential
correlates of physical activity in urban and
rural adults of various socioeconomic backgrounds
in the United States. Journal of Epidemiology and
Community Health 20035729-35.