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      The prevalence and correlates of physical inactivity among adults in Ho Chi Minh City

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          Abstract

          Background

          Socioeconomic changes have led to profound changes in individuals' lifestyles, including the adoption of unhealthy food consumption patterns, prevalent tobacco use, alcohol abuse and physical inactivity, especially in large cities like Ho Chi Minh City (HCMC). The Stepwise Approach to Surveillance of Non-communicable Disease Risk Factors survey was conducted to identify physical activity patterns and factors associated with 'insufficient' levels of physical activity for health in adults in HCMC.

          Methods

          A cross-sectional survey was conducted in 2005 among 1906 adults aged 25–64 years using a probability proportional to size cluster sampling method to estimate the prevalence of non-communicable disease risk factors including physical inactivity. Data on socioeconomic status, health behaviours, and time spent in physical activity during work, commuting and leisure time were collected. Physical activity was measured using the validated Global Physical Activity Questionnaire (GPAQ). Responders were classified as 'sufficiently active' or 'insufficiently active' using the GPAQ protocol. Correlates of insufficient physical activity were identified using multivariable logistic regression.

          Results

          A high proportion of adults were physically inactive, with only 56.2% (95% CI = 52.1–60.4) aged 25–64 years in HCMC achieving the minimum recommendation of 'doing 30 minutes moderate-intensity physical activity for at least 5 days per week'. The main contributors to total physical activity among adults were from working and active commuting. Leisure-time physical activity represented a very small proportion (9.4%) of individuals' total activity level. Some differences in the pattern of physical activity between men and women were noted, with insufficient activity levels decreasing with age among women, but not among men. Physical inactivity was positively associated with high income (OR = 1.77, 95% CI = 1.05–2.97) and high household wealth index (OR = 1.86, 95% CI = 1.29–2.66) amongst men.

          Conclusion

          Public health policies and programs to preserve active commuting in HCMC and to promote time spent in recreational physical activity in both genders and across all age groups, but especially among young adults, will be critical in any comprehensive national plan to tackle inactivity. Clear and consistent national recommendations about how much physical activity Vietnamese people need for preventing and managing non-communicable diseases should also be part of this population-wide promotional effort.

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          Most cited references28

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          Estimating wealth effects without expenditure data--or tears: an application to educational enrollments in states of India.

          Using data from India, we estimate the relationship between household wealth and children's school enrollment. We proxy wealth by constructing a linear index from asset ownership indicators, using principal-components analysis to derive weights. In Indian data this index is robust to the assets included, and produces internally coherent results. State-level results correspond well to independent data on per capita output and poverty. To validate the method and to show that the asset index predicts enrollments as accurately as expenditures, or more so, we use data sets from Indonesia, Pakistan, and Nepal that contain information on both expenditures and assets. The results show large, variable wealth gaps in children's enrollment across Indian states. On average a "rich" child is 31 percentage points more likely to be enrolled than a "poor" child, but this gap varies from only 4.6 percentage points in Kerala to 38.2 in Uttar Pradesh and 42.6 in Bihar.
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            Socioeconomic status differences in recreational physical activity levels and real and perceived access to a supportive physical environment.

            Spatial access to recreational facilities and perceptions of the neighborhood environment and physical activity levels were examined by the socioeconomic status of area of residence (SES). A cross-sectional survey of adults (18-59 years) (n = 1,803) stratified by SES using a geographic-based index was conducted. Respondents in low SES areas had superior spatial access to many recreational facilities, but were less likely to use them compared with those living in high SES areas. They were more likely to perceive that they had access to sidewalks and shops, but also perceived that their neighborhood was busier with traffic, less attractive, and less supportive of walking. After adjustment, respondents living in low SES areas were 36% less likely to undertake vigorous activity. While they were more likely to walk for transport, this was not statistically significant (OR, 1.27; 95% CI, 0.98-1.64), nor were other SES differences in walking for recreation and walking as recommended. Modifiable environmental factors were associated with walking and vigorous activity, especially perceived access to sidewalks and neighborhood attractiveness. Spatial access to attractive, public open space was associated with walking. Creating supportive environments--particularly sidewalks in attractive neighborhoods--has the potential to increase walking and vigorous activity.
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              Differential correlates of physical activity in urban and rural adults of various socioeconomic backgrounds in the United States.

              Few studies have analysed the rates and correlates of physical activity in economically and geographically diverse populations. Objectives were to examine: (1) urban-rural differences in physical activity by several demographic, geographical, environmental, and psychosocial variables, (2) patterns in environmental and policy factors across urban-rural setting and socioeconomic groups, (3) socioeconomic differences in physical activity across the same set of variables, and (4) possible correlations of these patterns with meeting of physical activity recommendations. A cross sectional study with an over sampling of lower income adults was conducted in 1999-2000. United States. 1818 United States adults. Lower income residents were less likely than higher income residents to meet physical activity recommendations. Rural residents were least likely to meet recommendations; suburban residents were most likely to meet recommendations. Suburban, higher income residents were more than twice as likely to meet recommendations than rural, lower income residents. Significant differences across income levels and urban/rural areas were found for those reporting neighbourhood streets, parks, and malls as places to exercise; fear of injury, being in poor health, or dislike as barriers to exercise and those reporting encouragement from relatives as social support for exercise. Evidence of a positive dose-response relation emerged between number of places to exercise and likelihood to meet recommendations for physical activity. Both income level and urban rural status were important predictors of adults' likelihood to meet physical activity recommendations. In addition, environmental variables vary in importance across socioeconomic status and urban-rural areas.
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                Author and article information

                Journal
                BMC Public Health
                BMC Public Health
                BioMed Central
                1471-2458
                2008
                9 June 2008
                : 8
                : 204
                Affiliations
                [1 ]Faculty of Public Health, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
                [2 ]School of Public Health and the George Institute for International Health, University of Sydney, NSW 2006, Australia
                [3 ]Centre for Physical Activity and Health, School of Public Health, University of Sydney, NSW 2006, Australia
                Article
                1471-2458-8-204
                10.1186/1471-2458-8-204
                2435539
                18541020
                10b1638c-2d34-4ab3-a4fa-1a9900a33494
                Copyright © 2008 Trinh et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 3 December 2007
                : 9 June 2008
                Categories
                Research Article

                Public health
                Public health

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