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      Human development, occupational structure and physical inactivity among 47 low and middle income countries

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          Abstract

          This study aimed to (a) assess the relationship between a person's occupational category and their physical inactivity, and (b) analyze the association among country-level variables and physical inactivity. The World Health Survey (WHS) was administered in 2002–2003 among 47 low- and middle-income countries (n = 196,742). The International Physical Activity Questionnaire (IPAQ) was used to collect verbal reports of physical activity and convert responses into measures of physical inactivity. Economic development (GDP/c), degree of urbanization, and the Human Development Index (HDI) were used to measure country-level variables and physical inactivity. Multilevel logistic regression analysis was used to examine the association among country-level factors, individual occupational status, and physical inactivity. Overall, the worldwide prevalence of physical inactivity in 2002–2003 was 23.7%. Individuals working in the white-collar industry compared to agriculture were 84% more likely to be physically inactive (OR: 1.84, CI: 1.73–1.95). Among low- and middle-income countries increased HDI values were associated with decreased levels of physical inactivity (OR: 0.98, CI: 0.97–0.99). This study is one of the first to adjust for within-country differences, specifically occupation while analyzing physical inactivity. As countries experience economic development, changes are also seen in their occupational structure, which result in increased countrywide physical inactivity levels.

          Highlights

          • We analyzed the relationship between occupation and physical inactivity.
          • The IPAQ was used to measure the level of physical inactivity.
          • All occupations other than agriculture were more likely to be physically inactive.
          • Gender, income and urban/rural are positively associated with physical inactivity.
          • The HDI was inversely associated with physical inactivity.

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          Most cited references 14

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          International physical activity questionnaire: 12-country reliability and validity.

          Physical inactivity is a global concern, but diverse physical activity measures in use prevent international comparisons. The International Physical Activity Questionnaire (IPAQ) was developed as an instrument for cross-national monitoring of physical activity and inactivity. Between 1997 and 1998, an International Consensus Group developed four long and four short forms of the IPAQ instruments (administered by telephone interview or self-administration, with two alternate reference periods, either the "last 7 d" or a "usual week" of recalled physical activity). During 2000, 14 centers from 12 countries collected reliability and/or validity data on at least two of the eight IPAQ instruments. Test-retest repeatability was assessed within the same week. Concurrent (inter-method) validity was assessed at the same administration, and criterion IPAQ validity was assessed against the CSA (now MTI) accelerometer. Spearman's correlation coefficients are reported, based on the total reported physical activity. Overall, the IPAQ questionnaires produced repeatable data (Spearman's rho clustered around 0.8), with comparable data from short and long forms. Criterion validity had a median rho of about 0.30, which was comparable to most other self-report validation studies. The "usual week" and "last 7 d" reference periods performed similarly, and the reliability of telephone administration was similar to the self-administered mode. The IPAQ instruments have acceptable measurement properties, at least as good as other established self-reports. Considering the diverse samples in this study, IPAQ has reasonable measurement properties for monitoring population levels of physical activity among 18- to 65-yr-old adults in diverse settings. The short IPAQ form "last 7 d recall" is recommended for national monitoring and the long form for research requiring more detailed assessment.
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            The pandemic of physical inactivity: global action for public health.

            Physical inactivity is the fourth leading cause of death worldwide. We summarise present global efforts to counteract this problem and point the way forward to address the pandemic of physical inactivity. Although evidence for the benefits of physical activity for health has been available since the 1950s, promotion to improve the health of populations has lagged in relation to the available evidence and has only recently developed an identifiable infrastructure, including efforts in planning, policy, leadership and advocacy, workforce training and development, and monitoring and surveillance. The reasons for this late start are myriad, multifactorial, and complex. This infrastructure should continue to be formed, intersectoral approaches are essential to advance, and advocacy remains a key pillar. Although there is a need to build global capacity based on the present foundations, a systems approach that focuses on populations and the complex interactions among the correlates of physical inactivity, rather than solely a behavioural science approach focusing on individuals, is the way forward to increase physical activity worldwide.
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              Worldwide variability in physical inactivity a 51-country survey.

              Physical inactivity is an important risk factor for chronic diseases, but for many (mainly developing) countries, no prevalence data have ever been published. To present data on the prevalence of physical inactivity for 51 countries and for different age groups and settings across these countries. Data analysis (conducted in 2007) included data from 212,021 adult participants whose questionnaires were culled from 259,526 adult observations from 51 countries participating in the World Health Survey (2002-2003). The validated International Physical Activity Questionnaire (IPAQ) was used to assess days and duration of vigorous, moderate, and walking activities during the last 7 days. Country prevalence of physical inactivity ranged from 1.6% (Comoros) to 51.7% (Mauritania) for men and from 3.8% (Comoros) to 71.2% (Mauritania) for women. Physical inactivity was generally high for older age groups and lower in rural as compared to urban areas. Overall, about 15% of men and 20% of women from the 51 countries analyzed here (most of which are developing countries) are at risk for chronic diseases due to physical inactivity. There were substantial variations across countries and settings. The baseline information on the magnitude of the problem of physical inactivity provided by this study can help countries and health policymakers to set up interventions addressing the global chronic disease epidemic.
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                Author and article information

                Contributors
                Journal
                Prev Med Rep
                Prev Med Rep
                Preventive Medicine Reports
                Elsevier
                2211-3355
                04 December 2015
                June 2016
                04 December 2015
                : 3
                : 40-45
                Affiliations
                [a ]Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
                [b ]School of Kinesiology & Health Studies, Queen's University, Kingston, ON K7L 3N6, Canada
                [c ]Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Room 529, Columbia, SC 29208, United States
                Author notes
                [* ]Corresponding author. mooreds4@ 123456mailbox.sc.edu
                Article
                S2211-3355(15)00166-7
                10.1016/j.pmedr.2015.11.009
                4733059
                26844185
                © 2015 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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