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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 references9

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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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            The physical activity transition.

            Physical activity is important for the prevention of chronic disease morbidity and mortality, and the lack of adequate levels of physical activity represents a growing public health burden around the world. The purpose of this report is to introduce the concept of the "Physical Activity Transition" and to explore the potential effects that declining physical activity levels may play on health and life expectancy as countries undergo economic and demographic changes. Physical activity is related to mortality rates in humans, and the available evidence suggests that the adoption of a lifestyle characterized by lower levels of physical activity will attenuate the expected gains in life expectancy associated with the epidemiological transition. Advances in the measurement of physical activity at work, in the home, for transport, and in leisure time in a wide variety of populations will be integral to advancing the current understanding of how macro-level factors shape physical activity patterns and patterns of morbidity and mortality.
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              Physical activity patterns and socioeconomic position: the German National Health Interview and Examination Survey 1998 (GNHIES98)

              Background We investigated the associations between education and leisure-time, occupational, sedentary and total physical-activity levels based on data from the German National Health Interview and Examination Survey 1998 (GNHIES98). The roles of income level, occupational status and other mediating variables for these associations were also examined. Methods The total study sample of the GNHIES98 comprised 7,124 participants between the ages of 18 and 79. Complete information was available for 6,800 persons on leisure-time, sedentary and total physical-activity outcomes and for 3,809 persons in regular employment on occupational activity outcomes. The associations between educational level and physical activity (occupational, sedentary, leisure-time and total physical activity) were analysed separately for men and women using multivariate logistic regression analysis. Odds ratios (OR) of educational level on physical-activity outcomes were calculated and adjusted for age, region, occupation, income and other mediating variables. Results After adjusting for age and region, a higher education level was associated with more leisure-time activity – with an OR of 1.6 (95% CI, 1.3-2.0) for men with secondary education and 2.1 (1.7-2.7) for men with tertiary education compared to men with primary education. The corresponding ORs for women were 1.3 (1.1-1.6) and 1.7 (1.2-2.4), respectively. Higher education was associated with a lower level of vigorous work activity: an OR of 6.9 (4.6-10.3) for men with secondary education and 18.6 (12.0-27.3) for men with primary education compared to men with tertiary education. The corresponding ORs for women were 2.8 (2.0-4.0) and 5.8 (4.0-8.5), respectively. Higher education was also associated with a lower level of total activity: an OR of 2.9 (2.2-3.8) for men with secondary education and 4.3 (3.3-5.6) for men with tertiary education compared to men with primary education. The corresponding ORs for women were 1.6 (1.2-2.0) and 1.6 (1.2-2.1), respectively. Conclusions In Germany adults with a lower level of education are more physically active, both at work and overall, compared to adults with a higher education level, although they are less physically active in their leisure time. Higher work-related activity levels among adults with lower education may explain why they are less active in their leisure time.
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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
                3abd9167-35b4-4ac9-b88d-f09b2904dfd6
                © 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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                Categories
                Regular Article

                physical inactivity,occupation,economic development,physical activity transition

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