Prevalence of Recommended Levels of Physical Activity Among Women -- Behavioral Risk Factor Surveillance System, 1992

Regular physical activity provides important health benefits for women, including lower risks for coronary heart disease, some cancers, osteoporosis, and other leading causes of death and disability (1-3). Despite such benefits, the proportion of women in the United States reporting regular physical activity has been low (4). Because even moderately intense physical activity has substantial health benefits, public health recommendations for physical activity have been expanded to a broader spectrum of activity, including gardening, walking, and housework in addition to more vigorous aerobic exercise (e.g., jogging) (5,6). To improve estimates of the prevalence of participation in physical activity at levels associated with health benefits among adult women, data about leisure-time physical activity were analyzed from the 1992 Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the results of these analyses.

Data were available for 55,506 women aged greater than or equal to 18 years in 48 states and the District of Columbia who participated in the 1992 BRFSS, a population-based, random-digit- dialed telephone survey. Respondents were asked about the frequency, duration, and intensity of leisure-time physical activities during the preceding month and were categorized as having reported 1) no leisure-time physical activity, 2) irregular activity that did not meet the recommended criteria for either moderate or vigorous physical activity, or 3) regular activity meeting either the previous recommendation for vigorous physical activity (greater than or equal to 20 minutes per day of vigorous physical activity on greater than or equal to 3 days per week) or the newer moderate activity recommendation (greater than or equal to 30 minutes per day of moderate activity on greater than or equal to 5 days per week {6}). Data were weighted and aggregated, and composite estimates and standard errors for selected groups were calculated using SESUDAAN (7). Prevalences and 95% confidence intervals were calculated by age, race/ethnicity, education level, and annual household income of respondents.

Overall, 27.1% of adult women reported participation in recommended activity levels, a proportion that was generally consistent across age groups. The prevalence of inactivity increased with age, from 25.6% among women aged 18-34 years to 42.1% among women aged greater than or equal to 65 years Table_1. Reported participation in recommended levels of physical activity varied substantially among racial/ethnic groups and by education levels and incomes. White non-Hispanic women were more likely to be more active (28.7%) than Hispanic women (24.7%) and black non-Hispanic women (17.5%). * The prevalence of participation in recommended levels was inversely related to education level and family income: women with less than a high school education were less likely to report regular activity (17.4%) than high school graduates (23.8%) and college graduates (33.5%). Women in the lowest income category (less than or equal to $14,999 per year) were least likely to report regular activity (21.4%), and women in the highest income category (greater than or equal to $50,000 per year) were most likely to report regular activity (34.9%). Reported by: State Behavioral Risk Factor Surveillance System coordinators. Health Interventions and Translation Br, and Statistics Br, Div of Chronic Disease Control and Community Intervention, National Center for Chronic Disease Prevention and Health Promotion, CDC.

Editorial Note

Editorial Note: CDC and the American College of Sports Medicine recently recommended that adults accumulate greater than or equal to 30 minutes of moderate physical activity on greater than or equal to 5 days per week (6). Adherence to either this recommendation or the previous recommendation (greater than or equal to 20 minutes of vigorous activity on greater than or equal to 3 days per week) should provide substantial health benefits (3,6,8). The findings in this report indicate that leisure-time physical activity levels among women were strongly associated with demographic characteristics and that two measures of socioeconomic status (i.e., education and income) were particularly strong predictors of participation in health-enhancing levels of physical activity. Because physical inactivity accounts for approximately 25% of all deaths from chronic disease in the United States (8), reducing preventable death and disability from disease (e.g., heart disease) attributable to physical inactivity (8,9) will require intervention programs that are directed toward and effective among the approximately 70% of women who are sedentary or irregularly active. These BRFSS data also address a priority surveillance need for information about physical activity among racial/ethnic minorities, as specified by the national health objectives for the year 2000 (5).

Interpretation of the findings in this report is subject to at least three limitations. First, because the BRFSS estimates for physical activity levels were based on self-reported data, activity levels may be overestimated. Second, the BRFSS did not ascertain nonleisure-time physical activity (i.e., occupational activity or walking or cycling to work); therefore, estimates restricted to leisure-time activity may underestimate the prevalence of physical activity in some groups. Third, because respondents to the BRFSS can report only two leisure-time activities, physical activity levels will be underestimated for those who participate in multiple activities.

Strategies for increasing levels of leisure-time physical activity should include public education about the health benefits of moderate physical activity and education of health-care providers to increase the number of providers who counsel their patients to become more active -- levels of physical activity have increased among patients who have been counseled by their physicians to become more active (10). Employers can encourage employees to walk on breaks or at other appropriate periods (e.g., lunch) or provide incentives for employees to participate in community-based programs. Community-based programs should offer opportunities for all women to participate in moderate physical activity, particularly women who are older, have low incomes, or have children. Such programs should address barriers to women for increasing activity levels (e.g., safety; child care; time; and the availability and accessibility of walking and cycling trails, sidewalks, and recreational facilities).

References

1. Blair SN, Kohl HW, Paffenbarger RS Jr, Clark DG, Cooper KH,

Gibbons LW. Physical fitness and all-cause mortality: a prospective study of healthy men and women. JAMA 1989;262:2395-401.

2. Blair SN, Kohl HW, Gordon NF, Paffenbarger RS Jr. How much physical activity is good for health? Annu Rev Public Health 1992;13:99-126.

3. Krall EA, Dawson HB. Walking is related to bone density and rates of bone loss. Am J Med 1994;96:20-6.

4. CDC. Prevalence of sedentary lifestyle -- Behavioral Risk Factor Surveillance System, United States, 1991. MMWR 1993;42:576-9.

5. Public Health Service. Healthy people 2000: national health promotion and disease prevention objectives -- full report, with commentary. Washington, DC: US Department of Health and Human Services, Public Health Service, 1991; DHHS publication no. (PHS)91-50212.

6. Pate RR, Pratt M, Blair SN, et al. Physical activity and public health: a recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA 1995;273:402-7.

7. Shah BV. SESUDAAN: standard errors program for computing of standardized rates from sample survey data. Research Triangle Park, North Carolina: Research Triangle Institute, 1981.

8. McGinnis JM, Foege WH. Actual causes of death in the United States. JAMA 1993;270:2207-12.

9. Hahn RA, Teutsch SM, Rothenberg RB, Marks JS. Excess deaths from nine chronic diseases in the United States, 1986. JAMA 1990;264:2654-9. 10. Long BJ, Calfas KJ, Sallis JF, et al. Evaluation of patient physical activity after counseling by primary care providers. Med Sci Sports Exerc 1994;26(suppl):S4.

• Numbers for other racial/ethnic groups were too small for meaningful analysis.

  
  

+------------------------------------------------------------------- ------+ | Erratum: Vol. 44, No. 6 | | ======================= | | SOURCE: MMWR 44(16);325 DATE: Apr 28, 1995 | |             | | In the article, "Prevalence of Recommended Levels of Physical | | Activity Among Women -- Behavioral Risk Factor Surveillance System, | | 1992," the fifth sentence on page 106 should read "The prevalence | | of participation in recommended levels was directly related to | | education level and family income . . . ." | |             | +------------------------------------------------------------------- ------+
Table_1
Note: To print large tables and graphs users may have to change their printer settings to landscape and use a small font size.

TABLE 1. Reported levels of leisure-time physical activity among women, by selected
characteristics -- Behavioral Risk Factor Surveillance System, 1992
================================================================================================
                           No leisure-time
                              activity           Irregular activity *       Regular activity +
                          -----------------      --------------------      -------------------
Characteristic            (%)    (95% CI &)       (%)      (95% CI)        (%)      (95% CI)
------------------------------------------------------------------------------------------------
Age group (yrs)
  18-34                   25.6  (24.7-26.6)       47.8   (46.8-48.9)       26.6   (25.6-27.5)
  35-49                   28.4  (27.4-29.4)       42.7   (41.6-43.8)       28.9   (27.9-29.9)
  50-64                   32.5  (31.1-33.9)       39.6   (38.2-41.0)       27.9   (26.6-29.2)
   >=65                   42.1  (40.8-43.4)       33.3   (32.0-34.6)       24.7   (23.5-25.8)

Race/Ethnicity @
  White, non-Hispanic     27.6  (27.0-28.2)       43.7   (43.0-44.4)       28.7   (28.1-29.3)
  Black, non-Hispanic     43.6  (41.7-45.6)       38.9   (37.0-40.8)       17.5   (16.1-18.8)
  Hispanic                40.2  (37.3-43.0)       35.1   (32.5-37.8)       24.7   (22.1-27.3)

Education level
  Less than high school   47.4  (45.6-49.2)       35.2   (33.5-37.0)       17.4   (16.0-18.7)
  High school/
    Technical school      33.4  (32.5-34.4)       42.8   (41.8-43.8)       23.8   (23.0-24.6)
  College/Post college    22.3  (21.5-23.1)       44.2   (43.2-45.2)       33.5   (32.6-34.4)

Annual
  household income
        <=$14,999         40.2  (38.9-41.5)       38.5   (37.2-39.8)       21.4   (20.3-22.5)
  $15,000-$24,999         31.3  (30.0-32.7)       44.1   (42.6-45.5)       24.6   (23.4-25.8)
  $25,000-$49,999         24.6  (23.5-25.7)       44.1   (42.9-45.3)       31.3   (30.2-32.5)
        >=$50,000         21.2  (19.6-22.8)       43.9   (42.0-45.8)       34.9   (33.0-36.7)

Total                     30.2  (29.7-30.8)       42.7   (42.1-43.3)       27.1   (26.5-27.6)

* Did not meet the recommended criteria for either moderate or vigorous physical activity.
+ Activity meeting either the traditional recommendation for vigorous physical activity (>=20
  minutes per day of vigorous physical activity on >=3 days per week) or the newer moderate
  activity recommendation (30 minutes per day of moderate activity on >=5 days per week).
& Confidence interval.
@ Numbers for other racial/ethnic groups were too small for meaningful analysis.
================================================================================================

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