Prevalence of Regular Physical Activity Among Adults --- United States, 2001 and 2005

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Regular physical activity is associated with decreased risk for obesity, heart disease, hypertension, diabetes, certain cancers, and premature mortality (1). CDC and the American College of Sports Medicine recommend that adults engage in at least 30 minutes of moderate physical activity on most days and preferably on all days (2). Healthy People 2010 objectives include increasing the proportion of adults who engage regularly in moderate or vigorous activity to at least 50% (objective 22-2). In addition, reducing racial and ethnic health disparities, including disparities in physical activity, is an overarching national goal (3). To examine changes in the prevalence of regular, leisure-time, physical activity from 2001 to 2005, CDC analyzed data from the Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the results of that analysis, which indicated that, from 2001 to 2005, the prevalence of regular physical activity increased 8.6% among women overall (from 43.0% to 46.7%) and 3.5% among men (from 48.0% to 49.7%). In addition, the prevalence of regular physical activity increased 15.0% (from 31.4% to 36.1%) among non-Hispanic black women and 12.4% (from 40.3% to 45.3%) among non-Hispanic black men, slightly narrowing previous racial disparities when compared with increases of 7.8% (from 46.0% to 49.6%) for white women and 3.4% (from 50.6% to 52.3%) for white men, respectively. CDC, state and local public health agencies, and other public health partners should continue to implement evidence-based, culturally appropriate initiatives to further increase physical-activity levels among all adults, with special focus on eliminating racial/ethnic disparities.

BRFSS is a state-based, random-digit--dialed telephone survey of the noninstitutionalized, U.S. civilian population aged >18 years. Data for this report were reported by the 50 states, District of Columbia, Puerto Rico, and U.S. Virgin Islands. CDC collected data for the 2001 BRFSS survey from 205,140 respondents (median response rate*: 51.1%; median cooperation rate: 52.7%) and the 2005 survey from 356,112 respondents (median response rate: 51.1%; median cooperation rate 75.1%) (4). Response rates were calculated using guidelines from the Council of American Survey and Research Organizations.

Beginning in 2001, BRFSS included biannual questions about participation in moderate and vigorous physical activities. To assess participation in moderate activities, respondents were asked if, when not working, they "do moderate activities for at least 10 minutes at a time, such as brisk walking, bicycling, vacuuming, gardening, or anything else that causes some increase in breathing or heart rate" in a usual week. Respondents who answered "yes" were asked how many days per week they engaged in moderate activities and the amount of time spent in activities on each of those days. To assess participation in vigorous activities, respondents were asked to report whether they "do vigorous activities for at least 10 minutes at a time, such as running, aerobics, heavy yard work, or anything else that causes large increases in breathing or heart rate" in a usual week, when not working. Respondents who answered "yes" were asked how many days per week they engaged in vigorous activities and the amount of time spent in activities on each of those days. For this report, respondents considered to be engaging in regular physical activity were those who met the Healthy People 2010 objective of at least 30 minutes a day of moderate-intensity activity on 5 or more days a week, or at least 20 minutes a day of vigorous-intensity activity on 3 or more days a week, or both. Data were age adjusted to the 2000 U.S. standard population and weighted to provide overall estimates; 95% confidence intervals and p-values were calculated. Statistically significant changes in prevalence from 2001 to 2005 were determined by t-test (p<0.05).

From 2001 to 2005, the prevalence of regular physical activity (Table) increased by 8.6% (from 43.0% to 46.7%) among women overall and by 3.5% (from 48.0% to 49.7%) among men. Among women, significant increases in regular activity were observed in all racial/ethnic, age, and education-level categories examined with the exception of women aged 18--24 years. Among men, significant increases in regular physical activity were observed among respondents aged 45--64 years, non-Hispanic whites, non-Hispanic blacks, high school graduates, and college graduates.

Among racial/ethnic groups, significant increases in the prevalence of regular physical activity from 2001 to 2005 were observed among non-Hispanic black women (15.0%, from 31.4% to 36.1%), non-Hispanic black men (12.4%, from 40.3% to 45.3%), Hispanic women (11.6%, from 36.3% to 40.5%), women of other races (13.1%, from 41.2% to 46.6%), non-Hispanic white women (7.8%, from 46.0% to 49.6%), and non-Hispanic white men (3.4%, from 50.6% to 52.3%) (Table).

Despite certain gains, racial/ethnic disparities in physical activity remained evident in the 2005 survey results. Among men, non-Hispanic whites had the highest prevalence of regular physical activity (52.3%), followed by men classified as of other race (45.7%), non-Hispanic blacks (45.3%), and Hispanics (41.9%). Among women, non-Hispanic whites had the highest prevalence of regular physical activity (49.6%), followed by women classified as of other race (46.6%), Hispanics (40.5%), and non-Hispanic blacks (36.1%) (Table).

Reported by: J Kruger, PhD, HW Kohl III, PhD, Div of Nutrition and Physical Activity, National Center for Chronic Disease Prevention and Health Promotion; IJ Miles, ScD, EIS Officer, CDC.

Editorial Note:

From 2001 to 2005, the prevalence of engaging in regular physical activity increased among both U.S. men and women. In 2005, 49.7% of men and 46.7% of women reported engaging in regular physical activity, with the largest increases reported among non-Hispanic black women and men. However, among racial/ethnic groups in 2005, only non-Hispanic white men (52.3%) had reached the Healthy People 2010 target of 50% of adults engaging in regular physical activity, although non-Hispanic white women (49.6%) had nearly reached that target.

The findings in this report are consistent with previous BRFSS physical-activity analyses (5), including a decrease in leisure-time physical inactivity from 2001 to 2004 among men and women in all racial/ethnic groups (6). These BRFSS findings and those from the previous BRFSS reports suggest that U.S. adults are becoming more physically active. However, data from the National Health Interview Survey indicate that regular leisure-time physical activity among U.S. adults decreased among men and did not change significantly among women from 2000 and 2005 (7). Differences in format, period of recall, and activities assessed might explain the differences in results from the two surveys.

In addition to the racial/ethnic disparities, disparities in education also were observed. In 2001 and 2005, increasing education level was associated with increased prevalence of regular physical activity in both men and women. In 2005, 54.6% of men and 53.3% of women who were college graduates engaged in regular physical activity, compared with 37.2% of men and 37.1% of women with less than a high school education. Why persons with higher levels of education reported more physical activity is not clear.

The findings in this report are subject to at least four limitations. First, BRFSS data are self-reported and subject to recall bias. Second, the survey questions were not designed to assess whether a combination of moderate and vigorous physical activity met the requirement for engaging in regular physical activity when the two activity types measured separately did not; therefore, prevalences might have been underestimated. Third, the "other race" category combined multiple racial and ethnic groups. Although this approach increased the power of analysis by creating a larger group, analysis could not be extended to any individual groups included in this category. Finally, persons without landline telephones are not eligible for participation in the BRFSS and might be younger or of lower socioeconomic status (8); their exclusion might affect estimates of regular physical activity.

In 2005, fewer than half the adult U.S. population engaged in recommended levels of physical activity. To increase physical-activity levels in the United States, CDC encourages states to implement evidence-based intervention strategies such as those described in the Guide to Community Preventive Services.^§ Examples of recommended intervention strategies include communitywide campaigns, point-of-decision prompts, social support for physical activity, and enhanced access to places to be physically active combined with informational outreach. Certain communities have successfully implemented these strategies to increase physical-activity levels. For example, Marin County, California developed a multipronged approach to encourage children and parents to walk or bike to schools daily (9). As a result, participating schools reported an increase in trips made by walking (64%) and biking (114%).

Despite increases in prevalence of physical activity among minorities, racial/ethnic disparities persist. Many persons in racial/ethnic minority groups are at increased risk for heart disease, hypertension, and diabetes, all of which have been linked to low levels of physical activity (10). To help eliminate racial and ethnic disparities in health, CDC implemented REACH Across the United States (REACH US) as a national, multilevel program. REACH US communities have implemented culturally appropriate, community-based, physical-activity interventions, including free classes, walking clubs, and faith-based nutrition and activity programs. State and local public health agencies should consult the Community Guide to Preventive Services and successful REACH US communities for examples of culturally appropriate, evidence-based initiatives to further increase physical-activity levels among racial and ethnic minorities.

References

* The percentage of persons who completed interviews among all eligible persons, including those who were not successfully contacted.

The cooperation rate is the proportion of all respondents interviewed of all eligible units in which a respondent was selected and actually contacted.

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