Better pathways promote physical activity and can decrease health inequalities

2021 ◽  
Keyword(s):  
Physical Activity ◽  
Health Inequalities

scholarly journals Income-related health inequality among Chinese adults during the COVID-19 pandemic: evidence based on an online survey

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Peng Nie ◽  
Lanlin Ding ◽  
Zhuo Chen ◽  
Shiyong Liu ◽  
Qi Zhang ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Health Outcomes ◽  
Family Member ◽  
Health Inequalities ◽  
Online Survey ◽  
Mainland China ◽  
Decomposition Analysis ◽  
National Sample ◽  
Vulnerable Groups

AbstractBackgroundPartial- or full-lockdowns, among other interventions during the COVID-19 pandemic, may disproportionally affect people (their behaviors and health outcomes) with lower socioeconomic status (SES). This study examines income-related health inequalities and their main contributors in China during the pandemic.MethodsThe 2020 China COVID-19 Survey is an anonymous 74-item survey administered via social media in China. A national sample of 10,545 adults in all 31 provinces, municipalities, and autonomous regions in mainland China provided comprehensive data on sociodemographic characteristics, awareness and attitudes towards COVID-19, lifestyle factors, and health outcomes during the lockdown. Of them, 8448 subjects provided data for this analysis. Concentration Index (CI) and Corrected CI (CCI) were used to measure income-related inequalities in mental health and self-reported health (SRH), respectively. Wagstaff-type decomposition analysis was used to identify contributors to health inequalities.ResultsMost participants reported their health status as “very good” (39.0%) or “excellent” (42.3%). CCI of SRH and mental health were − 0.09 (p < 0.01) and 0.04 (p < 0.01), respectively, indicating pro-poor inequality in ill SRH and pro-rich inequality in ill mental health. Income was the leading contributor to inequalities in SRH and mental health, accounting for 62.7% (p < 0.01) and 39.0% (p < 0.05) of income-related inequalities, respectively. The COVID-19 related variables, including self-reported family-member COVID-19 infection, job loss, experiences of food and medication shortage, engagement in physical activity, and five different-level pandemic regions of residence, explained substantial inequalities in ill SRH and ill mental health, accounting for 29.7% (p < 0.01) and 20.6% (p < 0.01), respectively. Self-reported family member COVID-19 infection, experiencing food and medication shortage, and engagement in physical activity explain 9.4% (p < 0.01), 2.6% (the summed contributions of experiencing food shortage (0.9%) and medication shortage (1.7%),p < 0.01), and 17.6% (p < 0.01) inequality in SRH, respectively (8.9% (p < 0.01), 24.1% (p < 0.01), and 15.1% (p < 0.01) for mental health).ConclusionsPer capita household income last year, experiences of food and medication shortage, self-reported family member COVID-19 infection, and physical activity are important contributors to health inequalities, especially mental health in China during the COVID-19 pandemic. Intervention programs should be implemented to support vulnerable groups.

scholarly journals Health Inequalities in Urban Adolescents: Role of Physical Activity, Diet, and Genetics

PEDIATRICS ◽  
2014 ◽  
Vol 133 (4) ◽  
pp. e884-e895 ◽  
Author(s):  
F. B. Ortega ◽  
J. R. Ruiz ◽  
I. Labayen ◽  
D. Martinez-Gomez ◽  
G. Vicente-Rodriguez ◽  
...  
Keyword(s):  
Physical Activity ◽  
Health Inequalities ◽  
Urban Adolescents

scholarly journals Systematic review of the effects of schools and school environment interventions on health: evidence mapping and synthesis

2013 ◽  
Vol 1 (1) ◽  
pp. 1-320 ◽  
Author(s):  
C Bonell ◽  
F Jamal ◽  
A Harden ◽  
H Wells ◽  
W Parry ◽  
...  
Keyword(s):  
Physical Activity ◽  
Health Inequalities ◽  
School Environment ◽  
School Level ◽  
Student Health ◽  
Quasi Experimental ◽  
Multilevel Studies ◽  
Organisation Management ◽  
Stage 1 ◽  
Physical Activity Environments

BackgroundIn contrast to curriculum-based health education interventions in schools, the school environment approach promotes health by modifying schools' physical/social environment. This systematic review reports on the health effects of the school environment and processes by which these might occur. It includes theories, intervention outcome and process evaluations, quantitative studies and qualitative studies.Research questionsResearch question (RQ)1: What theories are used to inform school environment interventions or explain school-level health influences? What testable hypotheses are suggested? RQ2: What are the effects on student health/inequalities of school environment interventions addressing organisation/management; teaching/pastoral care/discipline; and the physical environment? What are the costs? RQ3: How feasible/acceptable and context dependent are such interventions? RQ4: What are the effects on student health/inequalities of school-level measures of organisation/management; teaching/pastoral care/discipline; and the physical environment? RQ5: Through what processes might such influences occur?Data sourcesA total of 16 databases were searched between 30 July 2010 and 23 September 2010 to identify relevant studies, including the British Educational Index, the Cumulative Index to Nursing and Allied Health Literature, the Health Management Information Consortium, EMBASE, MEDLINE and PsycINFO. In addition, references of included studies were checked and authors contacted.Review methodsIn stage 1, we mapped references concerning how the school environment affects health and consulted stakeholders to identify stage 2 priorities. In stage 2, we undertook five reviews corresponding to our RQs.ResultsStage 1: A total of 82,775 references were retrieved and 1144 were descriptively mapped. Stage 2: A total of 24 theories were identified (RQ1). The human functioning and school organisation, social capital and social development theories were judged most useful. Ten outcome evaluations were included (RQ2). Four US randomised controlled trials (RCTs) and one UK quasi-experimental study examined interventions building school community/relationships. Studies reported benefits for some, but not all outcomes (e.g. aggression, conflict resolution, emotional health). Two US RCTs assessed interventions empowering students to contribute to modifying food/physical activity environments, reporting benefits for physical activity but not for diet. Three UK quasi-experimental evaluations examined playground improvements, reporting mixed findings, with benefits being greater for younger children and longer break times. Six process evaluations (RQ3) reported positively. One study suggested that implementation was facilitated when this built on existing ethos and when senior staff were supportive. We reviewed 42 multilevel studies, confining narrative synthesis to 10 that appropriately adjusted for confounders. Four UK/US reports suggested that schools with higher value-added attainment/attendance had lower rates of substance use and fighting. Three reports from different countries examined school policies on smoking/alcohol, with mixed results. One US study found that schools with more unobservable/unsupervised places reported increased substance use. Another US study reported that school size, age structure and staffing ratio did not correlate with student drinking. Twenty-one qualitative reports from different countries (RQ5) suggested that disengagement, lack of safety and lack of participation in decisions may predispose students to engage in health risks.LimitationsWe found no evidence regarding health inequalities or cost, and could not undertake meta-analysis.ConclusionsThere is non-definitive evidence for the feasibility and effectiveness of school environment interventions involving community/relationship building, empowering student participation in modifying schools' food/physical activity environments, and playground improvements. Multilevel studies suggest that schools that add value educationally may promote student health. Qualitative studies suggest pathways underlying these effects. This evidence lends broad support to theories of social development, social capital and human functioning and school organisation. Further trials to examine the effects of school environment modifications on student health are recommended.FundingThe National Institute for Health Research Public Health Research programme.

scholarly journals Social determinants of physical activity in healthy Sicilian women: targets to reduce health inequalities

2014 ◽  
Vol 24 (suppl_2) ◽  
Author(s):  
A Quattrocchi ◽  
M Barchitta ◽  
V Adornetto ◽  
N La Rosa ◽  
A Scalisi ◽  
...  
Keyword(s):  
Physical Activity ◽  
Health Inequalities ◽  
Social Determinants

scholarly journals Promoting physical activity-related health competences in people with intellectual disability

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Bruland ◽  
A Mauro ◽  
ÄD Latteck
Keyword(s):  
Physical Activity ◽  
Intellectual Disability ◽  
General Population ◽  
Intellectual Disabilities ◽  
Health Inequalities ◽  
Self Efficacy ◽  
Health Problems ◽  
Living Environment ◽  
Vulnerable Group ◽  
People With Intellectual Disabilities

Abstract Background Physical inactivity is a global health problem. Physically active people show lower rates of chronic diseases or mortality. People with intellectual disabilities (PWID), a vulnerable group for health problems, have significantly lower levels of physical activity (PA) than general population. Due to reduced cognitive abilities, communicative and literacy skills, PWID have less access to health programs. Target-group-oriented interventions are rare. Methods Methodological triangulation to survey PA-related health competences in all 3 subcategories: 3 participating observations and 24 interviews with PWID (inclusion criteria for both: mild or moderate ID); staff online survey (n = 67), all in an integration assistance institution. Participatory approach: 2 expert groups with PWID advise researchers e.g. validating results. Results As expected, movement abilities and body awareness various highly from general population. An effect knowledge is widely spread (PA = health), but execution knowledge of PA is only marginally available e.g. not knowing how to increase PA healthy. Control competences as results from interview and observations: intrinsic motivation is highly present (unlike results from staff survey), but volition - self-efficacy and bring into action - is very poor, self-management and a lack of ideas are identified as a major problem. Low expectation of self-efficacy proved to be the biggest obstacles for PA, but caregiver are an own health resource. Expert groups confirm important of PWID perspectives on living environment. Conclusions To promote a PA lifestyle, health education with a focus on promoting self-efficacy orientated to the living environment (incl. caregiver) regarding own perspectives and health resources is needed. In this way, a vulnerable group for health problems can be empowered. Results indicate a successful approach to promote PA-related health competences in PWID to minimize health inequalities in relation to general population. Key messages Health inequalities among people with intellectual disability through promoting a PA lifestyle can be minimized. Intervention for people with intellectual disabilities must take into account the perspectives and the resources of the users.

scholarly journals Equity impacts of interventions to increase physical activity: A health impact assessment

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J-K Schoenbach ◽  
G Bolte ◽  
G Czwikla ◽  
K Manz ◽  
M Mensing ◽  
...  
Keyword(s):  
Physical Activity ◽  
Population Health ◽  
Health Inequalities ◽  
Activity Pattern ◽  
Health Impact ◽  
Activity Level ◽  
Decision Makers ◽  
Intervention Effects ◽  
Physical Activity Pattern ◽  
Education Groups

Abstract Background Behavioural interventions may increase social inequalities in health. This study aimed to project the equity impact of physical activity interventions that have differential effectiveness across education groups on the long-term health inequalities among older adults in Germany. Methods We created six hypothetical intervention scenarios targeting adults aged 55 years and above: Scenarios #1 to #4 applied realistic intervention effects that varied by education. Under scenario #5, the lower and medium educated group adapted the physical activity pattern of the higher educated. Under scenario #6, all persons increased their physical activity level to the recommended 300 minutes weekly. The number of incident ischemic heart disease, stroke and diabetes cases as well as deaths from all causes was simulated under each of these six intervention scenarios for males and females over a 10-year projection period using the DYNAMO-HIA tool, and compared against a reference scenario with unchanged physical activity pattern. Results For males, the highest reduction of disease cases and deaths would be achieved under scenario #4 (most effective in higher educated persons), while increasing inequalities between education groups. For females, the highest reduction would be achieved under scenario #3 (most effective in lower educated persons), while decreasing inequalities between education groups. Scenarios #1 to #4 would prevent only a fraction of the disease cases and deaths that would be avoided under scenario #5 or scenario #6. Conclusions This modelling study shows how the overall population health impact varies, depending on how intervention-induced physical activity changes differ across education groups. For decision-makers, both the assessment of health impacts overall as well as within a population is relevant, as interventions with the greatest population health gain might be accompanied by an unintended increase in health inequalities. Key messages Health impact assessments with a focus on equity are essential for decision-makers. In order to correctly project population health effects, and choose between options of intervention types from a public health perspective, data on subgroup-specific intervention effects are needed.

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