Advanced Search

Journal Navigation

Journal Home

Subscriptions

Archive

Contact Us

Table of Contents

Sign In to gain access to subscriptions and/or personal tools.
Health Education Journal
This Article
Right arrow Abstract Freely available
Right arrow Free Full Text (Free PDF) Free
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Gidlow, C.
Right arrow Articles by James, D.
Right arrow Search for Related Content
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

A systematic review of the relationship between socio-economic position and physical activity

Christopher Gidlow

Staffordshire University, UK, c.gidlow{at}staffs.ac.uk

Lynne Halley Johnston

University of Newcastle Upon Tyne, UK

Diane Crone

University of Gloucestershire, UK

Naomi Ellis

Staffordshire University, UK

David James

University of Gloucestershire, UK

Objective The aim of the present review was to examine epidemiological evidence to determine if there is strong evidence of a positive gradient of increasing physical activity across the socio-economic strata, and how relationships are affected by socio-economic measurement.

Design Systematic review.

Method A search of major databases was conducted to identify published studies that reported physical activity in relation to socio-economic position (SEP) in adults.

Results Twenty-eight cross-sectional and five longitudinal studies met the inclusion criteria. Approximately half of these were American. Consequently education and income were most commonly used to represent SEP. The majority of studies were secondary analyses of existing health survey data, which could explain the generally large sample sizes and methodological weaknesses in physical activity and SEP measurement. There was consistent evidence of a higher prevalence or higher levels of leisure-time or moderate-vigorous intensity physical activity in those at the top of the socio-economic strata compared with those at the bottom. Evidence for positive gradients across the socio-economic strata was less consistent. Education produced the most stable relationships, less susceptible to confounding effects of ethnicity and the environment.

Conclusion Those at the top of the socio-economic scale appear to perform more leisure-time activity than those at the bottom. Diverse and often crude physical activity and socio-economic measurement made it difficult to distinguish between artefact and true effect in a relationship with so many potential confounding influences. Further studies using up-to-date methods of socio-economic and physical activity measurement are necessary to further explore this relationship and its confounders.

Key Words: physical activity • socio-economic • systematic review

References

  • MacIntyre S. The Black Report and beyond what are the issues? Social Science and Medicine, 1997: 44(6): 723-745 .
  • Acheson D. Independent Inquiry into Inequalities in Health. London: The Stationery Office , 1998.
  • Leyland AH. Increasing inequalities in premature mortality in Great Britain . Journal of Epidemiology and Community Health, 2004: 58: 296-302 .[Abstract/Free Full Text]
  • Department of Health and Social Security. Inequalities in Health: Report of a Working Group Chaired by Sir Douglas Black. London: DHSS , 1980.
  • Department of Health. Coronary Heart Disease National Service Framework: Modern Standards and Service Models. London: The Stationery Office , 2000.
  • Department of Health. Diabetes National Service Framework: Modern Standards and Service Models. London: The Stationery Office , 2001.
  • Goldman N. Social inequalities in health: Disentangling the underlying mechanisms . Annals New York Academy of Sciences, 2001: 94: 118-139 .
  • Dowler E. Inequalities in diet and physical activity in Europe . Public Health Nutrition, 2001: 4(2B): 701-709 .[Medline] [Order article via Infotrieve]
  • Kleinshmidt I, Hills M, Elliot P. Smoking behaviour can be predicted by neighbourhood deprivation measures . Journal of Epidemiology and Community Health, 1995: 49(Suppl 2): S72-S77 .
  • Najman JM. Commentary: General or cause-specific factors in explanations of class inequalities . International Journal of Epidemiology, 2001: 30: 296-297 .[Free Full Text]
  • Deaton A. Policy implications of the gradient of health and wealth . Health Affairs, 2002: March/April: 13-30 .
  • Macintyre S, Mutrie N. Socio-economic differences in cardiovascular disease and physical activity: Stereotypes and reality . The Journal of the Royal Society for the Promotion of Health 2004: 124(2): 66-69 .[Abstract]
  • DCMS. Game Plan: A Strategy for Delivering Government’s Sport and Physical Activity Objectives. London: Cabinet Office , 2002.
  • Health Education Authority. Physical Activity and Inequalities: A Briefing Paper. London: HEA , 1999.
  • Chinn DJ, White M, Harland J, Drinkwater C, Raybould S. Barriers to physical activity and socioeconomic position: Implications for health promotion . Journal of Epidemiology and Community Health, 1999: 53: 191-192 .[Web of Science][Medline] [Order article via Infotrieve]
  • Montoye H, Kemper H, Saris W, Washburn R. Measuring Physical Activity and Energy Expenditure. Champaign, IL: Human Kinetics , 1996.
  • Jones IG, Cameron D. Social class analysis - an embarrassment to epidemiology . Community Medicine, 1984: 6(1): 37-46 .[Medline] [Order article via Infotrieve]
  • Liberatos P, Link BG, Kelsey JL. The measurement of social class in epidemiology . Epidemiologic Reviews, 1988: 10: 87-121 .[Free Full Text]
  • Cooper A. Objective measurement of physical activity. In: J McKenna and C Riddoch (Eds), Perspectives on Health and Exercise (pp.83-108). Basingstoke: Palgrave Macmillan , 2003.
  • Berkman LF, MacIntyre S. The measurement of social class in health studies: Old measures and new formulations. In: M Kogevinaset al (Eds), Social Inequalities and Cancer (pp.51-64). Lyon, France: International Agency for Research on Cancer , 1997.
  • Martin D, Brigham P, Roderick P, Barnett S, Diamond I. The (mis)representation of rural deprivation . Environment and Planning 2000: 32: 735-751 .[CrossRef]
  • Rose D, O’Reilly K. Constructing Classes: Towards a New Social Classification for the UK. Swindon: ESRC and ONS , 1997.
  • Kaplan GA, Keil JE. Socio-economic factors and cardiovascular disease: A review of the literature . Circulation, 1993: 88(4).
  • Carr-Hill R, Chalmers-Dixon P. A Review of Methods for Monitoring and Measuring Social Inequality, Deprivation and Health Inequality. Vol. 2004. York: Centre for Health Economics, University of York , 2002.
  • Montoye H. Introduction: Evaluation of some measurements of physical activity and energy expenditure . Medicine and Science in Sports and Exercise, 2000: 32(9 [Suppl.]): S439-S441 .[Web of Science][Medline] [Order article via Infotrieve]
  • Wareham NJ, Rennie KL. The assessment of physical activity in individuals and populations: Why try to be more precise about how physical activity is assessed? International Journal of Obesity, 1998: 22(Suppl.2): S30-S38 .
  • Jacobs DR, Ainsworth BE, Hartman TJ, Leon AS. A simultaneous evaluation of 10 commonly used physical activity questionnaires . Medicine and Science in Sports and Exercise, 1993: 25: 81-91 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Duncan GE, Sydeman SJ, Perri MG, Limacher MC, Martin AD. Can sedentary adults accurately recall the intensity of their physical activity? Preventive Medicine, 2001: 33: 18-26 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Kim S, Symons M, Popkin BM. Contrasting socioeconomic profiles related to healthier lifestyles in China and the United States . American Journal of Epidemiology, 2004: 159(2): 184-191 .[Abstract/Free Full Text]
  • Yu Z, Nissinen A, Vartianen E, Song G, Guo Z, Tian H. Changes in cardiovascular risk factors in different socioeconomic groups: Seven year trends in a Chinese urban population . Journal of Epidemiology and Community Health, 2000: 54: 692-696 .[Abstract/Free Full Text]
  • Schmid TL, Pratt M, Howze EH. Policy as intervention: Environmental and policy approaches to the prevention of cardiovascular disease . American Journal of Public Health, 1995: 85(9): 1207-1211 .[Abstract/Free Full Text]
  • Kerr J, Eves F, Carroll D. The environment: The greatest barrier? In: J McKenna and C Riddoch (Eds), Perspectives on Health and Exercise (pp.203-226). Basingstoke: Palgrave Macmillan , 2003.
  • Prentice AM, Jebb SA. Obesity in Britain: Gluttony or sloth? British Medical Journal, 1995: 311(7002): 437-439 .[Free Full Text]
  • Sparling PB, Owen N, Lambert EV, Haskell WL. Promoting physical activity: The new imperative for public health . Health Education Research, 2000: 15(3): 367-376 .[Abstract/Free Full Text]
  • Wagner A, Evans SC, Ducimetiere P, Bongard V, Montaye M, Arveiler D. Physical activity patterns in 50-59 year men in France and Northern Ireland. Associations with socio-economic status and health behaviour . European Journal of Epidemiology, 2003: 18(4): 321-329 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Takao S, Kawakami N, Ohtsu T, the Japan Work Stress and Health Cohort Study Group. Occupational class and physical activity among Japanese employees . Social Science and Medicine, 2003: 57: 2281-2289 .
  • Sherman JA. Primordial prevention of cardiovascular disease among African-Americans: A social epidemiological perspective . Preventive Medicine, 1999: 29: S84-S89 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Pocock SJ, Collier TJ, Dandreo KJ, et al. Issues in the reporting of epidemiological studies: A survey of recent practice . British Medical Journal, 2004: 329(7471): 883-889 .[Abstract/Free Full Text]
  • Lantz PM, House JS, Lepowski JM, Williams DR, Mero RP, Chen J. Socioeconomic factors, health behaviours, and mortality: Results from a nationally representative prospective study of US adults . Journal of the American Medical Association, 1998: 279(21): 1703-1708 .[Abstract/Free Full Text]
  • Nies M, Kershaw T. Psychosocial and environmental influences physical activity and health outcomes in sedentary women . Journal of Nursing Scholarship, 2002: 34(3): 243-249 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • McTiernan A, Stanford JL, Daling JR, Viogt LF. Prevalence and correlates of recreational physical activity in women aged 50-64 years . Menopause, 1998: 5: 95-101 .[Web of Science][Medline] [Order article via Infotrieve]
  • Wilbur J, Chandler PJ, Dancy B, Lee H. Correlates of physical activity in urban Midwestern African-American women . American Journal of Preventive Medicine, 2003: 25(3Si): 45-52 .[Web of Science][Medline] [Order article via Infotrieve]
  • Eyler AA. Personal, social, and environmental correlates of physical activity in rural Midwestern white women . American Journal of Preventive Medicine, 2003: 25(3Si): 86-92 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Tudor-Locke C, Ham SA, Macera CA, et al. Descriptive epidemiology of the pedometer-determined physical activity . Medicine and Science in Sports and Exercise, 2004: 36(9): 1567-1573 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Yen IH, Kaplan GA. Poverty area residence and change in physical activity level: Evidence from the Alameda County Study . American Journal of Public Health, 1998: 88(11): 1709-1712 .[Abstract/Free Full Text]
  • Crespo CJ, Ainsworth BE, Keteyian S, Heath G, Smit E. Prevalence of physical inactivity and its relation to social class in US adults: Results from the Third National Health and Nutrition Examination Survey, 1988-1994 . Medicine and Science in Sports and Exercise, 1999: 31(12): 1821-1827 .[Web of Science][Medline] [Order article via Infotrieve]
  • Crespo CJ, Smith E, Andersen RE, Carter-Pokras O, Ainsworth BE. Race/ethnicity, social class and their relation to physical inactivity during leisure time: Results from the Third National Health and Nutrition Examination Survey, 1988-1994 . American Journal of Preventive Medicine, 2000: 18(1): 46-53 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Grzywacz JG, Marks NF. Social inequalities and exercise during adulthood: Toward an ecological perspective . Journal of Health and Social Behaviour, 2001: 42(June): 202-220 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Clark DO. Racial and educational differences in physical activity among older adults . The Gerontologist, 1995: 35(4): 472-480 .[Abstract]
  • Ford ES, Merritt RK, Heath GW, et al. Physical activity behaviours in lower and higher socioeconomic status populations . American Journal of Epidemiology, 1991: 133(12): 1246-1256 .[Abstract/Free Full Text]
  • Parks SE, Housemann RA, Brownson RC. Differential correlates of physical activity in urban and rural adults of various socioeconomic backgrounds in the United States . Journal of Epidemiology and Community Health, 2003: 27: 29-35 .
  • Dowda M, Ainsworth BE, Addy CL, Saunders RP, Riner W. Correlates of physical activity among U.S. young adults, 18 to 30 years of age, from NHANES III . Annals of Behavioural Medicine, 2003: 26(1): 15-23 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Ainsworth BE, Wilcox S, Thompson WW, Richter DL, Henderson KA. Personal, social and physical correlates of physical activity in African-American women in South Carolina . American Journal of Preventive Medicine, 2003: 25(3Si): 23-29 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Kaplan GA, Lazarus NB. Psychosocial factors in the natural history of physical activity . American Journal of Preventive Medicine, 1991: 7: 12-17 .[Medline] [Order article via Infotrieve]
  • Giles-Corti B, Donovan RJ. Socioeconomic status differences in recreational physical activity levels and real and perceived access to a supportive physical environment . Preventive Medicine, 2002: 35: 601-611 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Burton NW, Turrell G. Occupation, hours worked, and leisure-time physical activity . Preventive Medicine, 2000: 31(6): 673-681 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Kendig H, Browning C, Teshuva K. Health actions and social class among older Australians . Australian and New Zealand Journal of Public Health, 1998: 22: 808-813 .[Web of Science][Medline] [Order article via Infotrieve]
  • MacDougall C, Cooke R, Owen N, Wilson K, Bauman A. Relating physical activity to health status, social connections and community facilities . Australian and New Zealand Journal of Public Health, 1997: 21: 631-637 .[Web of Science][Medline] [Order article via Infotrieve]
  • Salmon J, Owen N, Bauman A, Kathryn M, Schmitz H, Booth M. Leisure-time, occupational, and household physical activity among professional, skilled, and less-skilled workers and homemakers . Preventive Medicine, 2000: 30: 191-199 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Kaplan MS, Newsom JT, McFarland BH, Lu L. Demographic and psychosocial correlates of physical activity in late life . American Journal of Preventive Medicine, 2001: 21(4): 306-312 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Millar WJ, Stephens T. Social status and health risks in Canadian adults: 1985 and 1991 . Health Reports, 1993: 5(2): 143-156 .[Medline] [Order article via Infotrieve]
  • Pomerleau J, Pederson LL, Ostbye T, Speechley M, Speechley K. Health behaviours and socio-economic status in Ontario, Canada . European Journal of Epidemiology, 1997: 13: 613-622 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Schroder H, Rohlfs I, Schmelz E, Marrugat J. Relationship of socio-economic status with cardiovascular risk factors in a lifestyle and Mediterranean population . European Journal of Nutrition, 2004: 43(2): 77-85 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Wardle J, Steptoe A. Socioeconomic differences in attitudes and beliefs about healthy lifestyles . Journal of Epidemiology and Community Health, 2003: 57: 440-443 .[Abstract/Free Full Text]
  • Bartley M, Martikainen P, Shipley M, Marmot M. Gender differences in the relationship of partner’s social class to behavioural factors and social support in the Whitehall II study . Social Science and Medicine, 2004: 59: 1925-1936 .
  • Boniface DR, Cottee MJ, Skinner A. Social and demographic factors predictive of change over seven years in CHD-related behaviours in men aged 18-49 years . Public Health, 2001: 115: 246-252 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Laaksonen M, Prattala R, Helasoja V, Uutela A, Lahelma E. Income and health behaviour: Evidence from monitoring surveys among Finnish adults . Journal of Epidemiology and Community Health, 2003: 57(9): 711-717 .[Abstract/Free Full Text]
  • Lindstrom M, Hason BS, Ostergren P-O. Socio-economic differences in leisure-time physical activity: The role of social participation and social capital in shaping health related behaviour . Social Science and Medicine, 2001: 52: 441-451 .
  • Bertrais S, Preziosi P, Mennen L, Galan P, Hercberg S, Oppert J. Sociodemographic and geographic correlates of meeting current recommendations for physical activity in middle-aged French adults: The supplementation en Vitamines et Minereaux Antioxydants (SUVIMAX) study . American Journal of Public Health, 2004: 94(9): 1560-1566 .[Abstract/Free Full Text]
  • Droomers M, Schrivers C, Machenback J. Educational level and decreases in leisure-time physical activity: Predictors from the longitudinal GLOBE study . Journal of Epidemiology and Community Health, 2001: 55: 562-568 .[Abstract/Free Full Text]
  • Papadopoulou SK, Papadopoulou SD, Zerva A, et al. Health status and socioeconomic factors as determinants of physical activity level in the elderly . Medical Science Monitor, 2003: 9(2): CR79-CR83 .
  • Kirkwood BR, Sterne JAC. Essential Medical Statistics. Second Edition. Oxford: Blackwell , 2003.
  • Pate RR, Pratt M, Blair SN, et al. Physical activity and public health: Recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine . Journal of the American Medical Association, 1995: 273(5): 402-407 .[Abstract/Free Full Text]
  • Department of Culture Media and Sport. Game Plan: A Strategy for Delivering Government’s Sport and Physical Activity Objectives. London: Cabinet Office , 2002.
  • MacIntyre S, Maciver S, Sooman A. Area, class and health: Should we be focusing on places or people? Journal of Social Policy, 1993: 22(2): 213-234 .[CrossRef][Web of Science]
  • Shouls S, Congdon P, Curtis S. Modelling inequality in reported long-term illness in the UK: Combining individual and area characteristics . Journal of Epidemiology and Community Health, 1996: 50(3): 366-376 .[Abstract/Free Full Text]
  • Ecob R, Jones K. Mortality variations in England and Wales between types of place: An analysis of the ONS longitudinal study . Social Science and Medicine, 1998: 47(12): 2055-2066 .
  • NHS Centre for Reviews and Dissemination. Undertaking Systematic Reviews of Research on Effectiveness. CRD report No.4. 2nd ed. York: University of York , 2001.
  • National Institute of Health and National Heart Lung and Blood Institiute. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults . Obesity Research, 1998: 6: 51S-209S .[Web of Science][Medline] [Order article via Infotrieve]
  • Denton M, Prus S, Walters V. Gender difference in health: A Canadian study of the psychosocial, structural and behavioural determinants of health . Social Science and Medicine, 2004: 58: 2585-2600 .
  • Duetz M, Arel T, Niemann S. Differentiating associations with gender and socioeconomic status . European Journal of Public Health, 2003: 13: 313-319 .[Abstract/Free Full Text]
  • Hunt K, Annandale E. Relocating gender and morbidity: Examining men’s and women’s health in contemporary western societies. Introduction to special issue on gender and health . Social Science and Medicine, 1999: 48: 1-5 .

Health Education Journal, Vol. 65, No. 4, 338-367 (2006)
DOI: 10.1177/0017896906069378
Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 Am J EpidemiolHome page
V. J. Cleland, K. Ball, C. Magnussen, T. Dwyer, and A. Venn
Socioeconomic Position and the Tracking of Physical Activity and Cardiorespiratory Fitness From Childhood to Adulthood
Am. J. Epidemiol., November 1, 2009; 170(9): 1069 - 1077.
[Abstract] [Full Text] [PDF]

Home page
 Am J EpidemiolHome page
K. Corder, D. Ogilvie, and E. M. F. van Sluijs
Invited Commentary: Physical Activity Over the Life Course--Whose Behavior Changes, When, and Why?
Am. J. Epidemiol., November 1, 2009; 170(9): 1078 - 1081.
[Abstract] [Full Text] [PDF]

Home page
 Health Educ ResHome page
V. J. Cleland, K. Ball, J. Salmon, A. F. Timperio, and D. A. Crawford
Personal, social and environmental correlates of resilience to physical inactivity among women from socio-economically disadvantaged backgrounds
Health Educ. Res., October 29, 2008; (2008) cyn054v1.
[Abstract] [Full Text] [PDF]

This Article
Right arrow Abstract Freely available
Right arrow Free Full Text (Free PDF) Free
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Gidlow, C.
Right arrow Articles by James, D.
Right arrow Search for Related Content
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?