Active transportation increases adherence to activity recommendations

Background: Levels of physical activity (PA) contribute to health statits and outcomes directly and indirectly via the effects of PA on obesity and other risk factors. Much past surveillance has focused on leisure-time physical activity (LTPA), but this may bias estimates of prevalence. This study explores inclusion of non-leisure-time walking and bicycling (NLTWB) used for transportation on the prevalence of adherence to PA recommendations and the magnitude of apparent disparities in adherence for California adults. Methods: Results of the 2001 California Health Interview Survey, a large (n =55,151) telephone survey were analyzed in 2005 using tabulation and logistic regression. Results: Higher levels of LTPA were associated with youth, males, education, income, Pacific Islanders, and non-Hispanic (NH) whites. Inclusion of NLTWTB reduced these differences for all five variables. The largest decreases in disparities in adherence occurred for race/ethnicity, education, and income, with decreases in adherence differences from similar to 18% to 7% for NH white vs Latino, similar to 27% to 16% for more than high school versus less than high school, and similar to 25% to 11% for more than 300% versus less than 100% of poverty level. Logistic regression comparing adherence gives similar results. For example, in respondents with more than high school education versus less than high school education (referent), the odds ratio changed from 2.23 (95% confidence interval [Cl]=2.0-2.4) to 1.7 (1.6-1.9) after the inclusion of NLTWB. Conclusions: Assessment of PA in multiple domains is required to understand differences in total levels of PA for people with different incomes, education levels, and racial/ethnic backgrounds. Inclusion of NLTWB reduces but does not eliminate disparities in adherence to recommended levels of PA.