Changing Sedentary Lifestyle Among Adult Utahns
by
Wu Xu, Ph.D.; Michael Friedrichs, M.Stat.; Kirsten
Davis, B.S.; and Rosemary Thackeray, M.P.H.
Abstract
Sedentary lifestyle as a recognized risk factor for health outcomes is a relatively new concept. Based on analyses of three available data sources, this article presents a multilevel overview of physical activity among Utah adults. Study I reports a trend of sedentary lifestyle in Utah since the 1980s. Study II reveals an inconsistency between Utahns’ awareness regarding the benefits of physical activity but apparent lack of action in the 1990s. In order to meet the challenge of changing sedentary lifestyle in Utah, Studies III and IV examine the influences of ten factors on physical activity, including the effects of individual socio-demographic characteristics, health insurance status, and relationships with others in family and community. The authors suggest that public health initiatives must be multifaceted; family- and community-focused, specific groups targeted; and grounded in research of health education, social sciences and behavior change, and effective social-marketing.
Introduction
Considerable research has documented that physical
activity reduces the risk for cardiovascular diseases, colon cancer,
non-insulin-dependent diabetes mellitus, osteoarthritis, obesity, and
depression, and it also enhances the overall quality of life (U.S.
Department of Health and Human Services, 1996). Scholars have suggested
that physical activity might provide the shortcut public health professionals
seek for the control of chronic diseases, similar to immunization-facilitated
progress against infectious diseases (McGinnis, 1992). Therefore,
physical activity and fitness have been listed as the first priority area of
national health promotion and disease prevention objectives (see Healthy
People 2000 or HP2000, U.S. Department of Health and Human Services,
Public Health Service, 1991). In 1996, the U.S. Surgeon General released
a landmark document, Physical Activity and Health: A Report of the Surgeon
General, identifying that physical inactivity is a serious, nationwide
problem (U.S. Department of Health and Human Services, 1996).
HP2000
proposed to monitor physical activity at three levels, that is,
light-to-moderate, vigorous, and no leisure-time physical activity.
Specific objectives were identified for the nation: (a) HP2000 1.3
objective: to increase to at least 30% the proportion of people aged six
and older who engage regularly, preferably daily, in light-to-moderate physical
activity for at least 30 minutes per day; (b) HP2000 1.4 objective: to
increase to at least 20% the proportion of people aged 18 and older who engage
in vigorous physical activity that promotes the development and maintenance of
cardiorespiratory fitness three or more days per week for 20 or more minutes
per occasion; and (c) HP2000 1.5 objective: to reduce to less than 15%
the proportion of people aged six and older who have no leisure-time physical
activity (U.S. Department of Health and Human Services, Public Health
Service, 1991). Since the release of the U.S. Surgeon General’s
report, the “public health message” on physical activity has focused on
promoting 30 minutes of accumulated physical activity every day.
This article presents a comprehensive review and
analysis of adults’ physical activity in Utah from 1985 to 1996 based on data
from three population-based surveys, namely, the Behavioral Risk Factor
Surveillance System (BRFSS), the 1996 Utah Health Status Surveys, and the 1996
Utah Chronic Disease Awareness Survey. Physical activity is
measured and analyzed at four different levels in this paper. Appropriate
methods were selected for specific analyses. Due to the complicated
nature of the measure, data source, and method for each issue under discussion,
the article is organized around specific studies. A brief literature
review and clarification of study method are presented at the beginning of each
study, followed by study results. Study I reports a trend of sedentary
lifestyle in Utah since the 1980s. Study II reveals an inconsistency
between Utahns’ awareness regarding the benefits of physical activity and their
lack of action in the 1990s. In order to meet the challenge of changing
sedentary lifestyle in Utah, Studies III and IV examine the influences of ten
factors on physical activity, including the effects of individual
socio-demographic characteristics, health insurance status, and relationships
with others in family and community. At the end of the paper, summary and
discussion of major findings from all studies and policy implications are
presented.
Study
I: A Trend of Sedentary Lifestyle
In the United States, participation in regular
physical activity increased during the 1960s, 1970s, and early 1980s but seems
to have plateaued since the mid-1980s (Pate, Pratt, & Blair, Haskell,
Macera, Bouchard et al., 1995; U.S. Department of Health and Human
Services, 1996 p.186). This pattern has also been observed in Utah.
Based on the BRFSS survey,[2] Figures 1 and 2 show trends for adults, aged 18 or
older, who engaged in light-to-moderate (HP2000 1.3 objective) or
vigorous (HP2000 1.4 objective) physical activity from 1989 to
1996 in Utah, the Rocky Mountain states, and the United States (U.S.).
The two physical activity measures were derived from 10 questions asked in
BRFSS (see the Appendix), using a complex formula developed by the Centers for
Disease Control and Prevention. The percentage of the median state among
all BRFSS participating states for each year is presented in the figures as the
national norm, a comparison point for states. The 95% confidence
intervals were calculated for statistical tests between the point estimates of
the states and the percentage of the median state, and between Utah and the
Rocky Mountain states’ estimates. SUDAAN, a software program for
analyzing complex sample-survey data, was used for standard error estimates
(Shah, 1981).
In 1996, approximately 27% of adult Utahns, 24% of
adult residents of Rocky Mountain states, and only 21% of adults from the
median state engaged in light-to-moderate physical activity. Adult Utahns
had a significantly higher rate in performing light-to-moderate exercise than
did adults living in the entire Intermountain West in 1991, 1992, and 1996
(Figure 1). Correspondingly, 16.1% of Utah adults and 15.9% of Rocky Mountain
states’ adults participated in vigorous physical activity, significantly higher
than the national norm for adults (14%) (Figure 2).
For the past decade, adults in Utah and Rocky Mountain
states were more likely to participate in physical activity than adults in the
U.S. as a whole. However, BRFSS data indicate that Utah’s physical activity
levels are still lower than the desired goals defined by HP2000.
There have been no significant changes in the level of physical activity in
Utah since 1989. The median percentage of regular-vigorous, as well as
light-to-moderate, physical activity has slightly increased nationwide since
1992, but this trend has not occurred in Utah.
Study
II: Inconsistency between Awareness and Behavior
Physical activity behavior is related to an
individual’s perception about his or her own physical fitness and health
risks. A recent study showed that those Utahns who consider exercise
important to their health were approximately 1.5 times more likely to engage in
exercise than those who did not consider it important (Larsen & Friedrichs,
unpublished).
The Utah Bureau of Chronic Disease Prevention and
Control recently conducted a chronic disease awareness survey to examine what
Utahns knew about their health risks and what they did about it (Larsen &
Friedrichs, unpublished). Six questions on awareness of health risks were
added to the BRFSS ongoing survey during April to June 1996. The
responses to the awareness questions were compared with the respondents’
self-reported behavior recorded in the same survey and with Utah’s specific
mortality rates reported by the Utah Office of Public Health Data.
Generally speaking, the public in Utah is aware of the
importance of physical activity for health. In the survey, not smoking,
regular exercise, and healthy diet were listed by more than 70% of respondents
(N’725) as the three most important things one should do to stay
healthy. However, respondents’ self-reported behaviors for regular
exercise were not consistent with those beliefs. Figure 3 contrasts Utah
adults’ beliefs about health behaviors with their reported actions regarding
them. Among those respondents who reported that not smoking was an
important health behavior, approximately 92% of them did not smoke. Yet,
only 35% of persons who reported exercise as an important health behavior and
21% of persons who reported healthy diet as important were reported acting on
those beliefs.
Study
III: Socio-Demographic Differentials in Lifestyle
Attitude towards physical activity is only one of the
determinants influencing the patterns of sedentary lifestyle. Literature
has suggested that exercise behavior is associated with individual
socio-demographic characteristics, relationships with others in family and
community, and interactions with health professionals and health insurance
companies (O’Neill & Reid, 1991; Sallis & Hovell, 1990). Study
III, based on the available data in BRFSS, further explored the effects of
gender, age, education, individual annual income, and employment status on an
individual’s physical activity.
In Study III, sedentary lifestyle is defined as a
respondent who engaged in leisure-time physical activity less than three times
per week for 20 minutes per occasion. In other words, Study III focuses
on those whose physical activities did not meet HP2000 objectives 1.3 or
1.4 or who did not engage in regular leisure-time exercise. In order to
statistically control the effect of historical time on individuals’ physical
activity, tests for linear trends in the prevalence estimates of sedentary
lifestyle were performed for each socio-demographic subgroup from 1985 to 1992,
1994, and 1996. The selected trend analysis method is appropriate for
proportions obtained from categorical responses, as recommended by Armitage
(1955). The results of chi-square tests for the trend analyses are reported
in Table 1. The findings indicated no statistically significant increase
or decrease in sedentary lifestyle in each socio-demographic subgroup during
the past 12 years. Thus, Study III only reported the number and
percentage of Utah adults, aged 18 or older, who reported sedentary lifestyle
by socio-demographic subgroups in 1996 (see Table 1).
Approximately half of adult Utahns (46.7%) were
sedentary in 1996. People with a high school education or lower had a
significantly higher percentage (51.2%) not engaging in regular physical
activity than the college graduates (39.7%). People with annual income
less than $20,000 were more likely to report a sedentary lifestyle (53.7%) than
their more affluent and educated counterparts (45.0%). Homemakers, college
students, or retired persons were less likely to be sedentary than their
employed counterparts. Gender and age differentials in sedentary
lifestyle were not statistically significant.
In order to further investigate the socioeconomic
status (SES) variation of physical inactivity, an additional trend analysis was
conducted on the refined five income subgroups: (a) <$10,000, (b)
$10,000-19,999, (c) $20,000-34,999, (d) $35,000-50,000, and (e)
>$50,000. A significant decline of the percentage of persons who reported
being sedentary from 1985 to 1996 only existed in the group of Utah adults with
annual individual income higher than $50,000 (N=1,952, X2=13.51,
df=1, p=.000). The “better-off” Utahns became significantly
less likely to be sedentary over the past twelve years.
Study
IV: Effects of Family, Multiple Roles, Religious Network, and Health Insurance
Status
The focus of promoting physical activity should move
beyond the individual level. Social encouragement or discouragement
creates pressures on individuals to engage in or to avoid certain
health-related behavior (Waldron, 1988). Family and friends can be role
models, provide encouragement, or be companions during physical activity (Pate
et al., 1995). Leisure-time exercise also requires an investment of
time. People with fewer family and work roles/obligations are more likely
to engage in regular exercise than those with more roles/obligations.
Women experience more time constraints than men (Bird & Fremont, 1991).
Given the same career commitments, women are more likely than men to spend
their off-work time in housework, child care, and helping others rather than in
leisure activities (Hochschild, 1989). Furthermore, religiosity, in the
broadest sense, can be an indicator of social networking and community culture
to which an individual belongs (Idler, 1987). Researchers have found a
negative relationship between smoking and religious involvement (Dwyer, Clarke,
& Miller, 1990; Gardner & Lyon, 1982). There may also be a
positive relationship between physical activity and religious
involvement. In addition, having health insurance may link an insured
person to a health information distribution system and expose him or her to
more health promotion information, including the benefits of physical activity.
These hypothetical relationships between the likelihood of physical activity
and household members exercise habits, an individual’s multiple roles, a
person’s religious network, and one’s health insurance status are tested in
Study IV.
The data for Study IV came from the third Utah
household telephone health status survey2 conducted by the Utah Department of Health in
1996. Respondents, age 18 to 64, were selected for the analysis.
The dichotomous measure of regular vigorous exercise was obtained from the
following question: “Does anyone living in your household, age six or older, do
vigorous exercise for 20 minutes at least three times a week?” (see the
Appendix for details) The 1996 Utah Health Status Survey (UHSS)
contains more household and social-network variables than does BRFSS.
Therefore, UHSS enables researchers to analyze physical activity in a broad
social context. However, the UHSS’ physical activity measure is not used
for official prevalence estimates by the Utah Department of Health.
In Study IV, the effects of family or household were
measured by whether or not any other adult member of the household participated
in regular vigorous exercise. For the analysis of multiple roles’
effect, a combined measure of an individual’s marital, employment, and parental
status is created with eight categories: (a) married, full-time employed, being
a parent; (b) married, full-time, not a parent; (c) married, not full-time, a
parent; (d) married, not full-time, not a parent; (e) not married, full-time, a
parent; (f) not married, full-time, not a parent; (g) not married, not
full-time, a parent; and (h) not married, not full-time, and not a
parent. The first category represents having three time-demanding
roles/obligations; whereas the last category is the comparison group for this
analysis, indicating those without any of these roles/obligations.
Religious network is measured by religious affiliation and involvement. Since
the Church of Jesus Christ of Latter-Day Saints (LDS) is the predominant
religion in Utah and approximately 68% of the respondents were self-reported
LDS members in this analysis, religious affiliation was coded as LDS, other
religions, or no religion. Respondents, who reported religious
affiliation and attended services once a week or more, were considered
“active,” whereas respondents reporting an affiliation but less attendance were
considered “less active.” The variable of religious affiliation and
involvement had four categories: (a) active LDS, (b) less active LDS, (c)
active other religion, and (d) less active other religion or no religion.
Health insurance status was measured by a dichotomous variable. In order
to control the effect of gender and education, all analyses were conducted
within each of the six gender-education subgroups. The results of
bivariate analysis are reported in Table 2, that is, the number and percentage
of adults who engaged in regular vigorous exercise by family and social network
variables according to gender-education subgroups. The results of
multivariate analysis (odds ratios from a multiple logistic analysis, conducted
by the statistical software SAS and SUDAAN) are presented in Table 3. The
important findings from the logistic regression analysis are highlighted below.
Effects
of Family or Household
There was a significant positive effect on an
individual’s exercise behavior regardless of gender or education when another
adult member of the household participated in vigorous exercise.
Individuals living in a household with adults who did not engage in vigorous
exercise had approximately an one-fifth to one-third likelihood of
participating in vigorous exercise themselves compared to those who lived with
physically active members.
Effects
of Multiple Roles
The analysis demonstrated significant opposite effects
on regular vigorous exercise by multiple roles for men and women at the highest
education level. Among college-educated women, those who were married,
full-time employed, and not a parent were less likely to engage in physical
activity than those who were not married, not full-time employed, and not a
parent. However, male college graduates who were married, full-time
employed, and not a parent were five times more likely to engage in vigorous
exercise than those male college graduates without those obligations.
Different results for men and women were also observed at the lowest education
level. Multiple roles/obligations had no significant effect on engaging
in regular vigorous exercise among women reporting high school or less
education; whereas men with the same level of education, being full-time
employed regardless of their marital and parental status, were significantly
less likely to engage in regular vigorous exercise than their comparison
group. These findings indicate an interactive effect of gender,
education, and multiple roles on physical activity.
Effects
of Religious Affiliation and Involvement
Approximately 49% of LDS members, age 18 to 64,
engaged in regular vigorous exercise at least three times per week; so did 56%
of non-LDS or nonreligious persons in the same age group. (The data are not
reported in Table 2.) Among male college graduates, active LDS persons were
significantly less likely to engage in vigorous exercise than all other
groups. Among women with some college education, there was no difference
in participation in vigorous exercise between LDS groups. However,
women of other or no religion with some college education were more likely to
participate in vigorous exercise than their LDS counterparts.
The religious effect was not statistically significant with regard to the
likelihood of vigorous exercise among men with some college education or
women with college degrees.
Effects
of Health Insurance Coverage
Approximately 42% of uninsured persons engaged in
regular vigorous exercise compared with 54% of insured persons. The
results of logistic regression indicated that uninsured women with some college
or higher education were less likely to participate in regular vigorous
exercise than women with health insurance at the same level of education.
Health insurance status had no influence on regular vigorous exercise among
men.
Summary
and Discussion
Sedentary lifestyle as a recognized risk factor for
health outcomes is a relatively new concept (National Center for Health
Statistics, 1997). Improving the understanding of physical activity in
Utah is urgently needed in order to make local promotion endeavors more effective.
As a part of the efforts and based on the available data, this article has
presented a relatively comprehensive picture of physical activity in Utah.
Utah is a relatively healthy state. However, the
trend of sedentary lifestyle in Utah since the 1980s, identified by Study I,
highlighted an area in which Utah adults can further improve their
health. Since Utahns and residents in the Rocky Mountain states, on
average, have a more active lifestyle than other parts of the nation, Utah with
other Rocky Mountain states needs to develop specific strategies to increase
physical activity. For example, strategies need to be introduced which
will reduce the disparity between the awareness of the benefits of physical
activity and the behavior of physical inactivity in Utah as reported in Study
II.
There are several possible explanations for the
disparities between awareness and behavior regarding physical activity
discussed in Study II. First, the small disparity on the issue of smoking
versus the large disparity for exercise and diet could be the result of the
long history of public health programs aimed at reducing smoking compared to
those more recently developed toward the promotion of regular physical activity
and a healthy diet. Second, although researchers demonstrated that
physical activity and fitness can reduce the risk of heart disease (Sopko,
Obarzanek, & Stone, 1992), an individual might not perceive that heart
disease could be a risk for his/her own health and that exercise could directly
impact on one’s well-being. Heart disease has been the leading cause of
deaths in Utah since the 1940s (Owens & Dandoy, 1987), yet only 38.4% of
adult Utahns were aware of this fact (Larsen & Friedrichs,
unpublished). Third, knowledge of the benefits of physical activity does
not automatically translate to exercise behavior. In addition to
believing that regular exercise is beneficial, the public needs to have
increased opportunities for participation and skill development in this area.
The findings from Study III suggest that public
programs on physical activity should target promotion efforts on those Utah
adults who have less education or income and who are employed. These
recommendations are also supported by the results from a multiple logistic analysis
on the combined 1985-1996 Utah BRFSS data, recently conducted by the Utah
Bureau of Health Education (UBHE). The UBHE’s study found that income,
education, race, gender, employment status, and marital status have independent
effects on sedentary lifestyle in Utah (Utah Bureau of Health Education,
1998). The findings also pointed out that non-Whites are more likely to
be sedentary than Whites and that there is no statistically significant
difference in physical activity between residents in urban and rural areas of
Utah.
Study IV further refines the target populations (lower
SES group) defined in Study III. Study IV suggests that full-time
employed men with low SES are more likely to have a sedentary lifestyle.
Moreover, the authors encourage readers to consider the effects of family,
individuals’ multiple roles, religious networks, and health insurance status on
physical activity, which have not been well-documented in current
literature. The study showed that social environment or system setting plays
a role in facilitating or hindering an individual’s physical activity.
Other adults in the household engaging in regular vigorous exercise had a
consistent positive effect on one’s exercise behavior across the six
gender-education groups. This finding is also consistent with the results
of a similar study based on the 1991 Utah Health Status Survey (Xu, Stinner,
& Paita, 1992). Both researches suggest that public health messages
on physical activity should include the family and household in the targeted audiences.
Attention also needs to be given to the effects of multiple roles and religious
networks on physical activity in Utah. Although, Xu and colleagues also
discovered the statistically significant effects of multiple roles and
religious affiliation and involvement on exercise, some of their findings (the
results of statistical tests, the strength and direction of relationships) are
different from those reported in Study IV. These variations could be
attributed to the changes that occurred during the five years between these two
surveys as well as the difference in measuring regular vigorous exercise as
well (see the Appendix). Therefore, it may be too soon to implement Study
IV’s findings on multiple roles and religious networks into the promotion of
physical activity, unless a study, based on comparable measures, replicates the
findings of Study IV.
The factor of health insurance status in Study IV was
conceptualized as a health system effect. Based on the available
information, the authors cannot completely explain how having health
insurance coverage affects exercise behavior, especially for women with some
college education or higher. However, considering communication or
information flow between managed care organizations (MCOs) and their enrollees
has been expanded and increased with the penetration of MCOs in the 1990s, this
study suggests that MCOs could be an influential partner in a community
coalition to promote physical activity in Utah.
The U.S. Surgeon General’s report pointed out the most
effective interventions occur on multiple levels (U.S. Department of Health and
Human Services, 1996). Three system and community-based strategies
affecting sedentary adults are recommended by HP2000: (a) to increase
the proportion of worksites offering employer-sponsored physical activity and
fitness programs; (b) to increase community availability and accessibility of
physical activity facilities such as fitness trails, public swimming pools,
park and recreation open space; and (c) to increase the proportion of primary
care providers’ counsel on physical activity (U.S. Department of Health and
Human Services, Public Health Service, 1991). Utah public health
agencies, voluntary organizations, and advocates have implemented some of these
recommendations in the 1990s, including the Utah Governor’s Council on Health
and Physical Fitness annual worksite health promotion conference and the Eat
Smart Move Smart Initiative. However, there has not yet been available
data to evaluate these efforts.
In sum, to change the trend of sedentary lifestyle in
Utah, public health initiatives must be multifaceted, family- and
community-focused, targeted to specific groups, as well as grounded in the
research of health education, social sciences and behavior change, and
effective social-marketing. Increased public attention to immediate and
long-term benefits from physical activity could include campaigns highlighting
the relationship between quality of life, risk factors, and chronic
diseases . In addition, community-level allocation of resources promoting
structural changes that create a supportive environment for active lifestyles,
is also needed. These changes can occur through community initiatives
which involve schools, employers, health insurance companies, and community and
religious organizations. Utahns can become a healthier population if
schools, government, and other social institutions act together to achieve this
common goal.
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Appendix:
Measures of Physical Activity in this Study
A.
The measures of light-to-moderate
and vigorous physical activity in Study I and II, and sedentary lifestyle in
Study III, were calculated from the following questions in the Behavioral Risk
Factors Surveillance System from 1985 to 1992, 1994, and 1996:
a1.
During the past month, did you participate in any physical activities or
exercises such as running, calisthenics, golfing, gardening, or walking for
exercise?
a2.
What type of physical activity or exercise did you spend the most time doing
during the past month?
a3.
How far did you usually walk/run/jog/swim?
a4.
How many times per week or per month did you take part in this activity during
the past month?
a5.
When you took part in this activity, for how many minutes or hours did you
usually keep at it?
a6.
Was there another physical activity or exercise that you participated in during
the last month?
a7.
What other type of physical activity gave you the next most exercise during the
past month? (Repeat Questions a3, a4, a5 for the second type of physical
activity.)
B.
The measures of regular vigorous exercise were calculated from the
following questions in the 1996 Utah Health Status Survey and were used for
Study IV:
b1.
Now I’d like to ask about vigorous exercise. By that I mean exercise that
increases heart and breathing rates a lot faster than usual. Does anyone
living in your household, AGE 6 OR OLDER, do vigorous exercise for 20 minutes
at least THREE times a WEEK?
b2.
I need to list all household members who exercise vigorously at least 20
minutes three times a week starting with the oldest?
C.
The measures of routine exercise were calculated from the
following questions in the 1991 Utah Health Status Survey and were compared
with Study IV’s measures and discussed in the summary and discussion:
c1.
Do any of the members of the household exercise vigorously at least three times
a week?
c2.
Which (other) members of the household exercise routinely?
About the Authors
Kirsten Davis is a research analyst at the Office of
Public Health Data, Utah Department of Health (UDOH). She has a BS degree in
sociology from the University of Utah. She is currently finishing work on
her MStat degree.
Michael Friedrichs has an MS degree in statistics. He
is an information analyst at the Bureau of Chronic Disease Prevention and
Control (UDOH).
Rosemary Thackeray is a program manager for physical
activity at UDOH. She has an MPH degree from the University of Utah. She is
currently working on a PhD degree in Health Education.
Wu Xu has a PhD degree in sociology. She is the data
resources program manager at the Division of Community and Family Health
Services (UDOH). She is also an adjunct assistant professor in the Department
of Sociology, University of Utah.
The authors sincerely acknowledge the anonymous reviewer’s and editorial
board’s comments and John Ross’ editorial help.
Table 1. Percentage of Respondents Aged 18+ Years
Reporting Participation in Leisure-Time Physical Activity Less Than 3 Times per
Week for 20+ Minutes per Occasion
(The socio-demographic characteristics,
1996, and the chi-square tests for linear trends in the prevalence estimates
(percentages) during 1985 to 1992, 1994 and 1996a, are based upon
the Utah Behavioral Risk Factors Surveillance System.)
|
Socio-Demographic Characteristics |
|
1996 |
|
|
|
1985-1996 |
|
|
|
|
|
95% CI |
|
Linear Trend Tests |
||
|
|
N |
% |
Lower |
Upper |
|
X2 (df=1) |
pb |
|
All Respondents |
2,887 |
46.7 |
44.3 |
49.1 |
|
0.098 |
0.754 |
|
Gender |
|
|
|
|
|
|
|
|
Male |
1,255 |
47.8 |
44.3 |
51.3 |
|
0.199 |
0.656 |
|
Female |
1,623 |
45.6 |
42.4 |
48.8 |
|
0.000 |
1.000 |
|
Age |
|
|
|
|
|
|
|
|
18-24 |
378 |
44.5 |
38.3 |
50.6 |
|
0.053 |
0.818 |
|
25-39 |
959 |
47.8 |
43.7 |
51.9 |
|
0.099 |
0.753 |
|
40-64 |
1,043 |
48.1 |
44.0 |
52.3 |
|
0.018 |
0.895 |
|
65 and older |
506 |
42.9 |
37.7 |
48.0 |
|
3.734 |
0.053 |
|
Education |
|
|
|
|
|
|
|
|
High School Graduate or lower |
1,192 |
51.2 |
47.6 |
54.9 |
|
0.079 |
0.779 |
|
Tech/Some College |
905 |
47.4 |
43.2 |
51.7 |
|
0.802 |
0.371 |
|
College Graduate or Higher |
785 |
39.7 |
35.3 |
44.1 |
|
0.443 |
0.506 |
|
Annual Income |
|
|
|
|
|
|
|
|
<$20,000 |
553 |
53.7 |
48.2 |
59.3 |
|
2.117 |
0.146 |
|
$20,000 + |
2,090 |
45.0 |
42.2 |
47.7 |
|
1.918 |
0.166 |
|
Employment Status |
|
|
|
|
|
|
|
|
Employed |
1,864 |
48.1 |
45.1 |
51.1 |
|
0.995 |
0.318 |
|
Unemployed |
130 |
65.5 |
54.5 |
76.5 |
|
3.362 |
0.067 |
|
Home/Student/Retired |
889 |
40.8 |
36.7 |
44.9 |
|
0.080 |
0.778 |
a Statistical tests for linear trends in
proportions and frequencies were performed based upon the method recommended by
P. Arimtage (Arimtage, 1955).
b Significant at p < 0.05.
Table 2. Percentage of Respondents Aged
18-64 Years Reporting Participation in Regular Vigorous Exercise1 by
Selected Characteristics: Utah Health Status Survey, 1996
|
|
|
|
|
|
Total |
|
Men |
|
Women |
||||||||||||||
|
Selected Characteristics |
|
|
|
H.S. Grad.- |
Some College |
Coll. Grad.+ |
|
H.S. Grad.- |
Some College |
Coll. Grad.+ |
|||||||||||||
|
|
|
|
|
|
N |
% |
|
N |
% |
N |
% |
N |
% |
|
N |
% |
N |
% |
N |
% |
|||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
|
All Respondents |
|
|
5,473 |
52.2 |
|
904 |
48.1 |
940 |
53.0 |
863 |
59.1 |
|
1,030 |
47.0 |
1,067 |
49.8 |
669 |
59.9 |
|||||
|
Other Adults in Household Participate in Regular Vigorous Exercise |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||
|
|
No |
|
|
|
2,981 |
37.3 |
|
548 |
31.7 |
466 |
39.2 |
412 |
40.7 |
|
636 |
32.5 |
594 |
38.0 |
325 |
47.8 |
|||
|
|
Yes |
|
|
|
2,427 |
70.7 |
|
329 |
74.2 |
461 |
67.1 |
444 |
76.0 |
|
386 |
70.5 |
466 |
65.7 |
340 |
72.0 |
|||
|
Multiple Roles |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
|
|
Married |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
|
|
|
Full-Time |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
|
|
|
|
Parent |
1,486 |
49.0 |
|
260 |
33.8 |
364 |
51.8 |
443 |
56.5 |
|
178 |
49.5 |
122 |
45.8 |
119 |
48.6 |
||||
|
|
|
|
Not Parent |
788 |
50.6 |
|
153 |
38.0 |
129 |
44.2 |
188 |
68.2 |
|
109 |
45.4 |
118 |
55.3 |
91 |
44.9 |
||||
|
|
|
Not Full-Time |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
|
|
|
|
Parent |
1,036 |
53.7 |
|
27 |
20.3 |
64 |
47.3 |
52 |
69.5 |
|
285 |
51.0 |
395 |
51.5 |
213 |
64.5 |
||||
|
|
|
|
Not Parent |
471 |
48.1 |
|
47 |
49.8 |
64 |
36.7 |
53 |
62.9 |
|
113 |
43.4 |
138 |
44.1 |
57 |
64.6 |
||||
|
|
Not Married |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
|
|
|
Full-Time |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
|
|
|
|
Parent |
363 |
50.6 |
|
108 |
44.2 |
35 |
68.0 |
10 |
63.6 |
|
104 |
41.9 |
65 |
56.1 |
42 |
62.6 |
||||
|
|
|
|
Not Parent |
525 |
61.5 |
|
122 |
62.6 |
100 |
66.4 |
67 |
59.5 |
|
60 |
57.7 |
92 |
50.0 |
84 |
71.1 |
||||
|
|
|
Not Full-Time |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
|
|
|
|
Parent |
363 |
55.6 |
|
95 |
71.3 |
65 |
39.2 |
2 |
95.2 |
|
111 |
47.0 |
71 |
62.0 |
19 |
54.5 |
||||
|
|
|
|
Not Parent |
426 |
54.3 |
|
83 |
76.4 |
118 |
69.9 |
47 |
27.1 |
|
70 |
31.1 |
66 |
32.6 |
41 |
70.5 |
||||
|
Religious Affiliation/Involvement |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||
|
|
Less Active Otherb/No religion |
1,051 |
54.4 |
|
265 |
51.6 |
221 |
62.5 |
74 |
63.4 |
|
285 |
42.1 |
153 |
53.5 |
52 |
60.5 |
||||||
|
|
Active Other Religionb |
342 |
61.2 |
|
48 |
33.8 |
39 |
56.9 |
59 |
88.2 |
|
78 |
60.9 |
63 |
60.7 |
55 |
60.0 |
||||||
|
|
Less Active LDS |
1,384 |
45.0 |
|
334 |
33.7 |
215 |
46.3 |
207 |
73.7 |
|
273 |
46.1 |
102 |
44.1 |
147 |
52.7 |
||||||
|
|
Active LDS |
|
|
2,616 |
52.6 |
|
239 |
61.6 |
454 |
51.4 |
503 |
51.4 |
|
387 |
48.2 |
629 |
49.0 |
402 |
60.3 |
||||
|
Health Insurance Status |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||
|
|
Uninsured |
|
|
621 |
42.1 |
|
143 |
43.8 |
108 |
56.2 |
45 |
41.6 |
|
167 |
36.6 |
119 |
36.8 |
38 |
36.9 |
||||
|
|
Insured |
|
|
4,802 |
53.7 |
|
745 |
48.8 |
830 |
52.6 |
817 |
59.9 |
|
837 |
49.5 |
941 |
51.8 |
630 |
61.3 |
||||
|
Age Groupsc |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
|
|
Age 41-64 |
|
|
2,109 |
49.1 |
|
252 |
38.6 |
322 |
43.1 |
460 |
61.7 |
|
363 |
39.5 |
427 |
45.3 |
285 |
62.7 |
||||
|
|
Age 18-40 |
|
|
3,364 |
54.2 |
|
652 |
51.8 |
618 |
58.1 |
404 |
56.0 |
|
667 |
51.0 |
640 |
52.9 |
383 |
57.8 |
||||
|
Health Statusc |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
|
|
Poor/Fair |
|
|
472 |
35.4 |
|
105 |
40.0 |
52 |
25.4 |
26 |
38.0 |
|
161 |
32.8 |
95 |
36.4 |
33 |
43.5 |
||||
|
|
Good/Very Good/ Excellent |
4,997 |
53.9 |
|
796 |
49.3 |
888 |
54.6 |
838 |
59.7 |
|
869 |
49.6 |
972 |
51.2 |
634 |
60.9 |
||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
aVigorous exercise increases heart and
breathing rates a lot faster than usual for 20 minutes at least 3 times a week.
bOther religion includes non-LDS persons who
reported having a religious affiliation.
cUsed as control variables.
Note: Results have been adjusted for random
sampling variation and disproportionate sampling based on the population
estimates provided by the Utah Governor's Office of Planning and Budget in
1994.
Table 3. Odds Ratio From Logistic
Regression Analysis of Regular Vigorous Exercisea by Gender and
Education Level: Utah Adults Age 18-64, Utah Health Status Survey, 1996
|
|
|
|
|
|
|
Men |
|
|
|
Women |
|
|
Selected Characteristics |
H.S. Grad.- |
Some College |
Coll. Grad.+ |
|
H.S. Grad.- |
Some College |
Coll. Grad.+ |
||||
|
|
|
|
|
|
OR |
OR |
OR |
|
OR |
OR |
OR |
|
Other Adults in Household Participate in Regular Vigorous Exercisea |
|
|
|
|
|
|
|
||||
|
|
|
|
|
|
|
|
|||||
|
|
No |
|
|
|
0.14* |
0.22* |
0.21* |
|
0.19* |
0.29* |
0.32* |
|
|
Yes |
|
|
1.00 |
1.00 |
1.00 |
|
1.00 |
1.00 |
1.00 |
|
|
Multiple Roles |
|
|
|
|
|
|
|
|
|||
|
|
Married |
|
|
|
|
|
|
|
|
||
|
|
|
Full-Time |
|
|
|
|
|
|
|
||
|
|
|
|
Parent |
0.08* |
0.39* |
4.25* |
|
1.38 |
1.97 |
0.27 |
|
|
|
|
|
Not Parent |
0.11* |
0.36* |
5.31* |
|
1.51 |
2.83* |
0.22* |
|
|
|
|
Not Full-Time |
|
|
|
|
|
|
|
||
|
|
|
|
Parent |
0.03* |
0.31 |
8.49* |
|
1.84 |
2.40* |
0.59 |
|
|
|
|
|
Not Parent |
0.23 |
0.2* |
4.12 |
|
1.30 |
1.96 |
0.40 |
|
|
|
Not Married |
|
|
|
|
|
|
|
|||
|
|
|
Full-Time |
|
|
|
|
|
|
|
||
|
|
|
|
Parent |
0.12* |
0.71 |
5.71 |
|
1.33 |
4.51* |
0.61 |
|
|
|
|
|
Not Parent |
0.32* |
1.06 |
5.55* |
|
3.00 |
2.21 |
1.00 |
|
|
|
|
Not Full-Time |
|
|
|
|
|
|
|
||
|
|
|
|
Parent |
0.27 |
0.15* |
116.11*d |
|
1.30 |
4.02* |
0.50 |
|
|
|
|
|
Not Parent |
1.00 |
1.00 |
1.00 |
|
1.00 |
1.00 |
1.00 |
|
|
Religious Affiliation/Involvement |
|
|
|
|
|
|
|
||||
|
|
Less Active Otherb/No Religion |
0.68 |
1.70 |
1.97* |
|
1.10 |
1.71* |
1.23 |
|||
|
|
Active Otherb Religion |
0.41 |
1.22 |
8.28* |
|
2.39* |
2.62* |
1.36 |
|||
|
|
Less Active LDS |
0.32* |
0.88 |
3.57* |
|
1.32 |
0.94 |
0.80 |
|||
|
|
Active LDS |
1.00 |
1.00 |
1.00 |
|
1.00 |
1.00 |
1.00 |
|||
|
Health Insurance Coverage |
|
|
|
|
|
|
|
||||
|
|
Uninsured |
0.92 |
0.80 |
0.85 |
|
0.70 |
0.5* |
0.28* |
|||
|
|
Insured |
|
1.00 |
1.00 |
1.00 |
|
1.00 |
1.00 |
1.00 |
||
|
Age Groupsc |
|
|
|
|
|
|
|
|
|||
|
|
Age 41-64 |
0.75 |
0.60 |
1.11 |
|
0.60 |
0.75 |
1.38 |
|||
|
|
Age 18-40 |
1.00 |
1.00 |
1.00 |
|
1.00 |
1.00 |
1.00 |
|||
|
Health Statusc |
|
|
|
|
|
|
|
|
|||
|
|
Poor/Fair |
|
0.80 |
0.42 |
0.37 |
|
0.68 |
0.65 |
0.53 |
||
|
|
Good/Very Good/Excellent |
1.00 |
1.00 |
1.00 |
|
1.00 |
1.00 |
1.00 |
|||
|
Model |
|
|
|
|
|
|
|
|
|
|
|
|
N |
|
|
|
747 |
720 |
657 |
|
1,094 |
1,121 |
699 |
|
|
Approximate Chi-Square |
240.8* |
117.4* |
129.17* |
|
187.93* |
130.4* |
86.4* |
||||
|
Degrees of Freedom |
10 |
10 |
10 |
|
10 |
10 |
10 |
||||
*Significant at p.<0.05.
aVigorous exercise increases heart and breathing rates a lot faster than usual for 20 minutes at least 3 times a week.
bOther religion includes all non-LDS persons who reported having a religious affiliation.
cUsed as control variables.
dThe value of odds ratio is unreliable due to small number of cases in the cell (N=2).
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
