Inequality in physical activity, global trends by income inequality and gender in adults

Background: Physical inactivity is a significant global pandemic causing serious health issues and premature mortality. There is a growing trend in economic inequality that affects population health.
Objectives: The study analyzes the relationship between income inequality and physical inactivity levels, particularly examining variations by gender and country income levels.

Physical inactivity is linked to diseases such as cardiovascular issues, type 2 diabetes, obesity, cancer, and depression.
The World Health Organization (WHO) aims for a 10% reduction in physical inactivity levels by 2025 due to alarming rates of physical inactivity globally, which remain at 27.5% as of 2016.
The correlation between systemic changes and physical inactivity emphasizes the need for broader public health strategies beyond individual behavior change.

Activity data comes from WHO encompassing 358 surveys in 168 countries, defining inactivity as not meeting 2010 WHO guidelines of at least 150 minutes of moderate or 75 minutes of vigorous physical activity weekly.
Income Inequality Measurement: The income interquantile ratio (S80/20) compares the incomes of the wealthiest 20% to the poorest 20% in a society, sourced from various databases (World Bank, OECD).

Multiple regression analysis determined the relationship between income inequality and inactivity across country income levels.
Models adjusted for GDP and health care expenditure to assess the specific impact of income inequality on inactivity levels.

Countries experiencing higher income inequality show significantly increased levels of inactivity, especially among women.
In high-income countries, every point increase in interquantile ratio leads to:
- Women: 3.73% higher inactivity (CI 0.89 - 6.57)
- Men: 2.04% higher inactivity (CI 0.08 - 4.15)
- Gender Gap: The inactivity gap between men and women increased by 1.50% (CI 0.16 - 2.83).
The analysis showed similar, albeit less pronounced, trends in middle-income countries, with no significant findings in low-income countries.

Economic Inequality's Role: Enhanced levels of physical inactivity in high and middle-income zones correlate strongly with income inequality, independent of overall country wealth.
- The nature of physical activity is examined, with distinctions made between voluntary leisure-time and utilitarian activity.
Social Cohesion and Health: Inequality may undermine social capital, trust, and cohesion, translating to poorer community health outcomes.
Policy Implications: Addressing economic inequalities could bolster efforts against inactivity, supporting WHO targets for health improvement.

The study's models demonstrated around 20% variance in inactivity levels linked to income inequality, further suggesting substantial policy action to mitigate these inequalities can lead to significant public health benefit.

Economic inequalities affect global physical activity levels and contribute significantly to the pandemic of physical inactivity. Addressing these inequalities may positively influence public health outcomes, supporting global efforts to curb inactivity levels significantly.

Physical Activity, Inactivity, Gender Inequality, Economic Inequality, WHO Guidelines, Public Health Policy.