Perspectives in Disease Prevention and Health Promotion Sex-, Age-, and Region-Specific Prevalence of Sedentary Lifestyle in Selected States in 1985 -- The Behavioral Risk Factor Surveillance System

The Behavioral Risk Factor Surveillance System (BRFSS) is a telephone survey conducted by state health departments to routinely collect risk factor data from adults ( 18 years of age). The following analysis examines sedentary lifestyle data from the 25,221 persons interviewed by the 22 states (including the District of Columbia) participating in the BRFSS during 1985.

Participants were asked to provide details of up to two activities performed during the past month. The prevalence of sedentary lifestyle was estimated by the percentage of persons who reported either no physical activity or physical activity less than three times per week and/or less than 20 minutes per occasion. This criterion level is based on the 1990 objectives for the nation regarding physical fitness and exercise (1) and represents the minimum amount of physical activity likely to confer health benefits.

Table 3 presents the sex-specific prevalence of sedentary lifestyle in the 22 states. The distribution of these prevalences is summarized in the "box-plots" in Figure 1. These plots provide the maximum range, the upper and lower quartiles, and the median (50th percentile) of the distribution of state-specific prevalences for the 22 states.

Figure 1 indicates that the median prevalence of sedentary lifestyle is somewhat higher for women than for men; however, the distribution of prevalence estimates for the two genders overlap considerably. This figure also shows that the variation in prevalence estimates of sedentary lifestyle is somewhat greater for women than for men.

Table 4 presents the age-specific prevalence of sedentary lifestyle for adults in the 22 states. In most instances, the prevalence of sedentary lifestyle for adults increased with increasing age. The distribution of these prevalences is summarized in Figure 2, which also indicates that there is considerable overlap between the three age-specific prevalence distributions of adult sedentary lifestyle in the states.

Figure 3 indicates that the median prevalence of sedentary lifestyle by region is somewhat higher for the southeastern states and lowest in the southwestern and mountain states. Northeastern and central states were intermediate in their prevalence of sedentary lifestyle. Again, there is considerable overlap of the region-specific distribution of prevalence estimates for the four regions. Reported by: T Hughes, Arizona Dept of Health Svcs. F Capell, California Dept of Health Svcs. S Benn, Connecticut State Dept of Health Svcs. R Conn, EdD, District of Columbia Dept of Human Svcs. J Godwin, Florida Dept of Health and Rehabilitative Svcs. JD Smith, Georgia Dept of Human Resources. JV Patterson, Idaho Dept of Health and Welfare. D Patterson, Illinois Dept of Public Health. S Jain, Indiana State Board of Health. K Bramblett, Kentucky Cabinet for Human Resources. N Salem, Minnesota Center for Health Statistics. R Moon, Montana State Dept of Health and Environmental Sciences. H Bzudch, New York State Dept of Health. C Washington, North Carolina Dept of Human Resources. B Lee, North Dakota State Dept of Health. E Capwell, Ohio Dept of Health. J Cataldo, Rhode Island Dept of Health. FC Wheeler, South Carolina Dept of Health and Environmental Control. J Fortune, Tennessee Dept of Health and Environment. C Chakley, Utah Dept of Health. R Anderson, West Virginia State Dept of Health. DR Murray, Wisconsin Center for Health Statistics. Div of Health Education, Center for Health Promotion and Education, CDC.

Editorial Note

Editorial Note: Eleven of the 1990 objectives for the nation relate to physical fitness and exercise. Most of these 11 objectives emphasize "appropriate physical activity," which is defined as "exercise which involves large muscle groups in dynamic movement for periods of 20 minutes or longer, three or more days per week, and which is performed at an intensity of 60 percent or greater of an individual's cardiorespiratory capacity." This amount of physical activity is rather strenuous, and evidence indicates that less intensive, yet regular, physical activity may also confer health benefits (2). Therefore, the analysis reported here sought to estimate the prevalence of sedentary lifestyle, i.e., physical activity less than three times per week, less than 20 minutes per occasion, or both, regardless of the intensity of participation.

An average of 55% of the 25,221 persons interviewed by telephone in the 22 states participating in the 1985 BRFSS reported so little physical activity in the past month as to be considered sedentary. Rates increased with age and were slightly higher for women than for men. The National Health Interview Survey (3), a representative survey conducted by the National Center for Health Statistics using household-interviews, provided very similar estimates of the prevalence of sedentary lifestyle for 1985. The trends for age, gender, and region have been noted previously in other national surveys (4).

The 1990 physical fitness and exercise objectives are also concerned with the regular monitoring of national trends, the use of community recreation programs and facilities, public and professional awareness of the benefits of regular physical activity, worksite fitness programs, and the evaluation of the short- and long-term effects of physical activity (5). Recent reports have summarized progress in these areas (5,6).

Specific health reasons for promoting physical activity stem from a wide variety of research findings. Increased levels of physical activity have been associated with reduced risk of coronary heart disease (7), enhanced weight control (8), reduced symptoms of anxiety and mild to moderate depression, and an enhanced sense of well-being derived from feeling and looking better (9). Further, there is emerging evidence that physical activity may have important beneficial effects on non-insulin-dependent diabetes mellitus, hypertension, and osteoporosis (6). In addition, physical activity is helpful in managing and treating many chronic diseases (10).

In spite of the fact that physical activity is a complex behavior (11) and difficult to assess (12), progress has been made in the ability to characterize national levels of physical activity. Unfortunately, these results indicate that less than half of the American population is physically active at a level likely to confer health benefits. Because of the multiple health benefits of physical activity and because of the high prevalence of sedentary lifestyle documented among the U.S. population, the promotion of prudent physical activity should be a national priority for the Public Health Service.

References

1. Public Health Service. Promoting health/preventing disease: objectives for the nation. Washington, DC: US Department of Health and Human Services, 1980.

2. Haskell WL, Montoye HJ, Orenstein D. Physical activity and exercise to achieve health-related physical fitness components. Public Health Rep 1985;100:202-12.

3. Caspersen CJ, Christenson GM, Pollard RA. Status of the 1990 physical fitness and exercise objectives--evidence from NHIS 1985. Public Health Rep 1986;101:587-92.

4. Stephens T, Jacobs DR Jr, White CC. A descriptive epidemiology of leisure-time physical activity. Public Health Rep 1985;100:147-58.

5. Iverson DC, Fielding JE, Crow RS, Christenson GM. The promotion of physical activity in the United States population: the status of programs in medical, worksite, community, and school settings. Public Health Rep 1985;100:212-24.

6. Siscovick DS, LaPorte RE, Newman JM. The disease-specific benefits and risks of physical activity and exercise. Public Health Rep 1985;100:180-8.

7. Powell KE, Thompson PD, Caspersen CJ, Kendrick JS. Physical activity and the incidence of coronary heart disease. Ann Rev Public Health (in press).

8. Blair SN, Jacobs DR Jr, Powell KE. Relationships between exercise or physical activity and other health behaviors. Public Health Rep 1985;100:172-80.

9. Taylor CB, Sallis JF, Needle R. The relation of physical activity and exercise to mental health. Public Health Rep 1985;100:195-202.

10. Kottke TE, Caspersen CJ, Hill CS. Exercise in the management and rehabilitation of selected chronic diseases. Prev Med 1984;13:47-65.

11. Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep 1985;100:126-31.

12. LaPorte RE, Montoye HJ, Caspersen CJ. Assessment of physical activity in epidemiologic research: problems and prospects. Public Health Rep 1985;100:131-46.

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