Sociodemographic Factors, Leisure-Time Physical Activity and Mortality

Introduction: Exploring sociodemographic effect modi fi cation is important to provide evidence for developing targeted recommendations and reducing health inequalities. This study evaluated how sociodemographic factors including age, sex, race/ethnicity and socioeconomic status (SES) modify the association between leisure -time physical activity (LTPA) and all -cause and major cause -speci fi c mortality. Methods: The study sample included 471,992 people from the 1997 - 2018 National Health Interview Survey (NHIS) and 41,830 people from the 1999 - 2018 National Health and Nutrition Examination Survey (NHANES). Data were analyzed in December 2022. Mortality data from the National Death Index were available to December 31, 2019. Suf fi cient LTPA was de fi ned as at least 150 minutes of moderate and/or vigorous intensity per week. Results: There were 46,289 deaths in NHIS participants and 4,617 deaths in NHANES participants during a mean follow-up of 10 years. Individuals with suf fi cient LTPA had lower risk of all -cause (NHIS: hazard ratio, 0.74, 95% CI: [0.74 - 0.74]; NHANES: 0.73 [0.68 - 0.79]) and cardiovascular mortality (NHIS: 0.75 [0.75 - 0.75]; NHANES: 0.80 [0.69 - 0.93]) compared with inactive participants. The subgroup analysis showed signi fi cant interactions between LTPA and all sociodemographic factors. Associations between LTPA and mortality were weaker among younger individuals, males, Hispanic adults or those of low SES, respectively. Conclusions: Sociodemographic factors signi fi cantly modi fi ed the associations between LTPA and mortality. The health bene fi ts of suf fi cient LTPA were smaller in younger individuals, males, Hispanic adults or those of low SES. These fi ndings can help identify target populations for promotion of physical activity to reduce health inequalities and the development of physical activity guidelines. Am J Prev Med 2024;66(4):598 - 608. (c) 2023 The Authors. Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine. This is an open access article under the CC BY -NC -ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).