Scottish Health Survey - topic report: physical activity

Executive Summary

This study presents an analysis of factors significantly associated with adults (age 16+ years) meeting the physical activity guidelines in Scotland in 2012. It is based on logistic regression analysis of the Scottish Health Survey (SHeS), the only national level data source of total physical activity levels in the adult population in Scotland. It is the first study to use logistic regression on the physical activity data in the SHeS, an approach which creates a more robust analysis of the variation in physical activity levels across different population groups than achieved through simple bivariate analysis alone.

This study also examined if a change in physical activity guidelines, which took place across the four home nations of the UK in 2011, affected the range and/or patterning of factors associated with meeting the guidelines. The previous guidelines stipulated that 30 minutes of moderate to vigorous physical activity (MVPA) should take place on at least five days of the week. The new guidelines removed the frequency stipulation, with 150 minutes of MVPA per week now recommended (though the guidelines still suggest activity over 5 days is one way to meet this, and also recommend some activity daily). The guideline change substantially increased the proportion of adult population in Scotland who met the guidelines from 38% in 2011 to 62% in 2012.

A third aspect of the study was to examine the factors associated with any participation in the different domains of physical activity measured in the SHeS that make up overall activity levels (sport and exercise; walking; housework/gardening/DIY and activity in paid work (occupational physical activity)).

The analysis on the 2012 SHeS found that demographic and health and lifestyle factors were of primary importance with meeting the 2012 physical activity guidelines, whereas socioeconomic factors were overall less influential. The exception to this was economic activity status, which showed a relatively strong influence on likelihood of meeting the guidelines. The factors in 2012 most strongly associated with meeting the new guidelines were economic activity status, self-assessed health, age, sex and mental wellbeing.

The change to the physical activity guidelines in 2011 has had little substantial effect on the overall patterning of who is most likely to meet the guidelines, though the range of significant factors associated with the new guidelines increased. The most influential factors in 2011 associated with meeting the previous guidelines were economic activity status, disability, obesity, sex and age.

Substantial differences were found in the types of people most likely to take part in the different activity domains. For example, in contrast to findings for meeting physical activity guidelines, socioeconomic factors (income, educational attainment and deprivation) were found to have more of an influence on participation in sport and exercise and a strong association with occupational physical activity. Age was not found to be an influential factor for participation in walking (with the exception of women) and the relationship found for women was not what might have been expected. In contrast to the finding that age tends to typically be negatively associated with levels of physical activity, the likelihood of walking in women increased with age. Perhaps less surprisingly, substantial differences between men and women in doing housework were found, with women much more likely to do activity in the housework domain.

The socioeconomic patterning of physical activity is often cited as important, however, it is not always clear how much of an impact it has and there is criticism that the evidence base is weak on this issue with overreliance on self-report measures of physical activity and lack of account taken of socioeconomic patterning of physical activity in the different domains. The results from this study are consistent with other research in suggesting that measures of socioeconomic status are not as strongly associated with total physical activity as other factors. However, the analysis of the patterning of factors across the different domains found socioeconomic factors to be more influential in some areas. Higher socioeconomic groups were found to have higher levels of leisure time or moderate to vigorous physical activity compared to those in lower socioeconomic groups, but those in lower socioeconomic groups were found to take part in more occupational physical activity. These differences across the different domains may explain some of the inconsistencies encountered in the evidence base for the relationship between measures of socioeconomic status and total physical activity.

The socioeconomic patterning of sport and exercise participation has important implications. Due to the wider societal, technological and occupational labour market trends it is likely that occupational physical activity will make up less and less of total physical activity and action will be required to ensure higher participation of those from lower socioeconomic groups in other domains of physical activity.

A further consideration is the likelihood that many of the health and lifestyle factors found here to have a negative relationship with achieving physical activity recommendations have been shown to be more likely to be present in those in lower socioeconomic groups, for example obesity, smoking, poor mental and physical health. Thus, this reinforces the message that socioeconomic factors are important within a broader perspective.

Finally, this study adds further evidence to the importance of walking in addressing inequalities in physical activity participation and highlights the importance on the recent Let's Get Scotland Walking - The National Walking Strategy and the work that continues to implement this at national and local level.