Leisure-time physical activity levels of the US workforce
Introduction
Physical inactivity and improper nutrition are the primary determinants of the national obesity epidemic (Biolo et al., 2005). Physical inactivity poses almost as much risk for heart disease as cigarette smoking, high blood pressure, or high cholesterol levels, but is more prevalent than any of these other risk factors (Dubbert et al., 2002, Carmichael and Bates, 2004, Biolo et al., 2005). Physical inactivity is also a burden on the US economy. For example, one study has estimated that physical inactivity accounts for over 9% of annual US health care expenditures (Garrett et al., 2004).
Some studies have examined sedentary lifestyles and associated factors at the population level, however few have approached the subject from the occupational standpoint (Bernstein et al., 1999, Varo et al., 2003). American occupations have become increasingly sedentary and long hours of sitting or standing at work have been significantly associated with risk of obesity (Hu, 2003a, Hu, 2003b, Hu et al., 2003). Furthermore, technological change has lowered the cost of calorie intake by making food cheaper, and has raised the cost of expending calories by transforming physical exercise from an occupational activity to an off-the-job leisure-time activity.
The Healthy People 2010 objectives have identified 15 goals directly related to improving the physical activity behaviors of the US population (USDHHS, 2000). The specific adult objectives selected to measure progress on the physical activity indicator included engagement in regular, preferably daily, moderate physical activity for at least 30 min per day. Given the rapidly increasing obesity epidemic already demonstrated in the US workforce (Caban et al., 2005), surveillance of leisure-time physical activity levels in US workers is essential so that healthcare providers can pursue targeted obesity intervention and prevention activities with their working patients. In the present study, over 153,000 US workers who participated in the 1997 to 2004 National Health Interview Survey were evaluated for meeting the Healthy People 2010 Guidelines of leisure-time physical activity by occupation and gender subpopulations.
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Methods
The National Health Interview Survey (NHIS) is a continuous multipurpose and multistage probability area survey of the US civilian non-institutionalized population living at addressed dwellings (Caban et al., 2005). Information on employment (paid and unpaid) during the week prior to the NHIS interview was collected on subjects aged ≥ 18 years, permitting classification of workers into 41 standardized occupational categories (Caban et al., 2005). Only workers with a valid occupational code were
Results
In the 1997–2004 NHIS, participants were aged from 18 to 88 years old with a mean age of 40.3 ± 12.7 (± Standard Deviation). Just over 31% of the male and 36% of the female US workers met the recommended Health People 2010 leisure-time physical activity guidelines. There were no significant upward or downward trends in the prevalence rate of leisure time physical activity from 1997 to 2004 among US workers stratified by gender, race and ethnicity (Fig. 2). Male workers had consistently higher
Discussion
Analysis of data from the National Health and Nutrition Examination Survey (NHANES) III indicated that workers who were employed in physically demanding occupations were less likely to be obese relative to workers engaged occupations which required little physical exertion (King et al., 2001). Unfortunately, the proportion of the US workforce employed in low physical activity occupations has increased from 23% in 1950 to 41% in 2000; during this same time period, the proportion of the US
Conclusions
Despite the limitations, the results of this study can be used as an indicator of overall low levels of leisure-time physical activity in the nation; it is also important to note that while obesity levels are increasing among US workers (Caban et al., 2005), leisure-time physical activity levels are not increasing in nearly all worker groups examined in the present analysis. Additionally, the substantial increase in the prevalence of obesity among US children and adolescents (Freedman et al.,
Acknowledgments
The Authors gratefully acknowledge the help of Rachel Steinfeld, M.H.S. (CDC/NHIS) who assisted with the development of the leisure-time physical activity definition used in this analysis. The data utilized in this publication were made available in part by the Inter-University Consortium for Political and Social Research. Data for the NHIS were originally collected and prepared by the US Department of Health and Human Services and the National Center for Health Statistics. Neither the
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