Socioeconomic inequalities in physical activity in Brazil: a pooled cross-sectional analysis from 2013 to 2019
Gérson Ferrari, Pedro Toteff Dulgheroff, Rafael Moreira Claro, Leandro F. M. Rezende, Catarina Machado Azeredo
Abstract
Abstract Background Information on socioeconomic inequalities in physical activity over time is sparse in low- to middle-income countries. In this study, we examined trends in physical activity educational inequalities in adults from Brazil between 2013 and 2019. Methods We analyzed data from seven cross-sectional studies including 359,038 adults (≥ 18 years) from the VIGITEL study conducted annually from 2013 to 2019. Participants responded to a questionnaire about physical activity (total, leisure, and commuting). Educational inequalities by sex and skin color were assessed through absolute (slope index of inequality – SII) and relative measures of inequality (concentration index – CIX). Results We found large absolute and relative inequalities for leisure-time physical activity, favoring those with higher educational attainment (SII 2019 = 35.4; CIX 2019 = 11.82). Active commuting was more prevalent in intermediate education groups, with a slight inequality toward the less educated group (SII 2019 = -2.8; CIX 2019 = -0.4). From 2013 to 2019, the absolute educational inequality in physical activity (total, leisure, and commuting) remained unchanged; however, the relative inequality gap narrowed for total physical activity (CIX: 8.4 in 2013 to 5.5 in 2019) and leisure-time physical activity (CIX: 18.3 in 2013 to 11.8 in 2019). Educational inequality increased in leisure-time physical activity among women and non-white individuals, while it reduced among men and white individuals; for active commuting, inequality decreased among women, and increased among men and white individuals. Conclusions Inequality in total physical activity and leisure-time physical activity favors the most educated groups in Brazil. Over time, relative educational inequality decreased for total and leisure-time physical activity, while no progress was found for absolute inequality.