Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE credits
Background: Physical inactivity is a major behavioural risk factor for chronic diseases—a growing public health problem in China—that is not well understood in the Chinese context. This study aims to assess for correlates of physical inactivity among older Chinese adults across socio-demographic, health-related, and psychosocial factors in addition to determining if community-level area effects influence the prevalence of physical inactivity in the Chinese setting.
Methods: Data from the 2010 WHO SAGE-China Wave 1 dataset was used, a nationally representative survey from China of adults aged 50 and above. A total of 11615 respondents were included in the analysis. Multilevel and multivariate logistic regressions were used to assess for factors associated with physical inactivity and, additionally, the multilevel logistic regression assessed for community-level variance in physical inactivity.
Results: The overall prevalence of physical inactivity among older adults in China is 27.0%. After adjusting for all variables included in the regression model, increased odds of physical inactivity is associated with the age categories 70-79 (OR = 1.61, 95% CI: 1.34– 1.94) and 80+ (3.25, 2.38–4.43), never being married (2.09, 1.16–3.74) and widowed marital status (1.15, 1.01–1.32), moderate (1.22, 1.07–1.38) and poor self-rated health (1.83, 1.54–2.18), insufficient dietary intake (1.59, 1.23–2.04), being underweight (1.32, 1.09– 1.60), and moderate community safety (1.26, 1.03–1.53). Additionally, the random effects component of the analysis indicates a VPC of 20.2% and a MOR of 2.38. This indicates one-fifth of the variation in physical inactivity can be explained by unobserved community- level characteristics and that in the median case the residual heterogeneity between communities in China results in a 2.38 times higher odds of being physically inactive when randomly picking two individuals from two different communities.
Conclusion: Physical inactivity is widespread among older Chinese adults, with almost one-third being inactive. Increased odds of physical inactivity are associated with advanced age, never having married, widowed marital status, poor self-rated health, inadequate dietary intake, and moderate community safety. Moreover, one-fifth of the variation in physical inactivity is due to unobserved community-level characteristics. The present results suggest physical activity promotion is needed in China and offers insight into factors associated with inactivity that can be used to tailor more effective interventions. For example, the results suggest adults whom have never married and are widowed are at heightened risk, which is perhaps suggestive that a physical activity promotion intervention should be tailored to this at-risk group. Additionally, the present results suggest the importance of including contextual area-level factors in future research seeking to understand the determinants of physical inactivity.
Keywords: Physical inactivity, Epidemiology, China, Non-communicable diseases, Older adults
2014. , 56 p.
physical inactivity, epidemiology, China, non-communicable diseases, older adults