Desigualdades demográficas e socioeconômicas na atividade física em seus diferentes domínios: uma abordagem interseccional e longitudinal na Coorte de nascimentos de 1982 de Pelotas

Abstract

Physical activity (PA) is a behavior that occurs across different domains, such as leisure, commuting, work, and domestic activities, with characteristics such as sex, race/ethnicity, and income being differentially associated with PA according to the domain. Intersectionality, an approach that considers the inseparability of these characteristics as social markers of inequality and their interrelated mechanisms of oppression and power in society, has gained attention in PA research. It highlights how these social markers combine and overlap, amplifying the impacts on health and health behaviors, including PA. This study aimed to assess demographic and socioeconomic inequalities, using an intersectional approach, across the four PA domains at age 23 and leisure and transportation at age 40, using data from the 1982 Pelotas Birth Cohort. PA data were collected using the International Physical Activity Questionnaire (IPAQ) for leisure and commuting domains at ages 23 and 40 (4,296 and 2,761 individuals, respectively) and for work and domestic domains at age 23. The inequality markers analyzed unidimensionally and intersectionally were sex, race/ethnicity, and family income. For all domains, prevalence and 95% confidence intervals (CI95%) of PA were calculated, along with the respective absolute and relative inequality measures (difference, ratios, SIope Index of Inequality, and Concentration Index) for each inequality social marker separately. Prevalence of PA and CI 95% for all intersectional categories were estimated, and Poisson regression was used to estimate prevalence ratios, considering double and triple interaction terms between social markers. The analytical sample consisted of 4,296 at 23 and 2,761 at 40 years, respectively. At 23 years, the most privileged group (high-income white men) had a lower prevalence of PA at work (66.7% vs. 84.7%) and domestic domain (57.9% vs. 95.8%) compared to the most vulnerable group (low-income black women). At 23 and 40 years, the most privileged group had a higher prevalence of PA during leisure time (77.1% and 71.4%) and lower prevalence during commuting (75.3% and 54.0%), compared to the most vulnerable group (29.7% and 41.9% during leisure time and 85.8% and 69.6% during commuting, respectively). Longitudinally, at age 40, inequalities between sexes and between extreme intersectional groups decreased in leisure. In contrast, inequalities increased in commuting for income in an absolute way and between extreme intersectional groups, both absolutely and relatively. It was concluded that unidimensionally and intersectionally, at both ages evaluated, vulnerability characteristics are related to a higher prevalence of PA in domains of need, while privilege characteristics are related to a higher prevalence of PA in the leisure domain.