Socioecological Risk Predictors of Physical Activity and Associated Mortality

Abstract

Purpose:

To assess (1) the cumulative effect of socioecological factors (social risk) on objectively measured physical activity, (2) the cumulative socioecological risk on all-cause mortality, (3) the potential interaction effects of social risk factors on physical activity and mortality, and (4) whether physical activity mediates the relationship between social risk and mortality.

Design:

Cross-sectional and prospective.

Setting:

Laboratory- and survey-based testing of the general US population.

Participants:

Five thousand five hundred seventy-four adult participants of the National Health and Nutrition Examination Survey 2003 to 2006.

Measures:

Social risk was assessed from 4 variables, namely poverty level, education, minority status, and social living status. Moderate-to-vigorous physical activity (MVPA) was assessed via accelerometry. Mortality was assessed via linkage with the National Death Index, with follow-up through 2011.

Analysis:

Negative binomial regression and Cox proportional hazard model.

Results:

Compared to those with 0 social risk factors, those with 1 and 2+ social risk factors engaged in 11% and 10% less MVPA, respectively. Those with 1 (vs 0) social risk factor had a 2.0-fold increase in mortality risk, and those with 2+ (vs 0) social risk factors had a 2.3-fold increase in mortality risk. Interaction effects for various socioecological factors on both MVPA and mortality were observable.

Conclusion:

Cumulative social risk is associated with less MVPA and increased all-cause mortality risk. Given the interaction effects of socioecological factors, targeted interventions in identified populations may be needed.