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Show Study I: A Trend of Sedentary Lifestyle In the United States, participation in regular physical activity increased during the 1960s, 1970s, and early 1980s but seems to have plateaued since the mid-1980s (Pate, Pratt, & Blair, Haskell, Macera, Bouchard et al., 1995; U.S. Department of Health and Human Services, 1996 p. 186). This pattern has also been observed in Utah. Based on the BRFSS survey,1 Figures 1 and 2 show trends for adults, aged 18 or older, who engaged in light-to-moderate (HP2000 1.3 objective) or vigorous (HP2000 1.4 objective) physical activity from 1989 to 1996 in Utah, the Rocky Mountain states, and the United States (U.S.). The two physical activity measures were derived from 10 questions asked in BRFSS (see the Appendix), using a complex formula developed by the Centers for Disease Control and Prevention. The percentage of the median state among all BRFSS participating states for each year is presented in the figures as the national norm, a comparison point for states. The 95% confidence intervals were calculated for statistical tests between the point estimates of the states and the percentage of the median state, and between Utah and the Rocky Mountain states' estimates. SUDAAN, a software program for analyzing complex sample-survey data, was used for standard error estimates (Shah, 1981). In 1996, approximately 27% of adult Utahns, 24% of adult residents of Rocky Mountain states, and only 21% of adults from the median state engaged in light-to-moderate physical activity. Adult Utahns had a significantly higher rate in performing light-to-moderate exercise than did adults living in the entire Intermountain West in 1991, 1992, and 1996 (Figure 1). Correspondingly, 16.1% of Utah adults and 15.9% of Rocky Mountain states' adults participated in vigorous physical activity, significantly higher than the national norm for adults (14%) (Figure 2). For the past decade, adults in Utah and Rocky Mountain states were more likely to participate in physical activity than adults in the U.S. as a whole. However, BRFSS data indicate that Utah's physical activity levels are still lower than the desired goals defined by HP2 000. There have been no significant changes in the level of physical activity in Utah since 1989. The median 1 BRFSS is a random-digit-dialed telephone survey of the adult noninstitutionalized population, aged 18 or older. It is a multistage cluster sample. percentage of regular-vigorous, as well as light-to-moderate, physical activity has slightly increased nationwide since 1992, but this trend has not occurred in Utah. Study II: Inconsistency between Awareness and Behavior Physical activity behavior is related to an individual's perception about his or her own physical fitness and health risks. A recent study showed that those Utahns who consider exercise important to their health were approximately 1.5 times more likely to engage in exercise than those who did not consider it important (Larsen & Friedrichs, unpublished). The Utah Bureau of Chronic Disease Prevention and Control recently conducted a chronic disease awareness survey to examine what Utahns knew about their health risks and what they did about it (Larsen & Friedrichs, unpublished). Six questions on awareness of health risks were added to the BRFSS ongoing survey during April to June 1996. The responses to the awareness questions were compared with the respondents' self-reported behavior recorded in the same survey and with Utah's specific mortality rates reported by the Utah Office of Public Health Data. Generally speaking, the public in Utah is aware of the importance of physical activity for health. In the survey, not smoking, regular exercise, and healthy diet were listed by more than 70% of respondents (N'725) as the three most important things one should do to stay healthy. However, respondents' self-reported behaviors for regular exercise were not consistent with those beliefs. Figure 3 contrasts Utah adults' beliefs about health behaviors with their reported actions regarding them. Among those respondents who reported that not smoking was an important health behavior, approximately 92% of them did not smoke. Yet, only 35% of persons who reported exercise as an important health behavior and 21% of persons who reported healthy diet as important were reported acting on those beliefs. Study III: Socio-Demographic Differentials in Lifestyle Attitude towards physical activity is only one of the determinants influencing the patterns of sedentary lifestyle. Literature has suggested that exercise behavior is associated with individual socio-demographic characteristics, relationships with others in family and community, and interactions with health professionals and health 37 |
