Transcript Temporal trends in adults' sports participation patterns in England between 1997 and 2006: the Health Survey for England.

Temporal trends in adults’ sports participation
patterns in England between 1997 and 2006: The
Health Survey for England
Emmanuel Stamatakis1, Moushumi Chaudhury1
1 Department of Epidemiology and Public Health, UCL
Br J Sports Med 2008;0:1-8. doi:10.1136/bjsm.2008.04082
What am I going to talk about
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Introduction
Data
Measurements
Sports and exercise groupings
Statistical analysis
Results
– Trends in participation overall and particular sports
• Conclusion
Introduction: What we already know
• Participating in PA shown to reduce many chronic
conditions e.g. Ischaemic heart disease, type II diabetes,
obesity, certain cancers
• Adults are recommended that on at least five days a week,
they should be active at moderate or greater intensity for
at least 30 minutes a day1
• Additional benefits of sports and exercise (SPEX)?
– enhanced social well being, general sense of
belonging, lower employment less crime and stronger
community cohesion
1 Donaldson
L. At least five a week: evidence on the impact of physical activity and its relationship to health. A report
from the Chief Medical Officer. Department of Public Health, London, 2004
Definitions
• Physical activity - any bodily movement produced by
skeletal muscles that results in energy expenditure above
resting level. This broad definition involves virtually all
types of activity like: walking, cycling, dance, gardening,
housework and sports
• Sports - is an activity that is governed by a set of rules or
customs and often engaged in competitively
• Exercise - Exercise is physical activity that is planned,
structured, and repetitive for the purpose of conditioning
any part of the body
Objective
To examine temporal trends in participation in
sports and exercise activities in England between
1997 and 2006,taking into account wider societal
changes
Data
• Health Survey for England (HSfE) 1997/98 2003/04,
2006
• Nationally representative annual cross-sectional study
• Face-to-face interview
• Analyses conducted on 60,938 adults aged 16 & over
– Men n = 27 217
– Women n= 33 721
Measurements & data collected on:
• Physical activity (questionnaire)
• Sports and exercise (SPEX) - response from show cards
• Questions on age, sex, ethnicity, social class, income,
education, smoking habits, self-reported health, car
ownership
• Body mass index (BMI) W/H2
Sports and exercise grouping
• Individual spex
– Swimming, dancing, cycling & running
• Grouped spex
– Team sports e.g. football/rugby, netball, volleyball
– Racquet sports e.g. badminton/tennis, squash
– Gym/fitness club based e.g. gym workout, weight
training, keep fit, aerobics
Show card example
CARD O
1
2
3
4
5
6
7
8
9
10
Swimming
Cycling
Workout at a gym / Exercise bike / Weight
Aerobics / Keep fit / Gymnastics / Dance for fitness
Any other type
Running / Jogging
Football / Rugby
Badminton / Tennis
Squash
Exercises (e.g. press-ups, sit-ups)
Please also include teaching, coaching and training/ practice session
Definition of any and regular sports and
exercise participation (SPEX)
• Any SPEX participation:
– At least once in the previous 4 weeks in any spex
grouping
• Regular SPEX participation:
– At least once a week in any spex grouping
Statistical analyses
• Age-standardised sports and exercise rates and
95% CI by time point (1997/8 combined, 2003/4
combined, 2006)
Data driven
• Logistic regression models
– Step 1: Merge HSfE data
– Step2: X2 test
– Step 3:Develop several sex-specific multiple LR models
Table 1a: Characteristics of the sample by survey year
Men
Data for survey year, %
1997-8
2003-04 2006
(n =11
(n =
(n =
091)
9798)
6324)
p*
Women
Data for survey year, %
1997-8
2003-04 2006
(n = 13
(n = 12
(n = 7818) p *
399)
504)
Age, mean
Obesity
46.1
48.1
49.2
<0.001 47.1
48.7
49.3
<0.001
17.2
23.0
24.9
<0.001 20.7
23.6
25.2
<0.001
Non-sporting/non0ccupational
activity ≥5 30
21.7
20.8
22.9
20.6
24.8
<0.001 23.3
minute
sessions/week
* Based on x 2 tests. Data from the Health Survey for England, men and women ≥ 16 years
<0.001
Table 1b: Characteristics of the sample by survey year
Men
Data for survey year, %
1997-8
2003-04 2006
(n =11 091) (n =
(n =
9798)
6324)
p*
Women
Data for survey year, %
1997-8
2003-04 2006
(n = 13
(n = 12
(n =
399)
504)
7818)
p*
Ethnicity, White
94.0
90.7
91.0
<0.001 94.4
90.4
91.0
<0.001
Social Class:
Manual
51.6
46.2
43.2
<0.001 48.5
39.8
40.4
<0.001
Self-reported
health status:
Fair or better
93.7
92.9
92.4
0.002
93.2
93.2
93.1
0.9
Work activity
level: At least
moderate level
20.7
19.2
18.5
<0.001 11.7
11.2
11.2
0.4
* Based on x2 tests. Data from the Health Survey for England, men and women ≥ 16 years
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Participation in sports and exercise, England
(1997, 1998, 2003, 2004 and 2006 combined)
Figure 1: Age-standardised and multivariable-adjusted odds for any and regular
sports and exercise participation in 2003/04 and 2006 (compared with the 1997/98
referent time point). Adults aged 16 and over living in England
1.40
1.30
1.10
1.00
0.90
Any participation
Regular participation
MEN
Any participation
2006
2003/4
2006
2003/4
2006
2003/4
2006
0.80
2003/4
Odds ratio
1.20
Regular participation
WOMEN
Table 2: Age-std participation rates between 1997/8 & 2006 adults aged ≥16
years living in England
MEN
WOMEN
Data for survey
1997/8
2003/04,
(referent)
%
p
Adjusted*
Data for survey
1997/8
2003/04,
(referent)
%
2006,
%
<0.001
31.2
34.0
33.9
<0.001
Sports groupings participation:
Regular participation ((≥ once a week on average)
Cycling
10.2
9.9
9.7
0.967
4.3
4.3
4.1
0.467
Swimming
6.9
7.1
6.6
0.286
8.8
9.0
9.1
0.963
Dance
3.7
2.8
2.3
<0.001 ↓
6.1
6.0
6.1
0.696
Run
9
8.1
8.0
0.138
2.4
3.2
4.0
<0.001↑
Team sports
8.9
8.3
8.6
0.285
0.5
0.4
0.5
0.706
Racquet sports
3.5
2.8
2.9
0.039 ↓
1.8
1.6
1.5
0.136
Golf
3
3.1
2.8
0.327
0.4
0.6
0.4
0.091
Gym/health club
17
18.7
19.0
<0.001 ↑
15.9
18.7
18.7
<0.001 ↑
Regular participation 40.8
(> once a week on
average
42.0
2006,
%
41.2
p
Adjusted*
*Using 1997/8 as the ref time point: adjusted for ethnicity, social class, income, education, obesity status, car ownership, smoking
status, general health, occupational activity, and non-sporting/non-occupational physical activity
Table 2: Age-std participation rates between 1997/8 & 2006 adults aged ≥16
years living in England
MEN
WOMEN
Data for survey
1997/8
2003/04,
(referent)
%
Data for survey
1997/8
2003/04,
(referent)
%
2006,
%
Sports groupings participation:
Any participation ((≥ once in the last 4 weeks)
Cycling
16.5
15.2
14.4 0.093 ↓
8
7.1
6.6
0.002 ↓
Swimming
13.7
12.8
12.8
0.087
15.7
15.0
15.3
0.101
Dance
7.4
6.0
4.7
<0.001 ↓
11.6
10.6
10.5
0.106
Run
12.7
11.8
11.0
0.075
4
5.1
6.0
<0.001
Team sports
15
14.0
13.6
0.331
1.4
1.5
1.7
0.459
Racquet sports
7
5.7
5.4
<0.001 ↓
3.5
3.1
3.0
0.061 ↓
Golf
5.3
5.3
4.7
0.133
0.133
0.7
0.9
0.007
Gym/health club
23.5
26.0
25.5
<0.001 ↑
<0.001
23.3
26.4
<0.001 ↑
2006,
%
p
Adjusted*
p
Adjusted*
*Using 1997/8 as the ref time point: adjusted for ethnicity, social class, income, education, obesity status, car ownership, smoking
status, general health, occupational activity, and non-sporting/non-occupational physical activity
Table 3: Overall sports and exercise participation at two levels by age
group
Men
%
Age group, years, &
sports participation
1997/8
2003/4
2006
Adjusted p
value for
trend*
0.932
61.0
46.7
62.4
48.9
61.5
48.7
0.454
0.139
59.0
46.7
0.555
0.041
50.8
36.4
54.8
41.1
53.4
40.7
0.007
<0.001
42.7
32.6
44.2
34.0
0.026
0.014
37.7
27.1
39.5
42.7
32.8
0.038
0.001
25.9
21.3
28.3
22.9
0.026
0.039
16.1
13.0
21.4
17.0
20.1
16.1
<0.001
1997/8
2003/4
2006
16–29
Any†
Regular‡
75.6
63.0
74.5
63.5
73.4
63.1
30–44
Any†
Regular‡
58.9
44.3
60.6
48.5
45–64
Any†
Regular‡
39.4
29.6
65+
Any†
Regular‡
23.2
18.5
Adjusted p
value for
trend*
Women
%
*Adjusted for ethnicity, social class, income, education, obesity status, car ownership, smoking status, general health,
occupational activity, and non-sporting/non-occupational physical activity . †At least once in the last 4 weeks. ‡At lest
once/week on average
Figure 2a: Multivariable-adjusted odds for regular participation in sport and exercise
groupings in 2003/04 and 2006 (compared with the 1997/98 referent time point). Men
aged 16 to 29 living in England
2.00
1.80
Odds ratio
1.60
1.40
1.20
1.00
0.80
0.60
† Trend p <0.05
∫ Trend p <0.001
† Cycling
Sw imming
∫ Dancing
∫ Running
† Team
Sports
† Racket
Sports
Golf
2006
2003/4
2006
2003/4
2006
2003/4
2006
2003/4
2006
2003/4
2006
2003/4
2006
2003/4
2006
2003/4
0.40
Fitness
Club/Gym
Figure 2b Multivariable-adjusted odds for regular participation in sport and exercise
groupings in 2003/04 and 2006 (compared with the 1997/98 referent time point).
Women aged 16 to 29 living in England.
2.00
1.80
Odds ratio
1.60
1.40
1.20
1.00
0.80
0.60
† Trend p <0.05
∫ Trend p <0.001
† Cycling
Sw imming
∫ Dancing
† Running
Team Sports
Racket Sports
2006
2003/4
2006
2003/4
2006
2003/4
2006
2003/4
2006
2003/4
2006
2003/4
2006
2003/4
0.40
Fitness
Club/Gym
Figure 3a: Age-standardised odds for regular sports and exercise participation in
2003/04 and 2006 (compared with the 1997/98 referent time point). Men aged 16 and
over living in England.
.
1.80
Odds ratio
1.60
1.40
1.20
1.00
0.80
† Non-Manual
† Trend p <0.05
∫ Trend p <0.001
Manual
Social Class
∫ White
Non-White
Ethnicity
∫ Top quintiles
2006
2003/4
2006
2003/4
2006
2003/4
2006
2003/4
2006
2003/4
2006
2003/4
0.60
Bottom quintiles
Income
Figure 3b: Age-standardised odds for regular sports and exercise participation in
2003/04 and 2006 (compared with the 1997/98 referent time point). Women aged 16
and over living in England
1.80
Odds ratio
1.60
1.40
1.20
1.00
0.80
∫ Non-Manual
† Trend p <0.05
∫ Trend p <0.001
† Manual
Social Class
∫ White
† Non-White
Ethnicity
∫ Top quintiles
2006
2003/4
2006
2003/4
2006
2003/4
2006
2003/4
2006
2003/4
2006
2003/4
0.60
∫ Bottom quintiles
Income
Main Findings
• Age std overall regular participation increased
– Men 40.8% to 41.2% (1997/98 to 2006)
– Women 31.2% to 33.9% (1997/98 to 2006)
• Regular G/FC increased
– 17.0% to 19.0% for men (1997/98 to 2006)
– 15.9 to 18.7% for women (1997/98 to 2006)
• Regular running increased for women only
– 2.4% to 4.0% (1997/98 to 2006)
• Overall increases were apparent in older adults (≥45years)
• Increase in participation among men from non manual
social class, higher income households and white ethnic
background
Conclusions
1. This is the first time trend analysis of SPEX in England
2. Overall regular SPEX in England has increased between
1997 and 2006
3. Middle aged and older adults show, main increase
individual activity, e.g. gym/ fitness clubs
4. Bad news! Younger male adults (16-29years) shows
decrease in all sports e.g. cycling, swimming, running
and racquet sports
Conclusions
5. There are no signs that the participation between lower
and higher socioeconomic strata and between white and
ethnic minority groups is narrowing.
Therefore sports promoting and health policy efforts
should focus on these groups and try to expand
participation.
Future work
• Better understanding of the mechanisms behind the
“success story” of middle-aged and older adults
• HSfE 2007: I am looking at Knowledge of & Attitudes to
physical activity (results due out December 2008)
• HSfE 2008 first time Objective measurements
– Step test
– Accelerometer