Paul D Loprinzi1,2,3, Robert E Davis2,3. 1. 1 Jackson Heart Study Vanguard Center of Oxford, The University of Mississippi, Oxford, MS, USA. 2. 2 Center for Health Behavior Research, The University of Mississippi, Oxford, MS, USA. 3. 3 Department of Health, Exercise Science and Recreation Management, The University of Mississippi, Oxford, MS, USA.
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.
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.
Entities:
Keywords:
epidemiology; exercise; social risk; survival