Prevalence of Sedentary Lifestyle -- Behavioral Risk Factor Surveillance System, United States, 1991

Despite increasing evidence of the health benefits of physical activity, the United States remains predominantly a sedentary society (1-4). In 1990, nearly 60% of the U.S. adult population reported little or no leisure-time physical activity (5). Persons who engage in no physical activity are at higher risk for death from coronary heart disease than are persons who exercise regularly (1). To estimate the prevalence of sedentary lifestyle and identify groups characterized by a high prevalence of physical inactivity, CDC analyzed data on leisure-time physical activity from the 1991 Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the results of the survey.

Data were available for 87,433 respondents aged greater than or equal to 18 years in 47 states and the District of Columbia that participated in the BRFSS, a population-based, random-digit-dialed telephone survey. Respondents were asked about the frequency, duration, and intensity of activities and were scored and categorized as having 1) no physical activity, 2) irregular activity only, 3) regular but not intensive activity (less than 50% of predicted maximal cardiorespiratory capacity, based on age), or 4) regular and intensive activity. Persons with no or irregular leisure-time activity were defined as having a sedentary lifestyle. Data were weighted and aggregated, and composite estimates and standard errors for selected groups were calculated using SESUDAAN (6). Prevalence of sedentary lifestyle and 95% confidence intervals were estimated by sex, race, and age (Figure 1). Because of limitations in sample sizes, race-specific prevalences could be estimated only for non-Hispanic whites and other races combined.

Overall, 58.1% of respondents were classified as sedentary; 29.8% reported no leisure-time activity. The crude prevalence did not differ by sex (57.7% for men and 58.5% for women). The prevalence of sedentary lifestyle was higher for other races (63.7%) than for non-Hispanic whites (56.7%), particularly for women of other races (64.9%).

The prevalence of sedentary lifestyle increased steadily with age (Figure 1). For younger respondents (aged 18-34 years) the prevalence was 54.6%; for persons aged 35-54 years, 58.9%; and for older respondents (aged greater than or equal to 55 years), 61.9%. Prevalence did not differ by sex for the youngest age group (55.0% for men and 54.2% for women); however, for the 35-54 year age group, men (60.9%) were more sedentary than women (56.9%), and for the older age group, women (64.9%) were more sedentary than men (59.1%).

The prevalence of sedentary lifestyle was inversely related to income (Figure 2) (i.e., prevalence was highest {65.0%} for the lowest income category {less than $15,000} and lowest {48.3%} for persons in the highest income category {greater than $50,000}). Prevalence also was inversely related to education and was 71.9% among persons with less than a 12th-grade education, compared with 50.1% among persons with a college education.

Reported by: State Behavioral Risk Factor Surveillance System coordinators. Statistics Br, Div of Chronic Disease Control and Community Intervention, National Center for Chronic Disease Prevention and Health Promotion, CDC.

Editorial Note

Editorial Note: The findings in this report underscore the need for most persons in the United States to increase physical activity. A national health objective for the year 2000 is to reduce to 15% the proportion of persons aged greater than or equal to 6 years who engage in no leisure-time physical activity (objective 1.5) (7).

The measurement of physical activity based on the BRFSS is subject to at least two limitations. First, the BRFSS findings reflect self-reported data and cannot be validated. Second, no equivalent estimates are available for occupational activity, which may be substantially higher in low-income and low-education groups; therefore, estimates restricted to leisure-time activities may overestimate the prevalence of sedentary lifestyle in these populations.

The increased prevalence of sedentary lifestyle among racial/ethnic minorities may be attributable to disparities in education and income, which were not adjusted for in this analysis. This pattern may reflect differences in availability of leisure time, access to facilities, or other barriers to increased physical activity.

Because of the high prevalence of sedentary lifestyle in the United States, CDC and the American College of Sports Medicine (ACSM) recently convened experts on physical activity and health to examine the science base supporting the health benefits of moderate physical activity and to develop a concise public health message for physical activity promotion. CDC and ACSM recommend that all U.S. residents aged greater than or equal to 18 years participate in moderate physical activity for 30 minutes or more on most days. Participation in such activity at least 5 days per week is a suggested goal. Achievement of this goal will require intensified efforts by health-care providers and others to increase public awareness of the health benefits of an active lifestyle and to establish environments in which persons can be more physically active (8).

References

1. Powell KE, Thompson PD, Caspersen CJ, Kendrick JS. Physical activity and the incidence of coronary heart disease. Annu Rev Public Health 1987;8:253-87.

2. Berlin JA, Colditz GA. A meta-analysis of physical activity in the prevention of coronary heart disease. Am J Epidemiol 1990;132:639-46.

3. Blair SN, Kohl HW, Paffenbarger RS Jr, Clark DG, Cooper KH, Gibbons LW. Physical fitness and all-cause mortality: a prospective study of healthy men and women. JAMA 1989;262:2395-401.

4. Paffenbarger RS Jr, Hyde RT, Wing AL, Lee I-M, Jung DL, Kampert JB. The association of changes in physical-activity level and other lifestyle characteristics with mortality among men. N Engl J Med 1993;328:538-45.

5. Siegel PZ, Brackbill RM, Frazier EL, et al. Behavioral Risk Factor Surveillance, 1986-1990. MMWR 1991;40(no. SS-4):1-23.

6. Shah BV. SESUDAAN: standard errors program for computing of standardized rates from sample survey data. Research Triangle Park, North Carolina: Research Triangle Institute, 1981.

7. Public Health Service. Healthy people 2000: national health promotion and disease prevention objectives -- full report, with commentary. Washington, DC: US Department of Health and Human Services, Public Health Service, 1991; DHHS publication no. (PHS)91-50212.

8. Fletcher GF, Blair SN, Blumenthal J, et al. Statement on exercise -- benefits and recommendations for physical activity programs for all Americans: a statement for health professionals by the Committee on Exercise and Cardiac Rehabilitation of the Council on Clinical Cardiology, American Heart Association. Circulation 1992;86:340-4.

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