Relationship between Brazilian adolescents' physical activity and social and economic indicators of the cities where they live

Global impact on human obesity - A robust non-linear panel data analysis

Purpose: Recent studies in economics showed that humans are bounded rational. This being consumers, they are not perfect judges of what matters for the standard of living. While with a marked increase in economic and social wellbeing, there is a consistent rise in obesity levels, especially in the developed world. Thus, this study intends to explore the empirical and socio-economic antecedents of human obesity across countries using six global indexes. Methods: This study used the data of 40 countries between 1975 to 2018 and used the Panel FGLS Regression with the quadratic specification. Findings: The results showed that health and food indicators increase global human obesity, environment and education indicators decrease global human obesity, and economic and social indicators follow an inverted U-shaped pattern in affecting global human obesity. Originality: Previous studies have used infant mortality and life expectancy as the major health indicator in determining the standard of living while overlooking global human obesity as a major deterrent to welfare. This study has provided a holistic assessment of the causes of obesity in global contexts.

Insufficient Level of Physical Activity and Its Effect on Health Costs in Low- and Middle-Income Countries

Evidence suggests that mortality attributed to noncommunicable diseases (NCDs) will increase from 38 million in 2012 to 52 million by 2030. The recent epidemiological data show that these diseases are increasing in low- and middle-income countries so that about 80% of all deaths of NCDs occurred in low- and middle-income countries. It has been estimated that an insufficient level of physical activity leads to a large share of the burden of these diseases. Evidence suggests that the rate of insufficient levels of physical activity in low- and middle-income countries has increased over the past 15 years. The authorities and policymakers must be advocated with consistent evidence from low- and middle-income countries on productivity loss and increased healthcare costs due to the absence or insufficient levels of physical activity. It is also necessary to include physical activity across all policies to prevent possible escalation of the economic burden related to physical inactivity in the near future.

Neighbourhood residential density and childhood obesity

Residential density is considered an important attribute of the built environment that may be relevant to childhood obesity. However, findings remain inconclusive, and there are no reviews yet on the association between residential density and childhood obesity. This study aimed to systematically review the associations between residential density and weight-related behaviours and outcomes. A comprehensive literature search was conducted using the Cochrane Library, PubMed and Web of Science for articles published before 1 January 2019. A total of 35 studies conducted in 14 countries were identified, including 33 cross-sectional studies, one longitudinal study and one containing both study designs. Residential density was measured by Geographic Information Systems in 28 studies within a varied radius from 0.25 to 2 km around the individual residence. Our study found a general positive association between residential density and physical activity (PA); no significant associations were observed. This study provided evidence for a supportive role of residential density in promoting PA among children. However, it remained difficult to draw a conclusion between residential density and childhood obesity. Future longitudinal studies are warranted to confirm this association.

Economics of physical activity in low-income and middle- income countries: a systematic review

BACKGROUND

Promotion of physical activity (PA) among populations is a global health investment. However, evidence on economic aspects of PA is sparse and scattered in low-income and middle-income countries (LMICs).

OBJECTIVE

The objective of this study was to summarise the available evidence on economics of PA in LMICs, identify potential target variables for policy and report gaps in the existing economic evidence alongside research recommendations.

DATA SOURCES

A systematic review of the electronic databases (Scopus, Web of Science and SPORTDiscus) and grey literature.

STUDY ELIGIBILITY CRITERIA

Cost-of-illness studies, economic evaluations, interventions and descriptive studies on economic factors associated with PA using preset eligibility criteria.

STUDY APPRAISAL AND SYNTHESIS OF METHODS

Screening, study selection and quality appraisal based on standard checklists performed by two reviewers with consensus of a third reviewer. Descriptive synthesis of data was performed.

RESULTS

The majority of the studies were from upper-middle-income countries (n=16, 88.8%) and mainly from Brazil (n=9, 50%). Only one economic evaluation study was found. The focus of the reviewed literature spanned the economic burden of physical inactivity (n=4, 22%), relationship between PA and costs (n=6, 46%) and socioeconomic determinants of PA (n=7, 39%). The findings showed a considerable economic burden due to insufficient PA, with LMICs accounting for 75% of disability-adjusted life years (DALYs) globally due to insufficient PA. Socioeconomic correlates of PA were identified, and inverse relationship of PA with the cost of chronic diseases was established. Regular PA along with drug treatment as a treatment scheme for chronic diseases showed advantages with a cost-utility ratio of US$3.21/quality-adjusted life year (QALY) compared with the drug treatment-only group (US$3.92/QALY) by the only economic evaluation conducted in the LMIC, Brazil.

LIMITATIONS

Meta-analysis was not performed due to heterogeneity of the studies.

CONCLUSIONS AND RECOMMENDATIONS

Economic evaluation studies for PA promotion interventions/strategies and local research from low-income countries are grossly inadequate. Setting economic research agenda in LMICs ought to be prioritised in those areas.

PROSPERO REGISTRATION NUMBER

CRD42018099856.

Structure for the practice of physical activities in Brazilian schools, Human Development Index and Basic Education Development Index: contributions to the Report Card Brazil

ABSTRACT The purpose of this study was to identify structures for the practice of physical activities (PA) in Brazilian Schools and relate them to the Human Development Index (HDI), Basic Education Development Index (IDEB) and quality indicators from the Report Card Brazil (RCB). This is a descriptive study that used secondary data from INEP-Brazil to identify and classify structures for the practice of PA in Brazilian schools based on the presence of “schoolyards”, “sports courts” and “sporting materials”, organized by elementary and high schools. Data were organized by Macroeconomic Region and related to HDI, IDEB and Report Card Brazil Quality Classification Criteria. Thus, for “Elementary School”, positive and significant relationship was observed between HDI and the presence of “schoolyards” (r=0.53; p=0.004), “sports courts” (r=0.855; p<0, 01) and “sporting materials”(r=0.764; p<0.01), while for IDEB, values followed the same logic, associated to the presence of “schoolyards” (r=0.475; p=0.01), “sports courts” (r=0.676; p<0.01) and “sporting materials” (r=0.535; p<0.01). For “High School”, relationship was observed between HDI and the presence of “sports courts” (r=0.517; p<0.01) and “sporting materials” (r=0.499; p<0.01), while for IDEB, relationship was only observed with the presence of “sporting materials” (r=0.508; p<0.01). It could be concluded that the Northern and Northeastern regions of Brazil have schools with lower presence of structure for the practice of Physical Activity and that there is positive relationship of this structure with HDI, IDEB and quality indicators of the Report Card Brazil.

Inequality in physical activity, global trends by income inequality and gender in adults

Background

Physical inactivity is a global pandemic associated with a high burden of disease and premature mortality. There is also a trend in growing economic inequalities which impacts population health. There is no global analysis of the relationship between income inequality and population levels of physical inactivity.

Methods

Two thousand sixteen World Health Organisation’s country level data about compliance with the 2010 global physical activity guidelines were analysed against country level income interquantile ratio data obtained from the World Bank, OECD and World Income Inequality Database. The analysis was stratified by country income (Low, Middle and High) according to the World Bank classification and gender. Multiple regression was used to quantify the association between physical activity and income inequality. Models were adjusted for GDP and percentage of GDP spent on health care for each country and out of pocket health care spent.

Results

Significantly higher levels of inactivity and a wider gap between the percentage of women and men meeting global physical activity guidelines were found in countries with higher income inequality in high and middle income countries irrespective of a country wealth and spend on health care. For example, in higher income countries, for each point increase in the interquantile ratio data, levels of inactivity in women were 3.73% (CI 0.89 6.57) higher, levels of inactivity in men were 2.04% (CI 0.08 4.15) higher and the gap in inactivity levels between women and men was 1.50% larger (CI 0.16 2.83). Similar relationships were found in middle income countries with lower effect sizes. These relationships were, however, not demonstrated in the low-income countries.

Conclusions

Economic inequalities, particularly in high- and middle- income countries might contribute to physical inactivity and might be an important factor to consider and address in order to combat the global inactivity pandemic and to achieve the World Health Organisation target for inactivity reduction.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-020-01039-x.

Níveis insuficientes de atividade física de adolescentes associados a fatores sociodemográficos, ambientais e escolares

Resumo Este estudo investigou as associações entre o nível de atividade física com os fatores sociodemográficos, ambientais e escolares de adolescentes. Participaram 2.545 jovens de 14 a 18 anos dos municípios da Grande Florianópolis. Foi utilizada a versão curta do Questionário Internacional de Atividade Física (IPAQ). A prevalência de jovens inativos foi de 48,6%, sendo maior no sexo feminino (53,9%). Para as moças, a inatividade física esteve associada com a falta de lugares apropriados e gratuitos para a prática de atividade física (OR = 1,30 IC95%1,05-1,82), independente da influência das outras variáveis. Já para os rapazes, aqueles que não possuíam atividade profissional (OR = 1,54 IC95%1,14-2,08), mães de menor instrução (OR = 0,41 IC95% 0,27-0,75) ou mães com ensino superior (OR = 0,35 IC95% 0,17- 0,73), pertencentes a cidades de grande porte (OR = 1,64 IC95%1,17-2,31) e classificação socioeconômica baixa quando comparada à média (OR = 0,69 IC95% 0,49-0,97), apresentaram maior chance de inatividade física. Observou-se que as variáveis sociodemográficas estiveram associadas ao comportamento inativo dos rapazes e às variáveis ambientais se associaram a inatividade física das moças. Já dentre os fatores escolares, apenas a reprovação escolar foi associada com inatividade, e somente para as moças.