德国成年人体育活动不活跃方面教育不平等状况的变化：一项2003年至2012年的趋势研究。
Changing educational inequalities in sporting inactivity among adults in Germany: a trend study from 2003 to 2012.
作者信息
Hoebel Jens, Finger Jonas D, Kuntz Benjamin, Kroll Lars E, Manz Kristin, Lange Cornelia, Lampert Thomas
机构信息
Unit of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, 12101, Berlin, Germany.
Unit of Health Behaviour, Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, 12101, Berlin, Germany.
出版信息
BMC Public Health. 2017 Jun 6;17(1):547. doi: 10.1186/s12889-017-4478-2.
BACKGROUND
Social inequalities in health can be explained in part by the social patterning of leisure-time physical activity, such as non-participation in sports. This study is the first to explore whether absolute and relative educational inequalities in sporting inactivity among adults have changed in Germany since the early 2000s.
METHODS
Data from four cross-sectional national health surveys conducted in 2003 (n = 6890), 2009 (n = 16,418), 2010 (n = 17,145) and 2012 (n = 13,744) were analysed. The study population was aged 25-69 years in each survey. Sporting inactivity was defined as no sports participation during the preceding 3 months. The regression-based Slope Index of Inequality (SII) and Relative Index of Inequality (RII) were calculated to estimate the extent of absolute and relative educational inequalities in sporting inactivity, respectively.
RESULTS
Sporting inactivity was consistently more prevalent in less-educated groups. The overall prevalence of sporting inactivity declined significantly over time. However, the decline was observed only in the high and medium education groups, while no change was observed in the low education group. Both absolute and relative educational inequalities in sporting inactivity were found to have widened significantly between 2003 (SII = 0.30, 95% CI = 0.25-0.35; RII = 2.08, 95% CI = 1.83-2.38) and 2012 (SII = 0.41, 95% CI = 0.37-0.45; RII = 3.44, 95% CI = 3.03-3.91). Interaction analysis showed that these increases in inequalities were larger in the younger population under the age of 50 than among the elderly.
CONCLUSIONS
The findings suggest that the gap in sports participation between adults with high and low educational attainment has widened in both absolute and relative terms because of an increase in sports participation among the better educated. Health-enhancing physical activity interventions specifically targeted to less-educated younger adults are needed to prevent future increases in social inequalities in health.
背景
健康方面的社会不平等现象部分可归因于休闲时间体育活动的社会模式，比如不参加体育运动。本研究首次探讨自21世纪初以来，德国成年人中体育活动不活跃方面的绝对和相对教育不平等是否发生了变化。
方法
对2003年（n = 6890）、2009年（n = 16418）、2010年（n = 17145）和2012年（n = 13744）进行的四项全国性横断面健康调查数据进行分析。每次调查的研究人群年龄均在25至69岁之间。体育活动不活跃被定义为在过去3个月内未参加任何体育运动。计算基于回归的不平等斜率指数（SII）和不平等相对指数（RII），分别用以估计体育活动不活跃方面绝对和相对教育不平等的程度。
结果
体育活动不活跃在受教育程度较低的群体中一直更为普遍。随着时间推移，体育活动不活跃的总体患病率显著下降。然而，这种下降仅在高学历和中等学历群体中观察到，而低学历群体未出现变化。2003年（SII = 0.30，95%CI = 0.25 - 0.35；RII = 2.08，95%CI = 1.83 - 2.38）至2012年（SII = 0.41，95%CI = 0.37 - 0.45；RII = 3.44，95%CI = 3.03 - 3.91）期间，体育活动不活跃方面的绝对和相对教育不平等均显著扩大。交互分析表明，50岁以下的年轻人群体中不平等的增加幅度大于老年人。
结论
研究结果表明，由于受教育程度较高者的体育活动参与增加，高学历和低学历成年人在体育参与方面的差距在绝对和相对层面均有所扩大。需要针对受教育程度较低的年轻成年人开展专门的增进健康的体育活动干预措施，以防止未来健康方面的社会不平等加剧。
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