Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway.
Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway.
BMC Public Health. 2023 Mar 22;23(1):541. doi: 10.1186/s12889-023-15435-y.
Understanding the associations between health behaviors and which subgroups are at risk of developing health risk behaviors is vital knowledge to develop effective public health interventions to reduce the high prevalence of non-communicable diseases (NCDs). The objective of the study was to assess the association between physical activity, diet, tobacco use, and alcohol consumption and sociodemographic determinants (sex and education), and to examine clustering patterns of these health behaviors.
Data was collected from an online self-reported questionnaire from the Norwegian public health survey conducted in 2019. The study sample consisted of 28,047 adults (≥ 18 years old) from Agder county in Southern Norway. Chi-square tests and logistic regression analysis were used to determine the association between sex and education according to physical activity, diet, tobacco use and alcohol consumption. Linear regression was used to examine the association between educational level and number of health risk behaviors, and cluster analysis were performed to determine cluster patterns.
Females were more likely than men to meet the national public health recommendations for diet (p < 0.001), tobacco use (p < 0.01), and alcohol consumption (p < 0.001). High education was associated with meeting the recommendations for each of the four health behaviors and with a lower risk of having three or four health risk behaviors simultaneously. Furthermore, clustering of health risk behaviors was observed in five of the sixteen health behavior patterns.
Our findings show a higher risk of having multiple health risk behaviors for males and individuals with low education, and these subgroup findings could inform public health policy and be target goals in future public health interventions. Clustering patterns were observed in over 30% of the health behavior patterns. More research is needed on the causal relationship between health behaviors and socioeconomic factors, and the association between clustering and health outcomes to design effective interventions in the future.
了解健康行为与哪些亚组有发展健康风险行为的风险之间的关联，对于制定有效的公共卫生干预措施以降低高发的非传染性疾病（NCD）至关重要。本研究的目的是评估体力活动、饮食、吸烟和饮酒与社会人口学决定因素（性别和教育）之间的关联，并检查这些健康行为的聚类模式。
数据来自于 2019 年在挪威进行的在线自我报告的公共卫生调查。研究样本包括来自挪威南部阿格德尔郡的 28047 名成年人（≥18 岁）。使用卡方检验和逻辑回归分析，根据体力活动、饮食、吸烟和饮酒情况，确定性别和教育之间的关联。使用线性回归检验教育水平与健康风险行为数量之间的关系，并进行聚类分析以确定聚类模式。
女性比男性更有可能满足国家公共卫生关于饮食（p<0.001）、吸烟（p<0.01）和饮酒（p<0.001）的建议。高教育与满足四项健康行为中的每一项建议以及同时具有三种或四种健康风险行为的风险较低相关。此外，在 16 种健康行为模式中的五种模式中观察到健康风险行为的聚类。
我们的研究结果表明，男性和教育程度较低的个体更有可能同时存在多种健康风险行为，这些亚组的发现可以为公共卫生政策提供信息，并成为未来公共卫生干预措施的目标。在超过 30%的健康行为模式中观察到聚类模式。需要进一步研究健康行为与社会经济因素之间的因果关系，以及聚类与健康结果之间的关系，以便未来设计有效的干预措施。
