Department of Health Management and Economics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
PLoS One. 2023 May 15;18(5):e0285620. doi: 10.1371/journal.pone.0285620. eCollection 2023.
Increasing level of physical activity (PA) among working population is of particular importance, because of the high return of investment on employees' PA. This study was aimed to investigate socioeconomic inequalities in Health-Enhancing Physical Activity (HEPA) among employees of a Medical Sciences University in Iran.
Data were extracted from the SHAHWAR Cohort study in Iran. Concentration index (C) and Wagstaff decomposition techniques were applied to determine socioeconomic inequality in the study outcomes and its contributors, respectively.
Nearly half of the university employees (44.6%) had poor HEPA, and employees with high socioeconomic status (SES) suffered more from it (C = 0.109; 95% CI: 0.075, 0.143). Also, we found while poor work-related PA (C = 0.175; 95% CI: 0.142, 0.209) and poor transport-related PA (C = 0.081, 95% CI: 0.047, 0.115) were more concentrated among high-SES employees, low-SES employees more affected by the poor PA at leisure time (C = -0.180; 95% CI: -0.213, -0.146). Shift working, and having higher SES and subjective social status were the main factors that positively contributed to the measured inequality in employees' poor HEPA by 33%, 31.7%, and 29%, respectively, whereas, having a married life had a negative contribution of -39.1%. The measured inequality in poor leisure-time PA was mainly attributable to SES, having a married life, urban residency, and female gender by 58.1%, 32.5%, 28.5%, and -32.6%, respectively. SES, urban residency, shift working, and female gender, with the contributions of 42%, 33.5%, 21.6%, and -17.3%, respectively, were the main contributors of poor work-related PA inequality. Urban residency, having a married life, SES, and subjective social status mainly contributed to the inequality of poor transport-related PA by 82.9%, -58.7%, 36.3%, and 33.5%, respectively, followed by using a personal car (12.3%) and female gender (11.3%).
To reduce the measured inequalities in employees' PA, workplace health promotion programs should aim to educate and support male, urban resident, high-SES, high-social-class, and non-shift work employees to increase their PA at workplace, and female, married, rural resident, and low-SES employees to increase their leisure-time PA. Active transportation can be promoted among female, married, urban resident, high-SES, and high-social-class employees and those use a personal car.
提高工作人群的身体活动水平（PA）尤为重要，因为这对员工的 PA 投资回报率很高。本研究旨在调查伊朗一所医学科学大学员工中健康促进身体活动（HEPA）的社会经济不平等现象。
数据来自伊朗 SHAHWAR 队列研究。集中指数（C）和 Wagstaff 分解技术分别用于确定研究结果和其决定因素的社会经济不平等程度。
近一半的大学员工（44.6%）身体活动水平较差，社会经济地位较高的员工（SES）的情况更为严重（C=0.109；95%CI：0.075，0.143）。此外，我们发现，较差的与工作相关的 PA（C=0.175；95%CI：0.142，0.209）和较差的与交通相关的 PA（C=0.081，95%CI：0.047，0.115）在 SES 较高的员工中更为集中，而 SES 较低的员工在闲暇时间的 PA 较差（C=-0.180；95%CI：-0.213，-0.146）。轮班工作以及 SES 较高和主观社会地位较高是导致员工 HEPA 较差的主要因素，分别贡献了 33%、31.7%和 29%，而已婚生活则产生了-39.1%的负向贡献。较差的闲暇时间 PA 主要归因于 SES、已婚生活、城市居住和女性性别，分别贡献了 58.1%、32.5%、28.5%和-32.6%。SES、城市居住、轮班工作和女性性别分别贡献了 42%、33.5%、21.6%和-17.3%，是导致较差的与工作相关的 PA 不平等的主要因素。城市居住、已婚生活、SES 和主观社会地位主要通过 82.9%、-58.7%、36.3%和 33.5%的贡献导致较差的与交通相关的 PA 不平等，其次是使用私家车（12.3%）和女性性别（11.3%）。
为了减少员工 PA 方面的测量不平等，工作场所健康促进计划应旨在教育和支持男性、城市居民、高 SES、高社会阶层和非轮班工作的员工增加工作场所的 PA，以及女性、已婚、农村居民和低 SES 的员工增加闲暇时间的 PA。可以促进女性、已婚、城市居民、高 SES 和高社会阶层以及使用私家车的员工进行积极的交通出行。
