Purpose: Socioeconomic inequalities in physical activity at the individual level are well reported. Whether inequalities in economic development and other macroenvironmental variables between countries are also related to physical activity at the country level is comparatively unstudied. Methods: We examined the relationship between country-level data on macroenvironmental factors (gross domestic product (GDP) per capita, public sector expenditure on health, percentage living in urban areas, and cars per 1000 population) with country-level physical activity prevalence obtained from previous pan-European studies. Studies that assessed leisuretime physical activity (n = 3 studies including 27 countries in adults, n = 2 studies including 28 countries in children) and total physical activity (n = 3 studies in adults including 16 countries) were analyzed separately as were studies among adults and children. Results: Strong and consistent positive correlations were observed between country prevalence of leisure-time physical activity and country GDP per capita in adults (average r = 0.70; all studies, P G 0.05). In multivariate analysis, country prevalence of leisure-time physical activity among adults remained associated with country GDP per capita (two of three studies) but not urbanization or educational attainment. Among school-age populations, no association was found between country GDP per capita and country prevalence of leisure-time physical activity. In those studies that assessed total physical activity (which also includes occupational and transport physical activity), no association with country GDP per capita was observed. Conclusion: Clear differences in national leisure-time physical activity levels throughout Europe may be a consequence of economic development. Lack of economic development of some countries in Europe may make increasing leisure-time physical activity more difficult. Further examination of the link between country GDP per capita and national physical activity levels (across leisure-time, occupational, and transport-related domains) is warranted.

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doi.org/10.1249/MSS.0b013e31826e69f0, hdl.handle.net/1765/70174
Medicine and Science in Sports and Exercise
Erasmus MC: University Medical Center Rotterdam

Cameron, A.J, van Stralen, M.M, Kunst, A.E, te Velde, S.J, van Lenthe, F.J, Salmon, J, & Brug, J. (2013). Macroenvironmental factors including GDP per capita and physical activity in Europe. Medicine and Science in Sports and Exercise, 45(2), 278–285. doi:10.1249/MSS.0b013e31826e69f0