activity is associated with decreased risk for obesity, heart disease,
hypertension, diabetes, certain cancers, and premature mortality. CDC and
the American College of Sports Medicine recommend that adults engage in at least
30 minutes of moderate physical activity on most days and preferably on all
days. Healthy People 2010 objectives include increasing the
proportion of adults who engage regularly in moderate or vigorous activity to at
least 50%. In addition, reducing racial and ethnic health disparities,
including disparities in physical activity, is an overarching national goal.
To examine changes in the prevalence of regular, leisure-time, physical activity
from 2001 to 2005, CDC analyzed data from the Behavioral Risk Factor
Surveillance System. This report summarizes the results of that analysis,
which indicated that, from 2001 to 2005, the prevalence of regular physical
activity increased 8.6% among women overall (from 43.0% to 46.7%) and 3.5% among
men (from 48.0% to 49.7%). In addition, the prevalence of regular physical
activity increased 15.0% (from 31.4% to 36.1%) among non-Hispanic black women
and 12.4% (from 40.3% to 45.3%) among non-Hispanic black men, slightly narrowing
previous racial disparities when compared with increases of 7.8% (from 46.0% to
49.6%) for white women and 3.4% (from 50.6% to 52.3%) for white men,
respectively. CDC, state and local public health agencies, and other public
health partners should continue to implement evidence-based, culturally
appropriate initiatives to further increase physical-activity levels among all
adults, with special focus on eliminating racial/ethnic disparities.
BRFSS is a state-based,
random-digit--dialed telephone survey of the noninstitutionalized, U.S. civilian
population aged >18 years. Data for this report were reported by the 50
states, District of Columbia, Puerto Rico, and U.S. Virgin Islands. CDC
collected data for the 2001 BRFSS survey from 205,140 respondents (median
response rate*: 51.1%; median cooperation rate†: 52.7%) and the 2005
survey from 356,112 respondents (median response rate: 51.1%; median cooperation
rate 75.1%) (4). Response rates were calculated using guidelines from the
Council of American Survey and Research Organizations.
Beginning in 2001, BRFSS included biannual
questions about participation in moderate and vigorous physical activities. To
assess participation in moderate activities, respondents were asked if, when not
working, they "do moderate activities for at least 10 minutes at a time, such as
brisk walking, bicycling, vacuuming, gardening, or anything else that causes
some increase in breathing or heart rate" in a usual week. Respondents who
answered "yes" were asked how many days per week they engaged in moderate
activities and the amount of time spent in activities on each of those days. To
assess participation in vigorous activities, respondents were asked to report
whether they "do vigorous activities for at least 10 minutes at a time, such as
running, aerobics, heavy yard work, or anything else that causes large increases
in breathing or heart rate" in a usual week, when not working. Respondents who
answered "yes" were asked how many days per week they engaged in vigorous
activities and the amount of time spent in activities on each of those days. For
this report, respondents considered to be engaging in regular physical activity
were those who met the Healthy People 2010 objective of at least 30
minutes a day of moderate-intensity activity on 5 or more days a week, or at
least 20 minutes a day of vigorous-intensity activity on 3 or more days a week,
or both. Data were age adjusted to the 2000 U.S. standard population and
weighted to provide overall estimates; 95% confidence intervals and p-values
were calculated. Statistically significant changes in prevalence from 2001 to
2005 were determined by t-test (p<0.05).
From 2001 to 2005, the prevalence of regular
physical activity increased by 8.6% (from 43.0% to 46.7%) among women overall
and by 3.5% (from 48.0% to 49.7%) among men. Among women, significant increases
in regular activity were observed in all racial/ethnic, age, and education-level
categories examined with the exception of women aged 18--24 years. Among men,
significant increases in regular physical activity were observed among
respondents aged 45--64 years, non-Hispanic whites, non-Hispanic blacks, high
school graduates, and college graduates.
Among racial/ethnic groups, significant
increases in the prevalence of regular physical activity from 2001 to 2005 were
observed among non-Hispanic black women (15.0%, from 31.4% to 36.1%),
non-Hispanic black men (12.4%, from 40.3% to 45.3%), Hispanic women (11.6%, from
36.3% to 40.5%), women of other races (13.1%, from 41.2% to 46.6%), non-Hispanic
white women (7.8%, from 46.0% to 49.6%), and non-Hispanic white men (3.4%, from
50.6% to 52.3%).
Despite certain gains, racial/ethnic disparities
in physical activity remained evident in the 2005 survey results. Among men,
non-Hispanic whites had the highest prevalence of regular physical activity
(52.3%), followed by men classified as of other race (45.7%), non-Hispanic
blacks (45.3%), and Hispanics (41.9%). Among women, non-Hispanic whites had the
highest prevalence of regular physical activity (49.6%), followed by women
classified as of other race (46.6%), Hispanics (40.5%), and non-Hispanic blacks
J Kruger, PhD, HW Kohl III, PhD, Div of Nutrition and Physical Activity,
National Center for Chronic Disease Prevention and Health Promotion; IJ Miles,
ScD, EIS Officer, CDC.
From 2001 to 2005, the prevalence of
engaging in regular physical activity increased among both U.S. men and women.
In 2005, 49.7% of men and 46.7% of women reported engaging in regular physical
activity, with the largest increases reported among non-Hispanic black women and
men. However, among racial/ethnic groups in 2005, only non-Hispanic white men
(52.3%) had reached the Healthy People 2010 target of 50% of adults
engaging in regular physical activity, although non-Hispanic white women (49.6%)
had nearly reached that target.
The findings in this report are consistent with
previous BRFSS physical-activity analyses, including a decrease in leisure-time
physical inactivity from 2001 to 2004 among men and women in all racial/ethnic
groups. These BRFSS findings and those from the previous BRFSS reports suggest
that U.S. adults are becoming more physically active. However, data from the
National Health Interview Survey indicate that regular leisure-time physical
activity among U.S. adults decreased among men and did not change significantly
among women from 2000 and 2005. Differences in format, period of recall, and
activities assessed might explain the differences in results from the two
In addition to the racial/ethnic disparities,
disparities in education also were observed. In 2001 and 2005, increasing
education level was associated with increased prevalence of regular physical
activity in both men and women. In 2005, 54.6% of men and 53.3% of women who
were college graduates engaged in regular physical activity, compared with 37.2%
of men and 37.1% of women with less than a high school education. Why persons
with higher levels of education reported more physical activity is not clear.
The findings in this report are subject to at
least four limitations. First, BRFSS data are self-reported and subject to
recall bias. Second, the survey questions were not designed to assess whether a
combination of moderate and vigorous physical activity met the requirement for
engaging in regular physical activity when the two activity types measured
separately did not; therefore, prevalences might have been underestimated.
Third, the "other race" category combined multiple racial and ethnic groups.
Although this approach increased the power of analysis by creating a larger
group, analysis could not be extended to any individual groups included in this
category. Finally, persons without landline telephones are not eligible for
participation in the BRFSS and might be younger or of lower socioeconomic
status; their exclusion might affect estimates of regular physical activity.
In 2005, fewer than half the adult U.S.
population engaged in recommended levels of physical activity. To increase
physical-activity levels in the United States, CDC encourages states to
implement evidence-based intervention strategies such as those described in the
Guide to Community Preventive Services.§ Examples of
recommended intervention strategies include communitywide campaigns,
point-of-decision prompts, social support for physical activity, and enhanced
access to places to be physically active combined with informational outreach.
Certain communities have successfully implemented these strategies to increase
physical-activity levels. For example, Marin County, California developed a
multipronged approach to encourage children and parents to walk or bike to
schools daily. As a result, participating schools reported an increase in trips
made by walking (64%) and biking (114%).
Despite increases in prevalence of physical
activity among minorities, racial/ethnic disparities persist. Many persons in
racial/ethnic minority groups are at increased risk for heart disease,
hypertension, and diabetes, all of which have been linked to low levels of
physical activity. To help eliminate racial and ethnic disparities in health,
CDC implemented REACH Across the United States (REACH US) as a national,
multilevel program. REACH US communities have implemented culturally
appropriate, community-based, physical-activity interventions, including free
classes, walking clubs, and faith-based nutrition and activity programs. State
and local public health agencies should consult the Community Guide to
Preventive Services and successful REACH US communities for examples of
culturally appropriate, evidence-based initiatives to further increase
physical-activity levels among racial and ethnic minorities.