Abstract Body: Introduction. Middle age is a pivotal period for implementing cardiovascular (CV) preventive measures, with physical activity (PA) being a key factor in preventing CV disease. However, the determinants of PA in this life stage, especially among minoritized populations in rural US areas, are not fully understood. This study investigates the relationship between socioeconomic, cardiometabolic conditions, and PA in midlife.
Hypothesis. Middle-aged adults with worse socioeconomic and more CV risk factors are more likely to engage in lower levels of PA compared to moderate or high PA levels.
Methods. We examined 1,289 participants (mean age 48 ± 5.24 years, 34.7% Black, 65.3% White) from the Bogalusa Heart Study, a long-term longitudinal rural study. Multinomial regression models assessed associations between education (>college), employment status, self-reported diabetes and hypertension medication use with PA scores low (minimal or no PA), moderate (>=600 MET-Minutes/week), high (>=3,000 MET-Minutes/week) measured by the International Physical Activity Questionnaire (IPAQ) long form. Models were adjusted for age, race, and sex.
Results. Employed individuals were more likely to meet moderate PA score (OR=2.23, 95% CI=1.66-2.99, p<0.001) and high PA score (OR=2.56, 95% CI=1.83-3.59, p<0.001) compared to low PA, after adjusting for covariates. Similarly, higher educated (>college) individuals were more likely to engage in moderate PA in adjusted models (O =1.29, 95% CI=1.12-1.49, p<0.001). Diabetes medication use was associated with lower odds of moderate PA (OR=0.65, 95% CI=0.44-0.96, p=0.033) on unadjusted models, and lower odds of reporting high PA compared to low PA in adjusted models (OR=0.57, 95% CI=0.35-0.93, p=0.024). Hypertension medication use was associated with lower odds of reporting moderate PA (OR = 0.67, 95% CI=0.51-0.89, p=0.006) and high PA (OR=0.66, 95% CI=0.48-0.92, p=0.001) in unadjusted models. (Table 2)
Conclusions. Education, employment, and diabetes medication use significantly influence PA levels in midlife. Participants with higher education and employment were more likely to engage in moderate to high PA, while diabetes medication users were less likely to achieve high PA. These findings highlight the need for further research into how socioeconomic factors shape PA and influence long-term CV health in vulnerable rural mixed middle-aged populations.