Life-course socioeconomic circumstances and changes in leisure-time physical activity among young and early midlife employees.

backgroundWhile socioeconomic differences in leisure-time physical activity (LTPA) are well established, less is known about the contribution of socioeconomic factors to changes in LTPA. This study examined the associations between life-course socioeconomic position (SEP) and changes in LTPA over a 5-year follow-up among young and early midlife employees.

methodsThis study used the Helsinki Health Study follow-up survey data, comprised of employees of the City of Helsinki aged 19–39 in 2017 (Phase 1). The follow-up was completed in 2022 (Phase 2). The analytical sample comprised 2,615 participants (80% women, which correspond to the target population). LTPA was measured as metabolic equivalent (METs, continuous and dichotomized) across three intensity levels (light, moderate, vigorous). SEP indicators included parental and own education, occupational class, childhood and current economic difficulties, household income, and household wealth. Marginal effects were calculated from generalized linear mixed models to examine associations between SEP and LTPA changes, adjusting for sociodemographic and health-related confounders.

resultsDuring the follow-up, total (-2.84 MET [95% CI: -4.32 to -1.35]) and vigorous (-6.68 MET [95% CI: -8.22 to -5.43]) LTPA decreased, while light LTPA increased (1.43 MET [95% CI: 0.69 to 2.17]). Engagement in vigorous LTPA declined across all SEP groups, indicating similar disengagement patterns and persistent disparities between high and low SEP groups over time. The largest decline in vigorous LTPA activity levels was observed among participants with high household income (-11.42 MET [95% CI: -16.15 to -6.69]) and higher own education (-9.15 MET [95% CI: -13.60 to -4.69]). While this led to narrowing differences in these and lower SEP groups over the follow-up, disparities in vigorous LTPA between high and low SEP groups remained. Moderate LTPA increased among the higher-educated, while light LTPA did so in higher-income groups, partially offsetting the decline in vigorous LTPA within these groups.

conclusionOur findings raise concerns about the long-term consequences of overall declining vigorous LTPA, particularly among lower SEP employees with lower initial engagement and no compensatory increases. Persistent SEP differences suggest a multi-dimensional challenge, emphasizing the need for targeted interventions to promote LTPA of all intensities and reduce health disparities. CLINICAL TRIAL NUMBER: Not applicable.