ABSTRACT
The literature recommends the practice of physical activity (PA), regardless of the domain. However, most studies ignore intersectional relations of oppression. The objective of the present study is to verify the associations between social determinants and distinct domains of physical activity (leisure-time, occupational, commuting, and domestic), especially from the perspective of the jeopardy index, which translates the intersectional relations of oppression in Vigitel´s research between the years of 2016 and 2020. From the data collected, the jeopardy index was calculated. It was possible to observe that the practice of PA during leisure time is more pronounced among groups with less social oppression. On the other hand, the most oppressed groups showed greater involvement in the domains of occupational, commuting and domestic PA. It is concluded, therefore, that the notion that any PA is better than being inactive should be reviewed.
Keywords: Exercise; Health; Public health; Intersectional framework
RESUMO
A literatura recomenda a prática de atividade física (AF), independente do domínio. Contudo, a maioria dos estudos desconsidera as relações interseccionais de opressão. O objetivo do presente estudo é verificar as associações entre determinantes sociais e distintos domínios da atividade física (lazer, ocupacional, deslocamento e doméstico), especialmente a partir da perspectiva do índice de desvantagem, que traduz as relações interseccionais de opressão na pesquisa do Vigitel entre os anos de 2016 e 2020. A partir dos dados coletados, foi calculado o índice de jeopardy. Foi possível observar que a prática de AF no lazer é mais acentuada entre os grupos com menos opressão social. Por outro lado, os grupos mais oprimidos apresentaram maior envolvimento nos domínios de AF ocupacional, de deslocamento e doméstica. Conclui-se, portanto, que a noção de que qualquer AF é melhor do que ser inativo deveria ser revista.
Palavras-chave: Exercício físico; Saúde; Saúde pública; Enquadramento interseccional
RESUMEN
La literatura recomienda la práctica de actividad física (AF), independientemente del dominio. Sin embargo, la mayoría de los estudios ignoran las relaciones interseccionales de opresión. El objetivo del presente estudio es verificar las asociaciones entre los determinantes sociales y los distintos dominios de la actividad física (tiempo libre, ocupacional, desplazamiento y doméstica), especialmente desde la perspectiva del índice de desventaja, que traduce las relaciones interseccionales de opresión en la investigación de Vigitel entre los años 2016 y 2020. A partir de los datos recolectados, se calculó el índice de desventaja. Se observó que la práctica de AF durante el tiempo libre es más pronunciada entre los grupos con menos opresión social. Por otro lado, los grupos más oprimidos mostraron un mayor involucramiento en los dominios de AF ocupacional, de desplazamiento y doméstica. Se concluye, por lo tanto, que la noción de que cualquier AF es mejor que la inactividad debe ser revisada.
Palabras-clave: Ejercicio físico; Salud; Salud pública; Marco interseccional
INTRODUCTION
Regularly practiced physical activity has been considered a relevant aspect of several disease prevention strategies despite its different domains, such as leisure-time, occupational, commuting, and domestic (Ekelund et al., 2016; World Health Organization, 2018, 2020). Therefore, based on scientific research, adults should meet at least 150 minutes of moderate-intensity or at least 75 minutes of vigorous physical activity per week, regardless of its domains (World Health Organization, 2018; World Health Organization, 2020).
Epidemiological research has traditionally used categories such as race, sex, and social class as variables associated with different health outcomes. However, Breilh (2021) critiques this approach as reductionist and functionalist, arguing that it fragments complex social phenomena into isolated empirical parts, disregarding their social context and interactions. This fragmented perspective often overlooks the cumulative and intersectional forms of oppression that shape health outcomes, including engagement in physical activity (Mielke et al., 2022).
In this context, the concept of intersectionality, as described by Carla Akotirene, emerges as a critical tool. Akotirene understands intersectionality as the analysis of multiple overlapping oppressions, revealing the interactions between race, gender, class, and other social categories that uniquely affect individuals, especially Black women (Akotirene, 2019). Similarly, Patricia Hill Collins and Sirma Bilge contribute the concept of the “matrix of domination,” which considers the intersection of these oppressions within power structures that shape social experiences (Collins and Bilge, 2020). Both authors highlight that these oppressions are not additive but interactive, deeply influencing patterns of inequality.
Recent studies, such as that by Mielke et al. (2022), have begun to explore the intersectional relations associated with leisure-time physical activity among Brazilian adults. Their findings indicate that leisure-time physical activity is more prevalent among white males with higher income and university degrees, suggesting that social privileges significantly influence engagement in physical activity. While Mielke et al. employed the jeopardy index—a tool designed to assess cumulative social deprivation and its intersectional effects—they did not extend this analysis to other physical activity domains. Consequently, it is possible to admit that more vulnerable social groups, particularly those experiencing multiple forms of oppression, such as women, people of color, and individuals from lower socioeconomic backgrounds, face structural barriers that limit their leisure-time physical activity. Instead, these groups may be disproportionately engaged in domestic and occupational physical activities, underscoring a broader landscape of social inequality (Paiva and Palma, 2021a).
By adopting an intersectional perspective, as proposed by Akotirene and Collins, it becomes evident that these inequalities are not merely additive but interactive. Different forms of oppression—such as race, gender, and class—converge to shape distinct experiences across physical activity domains. Thus, a deeper investigation into these intersectional factors is necessary to fully understand the social determinants that influence physical activity patterns in Brazil (Mielke et al., 2022; Paiva and Palma, 2021a,b).
In Brazil, since 2006, the Vigitel (Surveillance System of Risk and Protection Factors for Chronic Diseases by Telephone Survey) research is conducted to identify factors associated with non-transmissible chronic diseases. One of these associated factors is physical activity in its different domains (Brasil, 2021). Additionally, data collection encompasses distinct demographic aspects, among other factors. Therefore, the purpose of the present study is to verify the associations between social determinants and distinct domains of physical activity (leisure-time, occupational, commuting, and domestic), especially from the perspective of the jeopardy index, which translates the intersectional relations of oppression in Vigitel´s research between the years of 2016 and 2020.
METHODS
Participants
Data were collected from the Surveillance System of Risk and Protection Factors for Chronic Diseases by Telephone Survey (Vigitel). This surveillance has been conducted annually since 2006 by the Health Surveillance Department of the Ministry of Health. This is a telephone survey conducted with Brazilian residents of all National States as well as the Federal District seeking to monitor the frequency and distribution of risk and protective factors for non-transmissible chronic diseases.
For the present study, available data collected between 2016 and 2020 were grouped for analysis. Initially, there were 238.159 data available, but 12.877 were removed due to information regarding skin color not being standardized or reported. Thus, the present study uses information from 225.282 participants. Details regarding sampling procedures, ethics approval, and investigated items, among other aspects of the survey, can be found in Vigitel publications (Brasil, 2021).
Procedures
Data extraction
Data regarding physical activity, sex, skin color/ethnicity, education, and possession of private health insurance were collected. Considering sex, Vigitel provides a binary division of the male and female sexes. For skin color/ethnicity, five categories are presented: white, black, yellow (Asian; Eastern ancestry), “pardo” (mixed-race, light-skinned black, brown), and indigenous. However, there is a possibility that the participant chooses not to answer his or her ethnicity or chooses any other one different from ones previously mentioned. Thus, when it was not possible to correctly identify an individual´s skin color/ethnicity, information regarding that specific participant was excluded. Level of education refers to the total of schooling years and it was classified as found in Vigitel´s report: a) ≥ 12, b) 9-11, and c) ≤ 8 years. In addition, data regarding possessing or not having private health insurance could be presented as a) having more than one insurance, b) having insurance or c) do not have health insurance.
Similarly, to the procedures conducted by Mielke et al. (2022), the jeopardy index was calculated from the data presented above, except the age-group, assigning a score to each segment of the selected categories, with the highest score assigned to the condition of greatest oppression. According to the jeopardy index theory, various factors regarding an individual's identity can lead to discrimination and oppression, such as race and gender, in a combined and cumulative manner (6), which may reproduce intersectional relations of oppression. Thus, for each one of the variables the following scores were assigned: “gender” (male= 0, female= 1); “skin color/ethnicity” (white= 0, non-white= 1); “education” (≥ 12= 0, 9-11= 1, up to 8 years= 2); “private health insurance” (having more than one insurance = 0, having insurance= 1, do not have private health insurance= 2).
Scores from each category were summed, resulting in a “jeopardy index” ranging from “0” to “6” with the highest score attributed to the combination of greater oppression and the lowest score attributed to the combination of lesser oppression.
Vigitel presents raw data regarding the time (minutes) and weekly frequency dedicated to physical activity in its four different domains: leisure-time, occupational, commuting, and domestic. Information on leisure-time physical activity was obtained through the following questions: “In the last three months, did you practice any kind of physical exercise or sport?”, “How many days a week do you usually practice physical exercise or sport?” and “On the day that you practice physical exercise or sport, how long does this activity usually last?”.
Regarding the occupational domain, the following questions were adopted: “Did you go to work in the last three months?”, “During your occupation, do you carry weights or do any other heavy activities?”, “In a regular week, how many days do you practice this type of activity?” and “How long do these activities usually take?”. Domestic physical activity could be verified through the following questions: “Who is the person usually responsible for the household chores?” and “The heaviest part of the household chores goes to…?”.
For the commuting domain, the following questions were provided: “When going to or returning from your job occupation, do you walk or ride a bike?”, “How much time do you spend (walking or riding a bike) in these routes?”; “Are you currently attending any course/school or taking someone to any course/school?”; “When going to or returning from this course/school, do you walk or ride a bike?” and “How much time do you spend (walking or riding a bike) in these routes?”. The participant was considered active in this domain when ≥ 150 minutes per week were achieved.
Statistical analysis
To examine the relationship between the physical activity domains and sociodemographic variables alone or in combination (jeopardy index), initially, descriptive statistics were used to describe the prevalence of each situation. For inferential statistics, the Chi-Square test was used. In addition, Odds Ratio and its respective 95% confidence intervals were calculated.
Additionally, the Kolmogorov-Smirnov test was used to assess data distribution, which rejected data normality for the distribution of “time practicing physical activity” in all domains (p<0.001). To confirm the pattern of data distribution of the variable “physical activity time” in each of the physical activities’ domains, skewness, kurtosis, and graphical analyses of histograms and Q-Q plots of each distribution were observed confirming a non-standard Gaussian curve. Levene's test was applied to analyze the homogeneity of variances, which was also rejected (p<0.001). Thus, non-parametric statistics were used for inferences. The Kruskal-Wallis test was applied to compare the duration of weekly physical activity between the groups for each domain. Whenever differences were identified, Bonferroni´s multiple-comparison correction was applied. Level of significance was set at 5% (p<0.05), and the analyses were conducted using the Statistical Package for the Social Sciences (SPSS) 20.0.
RESULTS
Data on 225.282 participants of the Vigitel research between 2016 and 2020 were gathered, and the prevalence of leisure-time physical activity (≥ 150 minutes per week) was 38.3%. In general, it appears that physical activity during leisure time was higher among males and more pronounced among pardos, and those with higher education levels. The jeopardy index allowed to be observed that the practice of leisure-time physical activity was more commonly performed among those with lower jeopardy index values. According to the results, people with higher jeopardy index values (“6”) presented 3.59 times more chances (p<0.0001) of not performing leisure-time physical activity compared to the group that possessed a jeopardy index of “0” (zero). Thus, social groups who gather a greater set of oppressions are less likely to engage in leisure-time physical activity (Table 1).
Association between leisure-time physical activity (free time) and sociodemographic variables.
On the other hand, when analyzing the occupational, commuting, and domestic domains, groups who presented higher jeopardy indexes were the ones with greater engagement in these physical activities’ domains. Of the total of participants, 9.5% reported performing at least 150 minutes per week of commuting physical activity. Those who were more engaged in this type of physical activity were male, indigenous, black, or “pardo” with medium to lower levels of education and with a substantial set of social oppressions. Compared to white people, indigenous are 1.86 times more likely to perform this type of physical activity. Also, black people presented 1.76 times more chances of performing commuting physical activity when compared to whites. When compared to people with 12 or more years of education, those with 9 to 11 years and up to 8 years of schooling are, respectively, 1.56 and 1.23 times more likely to perform active commuting. Vulnerable social groups (jeopardy indexes “5” and “6”) present, respectively, 1.83 and 1.67 more chances of performing this physical activity domain when compared to those with less oppression (jeopardy index “0”) (Table 2).
Women are 4.94 times more engaged in domestic physical activity than men. Besides that, black people have 1.44 times more chances of engaging in this type of physical activity than white people. It was verified that people completing 9-11 years of education and up to 8 years of study have respectively 1.63 and 1.42 times more chances of performing domestic physical activity. Considering the jeopardy index, the most oppressed groups (jeopardy indexes “5” and “6”) exhibit, respectively, 8.82 and 11.34 more chances of performing domestic physical activity when compared to those who are less oppressed (jeopardy index “0”) (Table 3).
Job occupations that are significantly more active seem to be destined for men. Black-colored people are 1.81 times more likely to be active in the occupational physical activity domain than people with white skin color. At the same time, indigenous people, compared to whites, are 2.18 times more likely to be active in this domain. Education also seems to affect an individual´s engagement in more active job occupations. People who completed 9-11 years of schooling and up to 8 years of study have respectively 2.19 and 1.81 more chances of being active during their job occupations than individuals with higher levels of education. Still, considering the jeopardy index, most oppressed groups (jeopardy indexes “4”, “5” and “6”) exhibit, respectively, 2.66, 2.50, and 1.62 more chances of performing occupational physical activity when compared to those who are less oppressed (jeopardy index “0”) (Table 4).
In general, the jeopardy index was inversely associated with leisure-time physical activity, with a minor exception in the earlier groups. On the other hand, engagement in domestic physical activity grew as the set of oppressions increased, with all mean values statistically significant from each other (p<0.001), except for groups “0” and 1”. Commuting and Occupational physical activity presented a similar behavior (Figure 1).
Distribution of the mean values, expressed in minutes per week, of the practice of the different physical activity domains, considering the Jeopardy index. Footnote: Jeopardy index “0” is the lowest index of multiple social oppressions, while Jeopardy index “6” represents the social groups experiencing higher oppressions. The continuous dark line represents leisure-time physical activity; the dotted line refers to commuting physical activity; dashed line corresponds to domestic physical activity; gray line displays occupational physical activity. Source: Authors.
DISCUSSION
Previous research has been investigating the impact of social determinants on the practice of physical activity. However, in general, epidemiological investigations establish different categories such as race, gender, or social class, considering these variables as factors that may or may not be associated with their proposed outcomes, including physical inactivity. According to Breilh (2021), this is a reductionist and functionalist rationale. To the author, based on this proposed rationale, the investigated phenomenon is fragmented into isolated empirical parts of the social reality, objectifying these isolated parts as directly related to certain outcomes without elucidating its operation and social determination. In addition, studies that aim to verify possible interactions between different forms of oppression and the practice of regular physical activity are still scarce, especially when considering distinct domains of physical activity.
In the present study, the authors sought to verify, based on Vigitel´s (2016-2020), the association between social determinants and engagement in different domains of physical activity (leisure-time, occupational, commuting, and domestic) and comprehend the interaction between different forms of social oppression (Jeopardy index) that may impact the practice of different kinds of physical activity.
It was possible to observe that the practice of leisure-time physical activity was more pronounced among male individuals, “pardos”, young people aged 18-24, and with higher levels of education. According to the results, the practice of leisure-time activities had a higher prevalence among groups that presented lower jeopardy indexes while social groups that experienced a greater set of oppressions are less likely to be involved in this type of physical activity.
In general, women are less prone to perform regular physical activity as a result of their involvement in multiple tasks like motherhood, household chores, and the burden of sometimes being the full-time caregivers of their family while they are still part of the job market. Furthermore, women´s perception of safety regarding their neighborhood resources has been reported as a relevant factor contributing to the decision-making process of performing leisure-time physical activity (Prince et al., 2016; Ray, 2014). Socioeconomic inequities such as level of education, income, and ethnicity also impact the practice of leisure-time physical activity (Cruz et al., 2022; Ballesteros and Freidin, 2019) even though in the present investigation, mixed-race Brazilians reported greater engagement in this domain of physical activity, and no difference between white people and any other racial group had been reported. Under the notion of intersectionality, the present investigation tried to build the intersections between gender, race, education, and the possession of private health insurance to investigate how these intersections impact the practice of leisure-time activity. In summary, it was possible to observe that the greater the Jeopardy index, which expresses the gathering of multiple social oppressions, the lower an individual´s involvement in this type of physical activity.
Previous investigations presented similar outcomes. Mielke et al. (2022) found that intersections of gender, racial identity and socioeconomic position can strongly influence the practice of leisure-time physical activity in such a way that the greatest set of oppressions made practicing unfeasible. In other words, the Jeopardy index distribution was inversely associated with the practice of this type of physical activity. Ballesteros et al. (2020) analyzed the impact of intersectionality on the practice of physical activities during leisure time and were able to comprehend the multifaceted and interconnected nature of social inequalities.
Crespo et al. (2000) investigated the relationship between some aspects of social inequalities and the practice of leisure-time physical activity, observing that the prevalence rate of physical inactivity among white males with ≥ 16 years of education was set at 7% and 10% among white males with an annual income of US$50.000. On the other hand, black women with an annual income of <US$10.000 had a leisure-time inactivity prevalence rate of 46%.
The study conducted by Marshall et al. (2007) also demonstrated that black women with lower income and education levels perform less amount of leisure-time physical activity. The prevalence of leisure-time inactivity among white males with higher education levels was of 10.2%, and 8% among white males who had an annual income of ≥ US$75,000. However, black women with the lowest education level and income (<US$25,000/year) had the worst inactivity rates: 30.3% and 20.0%, respectively.
In a study conducted by Las Casas et al. (2018) using Vigitel data, it was observed that the prevalence of leisure-time physical activity (LTPA) was higher among men than women, and factors such as being male, young, having higher education, being white, having health insurance, not smoking, and consuming fruits and vegetables increased the likelihood of engaging in physical activity.
In this present investigation, it was possible to identify that groups that manifested higher jeopardy index values had greater engagement in the commuting, domestic, and occupational domains of physical activity. The fact that it was possible to observe a linear relationship between domestic physical activity and the sum of social oppressions should be highlighted. Similar behavior happened considering the time spent on occupational physical activities, even though the group with higher jeopardy index showed a remarkable decline on the number of minutes per week spent on this type of physical activity. This scenario may be the consequence of the high unemployment rate found in this group.
Studies regarding the association between intersectionality and the practice of physical activity are still scanty, especially when the aim is to discuss active commuting, domestic, and occupational physical activities. The study conducted by He and Baker (2005) is one of the few investigations in which it was possible to intersect some social indicators and associate them with the different domains of physical activity. In their investigation, it is possible to identify, from the intersection between sex and race, differences between the practice of leisure-time, domestic, and occupational physical activities, as in the present study. It was observed that the practice of leisure-time activity had a prevalence rate of 16.5% among white males, followed by black men with 13.5%, white women with 11.9%, and then black women with 6.3%. When analyzing the engagement in the domestic physical activity domain performed at least three times per week, the prevalence rates are as follows: 4.1% among white men; 8.8% among black men; 8.6% among white women; and 12.5% among black women. Strenuous job-related activities performed “all or almost all of the time” involved 15.9% of white men; 21.3% of black men; 11.3% of white women; and 17.0% of black women while 14.8% of white men; 13.0% of black men; 10.5% of white women; and 14.1% of black women were engaged in strenuous job-related activities “most of the time”. Both situations portray black men and women as the two social groups most involved in heavy work activities.
Roberts et al. (2019) conducted a qualitative research analysis with the purpose of examining the intersectionality in active commuting experiences, focusing on the gender-race-class trinity. According to the study, this trinity is an inhibiting factor of active commuting for the young, especially among girls.
Despite the difficulty of finding studies that allow the elaboration of intersections when analyzing multiple oppressions, it is possible to observe different relationships between the domains of physical activities and social indicators. Del Duca et al. (2013) identified that leisure-time physical activity had a higher prevalence among men of Caucasian ethnicity, and with higher education and per capita family income. On the other hand, as for commuting physical activities, the profile of practitioners was: women, black, with higher education (≥ 12 years), and the worst per capita family income. The characteristics of those most active at their job-related task were: women, dark skin, with lower education (≤ 4 years), and worse family income. Domestic physical activities are more common among women, dark skin, with low education (5 to 8 years) and intermediate family income.
In the present study, the jeopardy index, expressed by gender, skin color/ethnicity, education, and whether or not having private health insurance, was significantly associated with the different physical activity domains. Leisure-time physical activities were more prominent among those who experience a lesser amount of oppression. In contrast, groups that manifested higher jeopardy indexes, that is, suffering from a higher set of oppressions, were those with greater involvement in domestic and occupational activities. Probably, there is a social privilege that allows greater access to sports facilities and physical activities during leisure time, green and safe areas that allow for greater engagement in physical activities, more work flexibility, access to daycare, and availability of financial resources, among other aspects. Also, the sexist and racist structure of our society can severely impact the practice of physical activities (Mielke et al., 2022).
As mentioned by Cruz et al. (2022), the practice of physical activity is strongly mediated by socioeconomic inequities in such a way that certain social groups have the privilege of being able to perform physical activities during their leisure time, while others are in a vulnerable position with no adequate access to this scenario, as well as presenting a more recurrent engagement in occupational, domestic, and commuting physical activities. In this way, it is necessary to have the notion that social inequalities reverberate in an individual´s health. In this perspective, Breilh (2021) proposes an analysis of the social dynamic that produces these inequities. Thus, it would be necessary to understand the social process regarding this phenomenon so that it is possible to analyze social movements in a given historical context and enable the perception of the system of contradictions that impact this movement. Therefore, it is imperative to verify that the capitalist system involves a complexity of social relations, which include situations of exploitation and domination.
Some proposals that try to stimulate the practice of physical activities seem to reproduce inequalities by naturalizing exhausting work and domestic tasks, disregarding the social and sexual division of work and household chores. It also despises the work overload imposed on women in patriarchal societies, the processes of domination and exploitation at work, racial oppression, processes of fatigue, lack of financial resources, and the need of a safe and adequate environment, among other aspects. Thus, the problems existing in unequal societies may be hidden in favor of the simplistic idea that all physical activity counts when aiming to improve an individual´s health status. The results presented in this investigation may explain the panorama shaped by multiple forms of oppression. From the analytical perspective of intersectionality, it is possible to understand that social groups that are suffering from different forms of oppression end up being denied access to leisure-time physical activities at the same time that they are involved in the practicing of other activities, which can display different types of feelings, perceptions, and motivations. In this sense, in a society where opportunities have been offered only to a privileged fraction of the population, accountability to those who suffer needs to be questioned (Paiva and Palma, 2021b; Collins and Bilge, 2020).
Paraphrasing Ray (2014), the authors propose that performing different domains of physical activity may imply privilege or exploitation rooted in race, gender, and social class that converge in a differentiated way so that certain groups can be “more active” in the lightness of their leisure time or hard job-related/domestic work. Therefore, like the author, our research agenda is not solely about the performance of physical activities but rather about how the structural arrangements of societies contribute to healthy lifestyles.
CONCLUSION
The findings of this study reinforce the importance of considering intersectional relationships of oppression when investigating physical activity patterns. The biomedical conception that any physical activity is better than inactivity has produced an idea that disregards social oppressions and discriminations. The analysis, based on intersectionality, allows us to understand that the practice of physical activities in commuting, domestic work, and the occupational environment has been assigned to socially more vulnerable groups, reflecting different forms of exploitation. On the other hand, our results show that privileged groups, identified based on gender, race, education level, and access to medical resources, are more likely to engage in leisure-time physical activities.
Moreover, we indicate that it is important for future analyses to go beyond gender binarism, such as considering the trans population. The absence of these groups reinforces the need to expand the criteria of intersectional analysis to include diverse gender identities, which frequently face unique forms of oppression and barriers to accessing physical activity.
Finally, public health promotion policies should consider these structural inequalities, recognizing that groups with higher levels of oppression do not have the same access to leisure-time physical activities, facing socioeconomic and cultural barriers. Thus, it is essential that interventions be designed to mitigate these obstacles and promote equity in physical activity practices.
-
FUNDING
This study did not receive any financial support for its development.
REFERENCES
- Akotirene C. Interseccionalidade. São Paulo: Polém; 2019.
-
Ballesteros MS, Freidin B, Wilner A, Rendina LF. Interseccionalidad en las desigualdades sociales para la realización de actividad física en Argentina. Rev Cienc Salud. 2020;18(1):134-51. http://doi.org/10.12804/revistas.urosario.edu.co/revsalud/a.8777
» http://doi.org/10.12804/revistas.urosario.edu.co/revsalud/a.8777 -
Ballesteros MS, Freidin B. Desigualdades sociales en la realización de distintas modalidades de actividad física en Argentina. Educ Fís Cienc. 2019;21(1):e067-067. http://doi.org/10.24215/23142561e067
» http://doi.org/10.24215/23142561e067 - Brasil. Vigitel Brasil 2020: vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico: estimativas sobre frequência e distribuição sociodemográfica de fatores de risco e proteção para doenças crônicas nas capitais dos 26 estados brasileiros e no Distrito Federal em 2020. Brasília, DF: Ministério da Saúde; 2021.
-
Breilh J. Critical epidemiology and the people’s health. New York: Oxford University Press; 2021. http://doi.org/10.1093/med/9780190492786.001.0001
» http://doi.org/10.1093/med/9780190492786.001.0001 -
Casas RCR, Bernal RTI, Jorge AO, Melo EM, Malta DC. Fatores associados à prática de atividade Física na população brasileira – Vigitel 2013. Saúde Debate. 2018;42(spe4):134-44. http://doi.org/10.1590/0103-11042018s410
» http://doi.org/10.1590/0103-11042018s410 - Collins P, Bilge S. Intersectionality. Cambridge: Policy Press; 2020.
-
Crespo CJ, Smit E, Andersen RE, Carter-Pokras O, Ainsworth BE. Race/ethnicity, social class and their relation to physical inactivity during leisure time: results from the Third National Health and Nutrition Examination Survey, 1988-1994. Am J Prev Med. 2000;18(1):46-53. http://doi.org/10.1016/S0749-3797(99)00105-1 PMid:10808982.
» http://doi.org/10.1016/S0749-3797(99)00105-1 -
Cruz DKA, da Silva KS, Lopes MVV, Parreira FR, Pasquim HM. Socioeconomics inequities associated with different domains of physical activity: results of the National Health Survey 2019, Brazil. Epidemiol Serv Saude. 2022;31(spe1):e2021398. http://doi.org/10.1590/ss2237-9622202200015.especial PMid:35920462.
» http://doi.org/10.1590/ss2237-9622202200015.especial -
Del Duca GF, Nahas MV, Garcia LMT, Mota J, Hallal PC, Peres MA. Prevalence and sociodemographic correlates of all domains of physical activity in Brazilian adults. Prev Med. 2013;56(2):99-102. http://doi.org/10.1016/j.ypmed.2012.11.007 PMid:23200875.
» http://doi.org/10.1016/j.ypmed.2012.11.007 -
Ekelund U, Steene-Johannessen J, Brown WJ, Fagerland MW, Owen N, Powell KE, et al. Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. Lancet. 2016;388(10051):1302-10. http://doi.org/10.1016/S0140-6736(16)30370-1 PMid:27475271.
» http://doi.org/10.1016/S0140-6736(16)30370-1 -
He XZ, Baker DW. Differences in leisure‐time, household, and work‐related physical activity by race, ethnicity, and education. J Gen Intern Med. 2005;20(3):259-66. http://doi.org/10.1111/j.1525-1497.2005.40198.x PMid:15836530.
» http://doi.org/10.1111/j.1525-1497.2005.40198.x -
Marshall SJ, Jones DA, Ainsworth BE, Reis JP, Levy SS, Macera CA. Race/ethnicity, social class, and leisure-time physical inactivity. Med Sci Sports Exerc. 2007;39(1):44-51. http://doi.org/10.1249/01.mss.0000239401.16381.37 PMid:17218883.
» http://doi.org/10.1249/01.mss.0000239401.16381.37 -
Mielke GI, Malta DC, Nunes BP, Cairney J. All are equal, but some are more equal than others: social determinants of leisure time physical activity through the lens of intersectionality. BMC Public Health. 2022;22(1):36. http://doi.org/10.1186/s12889-021-12428-7 PMid:34991542.
» http://doi.org/10.1186/s12889-021-12428-7 - Paiva GB, Palma A. A complexidade da discriminação: interseccionalidade, práticas corporais/ atividades físicas, saúde e lazer. In: Palma A, Rodrigues P, Reis EC, editors. Práticas Corporais & Atividades Físicas: saúde e sociedade. Curitiba: CRV; 2021b. p. 59-71.
- Paiva GB, Palma A. O paradoxo da atividade física: esquadrinhando as atividades físicas ocupacionais e domésticas. In: Palma A, Rodrigues P, Reis EC, editors. Práticas Corporais & Atividades Físicas: saúde e sociedade. Curitiba: CRV; 2021a. p. 111-132.
-
Prince SA, Reed JL, Martinello N, Adamo KB, Fodor JG, Hiremath S, et al. Why are adult women physically active? A systematic review of prospective cohort studies to identify intrapersonal, social environmental and physical environmental determinants. Obes Rev. 2016;17(10):919-44. http://doi.org/10.1111/obr.12432 PMid:27465602.
» http://doi.org/10.1111/obr.12432 -
Ray R. An intersectional analysis to explaining a lack of physical activity among middle class black women. Sociol Compass. 2014;8(6):780-91. http://doi.org/10.1111/soc4.12172
» http://doi.org/10.1111/soc4.12172 -
Roberts JD, Mandic S, Fryer CS, Brachman ML, Ray R. Between privilege and oppression: an intersectional analysis of active transportation experiences among Washington D.C. area youth. Int J Environ Res Public Health. 2019;16(8):1313. http://doi.org/10.3390/ijerph16081313 PMid:31013698.
» http://doi.org/10.3390/ijerph16081313 - World Health Organization. Global action plan on physical activity 2018-2030: more active people for a healthier world. Geneva: World Health Organization; 2018.
- World Health Organization. Guidelines on physical activity and sedentary behaviour. Geneva: World Health Organization; 2020.
Publication Dates
-
Publication in this collection
22 Nov 2024 -
Date of issue
2024
History
-
Received
05 June 2024 -
Accepted
01 Oct 2024