Changes In Physical Inactivity Among U.S. Adults By Sociodemographic Characteristics, BRFSS, 2020 Versus 2018

Early in the COVID-19 pandemic, access to and participation in leisure-time physical activity was plausibly different across sociodemographic strata of the US population. Currently, the Behavioral Risk Factor Surveillance System (BRFSS) is the only national public health surveillance system with a consistent measure of physical activity pre- and intra-pandemic. PURPOSE: To assess changes in prevalence of leisure-time physical inactivity across sociodemographic groups in the US during 2020 versus 2018. METHODS: National data from BRFSS among 838,017 US adults aged ≥18 years were analyzed. Participants who reported “no” when asked, “during the past month, other than your regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening, or walking for exercise?” were classified as physically inactive. Prevalence differences with 95% confidence intervals [CI] of leisure-time physical inactivity during 2020 versus 2018 were calculated overall and by sociodemographic characteristics (sex, age, urbanicity, race/ethnicity, education, and income). Sex-specific prevalence differences were also calculated by sociodemographic group. CIs not containing zero were deemed statistically significant. RESULTS: Prevalence of inactivity among US adults overall decreased 0.7 percentage points (PP) (95% CI: -1.2, -0.3), from 24.5% in 2018 to 23.8% in 2020. Decreases were observed among persons aged 45-64 years (-1.5PP, [95% CI: -2.3, -0.7]) and ≥ 65 years (-1.3PP, [-2.1, -0. 4]), women (-1.2PP, [-1.8, -0.6]), non-Hispanic White persons (-1.5PP, [-2.0, -1.1]), and persons living in rural counties (-2.6PP, [-3.8, -1.4]) and in urban counties, to a smaller extent (-0.6PP, [-1.0, -0.1]). No significant decreases were observed for racial and ethnic minority groups overall. Notable sex-specific decreases occurred among rural-dwelling women (-3.1 PP, [-4.7, -1.5]), rural-dwelling men (-2.1 PP, [-3.8, -0.3]), and non-Hispanic White women (-2.1PP, [-2.7, -1.5]). CONCLUSIONS: Self-reported leisure-time physical inactivity modestly decreased among specific US subpopulations from 2018 to 2020. This study highlights a need to better understand drivers of leisure-time physical activity across populations, particularly during periods of social disruption.