Determinantes ambientais da prática de atividade física no lazer: uma análise multinível

Abstract

The chronic diseases are a serious public health problem and a threat to health and human development. In this context, the physical activity practice is highlighted as a strategy to health promotion and to avoid these diseases. In addition to individual factors, environmental characteristics in which people live, may offer opportunities or barriers in adopting healthy habits and this is related to the physical activity (PA) practice among individuals. The aim of this study is to estimate associations between variables of the built and social environment and physical activity in leisure time in adults. This is a cross-sectional study, developed using the database of Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey (VIGITEL 2008/2010) of Belo Horizonte, Minas Gerais. Individuals with the habit of practicing PA for at least 150 minutes of moderate-intensity PA or at least 75 minutes of vigorous-intensity PA throughout the week in leisure time were classified as active in leisure time. To characterize the built and social environment we used georeferenced data of public and private places for physical activity, establishments selling health food, population density, residential density, homicide rate and total income of the coverage area. The covered area of the basic health units was used as context unit. For data analysis, we used multilevel logistic regression. The study included 5779 adults, 58.77% female. There was variability of physical activity in leisure time between area covered by the basic health units (Median Odds ratio = 1.30). After adjusting for individual characteristics, the increase of number of private places for physical activity (OR = 1.31; 95% CI: 1.15 to 1.48) and the smaller homicide rate (OR = 0.82; IC95 %: 0.70 to 0.96) in the neighborhood increased physical activity in leisure time. The evidence of this study shows that neighborhood environment may influence the physical activity practice in leisure time and should be considered in future interventions and health promotion strategies.