Journal of Education and Health Promotion

A healthy behavior and socioeconomic inequality in school‑age children in the West of Iran

Document Type : Original Article

Authors

. Ali Kazemi Karyani
. Behzad Karami Matin
. Zhila Kazemi
. Shahin Soltani
. Mohammad Ebrahimi
. Satar Rezaei
Abstract
BACKGROUND: Sufficient physical activity (SPA) in children and adolescents has an important role
in health, growth, and development of persons. This study aimed to investigate the prevalence of
and inequality in physical activity (PA) in 12–15‑year‑old students in the West of Iran, 2018.
MATERIALS AND METHODS: In this cross‑sectional study, 1404 students from 14 schools of
Kermanshah city were included. Data on demographic and socioeconomic status (SES) of students
and their family, body mass index, moderate‑to‑vigorous PA of students were collected. Normalized
concentration index (NC) and decomposition analysis applied to measure inequality in SPA and the
contribution of affecting factors, respectively.
RESULTS: About 19% of the students had SPA. The proportion of SPA in boys was higher than
girls (38.98% vs. 9.84%). There was a significant deviation from equality line (NC = 0.31; 95%
confidence interval [CI]: 0.23, 0.38) and NC for boys and girls were 0.15 (95% CI: 0.04, 0.25) and
0.05  (95% CI: −0.07, 0.17). Sex of students and SES of households with 59.09% and 39.77%
contribution to the measured inequality in SPA were the highest positive contributors. Household
size (−2.60) had a negative contribution to inequality in SPA.
CONCLUSION: There was a significant pro‑rich socioeconomic inequality in SPA and sex, and SES
were the main contributors to the inequality in PA. Some interventions are needed to improve PA
among children and adolescents with a focus on girls and low‑SES groups to narrow the existing gaps.

Keywords

Adolescents
children
inequality
physical activity
Iran
  1. Malina RM, Bouchard C, Bar‑Or O. Growth, Maturation, and
    Physical Activity. Human Kinetics; Champaignunited states of
    America, 2004.
    2. de Greeff JW, Bosker RJ, Oosterlaan J, Visscher C, Hartman E.
    Effects of physical activity on executive functions, attention and
    academic performance in preadolescent children: A meta‑analysis.
    J Sci Med Sport 2018;21:501‑7.
    3. Pate RR, Hillman CH, Janz KF, Katzmarzyk PT, Powell KE,
    Torres A, et al. Physical activity and health in children younger
    than 6 years: A systematic review. Med Sci Sports Exerc
    2019;51:1282‑91.
    4. Poitras VJ, Gray CE, Borghese MM, Carson V, ChaputJP, Janssen I,
    et al. Systematic review of the relationships between objectively
    measured physical activity and health indicators in school‑aged
    children and youth. Appl Physiol Nutr Metab 2016;41:S197‑239.
    5. Katzmarzyk PT, Barreira TV, Broyles ST, Champagne CM,
    Chaput JP, Fogelholm M, et al. Physical activity, sedentary time,
    and obesity in an international sample of children. Med Sci Sports
    Exerc 2015;47:2062‑9.
    6. Sallis JF, Prochaska JJ, Taylor WC. A review of correlates of
    physical activity of children and adolescents. Med Sci Sports
    Exerc 2000;32:963‑75.
  2. 7. Kelishadi R, Qorbani M, Djalalinia S, Sheidaei A, Rezaei F,
    Arefirad T, et al. Physical inactivity and associated factors in
    Iranian children and adolescents: The weight disorders survey
    of the CASPIAN‑IV study. J Cardiovasc Thorac Res 2017;9:41‑8.
    8. KelishadiR, ZiaeeV, ArdalanG, NamaziA, NoormohammadpourP,
    Ghayour‑Mobarhan M, et al. A national experience on physical
    activity initiatives for adolescent girls and their mothers:
    CASPIAN study. Iran J Pediatr 2010;20:420‑6.
    9. Barreira TV, Broyles ST, Tudor‑Locke C, Chaput JP, Fogelholm M,
    Hu G, et al. Epidemiological transition in physical activity and
    sedentary time in children. J Phys Act Health 2019;16:518‑24.
    10. Lu C, Stolk RP, Sauer PJ, Sijtsma A, Wiersma R, Huang G,
    et al. Factors of physical activity among Chinese children and
    adolescents: A systematic review. Int J Behav Nutr Phys Act
    2017;14:36.
    11. Coombs N, Shelton N, Rowlands A, Stamatakis E. Children’s and
    adolescents’ sedentary behaviour in relation to socioeconomic
    position. J Epidemiol Community Health 2013;67:868‑74.
    12. Cohen KE, Morgan PJ, Plotnikoff RC, Callister R, Lubans DR.
    Fundamental movement skills and physical activity among
    children living in low‑income communities: A cross‑sectional
    study. Int J Behav Nutr Phys Act 2014;11:49.
    13. Mostafavi F, Moradi G, Azadi N, Esmaeilnasab N, Roshani D.
    Using oaxaca decomposition to study socioeconomic inequity
    of physical activity among children aged 10‑12 years: A study in
    West of Iran. Int J Prev Med 2019;10:83.
    14. Moradi G, Mostafavi F, Azadi N, Esmaeilnasab N, Nouri B.
    Evaluation of screen time activities and their relationship with
    physical activity, overweight and socioeconomic status in children
    10‑12 years of age in Sanandaj, Iran: A cross‑sectional study in
    2015. Med J Islam Repub Iran 2016;30:448.
    15. Ministry of Health and Medical Education. The Iranian Preventive
    Essential Non‑Communicable Diseases (IraPEN): Ministry of
    Health and Medical Education; 2016. Available from: http//
    baharestan.iums.ac.ir/files/baharestan/files/FixDastor‑Behvarz.
    pdf.[Last accessed on 2019 Sep 07].
    16. World Health Organization. Recommended Levels of Physical
    Activity for Children Aged 5 – 17 Years. World Health
    Organization; June, 2019. Available from: https://www.who.
    int/dietphysicalactivity/factsheet_young_people/en/, access
    date: 7th September, 2019.
    17. Walsh B, Cullinan J. Decomposing socioeconomic inequalities
    in childhood obesity: Evidence from Ireland. Econ Hum Biol
    2015;16:60‑72.
    18. Wagstaff A. The bounds of the concentration index when the
    variable of interest is binary, with an application to immunization
    inequality. Health Econ 2005;14:429‑32.
    19. Wagstaff A, Van Doorslaer E, Watanabe N. On decomposing
    the causes of health sector inequalities with an application to
    malnutrition inequalities in Vietnam. J Econ 2003;112:207‑23.
    20. Johnsen NF, Toftager M, Melkevik O, Holstein BE, Rasmussen M.
    Trends in social inequality in physical inactivity among Danish
    adolescents 1991‑2014. SSM Popul Health 2017;3:534‑8.
    21. Federico B, Falese L, Capelli G. Socio‑economic inequalities in
    physical activity practice among Italian children and adolescents:
    A cross‑sectional study. Z Gesundh Wiss 2009;17:377‑84.
    22. Moradi G, Mostafavi F, Azadi N, Esmaeilnasab N, Ghaderi E.
    Socioeconomic inequality in childhood obesity. J Res Health Sci
    2017;17:e00391.
    23. Chaput JP, Barnes JD, Tremblay MS, Fogelholm M, Hu G,
    Lambert EV, et al. Inequality in physical activity, sedentary
    behaviour, sleep duration and risk of obesity in children:
    A 12‑country study. Obes Sci Pract 2018;4:229‑37.
    24. Hallal PC, Andersen LB, Bull FC, Guthold R, Haskell W,
    Ekelund U. Global physical activity levels: Surveillance progress,
    pitfalls, and prospects. Lancet 2012;380:247‑57.
    25. Brown WJ, Mielke GI, Kolbe‑Alexander TL. Gender equality in
    sport for improved public health. Lancet 2016;388:1257‑8.
    26. Telford RM, Telford RD, Olive LS, Cochrane T, Davey R. Why are
    girls less physically active than boys? Findings from the LOOK
    longitudinal study. PLoS One 2016;11:e0150041.
    27. Kelishadi R, Ghatrehsamani S, Hosseini M, Mirmoghtadaee P,
    Mansouri S, Poursafa P. Barriers to physical activity in a
    population‑based sample of children and adolescents in Isfahan,
    Iran. Int J Prev Med 2010;1:131‑7.
    28. Day K. Physical environment correlates of physical activity in
    developing countries: A review. J Phys Act Health 2018;15:303‑14.
    29. Rajabi F, Mounesan L, Sayarifard A, Ghadirian L. Promoting
    physical activity of adolescent and young Iranian girls. Int J Prev
    Med 2018;9:10.
    30. Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in
    insufficient physical activity from 2001 to 2016: A pooled analysis
    of 358 population‑based surveys with 1·9 million participants.
    Lancet Glob Health 2018;6:e1077‑86.
    31. Hallal P, Andersen L, Bull F, Guthold R, Haskell W, Ekelund UJ.
    Physical activity levels of the world’s population: Surveillance
    progress, gaps and prospects. Lancet (London, England).
    2012;380 (9838):247‑257.
    32. Peltzer K. Health behavior and protective factors among school
    children in four African countries. Int J Behav Med 2009;16:172‑80.
    33. Sallis JF, Buono MJ, Roby JJ, Micale FG, Nelson JA. Seven‑day
    recall and other physical activity self‑reports in children and
    adolescents. Med Sci Sports Exerc 1993;25:99‑108.
Journal of Education and Health Promotion
Volume 10, Issue 3
March 2020
Pages 1-7

Home

Guide for Authors

Submit Manuscript

Reviewers

Contact Us