It is obvious that there are socioeconomic inequalities between people, resulting from a variety of differences determined by a person’s economic position relative to others and based on economic income, education level, employment status or occupation and ethnicity. And these inequalities affect people’s health.
In general, people with low socioeconomic levels live in disadvantaged areas and have a higher prevalence of poor health-related behaviors, which carry a higher risk of morbidity and mortality. It was already discussed in the health model of the 80s that the unhealthiest habits such as smoking, low consumption of fruit and vegetables or a sedentary lifestyle were more prevalent in the lower social classes.
If we want to know how to reduce health inequalities, it is important to understand the interaction between socioeconomic status and healthy behavior to determine future health on a global scale. Sedentary behavior or levels of physical activity do not escape this interaction with socioeconomic level. So much so that as early as 2020, a World Health Organization (WHO) working group identified a knowledge gap in understanding the role of socioeconomic level in the association between physical activity and sedentary lifestyles with health, an issue that is urgent to reduce health inequalities.
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An inverse relationship between socioeconomic level and physical activity levels has been demonstrated, although with limitations. This means that people with higher levels of education, better jobs and higher income levels generally have more physical activity. And on the contrary: physical activity fell more sharply among people with lower levels of education and lower income. Even with similar exposure to risk factors, groups with lower socioeconomic status have poorer overall health indicators; This phenomenon is known as the vulnerability hypothesis.
Consistent with this hypothesis, we might then expect this deleterious association between low levels of physical activity and high sedentary behavior with negative health outcomes to be stronger in low socioeconomic status groups. A recent study with more than 300,000 participants aged 40 to 69 confirms this hypothesis of vulnerability in relation to physical activity. This study suggests that unhealthy behaviors, particularly sedentary lifestyles, may cause more harm in lower socioeconomic groups. This vulnerability hypothesis is maintained even in older age. For example, a systematic review examining the effects of socioeconomic status on the effects of retirement on physical activity and sedentary behavior suggests that retirement has a more favorable impact on groups with higher socioeconomic status.
The ecological model, which attempts to explain why some people are active and others are not, assumes that both the physical and social environment (economic conditions, social norms, urbanization, industrialization…) are important determinants of physical activity . Although there is still enough research to fully understand the relationship between socioeconomic level and physical activity, it seems clear that more disadvantaged socioeconomic environments do not contribute to initiating or maintaining a healthy lifestyle related to physical activity, which is a good promotes general health.
For this reason, public health interventions targeting physical activity and sedentary behavior should focus on people and areas of lower socioeconomic status to reduce and reduce health inequalities. Furthermore, these interventions could provide a greater benefit-to-cost ratio.
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