1. Temporal trends in adults’ sports participation patterns in England between 1997 and 2006: The Health Survey for England Emmanuel Stamatakis 1, Moushumi Chaudhury 1 1 Department of Epidemiology and Public Health, UCL Br J Sports Med 2008;0:1-8. doi:10.1136/bjsm.2008.04082

2. What am I going to talk about Introduction Data Measurements Sports and exercise groupings Statistical analysis Results –Trends in participation overall and particular sports Conclusion

3. Introduction: What we already know Participating in PA shown to reduce many chronic conditions e.g. Ischaemic heart disease, type II diabetes, obesity, certain cancers Adults are recommended that on at least five days a week, they should be active at moderate or greater intensity for at least 30 minutes a day 1 Additional benefits of sports and exercise (SPEX)? –enhanced social well being, general sense of belonging, lower employment less crime and stronger community cohesion 1 Donaldson L. At least five a week: evidence on the impact of physical activity and its relationship to health. A report from the Chief Medical Officer. Department of Public Health, London, 2004

4. Definitions Physical activity - any bodily movement produced by skeletal muscles that results in energy expenditure above resting level. This broad definition involves virtually all types of activity like: walking, cycling, dance, gardening, housework and sports Sports - is an activity that is governed by a set of rules or customs and often engaged in competitively Exercise - Exercise is physical activity that is planned, structured, and repetitive for the purpose of conditioning any part of the body

5. Objective To examine temporal trends in participation in sports and exercise activities in England between 1997 and 2006,taking into account wider societal changes

6. Data Health Survey for England (HSfE) 1997/98 2003/04, 2006 Nationally representative annual cross-sectional study Face-to-face interview Analyses conducted on 60,938 adults aged 16 & over –Men n = 27 217 –Women n= 33 721

7. Measurements & data collected on: Physical activity (questionnaire) Sports and exercise (SPEX) - response from show cards Questions on age, sex, ethnicity, social class, income, education, smoking habits, self-reported health, car ownership Body mass index (BMI) W/H 2

8. Sports and exercise grouping Individual spex –Swimming, dancing, cycling & running Grouped spex –Team sports e.g. football/rugby, netball, volleyball –Racquet sports e.g. badminton/tennis, squash –Gym/fitness club based e.g. gym workout, weight training, keep fit, aerobics

9. Show card example CARD O 1Swimming 2Cycling 3Workout at a gym / Exercise bike / Weight 4Aerobics / Keep fit / Gymnastics / Dance for fitness 5Any other type 6Running / Jogging 7Football / Rugby 8Badminton / Tennis 9Squash 10Exercises (e.g. press-ups, sit-ups) Please also include teaching, coaching and training/ practice session

10. Definition of any and regular sports and exercise participation (SPEX) Any SPEX participation: –At least once in the previous 4 weeks in any spex grouping Regular SPEX participation: –At least once a week in any spex grouping

11. Statistical analyses Age-standardised sports and exercise rates and 95% CI by time point (1997/8 combined, 2003/4 combined, 2006) Data driven Logistic regression models –Step 1: Merge HSfE data –Step2: X 2 test –Step 3:Develop several sex-specific multiple LR models

12. Table 1a: Characteristics of the sample by survey year

13. Table 1b: Characteristics of the sample by survey year

15. Figure 1: Age-standardised and multivariable-adjusted odds for any and regular sports and exercise participation in 2003/04 and 2006 (compared with the 1997/98 referent time point). Adults aged 16 and over living in England

16. Table 2: Age-std participation rates between 1997/8 & 2006 adults aged ≥16 years living in England *Using 1997/8 as the ref time point: adjusted for ethnicity, social class, income, education, obesity status, car ownership, smoking status, general health, occupational activity, and non-sporting/non-occupational physical activity

17. Table 2: Age-std participation rates between 1997/8 & 2006 adults aged ≥16 years living in England *Using 1997/8 as the ref time point: adjusted for ethnicity, social class, income, education, obesity status, car ownership, smoking status, general health, occupational activity, and non-sporting/non-occupational physical activity

18. *Adjusted for ethnicity, social class, income, education, obesity status, car ownership, smoking status, general health, occupational activity, and non-sporting/non-occupational physical activity. † At least once in the last 4 weeks. ‡ At lest once/week on average

19. Figure 2a: Multivariable-adjusted odds for regular participation in sport and exercise groupings in 2003/04 and 2006 (compared with the 1997/98 referent time point). Men aged 16 to 29 living in England

20. Figure 2b Multivariable-adjusted odds for regular participation in sport and exercise groupings in 2003/04 and 2006 (compared with the 1997/98 referent time point). Women aged 16 to 29 living in England.

21. Figure 3a: Age-standardised odds for regular sports and exercise participation in 2003/04 and 2006 (compared with the 1997/98 referent time point). Men aged 16 and over living in England.

22. Figure 3b: Age-standardised odds for regular sports and exercise participation in 2003/04 and 2006 (compared with the 1997/98 referent time point). Women aged 16 and over living in England

23. Main Findings Age std overall regular participation increased –Men 40.8% to 41.2% (1997/98 to 2006) –Women 31.2% to 33.9% (1997/98 to 2006) Regular G/FC increased –17.0% to 19.0% for men (1997/98 to 2006) –15.9 to 18.7% for women (1997/98 to 2006) Regular running increased for women only –2.4% to 4.0% (1997/98 to 2006) Overall increases were apparent in older adults (≥45years) Increase in participation among men from non manual social class, higher income households and white ethnic background

24. Conclusions 1.This is the first time trend analysis of SPEX in England 2.Overall regular SPEX in England has increased between 1997 and 2006 3.Middle aged and older adults show, main increase individual activity, e.g. gym/ fitness clubs 4.Bad news! Younger male adults (16-29years) shows decrease in all sports e.g. cycling, swimming, running and racquet sports

25. Conclusions 5.There are no signs that the participation between lower and higher socioeconomic strata and between white and ethnic minority groups is narrowing. Therefore sports promoting and health policy efforts should focus on these groups and try to expand participation.

26. Future work Better understanding of the mechanisms behind the “success story” of middle-aged and older adults HSfE 2007: I am looking at Knowledge of & Attitudes to physical activity (results due out December 2008) HSfE 2008 first time Objective measurements –Step test –Accelerometer

27. Limitations of this study : Did not use but extra Self reported PA measures Cycling questions only asked for any purpose Decline in survey response Lack of statistical power

28. Strength of this study :Did not use but extra information Up to date information Large nationally representative samples High survey response Continuous data collection, Presentation of age std data and adjustment of our data to a plethora of SES, demographic, non sporting PA activities