Physical activity among Asians and Native Hawaiian or Other Pacific Islanders—50 states and the District of Columbia, 2001-2003

Morbidity and Mortality Weekly Report, August 27, 2004 by J. Kruger, S.A. Ham, H.W. Kohl, III, S. Sapkota

Data on physical activity participation rates among Asians and Native Hawaiian of Other Pacific Islanders (NHOPIs) in the United States are limited. For example, few studies have measured physical activity prevalence among the diverse Asian population, which was estimated to be 11.9 million in 2000 according to the U.S. Census and is projected to increase to 33.4 million by 2050 (1). One of the broadly defined goals of the 2010 national health objectives is to reduce disparities in health among population groups (2). To determine the prevalence of recommended levels of lifestyle (i.e., nonoccupational) physical activity (e.g., combined leisure-time, household-related, and transport-related), the prevalence of physical inactivity, and the prevalence of leisure-time physical inactivity among Asians and NHOPIs in the United States, CDC analyzed physical activity data from the Behavioral Risk Factor Surveillance System (BRFSS) surveys from 2001, 2002, and 2003 for the Asian and NHOPI populations from all 50 states and the District of Columbia (DC). This report summarizes the results of that analysis, which indicated that 38.6% of Asians and NHOPIs met recommended levels of lifestyle physical activity, compared with 45.8% of the total U.S. population, and approximately 24% were inactive during their leisure time. To increase physical activity in the Asian and NHOPI populations, state and local health departments and other organizations should adopt evidence-based strategies at the community and individual level to promote and encourage physical activity.

BRFSS conducts annual random-digit-dialed state-based telephone surveys of the noninstitutionalized, U.S. civilian population aged [greater than or equal to] 18 years. In 2001 and 2003, data for lifestyle physical activity and physical inactivity were collected in all states and DC. Data about leisure-time physical inactivity were collected in all 3 years (2001, 2002, and 2003). Annual sample sizes in BRFSS increased from 214,500 in 2001 to 264,684 in 2003.

For this analysis, Asians and NHOPIs were defined as those respondents who did not report being of Hispanic origin and either self-selected their racial/ethnic identity as Asian or NHOPI or selected the multiracial category and identified one race/ethnicity as Asian or NHOPI. Three variables were used to describe activity levels: lifestyle physical activity, lifestyle physical inactivity, and no leisure-time physical activity. Lifestyle physical activity was assessed on the basis of participants' responses about their participation in nonoccupational physical activities of moderate intensity (e.g., brisk walking, bicycling, vacuuming, gardening, or anything else that causes small increases in breathing or heart rate) and vigorous intensity (e.g., running, aerobics, heavy yard work, or anything else that causes large increases in breathing or heart rate) for [greater than or equal to] 10 minutes at a time in a usual week. Engaging in the recommended level of lifestyle physical activity was defined operationally as engaging in moderate-intensity physical activity [greater than or equal to] 5 days per week for [greater than or equal to] 30 minutes per day or in vigorous-intensity physical activity [greater than or equal to] 3 days per week for [greater than or equal to] 20 minutes per day of both. Respondents who reported no moderate of vigorous physical activity in a usual week were classified as inactive (lifestyle inactivity). Data for 2001 and 2003 were pooled to increase the sample size of Asians and NHOPIs. The sample size for NHOPIs was too small to allow for a separate analysis.

Respondents were classified as having engaged in no leisure-time physical activity if they answered "no" to the survey question, "During the past month, other than your regular job, did you participate in any physical activities or exercise such as running, calisthenics, golf, gardening, or walking for exercise?" The time frame of this survey question was the "past 30 days" in 2001 and "past month" in 2002 and 2003. The response rates were 51.1% in 2001, 59.5% in 2002, and 54.0% in 2003 (3). SUDAAN was used to account for the complex sampling design. The overall sample consisted of 5,186 Asian and NHOPI respondents in 2001, 6,567 in 2002, and 5,848 in 2003.

Physical activity was reported for body mass index (BMI) categories by using two guidelines. Participants' self-reported height and weight were used to calculate their BMI (weight in kg divided by height in [m.sup.2]). Participants were then categorized as underweight, normal weight, overweight, or obese. The first guideline used was the World Health Organization (WHO) standard: underweight (BMI < 18.5), normal weight (BMI = 18.5-24.9), overweight (BMI = 25.0-29.9), and obese (BMI [greater than or equal to] 30.0) (4). The second was the WHO Asia-Pacific guideline for Asian adults: underweight (BMI < 18.5), normal weight (BMI = 18.5-22.9), overweight (BMI = 23.0-24.9), and obese (BMI [greater than or equal to] 25.0) (5).