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Cross-sectional associations of active transport, employment status and objectively measured physical activity: analyses from the National Health and Nutrition Examination Survey
  1. Lin Yang1,2,
  2. Liang Hu3,
  3. J Aaron Hipp4,
  4. Kellie R Imm5,
  5. Rudolph Schutte6,
  6. Brendon Stubbs7,8,9,
  7. Graham A Colditz2,
  8. Lee Smith10
  1. 1 Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
  2. 2 Division of Public Health Sciences, School of Medicine, Washington University, Saint Louis, Missouri, USA
  3. 3 Department of Sport Science, Zhejiang University College of Education, Hangzhou, China
  4. 4 Center for Geospatial Analytics, Department of Parks, Recreation and Tourism Management, North Carolina State University, Raleigh, North Carolina, USA
  5. 5 Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
  6. 6 Department of Medical Science and Public Health, Faculty of Medical Science, Anglia Ruskin University, Chelmsford, UK
  7. 7 Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK
  8. 8 Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
  9. 9 Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK
  10. 10 Faculty of Science and Technology, Sports and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
  1. Correspondence to Dr Lin Yang, Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, 1090, Austria; lin.yang{at} and Dr Liang Hu, College of Education, Zhejiang University, Hangzhou, 310028, China; lianghu{at}


Background To investigate associations between active transport, employment status and objectively measured moderate-to-vigorous physical activity (MVPA) in a representative sample of US adults.

Methods Cross-sectional analyses of data from the National Health and Nutrition Examination Survey. A total of 5180 adults (50.2 years old, 49.0% men) were classified by levels of active transportation and employment status. Outcome measure was weekly time spent in MVPA as recorded by the Actigraph accelerometer. Associations between active transport, employment status and objectively measured MVPA were examined using multivariable linear regression models adjusted for age, body mass index, race and ethnicity, education level, marital status, smoking status, working hour duration (among the employed only) and self-reported leisure time physical activity.

Results Patterns of active transport were similar between the employed (n=2897) and unemployed (n=2283), such that 76.0% employed and 77.5% unemployed engaged in no active transport. For employed adults, those engaging in high levels of active transport (≥90 min/week) had higher amount of MVPA than those who did not engage in active transport. This translated to 40.8 (95% CI 15.7 to 65.9) additional minutes MVPA per week in men and 57.9 (95% CI 32.1 to 83.7) additional minutes MVPA per week in women. Among the unemployed adults, higher levels of active transport were associated with more MVPA among men (44.8 min/week MVPA, 95% CI 9.2 to 80.5) only.

Conclusions Findings from the present study support interventions to promote active transport to increase population level physical activity. Additional strategies are likely required to promote physical activity among unemployed women.

  • active transport
  • moderate to vigorous intensity physical activity
  • employment status
  • accelerometer

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  • Contributors Study concept and design: LY, LH and GAC. Analysis and interpretation of data: LY and LS. Drafting of the manuscripts: LY and LS. Critical revision of the manuscript for important intellectual content: JAH, KRI, RS, BS and GAC.

  • Funding This work was supported by the Transdisciplinary Research on Energetics and Cancer (TREC) Center at Washington University in St. Louis (LY) and the Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital Foundation and Washington University School of Medicine (GAC). The TREC Center is funded by the National Cancer Institute at NIH (U54 CA155496).

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The National Health and Nutrition Examination Survey obtained ethical approval from the National Center for Health Statistics Research Ethics Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.