Social vulnerability and leisure-time physical inactivity among US adults

Objectives: To examine the relationship between residential county social vulnerability and leisure-time physical inactivity among US adults. Methods: Individual- level data (N = 661,360) came from the Behavioral Risk Factor Surveillance System 2011 and 2012 surveys. Countylevel social vulnerability was measured by the Social Vulnerability Index (SVI) of the Centers for Disease Control and Prevention. Leisure-time physical inactivity was defined as no participation in any physical activity during the past month other than regular job. Multilevel logistic regression analyses were performed to examine the associations between SVI quartiles and physical inactivity. Results: Compared to those residing in counties of the lowest SVI quartile (least socially vulnerable), people living in counties of mid-low, mid-high, and highest SVI quartiles had 7.2% (95% confidence interval: 3.4% - 11.1%), 12.0% (8.0% - 16.1%), and 18.3% (14.0% - 22.9%) higher odds of being physically inactive during their leisure time, respectively. The relationship between residential county social vulnerability and leisure-time physical inactivity appeared more salient among women than among men. Conclusions: Neighborhood social vulnerability may profoundly impact individuals' engagement in physical activity. SVI could be a useful tool to guide community-based health promotion initiatives in addition to its intended use for emergency preparedness.