Findings from a new study in The American Journal of Medicine, published by Elsevier, demonstrate that increased social vulnerability worsens unhealthy lifestyle habits and health characteristics. Researchers found significant geographic differences and inequalities within the United States. They support the implementation of precision medicine approaches targeting specific groups and communities to reduce these differences.
Ross Arena, PhD, from the Department of Physical Therapy at the University of Illinois Chicago’s College of Applied Science and founder of the Healthy Living for Pandemic Event Protection (HL-PIVOT) Network in Chicago, stated: „The results of the current investigation point to a crisis within a crisis regarding a pandemic of physical inactivity in the United States. Nationally, physical activity is unacceptably low and has not significantly improved in the last decade, while simultaneously, a high degree of social vulnerability and … physical inactivity is concentrated in certain geographic regions.“
Physical activity extends both health and lifespan, collectively referred to as „healthy longevity.“ Even small increases in activity can make a big difference in a person’s health and well-being. However, the COVID-19 pandemic likely reduced the activity levels of many Americans as social distancing and stay-at-home orders to contain the virus resulted in even less movement.
This study examined the link between social vulnerability and physical inactivity through a spatial comparison of county-level data on the prevalence of physical inactivity and the Social Vulnerability Index (SVI). The relationship between physical inactivity and social vulnerability was evaluated within the context of unique regional cultures in the U.S., based on the American Nations model.
The results of this in-depth statistical analysis additionally highlight the importance of using social vulnerability metrics to identify regions/communities at higher risk for unhealthy lifestyle habits, chronic diseases, and poor health outcomes. Key findings include:
- Social vulnerability has a significant impact on the prevalence of physical inactivity in the U.S., especially regarding socioeconomic status and household characteristics.
- Using the American Nations model, there is noticeable and statistically significant heterogeneity of social vulnerability in different regions of the U.S. Similar to the previously described „stroke belt,“ there is evidence of a „belt of social vulnerability“ spreading over a large portion of the southern U.S. region. Even northern and western Alaska are areas of concern.
- The distribution of the SVI and the prevalence of physical inactivity in the U.S. show considerable overlap, suggesting interactions between these undesirable phenomena indicative of regional cultural influence.
- A high degree of social vulnerability and physical inactivity are concentrated in certain geographic regions that require tailored solutions to address health disparities.
According to the study, external factors affecting lifestyle in a heterogeneous way include cultural and geographic intersections, early settler effects, and the competing migration patterns of settler-colonizers from the 17th to 19th centuries, which established rival cultural traditions as well as political and socioeconomic preferences.
The researchers emphasize that traditional health messages and individual counseling approaches for addressing the crisis of physical inactivity suffer from a one-size-fits-all approach.
Co-investigator Nicolaas P. Pronk, Ph.D., President and Chief Science Officer of HealthPartners in Bloomington, MN, said: „In the past, we usually said: ‚Being physically active is good for everyone, so everyone should be more physically active. Ideally, engaging in 150 minutes or more per week of moderate-intensity exercise on most, if not all, days of the week.‘ Little attention is paid to the factors influencing a person’s decision to be physically active.“
Co-investigator Colin Woodard, MA, FRGS, Director of the Nationhood Lab at the Pell Center for International Relations and Public Policy at Salve Regina University in Newport, Rhode Island, noted: „Historically, some of the true causes of physical inactivity have been overlooked by public and individual health experts. Our goal with this study is to uncover what truly motivates behavior and behavior change. Data-driven intelligence and the work of historians and cultural geographers can help us find the best ways to promote a healthy lifestyle and, ultimately, improve people’s health.“
Dr. Arena adds: „Our findings suggest that social vulnerability and deeply rooted characteristics of the various regions of the United States likely influence decisions about physical activity. These factors should be considered in designing health promotion campaigns through physical activity and tailored individual counseling. We need to figure out how to help certain communities and individuals make behavior changes. What tools do they need? What message will resonate with them? It’s time to apply a precision medicine approach to the medicine of healthy living.“