Multiple inequalities and intersectionality in accelerometer-assessed physical activity among British adolescents

Purpose: Describe multiple sources of inequalities in moderate-to-vigorous physical activity (MVPA) among UK adolescents and verify their potential intersectionality.

Methods: Millennium Cohort Study (age 14 wave) participants wore wrist-worn GENEActive accelerometers for 2 days; MVPA was calculated using 5 seconds epochs and 1-minute bouts. Sources of inequality were based on the PROGRESS Plus framework: sex, disability, ethnicity, language spoken at home, religion, income quintiles, area of residence, and country. Multilevel linear regression analysis was performed, considering individual, family, and environmental levels, based on a preconstructed model. Intersectionality analyses used composite variables by adding sex to each inequality source.

Results: Of the 6206 adolescents included in the analyses, 51.3% were female, 93% reported no disability, and 88.1% self-identified as White. Male adolescents recorded on average 15 minutes more MVPA than females (Mean Females: 55.6; 51.7:59.5, Males: 70.6; 67.7: 73.6). Analysis considering single sources of inequality showed lowest mean minutes in MVPA for adolescents living with hearing disability (vs. no disability: -23.5; -44.4: -2.5), identifying as Pakistani/Bangladeshi ethnicity (vs. white: -24.9; -29.6: -20.1), and those in the poorest income quintile (vs. wealthiest quintile: -11.4; -20.5: -2.3,). Intersectionality analysis used the most advantaged females as reference, revealing much lower MVPA for female adolescents living with social/behavioural disability (vs. no disability/female: -30.4; -47.3: -13.6), from Pakistani/Bangladeshi ethnicity (vs. white/female: -28.4; -34.1: -22.7), who speak only/mostly a foreign language at home (vs. only/mostly English/female: -20.4; -27.3: -13.5), and those in the poorest income quintile (vs. wealthiest/female: -18.6; -29.6: -7.6). No differences were found with males.

Conclusion: Adolescents with a disability, a Pakistani/Bangladeshi ethnicity, speaking a foreign language, and having low income showed lowest MVPA. Being female and belonging to one of those groups adds another layer of inequality for MVPA.

Funding: None