Determinants of Physical Activity Among Black Women with Cardiometabolic Disease – Data from National Health and Nutrition Examination Survey (NHANES) 2013-2020

Research Objectives: To compare physical activity (PA) among Black women and men with cardiometabolic disease (CMD), and to determine factors predicting time spent in PA in Black women with CMD.

Design: Cross-sectional, observational.

Setting: Secondary data from the 2013-2020 National Health and Nutrition Examination Survey.

Participants: Non-Hispanic, Black participants (N=1037) with CMD (defined as having a diagnosis of coronary heart disease, angina pectoris, myocardial infarction, or diabetes mellitus).

Interventions: Covariates included demographic (age, education, marital status, poverty income ratio), lifestyle (body mass index (BMI), waist circumference, general health, smoking), clinical (overnight hospital stay, number of comorbidities, comorbidity type), and laboratory profile (glycosylated hemoglobin and lipid profile).

Main Outcome Measures: Total PA was assessed using the Global Physical Activity Questionnaire (GPAQ) comprising of 16 questions across three domains (work, transport, and leisure time). PA and sedentary time were measured in minutes per week and minutes per day, respectively.

Results: The prevalence of CMD among Black women (25,800,000 ± 2,175,342) in the estimated total population of United States was significantly greater than in Black men (20,800,000 ± 1,551,797) (t = -5.51, p < 0.001). Significantly more Black women were obese (70.15% versus 56.89%), belonged to lower income group (46.76% versus 35.82%), and had poor self-rated health (44.5% versus 33%), compared to Black men. Mean total minutes per week of PA was significantly lower for Black women compared to men (t = 3.70, p = 0.001), and a significantly greater proportion of Black women did not meet the recommended PA guidelines of 150 mins/week of moderate PA (t = -3.00, p = 0.004). Among Black women, after adjusting for sociodemographic and clinical variables, age, education, and income emerged as primary predictors of PA. Each additional year of age was associated with a reduction in total PA by 21.79 minutes/ week (-34.39, -9.19, p = 0.001). Every unit increase in annual income improved total PA by a coefficient of 93.42 (7.79, 517.38, p = 0.044) and greater than high school education was associated with an increase in total PA by a coefficient of 262.58 (7.10, 179.74, p = 0.034). In contrast, age and self-rated health emerged as significant predictors in Black men (p < 0.001 and p = 0.021, respectively).

Conclusions: These findings highlight the complex interplay between demographic, socioeconomic, and health-related factors in shaping PA behavior among Black women in the U.S., underscoring the need for targeted interventions to promote active lifestyles in this population.

Author(s) Disclosures: None