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Social Inequalities and Exercise during Adulthood: Toward an Ecological Perspective
Author(s): Joseph G. Grzywacz and Nadine F. Marks
Source: Journal of Health and Social Behavior, Vol. 42, No. 2 (Jun., 2001), pp. 202-220
Published by: American Sociological Association
Stable URL: http://www.jstor.org/stable/3090178
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Social Inequalities and Exercise during Adulthood: Toward an
Ecological Perspective*
JOSEPH G. GRZYWACZ
Universityof NorthernIowa
NADINE F. MARKS
Universityof Wisconsin-Madison


                            2001,Vol42 (June):
Journal Health SocialBehavior
      of                                     202-220
              and

 Grounded in ecological theory, this study examines the association among par-
 ticipation in regular vigorous exercise and social status, aspects of prominent
 life settings, interactions between life settings, and more proximal individual
resources and processes using data from the National Survey of Midlife
Development in the United States (N = 3,032). Among women, a higher level of
 earnings was associated with more vigorous exercise, yet those women with
 more education had a steeper decline in exercise across adulthood. Among men,
 those with the lowest level of education had the steepest decline in physical
activity across adulthood, and earnings did not affect exercise patterns. Less
participation in vigorous exercise among blacks, in contrast to nonblacks, was
 explained by their tendency to live in less safe neighborhoods and having more
functional health problems. Finally, contextual factors from multiple domains
 were independently associated with participation in regular exercise.
 Consistent with ecological theory, these results suggest that interventions to
promote exercise habits among adults need to consider the independent and
 interactive effects of multiple contextualfactors.


   Regular physical activity has been demon-       ic and acute morbidity (Breslow and Breslow
strated to promote longevity (Berkman and          1993; U.S. Departmentof Health and Human
Breslow 1983; Fried et al. 1998; Paffenbarger      Services 1996), and facilitate higher levels of
et al. 1994; U.S. Department of Health and         psychological well-being throughout adult-
Human Services 1996), reduce rates of chron-       hood (Albert 1995; Fries and Crapo 1985;
                                                   Folkins and Sime 1981; Rowe and Kahn 1987;
                                                   Tkachukand Martin1999; U.S. Department       of
*Please address correspondence Joseph G. Health and Human Services 1996). Most
                                   to:
            Divisionof Health           Schoolof adultsremaininactive despite widespreadpro-
                              Promotion,
Grzywacz,
                             and
Health,PhysicalEducation, LeisureServices,
                                                   gramming to initiate regularphysical activity
University of Northern Iowa, 203 Wellness/
                    Cedar Falls, IA 50614-0241. (Public Health Service 1991). National esti-
Recreation  Center,
                                                   mates indicate that 30 percent of American
joe.grzywacz@uni.edu:
   This research was supportedby a National adults remain completely sedentary,and only
                                       Traineeship 14-23 percent of adults engage in enough
Institute Mental
         of        Health Post-Doctoral
(MH19958), the National Institute on Aging physical activity to achieve health-related       ben-
             the
(AG12731), National      Institute Mental
                                 of        Health efits (Centers for Disease Control 1997; U.S.
(MH61083),and the John D. and Catherine        T.               of Health and Human Services
MacArthurFoundationResearch Network on Department
                                                   1996).
Successful  MidlifeDevelopment. significant
                                A            por-
                                         occurred Individuals in lower social status positions
tion of the preparation this manuscript
                       of
while the lead author was affiliated with the participatein less physical activity than their
                                              of higher status counterparts. Older adults,
             of            and
Department Psychology SocialBehavior
theUniversity California,
               of           Irvine.                women, blacks, and individuals of lower
                                                202
AND                                                                             203
     INEQUALITIESEXERCISE
SOCIAL
socioeconomic status are consistentlyfound to                AND EMPIRICAL
                                                   THEORETICAL
                                                   BACKGROUND
exercise less regularlyand are more likely to
be completely sedentarythan younger adults,
                                                      Ecological theory, as explicated by
men, whites, and higher socioeconomic status
                                                   Bronfenbrenner and colleagues (Bronfen-
individuals (for reviews see Blair 1988;
                                                   brenner1979; Bronfenbrenner Ceci 1994;
                                                                                  and
Centers for Disease Control 1997; Dishman
                                                   Bronfenbrennerand Morris 1998), can serve
1991; King et al. 1992; U.S. Department of
                                                   as a valuable tool for further understanding
Health and Human Services 1996). Given this
                                                   and modeling the determinants of positive
evidence, age, gender, race, and educationare      health behaviors (Fitzgerald et al. 1994;
typically included as important covariates
                                                   McLeroy et al. 1988; Sallis and Owen 1997;
when developing and testing models of physi-       Stokols 1996). Bronfenbrenner's   model posits
cal activity. However, inattentively quot;control-     that behaviors such as physical activity are
ling forquot; social status is a major limitation in   influenced by a variety of factors from multi-
health research (Marmot, Kogevinas, and            ple ecological levels (e.g., individual,
Elston 1987). Instead,Marmotand colleagues         microsystemic, mesosystemic, and macrosys-
(1987) as well as others (Krieger, Williams,       temic) and change as a function of develop-
and Moss 1997; Williams 1990) argue that           mental and historical time. Consequently,
more researchdirectlyexaminingthe effects of       using an ecological perspective, scholars can
                                                   integratea rich arrayof known determinants   of
social status on health-relatedphenomena is
                                                   physical activity (for reviews see Blair 1988;
critically needed since social status creates a
                                                   Dishman 1991; King et al. 1992; U.S.
broad context that shapes routine experiences
                                                   Department of Health and Human Services
that affect health-related behavior.
                                                   1996) into models of exercise to better specify
   In this study, we seek to expand our under-
                                                   predictive models for different periods in the
standing of physical activity patternsby con-
                                                   life course. In addition to being more con-
sidering exercise behavior within the broad        ducive to a more comprehensive theory of
context of social status, and examining how
                                                   health behavior, an ecological approach also
contextualfactors from prominentlife settings
                                                   has severalpracticalbenefits. Most notably,an
and more proximal individual resources and
                                                   ecological approachattenuatesthe possibility
processes help account for and uniquely con-       of quot;victim-blamingquot;(e.g., Becker 1986) by
tributeto differencesin exercise. Guidedby an
                                                   drawing attention to additional targets for
ecological perspective and previous research,      intervention beyond the individual. When
we theorize that the often-noted declines in       acted upon and changed, these socio-environ-
activity by age, and the frequentlycited differ-   mental factors frequently bring about more
ences in physical activity by gender,race, and     sustainable change in individual and popula-
                                                   tion health behavior(Green and Krueter1999;
socioeconomic status do not act independently
                                                   Stokols, Pelletier,and Fielding 1996).
of each other.Thus, in this study we systemat-
ically examine the independentand interactive
effects of age, gender,andmultipledimensions
                                                   Social Status and Physical Activity
of socioeconomic status on physical activity
patterns throughout adulthood. Consistent
                                                     Severalpersonalcharacteristics   representing
with previousscholars,we furthertheorizethat
                                                   individuals' relative location in status hierar-
social status partially allocates contextual
                                                   chies predict participationin regularphysical
resources, opportunities, and barriers at the
                                                   activity. Lower socioeconomic status, older
individual,family,work,and communitylevels
                                                   age, being female, and being black are consis-
that may influence physical activity patterns.
                                                   tently associatedwith less participationin reg-
Therefore,we examine the independenteffects        ular physical activity (for reviews see Blair
of individual-level, family- and work-related,     1988; Dishman 1991; King et al. 1992; U.S.
as well as community experiences on regular        Department of Health and Human Services
exercise, and we consider the extent to which      1996). Like previous scholars (Ross and Wu
the effects of social status operate through       1995; Stronegger,Freidl, and Rasky 1997), we
                                                   theorize that social location in status hierar-
shaping differences in these everyday experi-
                                                   chies is an importantconditioning factor for
ences.
204                                     JOURNALOF HEALTHAND SOCIALBEHAVIOR
the allocation of resources, opportunities,and    earnings on exercise habits will be more pro-
constraintsthat influence behaviors related to    nounced among men than women.
health, such as exercise.                            Time is a centralconcept in ecological mod-
   Socioeconomic status is consistentlyassoci-    els (Bronfenbrenner1995), and it draws our
ated with health behaviorsand health behavior     attentionto the enduringcontext of socioeco-
change: Lower socioeconomic status individu-      nomic status for the developmentand mainte-
als participatein fewer positive health behav-    nance of positive health behaviors such as
iors (e.g., exercise, maintaininghealthy body     exercise. The quot;cumulativeadvantagequot;hypoth-
weight) and change their negative health          esis (Ross and Wu 1996) directlyaddressesthe
behaviors (e.g., smoking) at a slower rate than   issue of time by positing that the longer an
higher socioeconomic status individuals           individual is exposed to a protective factor,
(Berkman and Breslow 1983; Blaxter 1990;          such socioeconomic advantage,the greaterthe
National Center for Health Statistics 1998;       health-related benefit. Scholars have found
Piani and Schoenborn 1993; Ross and Wu            some supportfor the cumulativehealth status
1995; Stroneggeret al. 1997; U.S. Department      benefits of education(e.g., House et al. 1990;
of Health and Human Services 1996).               House et al. 1994; Ross and Wu 1996), howev-
Evidence from different studies however sug-      er this question has not yet been considered
gests that differentindicatorsof socioeconom-     with respectto participation regularphysical
                                                                               in
ic status (e.g., education and earnings) may      activity.Assuming that socioeconomic advan-
have differentassociations with physical activ-   tage provides cumulative benefits for contin-
ity, and that these associations may differ by    ued participation regularexercise over time,
                                                                     in
gender (Cauley et al. 1991; Fordet al. 1991) or   we hypothesizethat a wider gap in the benefits
measure of physical activity (Cauley et al.       of educationand earningswill be more appar-
                                                  ent at older ages than younger ages.
1991).
   Three importantfeatures are demonstrated
by the previous studies that supportthe mean-
ingfulness of an ecological model in the study    Contextualand IndividualCorrelatesof
of physical activity. First, socioeconomic sta-   Physical Activity
tus is best conceptualized as being multidi-
mensional, and each independent dimension            Certainrecurring  patternsin everydaysocial
(e.g., education and income) has the ability to   life exert a disproportionate  amount of influ-
influence physical activity habits in different   ence on well-being (Stokols 1996) and, pre-
ways. For example, educationmight influence       sumably,on behaviors related to health. Most
health behaviors though a greater ability to      adults are nested within families, occupations,
receive and interpretinformationregardingthe      and communities; consequently, comprehen-
health benefits of regular exercise. Earnings,    sive models of physical activity need to con-
on the other hand, independent of education,      sider social and environmentalfactors from
                                                  each of these domains or settings
might promote physical activity throughaddi-
tional discretionaryincome that allows pursu-     (Bronfenbrenner 1979). Unfortunately,most
ing physically active hobbies during leisure      health behavior research does not give ade-
time. Next, this researchhighlights the impor-    quateattentionto notablecontextualor ecolog-
tance of recognizing the specific type of phys-   ical factorsthatmay supportor underminepar-
ical activity being studied (e.g., amount of      ticipationin regularphysical activity.However,
leisure time physical activity per week versus    researcherscan use middle-rangetheory and
kilocalories expended per day). Finally,multi-    empirical evidence from different fields (e.g.,
ple strands of evidence suggest that the link     family studies, occupational health, urban
between socioeconomic status and health is        planning) to identify high-powered leverage
gendered whereby education and earnings           points (i.e., factors that exert, or potentially
have consistent health effects among men but      exert, a disproportionate amount of influence;
not women (see Marmot et al. 1987;                see Stokols 1996) for influencing exercise.
McDonough et al. 1999). We hypothesize that          Thefamily microsystem.   The family is a pri-
a higher level of education and a higher level    mary life domain for most adults. Since indi-
of earnings will be independentlyassociated       viduals in specific family roles, such as spouse
with more regular physical activity. We also      or parent,are frequentlyfound to participatein
hypothesize that the effects of education and     fewer health-risk behaviors (Chilcoat and
205
     INEQUALITIES EXERCISE
               AND
SOCIAL

Breslau 1996; Horwitz and Raskin White            Cooper 1993; Frone, Russell, and Cooper
1991; Umberson 1987), the family is believed      1997), suggesting that incompatiblework and
to be an importantsource of social control of     family responsibilitiesmay underminepositive
behaviors related to health (Umberson 1987).      health behaviors such as exercise (Backett
Similarly, family life provides an important      1992; Backett and Davison 1995). However,
general context for health promotingbehavior      recent theory emphasizes the quality of fit
(Doherty and McCubbin 1985; Pratt 1976;           between work and family as opposed to expe-
Walsh 1993). Previous research, for example,      riences of strainsalone (Barnett1998). That is,
has demonstrated   that emotionally close fami-   both the benefits (Sieber 1974) and the strains
ly relationshipsand happy,stable, and satisfy-    (Goode 1960) of role accumulationneed to be
ing marriagespredictless healthrisk behaviors     consideredwhen examiningthe health impacts
among adults (Doherty and Harkaway 1990;          of the work-family interface. Based upon
Franks, Campbell, and Shields 1992; Pratt         recent work-family theory (Barnett 1999;
1976; Wickrama et al. 1997a). Following           Grzywacz and Marks 2000), we hypothesize
                                                  that more positive spilloverbetween work and
social controltheory,we hypothesizethatmar-
ried individualsand parentswill exercise more     family and less negative spillover between
frequentlythan single or childless individuals.   work and family will be associated with more
Consistent with family systems theory, we         regularphysical activity.
hypothesize that individualsin an emotionally        The researchcited here shares one common
                                                  limitation. Assuming that specific health
close family and an emotionally close mar-
                                                  behaviors are reflections of a common latent
riage will exercise more.
   The work microsystem.The workplace is a        quot;lifestylequot; construct,researcherstypically use
target for implementing health promotion          summed indices of health-related behavior
                                                  (e.g., non-smoking, non-problemalcohol use,
interventions(PublicHealth Service 1991), yet
                                                  and regular exercise) or substance use as the
we lack a body of clearly defined research
                                                  dependent variable. Consequently,it remains
explicitly examiningthe impact and the mech-
                                                  unclear what effect, if any, family, work, and
anisms through which the workplace influ-
                                                  work-familyspilloverwill have specifically on
ences behavior related to health (for recent
                                                  physical activity,since wellness enhancingand
review see Eakin 1997). Nonetheless, a variety
                                                  risk-taking behaviors (e.g., regular physical
of job characteristics,particularlyhigh deci-
                                                  activity versus substance use; Vickers,
sion latitude,have been found to predict fewer
                                                  Conway, and Hervig 1990) are qualitatively
health-risk behaviors (House et al. 1986;
                                                  different(for review, see Gochman 1997), and
Mensch and Kandel 1988; Weidneret al. 1997;
                                                  may not share the same contextual determi-
Wickramaet al. 1997b). Based upon occupa-
tional stress theory (House 1981; Karasekand      nants.
                                                     Community.A wide range of community
Theorell 1990) and previous research, we
                                                  characteristicsmay influence an individual's
hypothesize that having more decision latitude
                                                  ability to practice various behaviorsrelated to
on the job will be associatedwith more regular
                                                  health (Cheadle et al. 1999; Taylor, Repetti,
physical activity.We also hypothesizethat due
                                                  and Seeman 1997). Evidence from different
to time constraints,a greaternumberof hours
                                                  sources indicates that individuals who live in
worked per week will be associated with less
                                                  unsafe communitiesor neighborhoodsare less
exercise.
                                                  likely to engage in regular physical activity
   The work-family mesosystem. Ecological
                                                  (Centersfor Disease Control 1999; Eyler et al.
theory also contends that unique contributions
                                                  1998; Ross 1993; Sallis et al. 1997). Although
to the overall context of human development
                                                  some reportssuggest that neighborhoodsafety
are derived from interactionsbetween two or
                                                  serves as a physical barrierto regularactivity
more life settings (i.e., mesosystems;
                                                  throughfear of victimization (e.g., Centersfor
                  1979). Managingand integrat-
Bronfenbrenner
                                                  Disease Control 1999; Ross 1993), the mecha-
ing work and family is an increasinglysignifi-
                                                  nisms linking neighborhoodsafety to individ-
cant task for adults today (Bielby 1992;
                                                  ual physical activity have not been adequately
Heckhausen1997; Lachmanand Boone-James
                                                  tested or identified. We hypothesizethat living
 1997). Work-familystrainhas been foundto be
                                                  in neighborhoodscharacterizedas unsafe will
associatedwith more alcohol use among adults
                                                  be associatedwith less participationin regular
(Bromet, Dew, and Parkinson 1990; Frone,
Barnes, and Farrell 1994; Frone, Russell, and     physical activity.
JOURNALOF HEALTHAND SOCIALBEHAVIOR
206
ProximalIndividualResources and Processes          Physical Activity:An Ecological Perspective

                                                      The ecological model of physical activity
   An individual'sphysical and psychological
                                                   duringadulthoodthat guided this study is por-
characteristicsare perhaps the most proximal
                                                   trayed in Figure 1. Consistent with previous
determinantsof physical activity. In our con-
                                                   research, Figure 1 suggests that sociodemo-
ceptualization, we include these factors as
                                                   graphic characteristics, including multiple
potential proximal processes conditioned by
                                                   aspects of socioeconomic status, have direct
more macrosociological processes, working
                                                   effects on rates of participationin regular,vig-
throughthe opportunities,constraints,and rel-
                                                   orous exercise. Additionally, our model sug-
ative stressors that are allocated through the
                                                   gests that these sociodemographiccharacteris-
social hierarchiesindicated by socioeconomic
                                                   tics may also have indirecteffects on physical
status, age, gender, and race (see Williams
                                                   exercise by influencing the characteristicsof
1990).                                             individuals' daily contexts (family, work, and
   Physiologically, progressive reductions in
                                                   community)andthe interactions      betweenthese
maximal oxygen uptake(V02 max), cardiovas-
                                                   contexts (work-family interface). We also
cular function, and declining muscle mass
                                                   expect thatthe qualityof these life settingswill
through adulthood are believed to interfere        shape more proximalindividualresources and
with individuals'abilities to participatein reg-
                                                   processes-including functionaland breathing
ular or prolonged bouts of physical activity.      limitations to physical activity, body mass
However,studies clearly indicate that many of      index, environmentalmastery,exercise effica-
the physiological declines associated with
                                                   cy (i.e., belief that exercise is a good way to
aging are the result of, not the cause of,         promotehealth) and control over health-that,
reduced physical activity (see Goldberg,           in turn,influence rates of participation exer-
                                                                                            in
Dengel, and Hagberg 1996). This evidence           cise.
suggests that the unfolding of social and psy-
chological dynamics throughout adulthood
cause reductions in physical activity (Backett     METHOD
and Davison 1995) that become progressively
                                                   Data
reinforcedby subsequentreductionsin physio-
logical function. We hypothesize that a higher
                                                      The data used for this study are from the
body-mass index, more functional restrictions
                                                   National Survey of Midlife Development in
related to activity, and reduced lung capacity
                                                   the United States, collected in 1995 by the
will be associated with less regular vigorous
                                                   John D. and Catherine T. MacArthur
exercise.
                                                   FoundationResearch Network on Successful
   Psychological theories and models that
                                                   Midlife Development (N = 3,032; 1,471 men
place primary attention on individual-level
                                                   and 1,561 women). The originalpurposeof the
beliefs, attitudes, and values (Glanz, Lewis,
                                                   National Survey of Midlife Development was
and Rimer 1997) typically guide health behav-
                                                   to examine patterns, predictors, and conse-
ior research.Individualprocesses such as more
                                                   quences of midlife developmentin the areasof
self-efficacy (Dzewaltowski 1994; Rosen-
                                                   physical health, psychological well-being, and
stock, Strecher,and Becker 1988), a belief that    social responsibility.Respondentsare a nation-
exercise is an efficient way to promotehealth,
                                                                      sample of non-institutional-
                                                   ally representative
and a greater sense of control over health
                                                   ized persons aged 25-74 who have telephones.
(Strickland 1978) have all been theorized and      The samplewas obtainedthroughrandomdigit
subsequentlyfound to influence physical activ-     dialing, with an oversamplingof older respon-
ity among adults (King et al. 1992; U.S.           dents and men made to guaranteea good dis-
Department of Health and Human Services            tributionon the cross-classificationof age and
1996). We drawupon existing value-expectan-        gender.Samplingweights correctingfor selec-
cy theoriesto hypothesizethata higher level of     tion probabilitiesand non-responseallow this
self-efficacy, a greaterbelief in the healthben-   sample to match the composition of the U.S.
efits of exercise, and more perceived control      populationon age, sex, race, and education.
over health will be associated with more fre-         Respondents first participated in a tele-
quent participationin regularphysical activity.    phone interviewlasting approximately min-
                                                                                          40
207
     INEQUALITIES EXERCISE
               AND
SOCIAL
FIGURE 1. An Ecological Model for Regular Vigorous Physical Activity during Adulthood




utes. The response rate for the telephone ques- seasonal effects (Marmot et al. 1991).
tionnaire was 70 percent. Respondentsto the Specifically, respondents were asked: (1)
telephone survey were then asked to complete quot;Duringthe summer,how often do you engage
two self-administered mailback question- in vigorousphysical activity(for example,run-
naires. The response rate for the mailback ning or lifting heavy objects) long enough to
questionnaire was 86.8 percent of telephone work up a sweat?quot;and (2) quot;Duringthe winter,
respondents.This yielded an overall response how often do you engage in vigorous physical
rate of 60.8 percentfor both partsof the survey activity long enough to work up a sweat?quot;
(for a detailed technical reportregardingfield Response categories included several times a
procedures,response rates, and weighting, see week or more (6), about once a week (5), sev-
http://midmac.med.harvard.edu/research.htmleral times a month (4), aboutonce a month (3),
                                                less than once a month (2), or never (1). The
#tchrpt).
                                                two items were highly correlated (r = .89);
                                                consequently, we used the mean of the two
                                                items to assess regular,vigorous exercise. (See
Measures:Dependent Variable
                                                Table 1 for descriptivestatistics for all analyt-
              even a small amountof exercise is ic variables.)
   Although
better than being sedentary (e.g., Kunst et al.
1999; Dunn et al. 1999; U. S. Departmentof
Health and Human Services 1996), evidence Measures: IndependentVariables
indicatesthatregularexercise in 60-90 percent
                                                   Social status. Age was included as a contin-
of an individual'stargetheartrate is most ben-
eficial to overall health (American College of uous variable in these analyses. Gender (1 =
Sports Medicine 1990). Therefore, we con- female) and race/ethnicity (1 = black) were
structeda continuousoutcome measureof reg- included as dichotomousmeasures. Education
ular vigorous exercise using two previously representsthe numberof years of formal edu-
validated measures (Blair 1984; Kohl et al. cation completed and is coded as an ordinal
 1988; Washburn al. 1990) adaptedto include variable as follows: 1 = 1-6 years, 2 = 7-8
                  et
JOURNAL OF HEALTH AND SOCIAL BEHAVIOR
208

TABLE 1. Descriptive statistics for all analysis variables
                                                                               SD
                                                          M                                             Range
Dependent Variable
                                                                                1.75
                                                          4.04                                               1-6
  Regular,Vigorous Exercise
Social Status Characteristics
                                                         45.30                 13.48                      25-74
  Age
  Gender(female = 1)                                    56.6%
  Race/Ethnicity(black = 1)                             11.2%
                                                                               2.41
                                                          6.20                                              1-12
  EducationalAttainment
  Household Earnings                                                                                   0-300,000
                                                                             36,172
                                                        39,254
Family & WorkMicrosystems
  ParentalStatus(Child < 18 = 1)                        41.1%
  MaritalStatus (not married- 1)                        31.9%
                                                        37.3%
  High Spouse Emotional Support
                                                        30.4%
  Low Spouse Emotional Support
                                                                                 .63
                                                          3.41                                               1-4
  FamilyEmotional Support
  CurrentlyWorkingFor Pay (Yes = 1)                     73.8%
                                                         43.52                 15.53                       1-168
  HoursWorkedper Weeka
                                                                                 .87                         1-5
                                                          3.62
  Decision Latitudeat Worka
Spillover between Work Familya
                       &
                                                                                 .74                         1-5
                                                          2.62
  Negative Workto Family
                                                                                 .84                         1-5
                                                          2.62
  Positive Workto Family
                                                          2.11                   .68                         1-5
  Negative Familyto Work
                                                                                                             1-5
                                                                                 .84
                                                          3.41
  Positive Familyto Work
            Environment
Community
                                                           3.36                  .56                         1-4
  NeighborhoodSafety
IndividualProximalProcesses/Resources
                                                                                                   9.44-64.02
                                                                                5.65
                                                         26.80
  Body Mass Index
                                                                                                          1-4
                                                                                 .77
  FunctionalRestrictionsfrom Exercise                     1.44
                                                                                                          0-3
                                                                                 .57
                                                           .18
  Shortnessof Breathwhen Active
                                                                                                         3-21
                                                                                3.42
                                                         15.87
  Environmental  Mastery
                                                                                                          1-6
                                                                                 .77
  PerceivedControlover Health                             5.36
                                                                                                          0-4
  Efficacy of Exercise                                    3.68                   .85
Source: National Surveyof Midlife Developmentin the UnitedStates 1995.
Notes: Estimatesare based on weighted data.
aEstimateobtainedfrom only respondentswho were working for pay when they completed the questionaire.


years, 3 = 9-12 years but no diploma or GED,            categories to facilitate inclusion of all respon-
4 = GED, 5 = graduated from high school, 6 =            dents:(1) Individualswho were unmarried,      (2)
1-2 years of college but no degree yet, 7 = 3 or        married individuals with a mean response of
more years of college but no degree yet, 8 =            less than4 (i.e., low emotionalsupport;used as
graduatedfrom a two-yearcollege or vocation-            the contrastcategory),and (3) marriedindivid-
al school, or associate's degree, 9 = graduated         uals with a mean response of 4 (i.e., high emo-
from a four- or five-year college, or bachelor's        tional support;note: 56.4% of marriedrespon-
degree, 10 = some graduate school, 11 = mas-            dents had a mean of 4 for spouse emotional
ter's degree, and 12 = doctoralor otherprofes-          support;consequently,we chose this value for
sional degree. Household earningswere coded             maximal variability in the measure). Family
continuouslyin thousandsof dollars.                     emotional supportmeasuredthe level of emo-
   Family Characteristics. Spouse emotional             tional supportprovidedto the respondentfrom
support measured the level of emotional sup-            his or her other family memberswith a paral-
                                                        lel 4-item index (a = .83) that was included in
port providedto the respondentfrom his other
spouse using the mean of a 6-item index (a =            the model as a continuous measure. Parental
                                                        status (i.e., has a child under 18 years old = 1)
.85) adapted from Schuster, Kessler, and
Aseltine (1990) (e.g., quot;How much does your              was also included in our model.
spouse or partner really care about you?quot;                  Work   characteristics.Decision latitude was
quot;Howmuch can you rely on him or her for help            assessed by summing responses to five items
if you have a serious problem?quot;). Response              measuringthe amountof controlthe individual
categories for the index items were not at all          has over his or her work environment and
(1), a little (2), some (3), and a lot (4). Spouse      tasks, and the specialization of labor (e.g.,
emotional supportwas then divided into three            quot;How often do you have a choice in deciding
209
                  AND EXERCISE
SOCIAL INEQUALITIES

 how you do your tasks at work? How often do       egories were not at all (1), some (2), a little (3),
 you have a choice in deciding what tasks you      and a lot (4). Reduced VO2 max was opera-
 do at workquot;;a = .87). We also includeda mea-      tionalized using three items adaptedfrom the
 sure of the number of hours the respondent        Rose Questionnaire for angina (Rose et al.
 reportedworking(i.e., sum of responsesto two      1982) assessing if respondents get short of
 questions regardinghours worked last week in      breath (yes/no) while (1) quot;walkingwith other
 primaryand additionaljobs).                       people your age on level ground;quot; quot;walking
                                                                                       (2)
                                                   at your own pace on level ground;quot;and (3)
    Work-familyspillover. Negative spillover
                                                   quot;washing or dressingquot; (a = .74). Body mass
from worktofamily measuredthe respondent's
 perception of the extent to which work inter-     index was computed using the Quetlet Index
 fered with functioningat home by calculating      (i.e., weight/height2).
 the mean response to four items (e.g., quot;How          Control over health was measured using
 often does stress at work make you irritableat    three items adaptedfrom the WhitehallSurvey
 home?quot;; a = .84). Conversely, positive            (Marmot et al. 1991), including 1) quot;Keeping
 spillover from work to family assessed the        healthy depends on things that I can do;quot; (2)
 extent to which the respondent felt that their    quot;Thereare certainthings I can do for myself to
 work promoted better functioning at home          reducethe risk of heartattack;quot; (3) quot;There
                                                                                    and
 (e.g., quot;How often do the things you do at work    are certainthings I can do for myself to reduce
 help you deal with personal and practical         the risk of getting cancer.quot; Response categories
 issues at home?quot;;a = .74). Negative spillover     for the control over health items ranged from
from family to work assessed the extent to         strongly disagree (1) to strongly agree (6) (a
 which the respondentfelt their family life was    =.71).
 interferingwith their success on the job (e.g.,      Environmentalmastery is a component of
 quot;How often does stress at home make you irri-     psychological well-being that assesses an indi-
 table at work?quot;; a = .81). Finally, positive      vidual's sense of mastery and competence in
spillover from family to work measured the         managing the surroundingenvironment(Ryff
 extent to which respondents felt their family     1989). Environmentalmastery was measured
 life helped them perform better on the job        with three items: (1) quot;In general, I feel I am in
 (e.g., quot;How often does talkingwith someone at     charge of the situation in which I live;quot; (2)
 home help you deal with problems at work?quot;;       quot;The demands of everyday life often get me
 a = .73). Response categories ranged from         down;quot;and (3) quot;I am quite good at managing
 never (1) to all the time (5). The work-family    the many responsibilities of my daily life.quot;
                                                   Response categories for the environmental
 spillover items were developed for the
National Survey of Midlife Development in          mastery items ranged from strongly disagree
                                                   (1) to strongly agree (7) (a = .52). Although
 the United States.
                                                   the estimated reliability of the environmental
    Community. Perceived community safety
                                                   mastery scale used in the National Survey of
 was measuredwith the mean response to four
                                                   Midlife Development in the United States is
 items developed for the National Survey of
                                                   modest, previous research has indicated that
 Midlife Development in the United States: (1)
                                                   the three-item measure is strongly correlated
 quot;I feel safe being out alone in my neighbor-
                                                   with its highly reliable parent measure (Ryff
 hood during the daytime;quot; (2) quot;I feel safe
 being out alone in my neighborhoodat night;quot;      and Keyes 1995).
                                                      Exercise efficacy assessed the extent to
 (3) quot;I could call on a neighbor for help if I
                                                   which respondents believe that exercise is a
 needed it;quot; and (4) quot;People in my neighbor-
                                                   beneficial and preferred way of promoting
                          Response categoriesfor
 hood trusteach other.quot;
                                                   health. Respondentswere asked to respond to
 the communitysafety items rangedfrom not at
 all (1) to a lot (4) (a = .65).                   a hypothetical scenario during the telephone
                                                   interview quot;Assume for a moment that your
    Physiological and psychological resources
                                                   doctor said you had a heart condition and said
 andprocesses. Functional restrictionsto phys-
                                                   you could choose either to have coronary
 ical activity was assessed with a 4-item scale
                                                   bypass surgeryor exercise at least three times
 revised from the Medical Outcomes Study
                                                   a week for at least half an hour each time.
 (Brazier et al. 1992) asking how much the
                                                   Which one do you think you would choose?quot;
 respondent's health limited walking several
                                                   Respondentswere then asked, quot;How sure are
 blocks, walking one block, vigorous activity,
                                                   you that this is what you would choose?quot; very
 and moderateactivity (a = .92). Response cat-
210                                        JOURNAL OF HEALTH AND SOCIAL BEHAVIOR

                                                      pay when they completedthe telephone survey
(1), somewhat (2), or not very sure (3). Being
                                                      and self-administered questionnaires;conse-
very sure about choosing exercise was coded 3,
                                                      quently, some individuals were legitimately
being somewhat sure about exercise was coded
2, being not very sure about exercise was                          on   quot;decision                 hours
                                                                                    latitude,quot;
                                                      quot;missingquot;
                                                      worked/week, and each of the work-family
coded 1, and choosing bypass surgery was
                                                      spillover measures. Rather than limiting the
coded 0.
                                                      sample to employedadults only, we includeda
                                                      quot;missing flagquot; indicator variable for each
                                                                    measurein the model to generate
                                                      work-related
Analytic Sequence
                                                      more reliable population parameterestimates
                                                      (Orme and Reis 1991).
   To assess our first hypotheses regarding the
                                                         Unweighted results are reported since fac-
independent effects of various social status
                                                      tors used in over-samplingwere controlled in
factors, we began by regressing our physical
                                                      all analyses and the overallpatternof findings
activity outcome on age, gender, race, educa-
                                                      were similar for both weighted and unweight-
tion, and earnings. Then, to consider how age
                                                      ed analyses (Winshipand Radbill 1994).
and gender might condition the effect of edu-
cation and earnings we added interaction terms
for gender X education, gender X earnings,
                                                      RESULTS
age X education, age X earnings, age X gender
X education, and age X gender X earnings
                                                      Social Status and VigorousPhysical Activity
interaction terms to the model (to avoid
collinearity problems, we used age, education,
                                                         Table 2 reports the results of five models
and earnings centered on the mean in the
                                                      estimatingthe impact of social status, contex-
analyses and in the construction of the interac-
                                                      tual characteristics,and personal characteris-
tion terms; Cronbach 1987). Unfortunately, the
                                                      tics on regular,vigorous exercise. Consistent
black sample was not large enough to allow for
                                                      with previous reports (e.g., U. S. Department
a consideration of higher order race interac-
                                                      of Health and Human Services 1996), the first
tions. Change in R2 was used to assess if the
                                                      model in Table 2 indicates that younger indi-
addition of the interaction terms significantly
                                                      viduals, men, non-blacks, those with more
contributed to the explanatory model (Jaccard,
                                                      education, and those with higher household
Turrisi, and Wan 1990). We then proceeded to
                                                      earnings participatein more regular physical
add blocks of contextual experiences and indi-
                                                      activity.However,Model 2 furtherreveals that
vidual-level characteristics to the social status
                                                      the effects of earningson physical activity dif-
model and evaluated the corresponding
                                                      fer by genderandthatthe educationeffects dif-
changes in the association between social sta-
                                                      fer by age and gender. Figure 2 plots the sig-
tus and physical activity.
                                                      nificant gender X earnings interaction and
   Not all of the respondents were working for


TABLE 2. OLS Estimates of the Association between Social Status, Contextual Experiences,
         Individual Resources and Processes, and Regular Vigorous Exercise
                                          Model 1       Model 2     Model 3      Model 4     Model 5
                                          -.033***      -.029***    -.025***    -.029***     -.023***
Agea
                                                        (.003)
                                           (.002)                    (.004)      (.004)       (.004)
Gender(female = 1)                        -.741***      -.758***    -.708***    -.688***     -.628***
                                          (.063)        (.063)       (.065)      (.065)       (.062)
Race/ethnicity(black = 1)                 -.356**       -.336**     -.353**     -.285        -.162
                                           (.133)        (.133)      (.132)      (.132)       (.126)
Educationa                                  .057***       .022        .022        .022       -.006
                                           (.013)        (.018)      (.018)      (.018)       (.017)
Household Earnings(thousands)a              .003**        .001        .0002       .0002      -.0003
                                           (.001)        (.001)      (.001)      (.001)       (.001)
GenderX Agea                                            -.007       -.009+      -.007        -.005
                                                         (.005)      (.005)      (.005)       (.005)
GenderX Educationa                                                                               .034
                                                          .065        .053*       .046+
                                                         (.027)      (.027)      (.027)      (.025)
GenderX Earningsa                                         .003+       .004*       .004*       .003+
                                                         (.002)      (.002)      (.002)      (.002)
211
                 AND EXERCISE
SOCIALINEQUALITIES

TABLE 2. (Continued)
                                                Model 1       Model 2       Model 3        Model 4      Model 5
Agea X Educationa                                             .003**                        .003*
                                                                              .003**                      .003*
                                                              (.001)         (.001)        (.001)        (.001)
GenderX Agea X Educationa                                     -.005*        -.005*        -.005         -.004*
                                                              (.002)         (.002)        (.002)        (.002)
Family & Work Microsystems
  ParentalStatus (Child < 18 = 1)                                            .074          .051           .040
                                                                             .077          .077           .073
                                                                                           .187*
  Not CurrentlyMarriedb                                                      .189*                        .215**
                                                                            (.084)        (.083)         (.080)
  High Spouse EmotionalSupportb                                              .185*         .118           .089
                                                                            (.079)        (.081)         (.078)
  FamilyEmotional Support                                                    .120*         .024         -.036
                                                                            (.052)        (.053)         (.051)
  Decision Latitudeat Workc                                                  .105**        .041           .040
                                                                            (.038)        (.043)         (.041)
  HoursWorked/Week                                                           .004+         .006*          .006*
                                                                            (.002)        (.003)         (.002)
           Mesosystemc& CommunityEnvironment
Work-Family
 Negative SpilloverWorkto Family                                                          -.160**       -.062
                                                                                           (.061)        (.059)
  Positive SpilloverWorkto Family                                                           .144**        .131**
                                                                                           (.049)        (.046)
  Negative Spillover Familyto Work                                                          .046          .093
                                                                                                         (.065)
                                                                                           (.068)
  Positive SpilloverFamilyto Work                                                           .055          .032
                                                                                           (.047)        (.045)
                                                                                            .351***       .268***
  NeighborhoodSafety
                                                                                                         (.059)
                                                                                           (.061)
IndividualProximalProcesses
  FunctionalRestrictions                                                                                -.570***
                                                                                                         (.049)
  Shortnessof Breath                                                                                    -.177**
                                                                                                         (.062)
  Body Mass Index                                                                                       -.013*
                                                                                                        (.006)
                                                                                                         .019*
  Environmental
              Mastery
                                                                                                        (.010)
  PerceivedControlover Health                                                                            .071+
                                                                                                        (.042)
                                                                                                         .099**
  Exercise Efficacy
                                                                                                        (.036)
                                                                                          2.48***       2.79***
                                                              4.52          3.40***
Constant                                        4.50***
                                                                                                         .447
                                                               .045                        .351
                                                 .045                        .247
                                                                                                         .253
                                                                                           .172
                                                               .143          .153
AdjustedR2                                       .138
                                                                                           .022***       .082***
                                                               .007***       .012***
                                                  n/a
AR2
+p <.10; * p <.05; **p < .01; ***p <.001 (two-tailed)
Source: National Surveyof MidlifeDevelopmentin the United States, 1995.
Note: Numbers in parenthesesare standarderrors.Estimatesare based on unweighteddata.
          have been centeredon the mean to avoid collinearityproblems.
aVariables
bIncontrastto marriedindividualswith low emotional support.
                                                                                               variableswere also
           only relevantto employed individuals.Missing indicatorflag variablesfor work-related
CEstimates
included in models 3-5.


                                                           activity across adulthood are the direction of
indicatesthat a higher level of household earn-
                                                           the association in early adulthoodand the rate
ings is associated with more vigorous exercise
                                                           of decline with age. In contrastto the frequent-
among women but not men.
                                                           ly reportedpositive association between more
  To interpretthe significant three-way gen-
                                                           physical activity and higher education, these
der X age X education interactioneffect, we
                                                           results indicate that men with the lowest level
plotted the predicted mean levels of regular
                                                           of educationhave the highest level of regular,
exercise by age, education, and gender (see
                                                           vigorous exercise during young adulthood,
Figure 3). The most salient education differ-
                                                           while the most educated men exercise least
ences between men and women in physical
212                                      JOURNALOF HEALTHAND SOCIALBEHAVIOR

                                    Earningsand Gender
FIGURE2. Vigorous
                Exerciseby Household

      4.8 -
      4.6 -
 .)
      4.4 -
      4.2 -
 0      4-                                                                                  Men
                                                                                        -I0
 o
                                                                                        _-U-W omen
      3.8 -
 o
 ._
 >
                      w
      3.6 -
      3.4 -
      3.2
        3                         I                        I                        I

              -1 S.D. Household                                +1 S.D. Household
                                      Mean Household
                   Earnings              Earnings                   Earnings


during the younger years. However, the age-        earnings does not accumulate with age (con-
related decline in vigorous exercise is steepest   traryto our cumulativeadvantagehypothesis).
among the least educatedmen and most grad-         It is also noteworthythat blacks reportedsig-
ual for the best educated. This leads to age-      nificantly less vigorous physical exercise than
related trajectoriesin physical activity among     non-blacks,even controlling for major dimen-
men that converge in midlife (i.e., 50-55) and     sions of socioeconomic status.
then proceed to provide an advantagein phys-
ical activity during later adulthood to those
with the highest education.By contrast,among       ContextualCharacteristicsand Regular
women, having a high level of education is         Physical Activity
associated with more vigorous exercise in
                                                      Results reported in Table 2, Model 3 also
young adulthood,but this benefit is attenuated
                                                   indicate contextualfactors from multiple con-
in later adulthood. Counter to the cumulative
                                                   texts, and multiplelevels are notablecorrelates
advantagehypothesis, the slope of age-related
decline in exercise among women is the least       of regularphysical activity.In contrastto indi-
                                                   viduals in marriages characterizedby a low
steep for those with the lowest level of educa-
tion and greatest among those with the highest     level of spouse emotional support,single indi-
level of education.The age X earnings,and the      viduals and individuals with a high level of
gender X age X earningsinteractionterms did        spouse emotional supportparticipatein more
not contribute to the model in preliminary         vigorous exercise. Also consistent with our
analyses, so they are not included in Model 2.     family systems-basedhypothesis, we find that
   Collectively this evidence provides mixed       a higher level of family emotional supportwas
support for our social status hypotheses.          also independentlyassociated with more regu-
Consistent with the cumulative advantage           lar exercise. Paralleling other reports using
hypothesis and our hypothesisanticipatingthat      health behaviorscales as outcomes, our results
socioeconomic advantage would be most              also indicatethat a higher level of decision lat-
applicableto men, we find that advancededu-        itude among currently employed respondents
cation contributesto a slower decline in physi-    was associated with more regular, vigorous
cal activity among men than women. However,        exercise. Contrary our hypothesis,trendevi-
                                                                       to
contraryto the cumulativeadvantagehypothe-         dence indicate that working more hours was
sis, women with a college education have a         associated with more regular exercise.
steeper decline than women with less educa-        Collectively,these results supportthe ecologi-
tion. Additionally,a higher level of household     cal perspective suggesting that factors from
earnings appearsto promote regular,vigorous        multiple contexts of daily life influence behav-
exercise among women only (contraryto our          ior and development.
gender hypothesis), and the benefit of higher         Higher ordercontextualfactors, such as the
213
                 AND EXERCISE
SOCIALINEQUALITIES

                          Exerciseby GenderandAge
FIGURE3. Education Vigorous
                  in

       Men



            6.00 -

            5.50 -
    e 5.00 -
                      >1fifo


    C 4.50 -
    o
    o 4.00 -

      >3.50 -
            3.00                   I                                                                              I            I            I        I        I
                                                I            I            I            I             I


                                                                                                                                                         75
                     25                30           35           40                                                   60                        70
                                                                              45            50           55                        65
                                                                                           Age


       Women

                                                                                                                                        -   -< High School
       5.50 -
                                                                                                                                                  School
                                                                                                                                        --High
     ) 5.00 -                                                                                                                                     3 Yrs College
                                                                                                                                                iquot; College Grad
       4.50 -
     4.00
    O 4.00 -

    > 3.50 -

       3.00                    I            I                         I            I             I            I                             I        I        I
                                                         I                                                                 I




                     25                30           35           40           45           50            55           60           65           70       75
                                                                                           Age


Source: National Survey of Midlife Development in the United States, 1995




quality of fit between work and family and the                                              family interface completely explained the
community environment, are also important                                                   association between family and spouse emo-
correlates of physical activity among adults.                                               tional supportand physical activity.That is, a
Table2, Model 4 indicatesthata lower level of                                               higher level of family and spouse emotional
negative spillover from work to family and a                                                support is associated with more positive and
higher level of positive spillover from work to                                             less negative spillover from work to family,
family is associated with more regular exer-                                                which in turn is associated with more healthy
                                                                                            activity habits. Moreover,once the quality of
cise. Additional analyses (not shown) further
                                                                                            the work-family fit was controlled in the
indicated that these dimensions of the work-
214                                      JOURNALOF HEALTHAND SOCIALBEHAVIOR

model, we find that working more, ratherthan      family appearsto be indirectlyassociatedwith
fewer, hours per week was associated with         lower physical activity throughits association
more regularexercise. Finally, consistent with    with a lower level of environmental mastery.
our hypothesis, analyses indicatedthat respon-
dents who perceived their neighborhoods as
more safe participatedin more regular,vigor-      DISCUSSION, SUMMARY,
                                                  AND CONCLUSIONS
ous exercise than individualsin less safe com-
munities. Moreover,neighborhoodsafety part-
                                                     The overall goal of this study was to use
ly explains the race/ethnicity effect; that is,
blacks are less likely than non-blacksto report   ecological theory to systematically examine
                                                  the complex associations between multiple
living in a safe neighborhood,and,in turn,par-
                                                  social status characteristicsand participation
ticipate in less regularphysical activity.
                                                  in regular,vigorous exercise. We also wanted
                                                  to explore the degree to which everyday con-
ProximalResources & Processes and Regular         textual factors in family, work, and communi-
                                                  ty, as well as more proximal individual
Physical Activity
                                                  resourcesandprocesses might help accountfor
   Building from ecological theory,we expect-     and also uniquely contributeto differences in
ed that important individual resources and        exercise behaviorduringadulthood.
processes would be independentlyassociated           Results from this study replicateand extend
with physical activity and might also partially   previous research in several importantways.
account for the associations between social       First,with regardto socioeconomic status, our
status and contextualexperiences and exercise     descriptivefindings replicateothers indicating
behavior (see Table 2, Model 5). Consistent       that higher levels of earnings and education
with a largebody of previousresearch,we find      were both independentlyassociated with more
that physiological declines, including            exercise among some populationsubgroupsof
increased body mass index, physical activity      adults. Consistent with some conceptualiza-
limitations due to functional impairment,and      tions of social inequality,these results suggest
shortness of breath associated with physical      thathealthpractitioners  need to recognizemul-
activity are associated with less participation         dimensions of socioeconomic position
                                                  tiple
in regular exercise. Similarly, consistent with   when formulatingand implementingstrategies
our hypotheses guided by value-expectancy         to eliminate health inequalities. If socioeco-
theories of health behavior, we find that         nomic status is viewed in terms of education
greater environmental mastery (a proxy for        alone, interventions targeting income-related
self-efficacy), more perceived control over       determinantsof physical activity will remain
health (trend), and a higher level of exercise    unrecognizedor under-prioritized.
efficacy were associated with more regular           Equally important however are our new
                                                  results indicating that age and gender condi-
physical activity.
   The persistent race/ethnicity effect evi-      tion associations between educationand regu-
denced in all previous models is completely       lar exercise. This patternof results is notewor-
explained in the full biopsychosocial model of    thy for several reasons. First, since the slope
exercise (i.e., Table 2, Model 5). African        between educationand the rate of participation
Americansreportedhigherlevels of body mass        in vigorous exercise is different depending
index, more functional limitations related to     upon age and gender (Krieger et al. 1997),
activity, and greater shortness of breath than    these results raise caution regardingthe unex-
whites, and this accounted for the remaining      amined inclusion of educationmerely as a lin-
exercise differences between blacks and non-      ear covariate in studies of physical activity.
blacks. Likewise, educational differences in      These resultsalso suggest thattargetsfor phys-
physical activity among women were com-           ical activity interventionsmay need to change
pletely explained by these individual-level       dependingupon the age, gender,and education
resources.Womenwith a bettereducationwere         of the target population. For example, inter-
in better physical condition, and had a higher    ventions targetingpoorly educatedyoung men
level of each of the psychological resources      may need to focus on maintaining physical
conducive to healthy exercise habits. Finally,a   activity habits, while interventions targeting
higher level of negative spillover from work to   poorly educated young women may need to
215
SOCIAL
     INEQUALITIES EXERCISE
               AND

                                                     thatprovidethe flexibility,opportunity, the
focus on initiating exercise habits. Finally,                                                  and
                                                     expectation of regular physical activity (e.g.,
these results again remindscholarsthat survey
questions about physical activity may tap dif-       golf outings with clients, on-site fitness facili-
ferent meanings for different groups of indi-        ties, company sponsoredgym memberships).
viduals. That is, it is possible that the counter-      The contextual effects found in this study
intuitiveeducation-exerciseassociationamong          extend previous health behavior research.
young men is capturing occupation-based              First,in contrastto several studies using health
                                                     behavior indices, this study found that differ-
physical activity that may yield less notable
health gains than regular aerobic-forms of           ent aspects of work and family were specifi-
exercise, which may have more health bene-           cally associatedwith physical activity.Perhaps
fits.                                                even more importantly,however, this study
   We also think that the explanatorypower of        demonstrated   how overlookedaspects of work
the social status model is worthy of attention.      and family may influence different health-
Although our final model only accounted for          relatedbehaviors.For example, the work-fam-
25 percentof the variancein vigorous exercise,       ily literaturehas been dominated by studies
social status factors provided most of the           exploring the effects of work-family conflict
explanatorypower (i.e., 14 percent). Consis-         (Barnett 1998), and this research frequently
tent with an ecological perspective, this            finds that work-family conflict is associated
evidence suggests that models that integrate         with behaviors and conditions (e.g., alcohol
theory and concepts from across disciplines          abuse and depression; Frone, Russell and
                                                     Cooper 1997) that undermineregularexercise
(e.g., social status and behavioral intention)
will generate more comprehensive explana-            (King et al. 1992). However, the evidence
tions for behaviorand may facilitatemore suc-        reportedin this study indicate that more posi-
cessful interventionsto change behavior.             tive spilloverfromworkto family (a dimension
                                                     not typically considered) has the most robust
   It is also interestingto note that contextual
                                                     association with greater frequency of regular
experiences and physiological resources
explained education-level differences in exer-       physical activity.
                                                        The pattern of findings surrounding
cise among youngerwomen. These resultspar-
                                                     race/ethnicityin these models is also an impor-
tially supportthe hypothesis that social status
                                                                                                  The
conditions the resources and experiences that        tant contributionto the exercise literature.
                                                     fact that blacks were consistently found to
facilitate participationin positive health-relat-
                                                     exercise less than non-blacks, independentof
ed behaviors (e.g., Ross and Wu 1995). This
                                                     education and earnings, suggests that race is
everyday interactional perspective of the
                                                     not an adequateproxy for socioeconomic sta-
socioeconomic statusand healthbehaviorrela-
                                                     tus, and thatotherfactorspertainingto race are
tion is markedly different from assumptions
                                                     contributingto differences in physical activity
regarding the absence of important health
                                                     patterns. Consistent with a recent biopsy-
related benefits of exercise (e.g., the Health
                                                     chosocial model of racism as a stressor(Clark
Behavior Model) that may accompanyhigher
                                                     et al. 1999), our results suggest that contextual
levels of education. Although the pattern of
                                                     factors from the social environment such as
results for education among men supportsthe
                                                     neighborhoodsafety may directlyand indirect-
cumulative advantage hypothesis and theory
                                                     ly undermineexercise habits. Inadequatestreet
suggesting that the health effects of socioeco-
                                                     lighting at a modest level or witnessing violent
nomic status are gendered (Marmot et al.
                                                     crime in your neighborhood at an extreme
 1987; McDonough et al. 1999), none of the
                                                     level are direct physical barriers to outdoor
contextual experiences or individual-level
                                                     regular,vigorous activity, while the threat of
resources could explain men's educationaltra-
                                                     victimization (e.g., Ross 1993) and compro-
jectories across adulthood.Perhapsthe persis-
                                                     mised feelings of masteryor controlare impor-
tent educationeffect among men can be attrib-
                                                     tantpsychological barriers.These physical and
uted to the confounded nature of physical
                                                     psychological barriersto physical activity may
activity in men's occupations(see Eakin 1997).
                                                     set into motion reductionsin physical activity
That is, men who have a low education may
                                                     habitswhich become furtherreinforcedby cor-
find themselves in working-class jobs that
                                                     responding reductions in physiological func-
become less physically demanding as they
                                                     tioning and ultimately undermine health.
spend more time on the job, while men with
                                                     Althoughthese linkages are supportedtheoret-
more education may work their way into jobs
216                                      JOURNALOF HEALTHAND SOCIALBEHAVIOR

ically (Clark et al. 1999), we could not evalu-    study may be due to common methodvariance
ate these causal pathways with the current         or endogeneity.Additionally,a more stringent
cross-sectional data.                              operationalizationof ecological theory would
   We also feel the persistence of the robust      require measures from additional levels and
age effect on exercise should not go unno-         sources (e.g., self-report of decision latitude
ticed. Overall, in these data about 32 percent     supplementedby a rating of decision latitude
of respondents aged 25-35 indicated they           for a respondent's occupational category).
participated in vigorous exercise several          Moreover,a comprehensiveecological model,
times a week or more, while 28 percent of          informed by other middle range theories,
those 45-54, and 18 percent of those aged          might furtherinclude a myriadof other possi-
65-74 did. After adjusting for so many con-        ble interactions.
textual and individual factors, including             Nonetheless, our results supportthe value of
declines in physiological capacity, we might
                                                   employing an ecological perspective when
have expected this effect to diminish more
                                                   attemptingto understandhealth behavior.We
substantially.                                     find that, indeed, different aspects of social
   In an attemptto furtherunpack the persis-       status were independently associated with
tent age effect in these analyses,we rana series
                                                   exercise, and that the influence of some status
of post-hoc analyses including two- and three-     factors variedby gender and age. We also find
way interactions terms between age, gender,        that contextualexperiencesin family and work
and the contextual correlates. Only one of all
                                                   life, the quality of the work-family interface,
the possible interactionterms emerged signifi-     and the community environment were all
cant; paralleling other reports (Potts et al.
                                                   directly or indirectly associated with exercise
1992; Rakowski et al. 1987; Zimmermanand           habits and added significantly to the explana-
Connor 1989), the two-way interaction
                                                   tory power of our model. In short, our results
between age and family emotional supportwas
                                                   supporta biopsychosocialperspectiveof phys-
significant (p < .05), suggesting that family      ical activity duringadulthood,and they suggest
supportwas associatedwith more regularexer-        that future health behavior research needs to
cise among older adultsthanyoungeradults.In
                                                   consider determinantsfrom multiple contexts
all the post-hoc models we examined,the neg-
                                                   and multiple levels of the humanecology.
ative associationbetween age and exercise per-
sisted. What other experiences underminepar-
ticipation in regularexercise as adults traverse
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3090178

  • 1. Social Inequalities and Exercise during Adulthood: Toward an Ecological Perspective Author(s): Joseph G. Grzywacz and Nadine F. Marks Source: Journal of Health and Social Behavior, Vol. 42, No. 2 (Jun., 2001), pp. 202-220 Published by: American Sociological Association Stable URL: http://www.jstor.org/stable/3090178 Accessed: 13/05/2009 19:06 Your use of the JSTOR archive indicates your acceptance of JSTOR's Terms and Conditions of Use, available at http://www.jstor.org/page/info/about/policies/terms.jsp. JSTOR's Terms and Conditions of Use provides, in part, that unless you have obtained prior permission, you may not download an entire issue of a journal or multiple copies of articles, and you may use content in the JSTOR archive only for your personal, non-commercial use. Please contact the publisher regarding any further use of this work. Publisher contact information may be obtained at http://www.jstor.org/action/showPublisher?publisherCode=asa. Each copy of any part of a JSTOR transmission must contain the same copyright notice that appears on the screen or printed page of such transmission. JSTOR is a not-for-profit organization founded in 1995 to build trusted digital archives for scholarship. We work with the scholarly community to preserve their work and the materials they rely upon, and to build a common research platform that promotes the discovery and use of these resources. For more information about JSTOR, please contact support@jstor.org. American Sociological Association is collaborating with JSTOR to digitize, preserve and extend access to Journal of Health and Social Behavior. http://www.jstor.org
  • 2. Social Inequalities and Exercise during Adulthood: Toward an Ecological Perspective* JOSEPH G. GRZYWACZ Universityof NorthernIowa NADINE F. MARKS Universityof Wisconsin-Madison 2001,Vol42 (June): Journal Health SocialBehavior of 202-220 and Grounded in ecological theory, this study examines the association among par- ticipation in regular vigorous exercise and social status, aspects of prominent life settings, interactions between life settings, and more proximal individual resources and processes using data from the National Survey of Midlife Development in the United States (N = 3,032). Among women, a higher level of earnings was associated with more vigorous exercise, yet those women with more education had a steeper decline in exercise across adulthood. Among men, those with the lowest level of education had the steepest decline in physical activity across adulthood, and earnings did not affect exercise patterns. Less participation in vigorous exercise among blacks, in contrast to nonblacks, was explained by their tendency to live in less safe neighborhoods and having more functional health problems. Finally, contextual factors from multiple domains were independently associated with participation in regular exercise. Consistent with ecological theory, these results suggest that interventions to promote exercise habits among adults need to consider the independent and interactive effects of multiple contextualfactors. Regular physical activity has been demon- ic and acute morbidity (Breslow and Breslow strated to promote longevity (Berkman and 1993; U.S. Departmentof Health and Human Breslow 1983; Fried et al. 1998; Paffenbarger Services 1996), and facilitate higher levels of et al. 1994; U.S. Department of Health and psychological well-being throughout adult- Human Services 1996), reduce rates of chron- hood (Albert 1995; Fries and Crapo 1985; Folkins and Sime 1981; Rowe and Kahn 1987; Tkachukand Martin1999; U.S. Department of *Please address correspondence Joseph G. Health and Human Services 1996). Most to: Divisionof Health Schoolof adultsremaininactive despite widespreadpro- Promotion, Grzywacz, and Health,PhysicalEducation, LeisureServices, gramming to initiate regularphysical activity University of Northern Iowa, 203 Wellness/ Cedar Falls, IA 50614-0241. (Public Health Service 1991). National esti- Recreation Center, mates indicate that 30 percent of American joe.grzywacz@uni.edu: This research was supportedby a National adults remain completely sedentary,and only Traineeship 14-23 percent of adults engage in enough Institute Mental of Health Post-Doctoral (MH19958), the National Institute on Aging physical activity to achieve health-related ben- the (AG12731), National Institute Mental of Health efits (Centers for Disease Control 1997; U.S. (MH61083),and the John D. and Catherine T. of Health and Human Services MacArthurFoundationResearch Network on Department 1996). Successful MidlifeDevelopment. significant A por- occurred Individuals in lower social status positions tion of the preparation this manuscript of while the lead author was affiliated with the participatein less physical activity than their of higher status counterparts. Older adults, of and Department Psychology SocialBehavior theUniversity California, of Irvine. women, blacks, and individuals of lower 202
  • 3. AND 203 INEQUALITIESEXERCISE SOCIAL socioeconomic status are consistentlyfound to AND EMPIRICAL THEORETICAL BACKGROUND exercise less regularlyand are more likely to be completely sedentarythan younger adults, Ecological theory, as explicated by men, whites, and higher socioeconomic status Bronfenbrenner and colleagues (Bronfen- individuals (for reviews see Blair 1988; brenner1979; Bronfenbrenner Ceci 1994; and Centers for Disease Control 1997; Dishman Bronfenbrennerand Morris 1998), can serve 1991; King et al. 1992; U.S. Department of as a valuable tool for further understanding Health and Human Services 1996). Given this and modeling the determinants of positive evidence, age, gender, race, and educationare health behaviors (Fitzgerald et al. 1994; typically included as important covariates McLeroy et al. 1988; Sallis and Owen 1997; when developing and testing models of physi- Stokols 1996). Bronfenbrenner's model posits cal activity. However, inattentively quot;control- that behaviors such as physical activity are ling forquot; social status is a major limitation in influenced by a variety of factors from multi- health research (Marmot, Kogevinas, and ple ecological levels (e.g., individual, Elston 1987). Instead,Marmotand colleagues microsystemic, mesosystemic, and macrosys- (1987) as well as others (Krieger, Williams, temic) and change as a function of develop- and Moss 1997; Williams 1990) argue that mental and historical time. Consequently, more researchdirectlyexaminingthe effects of using an ecological perspective, scholars can integratea rich arrayof known determinants of social status on health-relatedphenomena is physical activity (for reviews see Blair 1988; critically needed since social status creates a Dishman 1991; King et al. 1992; U.S. broad context that shapes routine experiences Department of Health and Human Services that affect health-related behavior. 1996) into models of exercise to better specify In this study, we seek to expand our under- predictive models for different periods in the standing of physical activity patternsby con- life course. In addition to being more con- sidering exercise behavior within the broad ducive to a more comprehensive theory of context of social status, and examining how health behavior, an ecological approach also contextualfactors from prominentlife settings has severalpracticalbenefits. Most notably,an and more proximal individual resources and ecological approachattenuatesthe possibility processes help account for and uniquely con- of quot;victim-blamingquot;(e.g., Becker 1986) by tributeto differencesin exercise. Guidedby an drawing attention to additional targets for ecological perspective and previous research, intervention beyond the individual. When we theorize that the often-noted declines in acted upon and changed, these socio-environ- activity by age, and the frequentlycited differ- mental factors frequently bring about more ences in physical activity by gender,race, and sustainable change in individual and popula- tion health behavior(Green and Krueter1999; socioeconomic status do not act independently Stokols, Pelletier,and Fielding 1996). of each other.Thus, in this study we systemat- ically examine the independentand interactive effects of age, gender,andmultipledimensions Social Status and Physical Activity of socioeconomic status on physical activity patterns throughout adulthood. Consistent Severalpersonalcharacteristics representing with previousscholars,we furthertheorizethat individuals' relative location in status hierar- social status partially allocates contextual chies predict participationin regularphysical resources, opportunities, and barriers at the activity. Lower socioeconomic status, older individual,family,work,and communitylevels age, being female, and being black are consis- that may influence physical activity patterns. tently associatedwith less participationin reg- Therefore,we examine the independenteffects ular physical activity (for reviews see Blair of individual-level, family- and work-related, 1988; Dishman 1991; King et al. 1992; U.S. as well as community experiences on regular Department of Health and Human Services exercise, and we consider the extent to which 1996). Like previous scholars (Ross and Wu the effects of social status operate through 1995; Stronegger,Freidl, and Rasky 1997), we theorize that social location in status hierar- shaping differences in these everyday experi- chies is an importantconditioning factor for ences.
  • 4. 204 JOURNALOF HEALTHAND SOCIALBEHAVIOR the allocation of resources, opportunities,and earnings on exercise habits will be more pro- constraintsthat influence behaviors related to nounced among men than women. health, such as exercise. Time is a centralconcept in ecological mod- Socioeconomic status is consistentlyassoci- els (Bronfenbrenner1995), and it draws our ated with health behaviorsand health behavior attentionto the enduringcontext of socioeco- change: Lower socioeconomic status individu- nomic status for the developmentand mainte- als participatein fewer positive health behav- nance of positive health behaviors such as iors (e.g., exercise, maintaininghealthy body exercise. The quot;cumulativeadvantagequot;hypoth- weight) and change their negative health esis (Ross and Wu 1996) directlyaddressesthe behaviors (e.g., smoking) at a slower rate than issue of time by positing that the longer an higher socioeconomic status individuals individual is exposed to a protective factor, (Berkman and Breslow 1983; Blaxter 1990; such socioeconomic advantage,the greaterthe National Center for Health Statistics 1998; health-related benefit. Scholars have found Piani and Schoenborn 1993; Ross and Wu some supportfor the cumulativehealth status 1995; Stroneggeret al. 1997; U.S. Department benefits of education(e.g., House et al. 1990; of Health and Human Services 1996). House et al. 1994; Ross and Wu 1996), howev- Evidence from different studies however sug- er this question has not yet been considered gests that differentindicatorsof socioeconom- with respectto participation regularphysical in ic status (e.g., education and earnings) may activity.Assuming that socioeconomic advan- have differentassociations with physical activ- tage provides cumulative benefits for contin- ity, and that these associations may differ by ued participation regularexercise over time, in gender (Cauley et al. 1991; Fordet al. 1991) or we hypothesizethat a wider gap in the benefits measure of physical activity (Cauley et al. of educationand earningswill be more appar- ent at older ages than younger ages. 1991). Three importantfeatures are demonstrated by the previous studies that supportthe mean- ingfulness of an ecological model in the study Contextualand IndividualCorrelatesof of physical activity. First, socioeconomic sta- Physical Activity tus is best conceptualized as being multidi- mensional, and each independent dimension Certainrecurring patternsin everydaysocial (e.g., education and income) has the ability to life exert a disproportionate amount of influ- influence physical activity habits in different ence on well-being (Stokols 1996) and, pre- ways. For example, educationmight influence sumably,on behaviors related to health. Most health behaviors though a greater ability to adults are nested within families, occupations, receive and interpretinformationregardingthe and communities; consequently, comprehen- health benefits of regular exercise. Earnings, sive models of physical activity need to con- on the other hand, independent of education, sider social and environmentalfactors from each of these domains or settings might promote physical activity throughaddi- tional discretionaryincome that allows pursu- (Bronfenbrenner 1979). Unfortunately,most ing physically active hobbies during leisure health behavior research does not give ade- time. Next, this researchhighlights the impor- quateattentionto notablecontextualor ecolog- tance of recognizing the specific type of phys- ical factorsthatmay supportor underminepar- ical activity being studied (e.g., amount of ticipationin regularphysical activity.However, leisure time physical activity per week versus researcherscan use middle-rangetheory and kilocalories expended per day). Finally,multi- empirical evidence from different fields (e.g., ple strands of evidence suggest that the link family studies, occupational health, urban between socioeconomic status and health is planning) to identify high-powered leverage gendered whereby education and earnings points (i.e., factors that exert, or potentially have consistent health effects among men but exert, a disproportionate amount of influence; not women (see Marmot et al. 1987; see Stokols 1996) for influencing exercise. McDonough et al. 1999). We hypothesize that Thefamily microsystem. The family is a pri- a higher level of education and a higher level mary life domain for most adults. Since indi- of earnings will be independentlyassociated viduals in specific family roles, such as spouse with more regular physical activity. We also or parent,are frequentlyfound to participatein hypothesize that the effects of education and fewer health-risk behaviors (Chilcoat and
  • 5. 205 INEQUALITIES EXERCISE AND SOCIAL Breslau 1996; Horwitz and Raskin White Cooper 1993; Frone, Russell, and Cooper 1991; Umberson 1987), the family is believed 1997), suggesting that incompatiblework and to be an importantsource of social control of family responsibilitiesmay underminepositive behaviors related to health (Umberson 1987). health behaviors such as exercise (Backett Similarly, family life provides an important 1992; Backett and Davison 1995). However, general context for health promotingbehavior recent theory emphasizes the quality of fit (Doherty and McCubbin 1985; Pratt 1976; between work and family as opposed to expe- Walsh 1993). Previous research, for example, riences of strainsalone (Barnett1998). That is, has demonstrated that emotionally close fami- both the benefits (Sieber 1974) and the strains ly relationshipsand happy,stable, and satisfy- (Goode 1960) of role accumulationneed to be ing marriagespredictless healthrisk behaviors consideredwhen examiningthe health impacts among adults (Doherty and Harkaway 1990; of the work-family interface. Based upon Franks, Campbell, and Shields 1992; Pratt recent work-family theory (Barnett 1999; 1976; Wickrama et al. 1997a). Following Grzywacz and Marks 2000), we hypothesize that more positive spilloverbetween work and social controltheory,we hypothesizethatmar- ried individualsand parentswill exercise more family and less negative spillover between frequentlythan single or childless individuals. work and family will be associated with more Consistent with family systems theory, we regularphysical activity. hypothesize that individualsin an emotionally The researchcited here shares one common limitation. Assuming that specific health close family and an emotionally close mar- behaviors are reflections of a common latent riage will exercise more. The work microsystem.The workplace is a quot;lifestylequot; construct,researcherstypically use target for implementing health promotion summed indices of health-related behavior (e.g., non-smoking, non-problemalcohol use, interventions(PublicHealth Service 1991), yet and regular exercise) or substance use as the we lack a body of clearly defined research dependent variable. Consequently,it remains explicitly examiningthe impact and the mech- unclear what effect, if any, family, work, and anisms through which the workplace influ- work-familyspilloverwill have specifically on ences behavior related to health (for recent physical activity,since wellness enhancingand review see Eakin 1997). Nonetheless, a variety risk-taking behaviors (e.g., regular physical of job characteristics,particularlyhigh deci- activity versus substance use; Vickers, sion latitude,have been found to predict fewer Conway, and Hervig 1990) are qualitatively health-risk behaviors (House et al. 1986; different(for review, see Gochman 1997), and Mensch and Kandel 1988; Weidneret al. 1997; may not share the same contextual determi- Wickramaet al. 1997b). Based upon occupa- tional stress theory (House 1981; Karasekand nants. Community.A wide range of community Theorell 1990) and previous research, we characteristicsmay influence an individual's hypothesize that having more decision latitude ability to practice various behaviorsrelated to on the job will be associatedwith more regular health (Cheadle et al. 1999; Taylor, Repetti, physical activity.We also hypothesizethat due and Seeman 1997). Evidence from different to time constraints,a greaternumberof hours sources indicates that individuals who live in worked per week will be associated with less unsafe communitiesor neighborhoodsare less exercise. likely to engage in regular physical activity The work-family mesosystem. Ecological (Centersfor Disease Control 1999; Eyler et al. theory also contends that unique contributions 1998; Ross 1993; Sallis et al. 1997). Although to the overall context of human development some reportssuggest that neighborhoodsafety are derived from interactionsbetween two or serves as a physical barrierto regularactivity more life settings (i.e., mesosystems; throughfear of victimization (e.g., Centersfor 1979). Managingand integrat- Bronfenbrenner Disease Control 1999; Ross 1993), the mecha- ing work and family is an increasinglysignifi- nisms linking neighborhoodsafety to individ- cant task for adults today (Bielby 1992; ual physical activity have not been adequately Heckhausen1997; Lachmanand Boone-James tested or identified. We hypothesizethat living 1997). Work-familystrainhas been foundto be in neighborhoodscharacterizedas unsafe will associatedwith more alcohol use among adults be associatedwith less participationin regular (Bromet, Dew, and Parkinson 1990; Frone, Barnes, and Farrell 1994; Frone, Russell, and physical activity.
  • 6. JOURNALOF HEALTHAND SOCIALBEHAVIOR 206 ProximalIndividualResources and Processes Physical Activity:An Ecological Perspective The ecological model of physical activity An individual'sphysical and psychological duringadulthoodthat guided this study is por- characteristicsare perhaps the most proximal trayed in Figure 1. Consistent with previous determinantsof physical activity. In our con- research, Figure 1 suggests that sociodemo- ceptualization, we include these factors as graphic characteristics, including multiple potential proximal processes conditioned by aspects of socioeconomic status, have direct more macrosociological processes, working effects on rates of participationin regular,vig- throughthe opportunities,constraints,and rel- orous exercise. Additionally, our model sug- ative stressors that are allocated through the gests that these sociodemographiccharacteris- social hierarchiesindicated by socioeconomic tics may also have indirecteffects on physical status, age, gender, and race (see Williams exercise by influencing the characteristicsof 1990). individuals' daily contexts (family, work, and Physiologically, progressive reductions in community)andthe interactions betweenthese maximal oxygen uptake(V02 max), cardiovas- contexts (work-family interface). We also cular function, and declining muscle mass expect thatthe qualityof these life settingswill through adulthood are believed to interfere shape more proximalindividualresources and with individuals'abilities to participatein reg- processes-including functionaland breathing ular or prolonged bouts of physical activity. limitations to physical activity, body mass However,studies clearly indicate that many of index, environmentalmastery,exercise effica- the physiological declines associated with cy (i.e., belief that exercise is a good way to aging are the result of, not the cause of, promotehealth) and control over health-that, reduced physical activity (see Goldberg, in turn,influence rates of participation exer- in Dengel, and Hagberg 1996). This evidence cise. suggests that the unfolding of social and psy- chological dynamics throughout adulthood cause reductions in physical activity (Backett METHOD and Davison 1995) that become progressively Data reinforcedby subsequentreductionsin physio- logical function. We hypothesize that a higher The data used for this study are from the body-mass index, more functional restrictions National Survey of Midlife Development in related to activity, and reduced lung capacity the United States, collected in 1995 by the will be associated with less regular vigorous John D. and Catherine T. MacArthur exercise. FoundationResearch Network on Successful Psychological theories and models that Midlife Development (N = 3,032; 1,471 men place primary attention on individual-level and 1,561 women). The originalpurposeof the beliefs, attitudes, and values (Glanz, Lewis, National Survey of Midlife Development was and Rimer 1997) typically guide health behav- to examine patterns, predictors, and conse- ior research.Individualprocesses such as more quences of midlife developmentin the areasof self-efficacy (Dzewaltowski 1994; Rosen- physical health, psychological well-being, and stock, Strecher,and Becker 1988), a belief that social responsibility.Respondentsare a nation- exercise is an efficient way to promotehealth, sample of non-institutional- ally representative and a greater sense of control over health ized persons aged 25-74 who have telephones. (Strickland 1978) have all been theorized and The samplewas obtainedthroughrandomdigit subsequentlyfound to influence physical activ- dialing, with an oversamplingof older respon- ity among adults (King et al. 1992; U.S. dents and men made to guaranteea good dis- Department of Health and Human Services tributionon the cross-classificationof age and 1996). We drawupon existing value-expectan- gender.Samplingweights correctingfor selec- cy theoriesto hypothesizethata higher level of tion probabilitiesand non-responseallow this self-efficacy, a greaterbelief in the healthben- sample to match the composition of the U.S. efits of exercise, and more perceived control populationon age, sex, race, and education. over health will be associated with more fre- Respondents first participated in a tele- quent participationin regularphysical activity. phone interviewlasting approximately min- 40
  • 7. 207 INEQUALITIES EXERCISE AND SOCIAL FIGURE 1. An Ecological Model for Regular Vigorous Physical Activity during Adulthood utes. The response rate for the telephone ques- seasonal effects (Marmot et al. 1991). tionnaire was 70 percent. Respondentsto the Specifically, respondents were asked: (1) telephone survey were then asked to complete quot;Duringthe summer,how often do you engage two self-administered mailback question- in vigorousphysical activity(for example,run- naires. The response rate for the mailback ning or lifting heavy objects) long enough to questionnaire was 86.8 percent of telephone work up a sweat?quot;and (2) quot;Duringthe winter, respondents.This yielded an overall response how often do you engage in vigorous physical rate of 60.8 percentfor both partsof the survey activity long enough to work up a sweat?quot; (for a detailed technical reportregardingfield Response categories included several times a procedures,response rates, and weighting, see week or more (6), about once a week (5), sev- http://midmac.med.harvard.edu/research.htmleral times a month (4), aboutonce a month (3), less than once a month (2), or never (1). The #tchrpt). two items were highly correlated (r = .89); consequently, we used the mean of the two items to assess regular,vigorous exercise. (See Measures:Dependent Variable Table 1 for descriptivestatistics for all analyt- even a small amountof exercise is ic variables.) Although better than being sedentary (e.g., Kunst et al. 1999; Dunn et al. 1999; U. S. Departmentof Health and Human Services 1996), evidence Measures: IndependentVariables indicatesthatregularexercise in 60-90 percent Social status. Age was included as a contin- of an individual'stargetheartrate is most ben- eficial to overall health (American College of uous variable in these analyses. Gender (1 = Sports Medicine 1990). Therefore, we con- female) and race/ethnicity (1 = black) were structeda continuousoutcome measureof reg- included as dichotomousmeasures. Education ular vigorous exercise using two previously representsthe numberof years of formal edu- validated measures (Blair 1984; Kohl et al. cation completed and is coded as an ordinal 1988; Washburn al. 1990) adaptedto include variable as follows: 1 = 1-6 years, 2 = 7-8 et
  • 8. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 208 TABLE 1. Descriptive statistics for all analysis variables SD M Range Dependent Variable 1.75 4.04 1-6 Regular,Vigorous Exercise Social Status Characteristics 45.30 13.48 25-74 Age Gender(female = 1) 56.6% Race/Ethnicity(black = 1) 11.2% 2.41 6.20 1-12 EducationalAttainment Household Earnings 0-300,000 36,172 39,254 Family & WorkMicrosystems ParentalStatus(Child < 18 = 1) 41.1% MaritalStatus (not married- 1) 31.9% 37.3% High Spouse Emotional Support 30.4% Low Spouse Emotional Support .63 3.41 1-4 FamilyEmotional Support CurrentlyWorkingFor Pay (Yes = 1) 73.8% 43.52 15.53 1-168 HoursWorkedper Weeka .87 1-5 3.62 Decision Latitudeat Worka Spillover between Work Familya & .74 1-5 2.62 Negative Workto Family .84 1-5 2.62 Positive Workto Family 2.11 .68 1-5 Negative Familyto Work 1-5 .84 3.41 Positive Familyto Work Environment Community 3.36 .56 1-4 NeighborhoodSafety IndividualProximalProcesses/Resources 9.44-64.02 5.65 26.80 Body Mass Index 1-4 .77 FunctionalRestrictionsfrom Exercise 1.44 0-3 .57 .18 Shortnessof Breathwhen Active 3-21 3.42 15.87 Environmental Mastery 1-6 .77 PerceivedControlover Health 5.36 0-4 Efficacy of Exercise 3.68 .85 Source: National Surveyof Midlife Developmentin the UnitedStates 1995. Notes: Estimatesare based on weighted data. aEstimateobtainedfrom only respondentswho were working for pay when they completed the questionaire. years, 3 = 9-12 years but no diploma or GED, categories to facilitate inclusion of all respon- 4 = GED, 5 = graduated from high school, 6 = dents:(1) Individualswho were unmarried, (2) 1-2 years of college but no degree yet, 7 = 3 or married individuals with a mean response of more years of college but no degree yet, 8 = less than4 (i.e., low emotionalsupport;used as graduatedfrom a two-yearcollege or vocation- the contrastcategory),and (3) marriedindivid- al school, or associate's degree, 9 = graduated uals with a mean response of 4 (i.e., high emo- from a four- or five-year college, or bachelor's tional support;note: 56.4% of marriedrespon- degree, 10 = some graduate school, 11 = mas- dents had a mean of 4 for spouse emotional ter's degree, and 12 = doctoralor otherprofes- support;consequently,we chose this value for sional degree. Household earningswere coded maximal variability in the measure). Family continuouslyin thousandsof dollars. emotional supportmeasuredthe level of emo- Family Characteristics. Spouse emotional tional supportprovidedto the respondentfrom support measured the level of emotional sup- his or her other family memberswith a paral- lel 4-item index (a = .83) that was included in port providedto the respondentfrom his other spouse using the mean of a 6-item index (a = the model as a continuous measure. Parental status (i.e., has a child under 18 years old = 1) .85) adapted from Schuster, Kessler, and Aseltine (1990) (e.g., quot;How much does your was also included in our model. spouse or partner really care about you?quot; Work characteristics.Decision latitude was quot;Howmuch can you rely on him or her for help assessed by summing responses to five items if you have a serious problem?quot;). Response measuringthe amountof controlthe individual categories for the index items were not at all has over his or her work environment and (1), a little (2), some (3), and a lot (4). Spouse tasks, and the specialization of labor (e.g., emotional supportwas then divided into three quot;How often do you have a choice in deciding
  • 9. 209 AND EXERCISE SOCIAL INEQUALITIES how you do your tasks at work? How often do egories were not at all (1), some (2), a little (3), you have a choice in deciding what tasks you and a lot (4). Reduced VO2 max was opera- do at workquot;;a = .87). We also includeda mea- tionalized using three items adaptedfrom the sure of the number of hours the respondent Rose Questionnaire for angina (Rose et al. reportedworking(i.e., sum of responsesto two 1982) assessing if respondents get short of questions regardinghours worked last week in breath (yes/no) while (1) quot;walkingwith other primaryand additionaljobs). people your age on level ground;quot; quot;walking (2) at your own pace on level ground;quot;and (3) Work-familyspillover. Negative spillover quot;washing or dressingquot; (a = .74). Body mass from worktofamily measuredthe respondent's perception of the extent to which work inter- index was computed using the Quetlet Index fered with functioningat home by calculating (i.e., weight/height2). the mean response to four items (e.g., quot;How Control over health was measured using often does stress at work make you irritableat three items adaptedfrom the WhitehallSurvey home?quot;; a = .84). Conversely, positive (Marmot et al. 1991), including 1) quot;Keeping spillover from work to family assessed the healthy depends on things that I can do;quot; (2) extent to which the respondent felt that their quot;Thereare certainthings I can do for myself to work promoted better functioning at home reducethe risk of heartattack;quot; (3) quot;There and (e.g., quot;How often do the things you do at work are certainthings I can do for myself to reduce help you deal with personal and practical the risk of getting cancer.quot; Response categories issues at home?quot;;a = .74). Negative spillover for the control over health items ranged from from family to work assessed the extent to strongly disagree (1) to strongly agree (6) (a which the respondentfelt their family life was =.71). interferingwith their success on the job (e.g., Environmentalmastery is a component of quot;How often does stress at home make you irri- psychological well-being that assesses an indi- table at work?quot;; a = .81). Finally, positive vidual's sense of mastery and competence in spillover from family to work measured the managing the surroundingenvironment(Ryff extent to which respondents felt their family 1989). Environmentalmastery was measured life helped them perform better on the job with three items: (1) quot;In general, I feel I am in (e.g., quot;How often does talkingwith someone at charge of the situation in which I live;quot; (2) home help you deal with problems at work?quot;; quot;The demands of everyday life often get me a = .73). Response categories ranged from down;quot;and (3) quot;I am quite good at managing never (1) to all the time (5). The work-family the many responsibilities of my daily life.quot; Response categories for the environmental spillover items were developed for the National Survey of Midlife Development in mastery items ranged from strongly disagree (1) to strongly agree (7) (a = .52). Although the United States. the estimated reliability of the environmental Community. Perceived community safety mastery scale used in the National Survey of was measuredwith the mean response to four Midlife Development in the United States is items developed for the National Survey of modest, previous research has indicated that Midlife Development in the United States: (1) the three-item measure is strongly correlated quot;I feel safe being out alone in my neighbor- with its highly reliable parent measure (Ryff hood during the daytime;quot; (2) quot;I feel safe being out alone in my neighborhoodat night;quot; and Keyes 1995). Exercise efficacy assessed the extent to (3) quot;I could call on a neighbor for help if I which respondents believe that exercise is a needed it;quot; and (4) quot;People in my neighbor- beneficial and preferred way of promoting Response categoriesfor hood trusteach other.quot; health. Respondentswere asked to respond to the communitysafety items rangedfrom not at all (1) to a lot (4) (a = .65). a hypothetical scenario during the telephone interview quot;Assume for a moment that your Physiological and psychological resources doctor said you had a heart condition and said andprocesses. Functional restrictionsto phys- you could choose either to have coronary ical activity was assessed with a 4-item scale bypass surgeryor exercise at least three times revised from the Medical Outcomes Study a week for at least half an hour each time. (Brazier et al. 1992) asking how much the Which one do you think you would choose?quot; respondent's health limited walking several Respondentswere then asked, quot;How sure are blocks, walking one block, vigorous activity, you that this is what you would choose?quot; very and moderateactivity (a = .92). Response cat-
  • 10. 210 JOURNAL OF HEALTH AND SOCIAL BEHAVIOR pay when they completedthe telephone survey (1), somewhat (2), or not very sure (3). Being and self-administered questionnaires;conse- very sure about choosing exercise was coded 3, quently, some individuals were legitimately being somewhat sure about exercise was coded 2, being not very sure about exercise was on quot;decision hours latitude,quot; quot;missingquot; worked/week, and each of the work-family coded 1, and choosing bypass surgery was spillover measures. Rather than limiting the coded 0. sample to employedadults only, we includeda quot;missing flagquot; indicator variable for each measurein the model to generate work-related Analytic Sequence more reliable population parameterestimates (Orme and Reis 1991). To assess our first hypotheses regarding the Unweighted results are reported since fac- independent effects of various social status tors used in over-samplingwere controlled in factors, we began by regressing our physical all analyses and the overallpatternof findings activity outcome on age, gender, race, educa- were similar for both weighted and unweight- tion, and earnings. Then, to consider how age ed analyses (Winshipand Radbill 1994). and gender might condition the effect of edu- cation and earnings we added interaction terms for gender X education, gender X earnings, RESULTS age X education, age X earnings, age X gender X education, and age X gender X earnings Social Status and VigorousPhysical Activity interaction terms to the model (to avoid collinearity problems, we used age, education, Table 2 reports the results of five models and earnings centered on the mean in the estimatingthe impact of social status, contex- analyses and in the construction of the interac- tual characteristics,and personal characteris- tion terms; Cronbach 1987). Unfortunately, the tics on regular,vigorous exercise. Consistent black sample was not large enough to allow for with previous reports (e.g., U. S. Department a consideration of higher order race interac- of Health and Human Services 1996), the first tions. Change in R2 was used to assess if the model in Table 2 indicates that younger indi- addition of the interaction terms significantly viduals, men, non-blacks, those with more contributed to the explanatory model (Jaccard, education, and those with higher household Turrisi, and Wan 1990). We then proceeded to earnings participatein more regular physical add blocks of contextual experiences and indi- activity.However,Model 2 furtherreveals that vidual-level characteristics to the social status the effects of earningson physical activity dif- model and evaluated the corresponding fer by genderandthatthe educationeffects dif- changes in the association between social sta- fer by age and gender. Figure 2 plots the sig- tus and physical activity. nificant gender X earnings interaction and Not all of the respondents were working for TABLE 2. OLS Estimates of the Association between Social Status, Contextual Experiences, Individual Resources and Processes, and Regular Vigorous Exercise Model 1 Model 2 Model 3 Model 4 Model 5 -.033*** -.029*** -.025*** -.029*** -.023*** Agea (.003) (.002) (.004) (.004) (.004) Gender(female = 1) -.741*** -.758*** -.708*** -.688*** -.628*** (.063) (.063) (.065) (.065) (.062) Race/ethnicity(black = 1) -.356** -.336** -.353** -.285 -.162 (.133) (.133) (.132) (.132) (.126) Educationa .057*** .022 .022 .022 -.006 (.013) (.018) (.018) (.018) (.017) Household Earnings(thousands)a .003** .001 .0002 .0002 -.0003 (.001) (.001) (.001) (.001) (.001) GenderX Agea -.007 -.009+ -.007 -.005 (.005) (.005) (.005) (.005) GenderX Educationa .034 .065 .053* .046+ (.027) (.027) (.027) (.025) GenderX Earningsa .003+ .004* .004* .003+ (.002) (.002) (.002) (.002)
  • 11. 211 AND EXERCISE SOCIALINEQUALITIES TABLE 2. (Continued) Model 1 Model 2 Model 3 Model 4 Model 5 Agea X Educationa .003** .003* .003** .003* (.001) (.001) (.001) (.001) GenderX Agea X Educationa -.005* -.005* -.005 -.004* (.002) (.002) (.002) (.002) Family & Work Microsystems ParentalStatus (Child < 18 = 1) .074 .051 .040 .077 .077 .073 .187* Not CurrentlyMarriedb .189* .215** (.084) (.083) (.080) High Spouse EmotionalSupportb .185* .118 .089 (.079) (.081) (.078) FamilyEmotional Support .120* .024 -.036 (.052) (.053) (.051) Decision Latitudeat Workc .105** .041 .040 (.038) (.043) (.041) HoursWorked/Week .004+ .006* .006* (.002) (.003) (.002) Mesosystemc& CommunityEnvironment Work-Family Negative SpilloverWorkto Family -.160** -.062 (.061) (.059) Positive SpilloverWorkto Family .144** .131** (.049) (.046) Negative Spillover Familyto Work .046 .093 (.065) (.068) Positive SpilloverFamilyto Work .055 .032 (.047) (.045) .351*** .268*** NeighborhoodSafety (.059) (.061) IndividualProximalProcesses FunctionalRestrictions -.570*** (.049) Shortnessof Breath -.177** (.062) Body Mass Index -.013* (.006) .019* Environmental Mastery (.010) PerceivedControlover Health .071+ (.042) .099** Exercise Efficacy (.036) 2.48*** 2.79*** 4.52 3.40*** Constant 4.50*** .447 .045 .351 .045 .247 .253 .172 .143 .153 AdjustedR2 .138 .022*** .082*** .007*** .012*** n/a AR2 +p <.10; * p <.05; **p < .01; ***p <.001 (two-tailed) Source: National Surveyof MidlifeDevelopmentin the United States, 1995. Note: Numbers in parenthesesare standarderrors.Estimatesare based on unweighteddata. have been centeredon the mean to avoid collinearityproblems. aVariables bIncontrastto marriedindividualswith low emotional support. variableswere also only relevantto employed individuals.Missing indicatorflag variablesfor work-related CEstimates included in models 3-5. activity across adulthood are the direction of indicatesthat a higher level of household earn- the association in early adulthoodand the rate ings is associated with more vigorous exercise of decline with age. In contrastto the frequent- among women but not men. ly reportedpositive association between more To interpretthe significant three-way gen- physical activity and higher education, these der X age X education interactioneffect, we results indicate that men with the lowest level plotted the predicted mean levels of regular of educationhave the highest level of regular, exercise by age, education, and gender (see vigorous exercise during young adulthood, Figure 3). The most salient education differ- while the most educated men exercise least ences between men and women in physical
  • 12. 212 JOURNALOF HEALTHAND SOCIALBEHAVIOR Earningsand Gender FIGURE2. Vigorous Exerciseby Household 4.8 - 4.6 - .) 4.4 - 4.2 - 0 4- Men -I0 o _-U-W omen 3.8 - o ._ > w 3.6 - 3.4 - 3.2 3 I I I -1 S.D. Household +1 S.D. Household Mean Household Earnings Earnings Earnings during the younger years. However, the age- earnings does not accumulate with age (con- related decline in vigorous exercise is steepest traryto our cumulativeadvantagehypothesis). among the least educatedmen and most grad- It is also noteworthythat blacks reportedsig- ual for the best educated. This leads to age- nificantly less vigorous physical exercise than related trajectoriesin physical activity among non-blacks,even controlling for major dimen- men that converge in midlife (i.e., 50-55) and sions of socioeconomic status. then proceed to provide an advantagein phys- ical activity during later adulthood to those with the highest education.By contrast,among ContextualCharacteristicsand Regular women, having a high level of education is Physical Activity associated with more vigorous exercise in Results reported in Table 2, Model 3 also young adulthood,but this benefit is attenuated indicate contextualfactors from multiple con- in later adulthood. Counter to the cumulative texts, and multiplelevels are notablecorrelates advantagehypothesis, the slope of age-related decline in exercise among women is the least of regularphysical activity.In contrastto indi- viduals in marriages characterizedby a low steep for those with the lowest level of educa- tion and greatest among those with the highest level of spouse emotional support,single indi- level of education.The age X earnings,and the viduals and individuals with a high level of gender X age X earningsinteractionterms did spouse emotional supportparticipatein more not contribute to the model in preliminary vigorous exercise. Also consistent with our analyses, so they are not included in Model 2. family systems-basedhypothesis, we find that Collectively this evidence provides mixed a higher level of family emotional supportwas support for our social status hypotheses. also independentlyassociated with more regu- Consistent with the cumulative advantage lar exercise. Paralleling other reports using hypothesis and our hypothesisanticipatingthat health behaviorscales as outcomes, our results socioeconomic advantage would be most also indicatethat a higher level of decision lat- applicableto men, we find that advancededu- itude among currently employed respondents cation contributesto a slower decline in physi- was associated with more regular, vigorous cal activity among men than women. However, exercise. Contrary our hypothesis,trendevi- to contraryto the cumulativeadvantagehypothe- dence indicate that working more hours was sis, women with a college education have a associated with more regular exercise. steeper decline than women with less educa- Collectively,these results supportthe ecologi- tion. Additionally,a higher level of household cal perspective suggesting that factors from earnings appearsto promote regular,vigorous multiple contexts of daily life influence behav- exercise among women only (contraryto our ior and development. gender hypothesis), and the benefit of higher Higher ordercontextualfactors, such as the
  • 13. 213 AND EXERCISE SOCIALINEQUALITIES Exerciseby GenderandAge FIGURE3. Education Vigorous in Men 6.00 - 5.50 - e 5.00 - >1fifo C 4.50 - o o 4.00 - >3.50 - 3.00 I I I I I I I I I I I 75 25 30 35 40 60 70 45 50 55 65 Age Women - -< High School 5.50 - School --High ) 5.00 - 3 Yrs College iquot; College Grad 4.50 - 4.00 O 4.00 - > 3.50 - 3.00 I I I I I I I I I I I 25 30 35 40 45 50 55 60 65 70 75 Age Source: National Survey of Midlife Development in the United States, 1995 quality of fit between work and family and the family interface completely explained the community environment, are also important association between family and spouse emo- correlates of physical activity among adults. tional supportand physical activity.That is, a Table2, Model 4 indicatesthata lower level of higher level of family and spouse emotional negative spillover from work to family and a support is associated with more positive and higher level of positive spillover from work to less negative spillover from work to family, family is associated with more regular exer- which in turn is associated with more healthy activity habits. Moreover,once the quality of cise. Additional analyses (not shown) further the work-family fit was controlled in the indicated that these dimensions of the work-
  • 14. 214 JOURNALOF HEALTHAND SOCIALBEHAVIOR model, we find that working more, ratherthan family appearsto be indirectlyassociatedwith fewer, hours per week was associated with lower physical activity throughits association more regularexercise. Finally, consistent with with a lower level of environmental mastery. our hypothesis, analyses indicatedthat respon- dents who perceived their neighborhoods as more safe participatedin more regular,vigor- DISCUSSION, SUMMARY, AND CONCLUSIONS ous exercise than individualsin less safe com- munities. Moreover,neighborhoodsafety part- The overall goal of this study was to use ly explains the race/ethnicity effect; that is, blacks are less likely than non-blacksto report ecological theory to systematically examine the complex associations between multiple living in a safe neighborhood,and,in turn,par- social status characteristicsand participation ticipate in less regularphysical activity. in regular,vigorous exercise. We also wanted to explore the degree to which everyday con- ProximalResources & Processes and Regular textual factors in family, work, and communi- ty, as well as more proximal individual Physical Activity resourcesandprocesses might help accountfor Building from ecological theory,we expect- and also uniquely contributeto differences in ed that important individual resources and exercise behaviorduringadulthood. processes would be independentlyassociated Results from this study replicateand extend with physical activity and might also partially previous research in several importantways. account for the associations between social First,with regardto socioeconomic status, our status and contextualexperiences and exercise descriptivefindings replicateothers indicating behavior (see Table 2, Model 5). Consistent that higher levels of earnings and education with a largebody of previousresearch,we find were both independentlyassociated with more that physiological declines, including exercise among some populationsubgroupsof increased body mass index, physical activity adults. Consistent with some conceptualiza- limitations due to functional impairment,and tions of social inequality,these results suggest shortness of breath associated with physical thathealthpractitioners need to recognizemul- activity are associated with less participation dimensions of socioeconomic position tiple in regular exercise. Similarly, consistent with when formulatingand implementingstrategies our hypotheses guided by value-expectancy to eliminate health inequalities. If socioeco- theories of health behavior, we find that nomic status is viewed in terms of education greater environmental mastery (a proxy for alone, interventions targeting income-related self-efficacy), more perceived control over determinantsof physical activity will remain health (trend), and a higher level of exercise unrecognizedor under-prioritized. efficacy were associated with more regular Equally important however are our new results indicating that age and gender condi- physical activity. The persistent race/ethnicity effect evi- tion associations between educationand regu- denced in all previous models is completely lar exercise. This patternof results is notewor- explained in the full biopsychosocial model of thy for several reasons. First, since the slope exercise (i.e., Table 2, Model 5). African between educationand the rate of participation Americansreportedhigherlevels of body mass in vigorous exercise is different depending index, more functional limitations related to upon age and gender (Krieger et al. 1997), activity, and greater shortness of breath than these results raise caution regardingthe unex- whites, and this accounted for the remaining amined inclusion of educationmerely as a lin- exercise differences between blacks and non- ear covariate in studies of physical activity. blacks. Likewise, educational differences in These resultsalso suggest thattargetsfor phys- physical activity among women were com- ical activity interventionsmay need to change pletely explained by these individual-level dependingupon the age, gender,and education resources.Womenwith a bettereducationwere of the target population. For example, inter- in better physical condition, and had a higher ventions targetingpoorly educatedyoung men level of each of the psychological resources may need to focus on maintaining physical conducive to healthy exercise habits. Finally,a activity habits, while interventions targeting higher level of negative spillover from work to poorly educated young women may need to
  • 15. 215 SOCIAL INEQUALITIES EXERCISE AND thatprovidethe flexibility,opportunity, the focus on initiating exercise habits. Finally, and expectation of regular physical activity (e.g., these results again remindscholarsthat survey questions about physical activity may tap dif- golf outings with clients, on-site fitness facili- ferent meanings for different groups of indi- ties, company sponsoredgym memberships). viduals. That is, it is possible that the counter- The contextual effects found in this study intuitiveeducation-exerciseassociationamong extend previous health behavior research. young men is capturing occupation-based First,in contrastto several studies using health behavior indices, this study found that differ- physical activity that may yield less notable health gains than regular aerobic-forms of ent aspects of work and family were specifi- exercise, which may have more health bene- cally associatedwith physical activity.Perhaps fits. even more importantly,however, this study We also think that the explanatorypower of demonstrated how overlookedaspects of work the social status model is worthy of attention. and family may influence different health- Although our final model only accounted for relatedbehaviors.For example, the work-fam- 25 percentof the variancein vigorous exercise, ily literaturehas been dominated by studies social status factors provided most of the exploring the effects of work-family conflict explanatorypower (i.e., 14 percent). Consis- (Barnett 1998), and this research frequently tent with an ecological perspective, this finds that work-family conflict is associated evidence suggests that models that integrate with behaviors and conditions (e.g., alcohol theory and concepts from across disciplines abuse and depression; Frone, Russell and Cooper 1997) that undermineregularexercise (e.g., social status and behavioral intention) will generate more comprehensive explana- (King et al. 1992). However, the evidence tions for behaviorand may facilitatemore suc- reportedin this study indicate that more posi- cessful interventionsto change behavior. tive spilloverfromworkto family (a dimension not typically considered) has the most robust It is also interestingto note that contextual association with greater frequency of regular experiences and physiological resources explained education-level differences in exer- physical activity. The pattern of findings surrounding cise among youngerwomen. These resultspar- race/ethnicityin these models is also an impor- tially supportthe hypothesis that social status The conditions the resources and experiences that tant contributionto the exercise literature. fact that blacks were consistently found to facilitate participationin positive health-relat- exercise less than non-blacks, independentof ed behaviors (e.g., Ross and Wu 1995). This education and earnings, suggests that race is everyday interactional perspective of the not an adequateproxy for socioeconomic sta- socioeconomic statusand healthbehaviorrela- tus, and thatotherfactorspertainingto race are tion is markedly different from assumptions contributingto differences in physical activity regarding the absence of important health patterns. Consistent with a recent biopsy- related benefits of exercise (e.g., the Health chosocial model of racism as a stressor(Clark Behavior Model) that may accompanyhigher et al. 1999), our results suggest that contextual levels of education. Although the pattern of factors from the social environment such as results for education among men supportsthe neighborhoodsafety may directlyand indirect- cumulative advantage hypothesis and theory ly undermineexercise habits. Inadequatestreet suggesting that the health effects of socioeco- lighting at a modest level or witnessing violent nomic status are gendered (Marmot et al. crime in your neighborhood at an extreme 1987; McDonough et al. 1999), none of the level are direct physical barriers to outdoor contextual experiences or individual-level regular,vigorous activity, while the threat of resources could explain men's educationaltra- victimization (e.g., Ross 1993) and compro- jectories across adulthood.Perhapsthe persis- mised feelings of masteryor controlare impor- tent educationeffect among men can be attrib- tantpsychological barriers.These physical and uted to the confounded nature of physical psychological barriersto physical activity may activity in men's occupations(see Eakin 1997). set into motion reductionsin physical activity That is, men who have a low education may habitswhich become furtherreinforcedby cor- find themselves in working-class jobs that responding reductions in physiological func- become less physically demanding as they tioning and ultimately undermine health. spend more time on the job, while men with Althoughthese linkages are supportedtheoret- more education may work their way into jobs
  • 16. 216 JOURNALOF HEALTHAND SOCIALBEHAVIOR ically (Clark et al. 1999), we could not evalu- study may be due to common methodvariance ate these causal pathways with the current or endogeneity.Additionally,a more stringent cross-sectional data. operationalizationof ecological theory would We also feel the persistence of the robust require measures from additional levels and age effect on exercise should not go unno- sources (e.g., self-report of decision latitude ticed. Overall, in these data about 32 percent supplementedby a rating of decision latitude of respondents aged 25-35 indicated they for a respondent's occupational category). participated in vigorous exercise several Moreover,a comprehensiveecological model, times a week or more, while 28 percent of informed by other middle range theories, those 45-54, and 18 percent of those aged might furtherinclude a myriadof other possi- 65-74 did. After adjusting for so many con- ble interactions. textual and individual factors, including Nonetheless, our results supportthe value of declines in physiological capacity, we might employing an ecological perspective when have expected this effect to diminish more attemptingto understandhealth behavior.We substantially. find that, indeed, different aspects of social In an attemptto furtherunpack the persis- status were independently associated with tent age effect in these analyses,we rana series exercise, and that the influence of some status of post-hoc analyses including two- and three- factors variedby gender and age. We also find way interactions terms between age, gender, that contextualexperiencesin family and work and the contextual correlates. Only one of all life, the quality of the work-family interface, the possible interactionterms emerged signifi- and the community environment were all cant; paralleling other reports (Potts et al. directly or indirectly associated with exercise 1992; Rakowski et al. 1987; Zimmermanand habits and added significantly to the explana- Connor 1989), the two-way interaction tory power of our model. In short, our results between age and family emotional supportwas supporta biopsychosocialperspectiveof phys- significant (p < .05), suggesting that family ical activity duringadulthood,and they suggest supportwas associatedwith more regularexer- that future health behavior research needs to cise among older adultsthanyoungeradults.In consider determinantsfrom multiple contexts all the post-hoc models we examined,the neg- and multiple levels of the humanecology. ative associationbetween age and exercise per- sisted. What other experiences underminepar- ticipation in regularexercise as adults traverse REFERENCES the life course? We acknowledge the limits of these cross- Albert, Steven M. 1995. quot;New Perspectiveson the sectional data when interpretingage-effects in Elderly: Epidemiology and Public Health.quot; our analyses. That is we cannot differentiate CurrentIssues in Public Health 1:77-81. true quot;agequot;(i.e., developmental)from quot;cohortquot; American College of Sports Medicine. 1990. quot;The or quot;periodquot; effects. For example, the oldest RecommendedQuantityand Qualityof Exercise group in this sample would have been at the for and Developing Maintaining height of midlife when the Surgeon General Cardiorespiratory and Muscular Fitness in announcedthe first Healthy People objectives HealthyAdults.quot;Medicine and Science in Sports in 1979. Since original messages about exer- and Exercise 22:265-74. cise during this period targeted reducing car- Backett, Kathryn. 1992. quot;The Construction of HealthKnowledge MiddleClass Families.quot; in diovasculardisease (particularlyamong men), Health Education Research: Theory and it might be that highly educated young and Practice 7:497-507. middle-aged men from these cohorts respond- Backett, Kathryn C. and Charlie Davison. 1995. ed to such social marketingand this is reflect- quot;Lifecourse and Lifestyle: The Social and ed in contemporaryage-relatedphysical activ- CulturalLocation of Health Behaviours.quot;Social ity patterns. Not all birth cohorts might be Science and Medicine 40:629-38. expected to reportthe same levels of physical Barett, Rosalind C. 1998. quot;Towarda Review and activity at young and old ages. Reconceptualization of the Work/Family Considerationof these results must also be Literature.quot; Genetic, Social & General temperedby additionallimitationsof the study. Psychology Monographs124:125-82. For example, the data were all self-reported; . 1999. quot;A New Work-Life Model for the consequently,some of the associations in this Annals of the American Twenty-FirstCentury.quot;
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