Physical activity in Swedes in general and minority women in particular

Sammanfattning: Background: Despite the well-known positive effects of physical activity on health, many people are not sufficiently active. Several studies have reported a low level of physical activity among minority women, but few studies have investigated the reason why. The purpose of this thesis was to investigate physical activity among Swedes with a special focus on minority women. The specific aims were to examine the association between physical activity and self-rated health, patterns of physical activity and the relationship between physical activity and country of birth in minority women. In order to increase our understanding of the possible underlying causes of low levels of physical activity, this thesis also explores minority women s attitudes and experiences of physical activity and exercise, using a qualitative approach. Methods: A sample (n = 3756) of the Swedish population (aged 25 64) was used to examine the association between physical activity and self-rated health (Study I). Patterns of physical activity and the relationship between physical activity and country of birth were examined in a simple random sample (n = 1945) of minority women in Stockholm (Studies II III). The women (aged 18 65) were all first-generation immigrants born in Finland, Iraq and Chile. A random sample of Swedish women (n = 704) was used as a control group (Study II). In the qualitative part, data were collected through interviews in 10 focus groups (Study IV). The participating women (n = 63) were first-generation immigrants (aged 26 65) born in Iraq, Chile and Turkey and living in Stockholm. Results: The results showed an apparent gradient: with increasing physical activity, the odds of good self-rated health increased. Women born in Sweden reported more exercise and rated their health better than foreign-born women did. The patterns of physical activity varied within and between different domains of physical activity and countries of birth. Finnish women were physically active to a higher degree than women from Chile and Iraq; they had the highest total amount and highest average intensity of physical activity. However, there were no significant differences in time spent in the lower intensity categories. The results imply that the Finnish women balanced sedentary time with active periods at higher intensities. A strong and varied association between country of birth and physical activity (subjectively and objectively assessed) was found. Women from Finland were more likely and women from Iraq less likely to report higher levels of physical activity than Swedish-born women. Women from Finland also had significantly more time at higher intensities compared to Chilean and Iraqi women. The women in the focus groups expressed a strong desire to start exercising, but they felt that they were unable to do it by themselves. They all agreed that the local community should help them and arrange appropriate exercise. Conclusions: The diverse results underline the need to examine physical activity in each minority group separately. The included socio-demographic and lifestyle variables could not explain the differences between countries of birth. This implies that there are other factors influencing the association, such as cultural ones. Future studies should try to identify factors that have an impact on the levels of physical activity among minority women.