To be able to curb the global pandemic of physical inactivity and the associated 5.3 million deaths per year, we need to understand the basic principles that govern physical activity. However, there is a lack of large-scale measurements of physical activity patterns across free-living populations worldwide. Here we leverage the wide usage of smartphones with built-in accelerometry to measure physical activity at the global scale. We study a dataset consisting of 68 million days of physical activity for 717,527 people, giving us a window into activity in 111 countries across the globe. We find inequality in how activity is distributed within countries and that this inequality is a better predictor of obesity prevalence in the population than average activity volume. Reduced activity in females contributes to a large portion of the observed activity inequality. Aspects of the built environment, such as the walkability of a city, are associated with a smaller gender gap in activity and lower activity inequality. In more walkable cities, activity is greater throughout the day and throughout the week, across age, gender, and body mass index (BMI) groups, with the greatest increases in activity found for females. Our findings have implications for global public health policy and urban planning and highlight the role of activity inequality and the built environment in improving physical activity and health.From Erickson's summary of the work:
Interestingly, the average number of steps stepped was not correlated to obesity levels in a particular country...In places where some people got lots of steps and others got just a tiny amount, obesity levels were higher...Sweden had one of the smallest gaps between activity rich and activity poor...it also had one of the lowest rates of obesity...That pattern becomes even more clear when you compare the United States to Mexico. The countries have a similar step average, but Mexico's activity inequality and obesity levels are both much lower...When activity inequality is greatest, women's activity is reduced much more dramatically than men's activity, and thus the negative connections to obesity can affect women more greatly.