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Living Well Study > Blog > Public Health > Study Highlights How Social Inequality Hinders Physical Activity
Public Health

Study Highlights How Social Inequality Hinders Physical Activity

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A decade-long study of residents in São Paulo, Brazil, has found that inequalities in leisure-time physical activity have widened, with exercise increasingly concentrated among socially advantaged groups. While highly educated white men became more active over the ten years, women from racial minority groups with lower levels of education consistently had the lowest rates of leisure-time physical activity. In contrast, walking for transportation, such as commuting to work, was distributed much more evenly across the population. The findings were published in the International Journal of Behavioral Nutrition and Physical Activity.

Led by researchers at the University of São Paulo (USP), the study followed 978 adults from 2014 to 2024, collecting data in 2014/15, 2020/21, and 2023/24. Using an intersectional approach that examined how sex, race, and education interact to shape opportunities for physical activity, the researchers argue that public policies should prioritise the most socially vulnerable groups.

“We concluded that engaging in physical activity for leisure doesn’t depend solely on motivation or individual choice,” says corresponding author Andreia Alexandra Machado Miranda of USP’s Center for Epidemiological Research in Nutrition and Health (NUPENS). “It’s shaped by environmental, structural, and social factors. Unfortunately, leisure-time physical activity remains a privilege of the most socially advantaged groups, while women from Black, Brown, Asian, or Indigenous backgrounds with fewer years of schooling face the greatest barriers.”

Co-author Alex Antonio Florindo, a professor at USP, explains that physical activity is influenced by much more than personal motivation. Life experiences, family support, access to safe public spaces, neighbourhood infrastructure, and public policies all affect whether people are able to exercise during their free time. “There’s a significant gap between those who are able to engage in physical activity during their leisure time and those who aren’t, even if they want to,” he says.

The disparities became more pronounced over time. At the beginning of the study, 51% of highly educated white men reported participating in leisure-time physical activity, compared with 29% of the most socially vulnerable group. By the final assessment, those figures had increased to 65% and 39%, respectively, widening the gap between the two groups.

Miranda notes that women often face multiple obstacles to participating in sports and recreational exercise. Beyond carrying a disproportionate share of domestic responsibilities, many earn lower wages, experience safety concerns in public spaces, and live in neighbourhoods with limited green space, poor lighting, or inadequate recreational infrastructure. The researchers assessed these inequalities using the International Physical Activity Questionnaire and a Multiple Jeopardy Index that combined sex, race, and educational attainment into a social vulnerability score.

Regular physical activity is known to improve physical and mental health while reducing the risk of cardiovascular disease, stroke, diabetes, and other chronic conditions. The World Health Organization recommends that adults achieve at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity physical activity each week. Yet nearly one-third of adults worldwide failed to meet these recommendations in 2022, contributing to an estimated five million deaths annually from sedentary lifestyles.

Unlike leisure-time exercise, walking for transportation showed no significant association with social vulnerability. Participation increased from 61.8% to 71.6% over the study period and was most common among younger Black or mixed-race men with a high school education. The researchers suggest that walking for commuting is driven more by daily necessity and urban mobility than by personal choice, making it a practical way to increase physical activity while supporting public health and more sustainable transport.

More information: Andreia Alexandra Machado Miranda et al, Social inequalities in leisure-time and transport-related physical activity through the lens of intersectionality: 10-year longitudinal study in Brazil, International Journal of Behavioral Nutrition and Physical Activity. DOI: 10.1186/s12966-026-01900-5

Journal information: International Journal of Behavioral Nutrition and Physical Activity Provided by Fundação de Amparo à Pesquisa do Estado de São Paulo

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