A healthy behavior and socioeconomic inequality in school-age children in the West of Iran

BACKGROUND: Sufficient physical activity (SPA) in children and adolescents has an important role in health, growth, and development of persons. This study aimed to investigate the prevalence of and inequality in physical activity (PA) in 12–15-year-old students in the West of Iran, 2018. MATERIALS AND METHODS: In this cross-sectional study, 1404 students from 14 schools of Kermanshah city were included. Data on demographic and socioeconomic status (SES) of students and their family, body mass index, moderate-to-vigorous PA of students were collected. Normalized concentration index (NC) and decomposition analysis applied to measure inequality in SPA and the contribution of affecting factors, respectively. RESULTS: About 19% of the students had SPA. The proportion of SPA in boys was higher than girls (38.98% vs. 9.84%). There was a significant deviation from equality line (NC = 0.31; 95% confidence interval [CI]: 0.23, 0.38) and NC for boys and girls were 0.15 (95% CI: 0.04, 0.25) and 0.05 (95% CI: −0.07, 0.17). Sex of students and SES of households with 59.09% and 39.77% contribution to the measured inequality in SPA were the highest positive contributors. Household size (−2.60) had a negative contribution to inequality in SPA. CONCLUSION: There was a significant pro-rich socioeconomic inequality in SPA and sex, and SES were the main contributors to the inequality in PA. Some interventions are needed to improve PA among children and adolescents with a focus on girls and low-SES groups to narrow the existing gaps.