Association Between Leisure-Time Physical Activity and Occupation Activity Level, National Health Interview Survey-United States, 2020

Background: Physical activity for any purpose counts toward meeting Physical Activity Guidelines (PAG). However, national surveillance systems traditionally focus on leisure -time physical activity. There is an incomplete understanding of the association between meeting PAG in leisure time and occupation activity level among US workers. Methods: We used cross-sectional 2020 National Health Interview Survey data to examine US adults aged 18-64 years who worked the week before the survey (n =14,814). We estimated the proportion meeting aerobic and muscle -strengthening PAG in leisure time by occupation activity level (low, intermediate, and high). Using logistic regression, we examined the association between meeting PAG in leisure time and occupation activity level, adjusted for sociodemographic characteristics and stratified by hours worked. We compared the sociodemographic characteristics of adults working >_40 hours (the previous week) in high -activity occupations to those in lowor intermediate -activity occupations. Results: Adults working in high -activity occupations were less likely to meet PAG in leisure time (26.1% [24.3-28.1]) versus those in low -activity (30.6% [29.1-32.2], P < .01) or intermediate -activity (32.4% [30.8- 34.2]) occupations. In stratified, adjusted models, adults working >_40 hours in lowand intermediate -activity occupations were 13% and 20%, respectively, more likely to meet PAG in leisure time versus those in high -activity occupations. Among those working >_40 hours, adults in high -activity occupations were more likely to be Hispanic or Latino, male, younger, and have a high school education or lower compared with those in less active occupations. Conclusion: Traditional surveillance may underestimate meeting PAG among people working in high -activity occupations, potentially disproportionately affecting certain groups.