Performance in physical education and health impairment 30 years later--a community based cohort study

A main purpose of physical education (PE) in school is to promote future health. However, there is very limited evidence of the effects of PE on the adult health. We hypothesized that a low performance in PE was associated with an increased risk of health impairment by middle age.

We performed a cohort study in a community-based setting in Sweden spanning over three decades. We followed up on 1712 of 2225 students (76.9%) who in 1974-1976 graduated with a grade in PE after 9 years of education (mean subject age 16 years). The grade in PE (compulsory subject) was retrieved from municipal archives. We defined three proxies for health impairment: total number of visits to primary care physicians in 2003-2007, having been hospitalized 2003-2007, and total number of days with sick leave in 2004-2007. Using binomial regression models, we adjusted the risk estimates for level of education and occupation. Subjects with an average grade in PE served as reference category.

In both the crude and adjusted model, women with a low grade in PE had more physician visits (adjusted IRR 1.30, 95% confidence interval 1.06-1.60) and an increased number of days with sick leave (adjusted IRR 1.44, 1.05-1.95). An increased, although not significant, risk was also observed for having received in-patient care (adjusted RR 1.26; 0.88-1.80). No significant results or similar pattern were observed in men.

Women with a low grade in PE in adolescence seem to have an increased risk of health impairment by middle age, raising the question of early primary prevention towards these students in particular.