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Racial health disparities: a population-based analysis of physical activity and diabetes-related complications in
J Feter1, N Feter2, D Umpierre3
1Postgraduate Program of Health Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; LADD Lab, Hospital de Clínicas de Porto Alegre, Centro de Pesquisa Clínica, Porto Alegre, RS, Brazil.
Objectives:
Racial disparity in physical activity in people with diabetes in Brazil remains scarcely investigated. We examined the association between physical activity and diabetes-related complications according to race in the Brazilian population.
Study Design:
Cross-sectional.
Methods:
We analyzed data from the 2019 National Health Survey, a population-based survey of Brazilian adults. We used a self-reported questionnaire to assess physical activity during commuting, leisure-time, domestic, and occupational activities. Diabetes-related complications included vision, kidney, and circulatory impairment, foot ulcers, diabetic coma, and all-cause complications. We used robust Poisson regression models with restricted cubic splines to examine the association between physical activity and diabetes-related complications.
Results:
We included 2529 adults with diabetes (48.9% women; mean age: 53.5 ± 11.9 years). One-third experienced diabetes-related complications. Black adults performed less leisure-time and more occupational and commuting physical activity than White participants. Black participants showed a higher probability of all-cause (1.61; 95%CI: 1.29, 2.02) and vision complications (1.58; 95%CI: 1.23, 2.04) compared to White participants independent of physical activity status. Only leisure-time physical activity was associated with a reduced probability of all-cause complications (PR: 0.78; 0.71, 0.86) whereas commuting and occupational physical activity were not associated with any diabetes-related complications. Physically inactive, Brown adults showed a higher probability of kidney, circulatory, vision, and all-cause complications than active, White adults. However, physical activity attenuated the probability of these complications in Brown participants.
Conclusion:
The association between physical activity and diabetes-related complications is domain-specific. We revealed a racial disparity in physical activity in people with diabetes in Brazil.
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