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Adherence to 24-Hour Movement Guidelines and Self-Rated Health Among U.S. Adults With and Without Disabilities
1Department of Human Movement Studies and Special Education, Old Dominion University, Norfolk, Virginia.
Introduction:
Self-rated health reflects individuals' perceptions of their overall health status and is a strong predictor of morbidity and mortality. This study examines the associations between adherence to 24-hour movement guidelines and self-rated health among U.S. adults with and without disabilities.
Methods:
This cross-sectional study utilized data from the 2021-2023 National Health and Nutrition Examination Survey, a nationally representative sample of U.S. adults (N=8,153). Survey-weighted logistic regression with multiple imputation was used to assess the associations between meeting individual and combined 24-hour movement guidelines and self-rated health by disability status. Sensitivity analyses were conducted using complete-case analysis with (1) survey-weighted complex-sample logistic regression and (2) unweighted logistic regression to assess the robustness of the findings.
Results:
Meeting the full 24-hour movement guidelines was associated with higher odds of having good-to-excellent self-rated health than meeting none among adults without disabilities (AOR=4.63, 95% CI=3.00, 7.16) and those with disabilities (AOR=2.69, 95% CI=1.73, 4.17). Among adults without disabilities, meeting all 3 guidelines showed the greatest association with good-to-excellent self-rated health (AOR=4.63), whereas among adults with disabilities, the highest ORs were observed for meeting physical activity + sedentary behavior (AOR=3.47, 95% CI=2.11, 5.68) and physical activity + sleep (AOR=3.10, 95% CI=1.18, 8.14) guidelines. The ORs of good-to-excellent self-rated health increased progressively with the number of guidelines met across all adults (met 1: AOR=1.38; met 2: AOR=2.24; met 3: AOR=4.18; all p<0.05).
Conclusions:
Adherence to multiple components of the 24-hour movement guidelines, especially those including physical activity, was positively associated with self-rated health. For adults with disabilities, meeting at least 2 guidelines was associated with better self-rated health than meeting none.
