Long-term trends (1973-14) for obesity and educational inequalities among Austrian adults: men in the fast lane.

BACKGROUND: The examination of obesity trends is important to plan public health interventions specific to target-groups. We investigated long-term trends of obesity for the Austrian adult population between 1973 and 2014 according to their sex, age and education and the magnitude of educational-inequalities. METHODS: Data were derived from six national, representative, cross-sectional interview surveys (N = 194 030). Data correction factors for self-reported body mass index (BMI) were applied. Obesity was defined as BMI ≥ 30 kg/m2. Absolute changes (ACs) and aetiologic fractions (AFs) were calculated to identify trends in the obesity prevalence. To measure the extent of social inequality, the relative index of inequality was computed based on educational levels. RESULTS: In 2014, the age-adjusted prevalence of obesity was 14.6% (95%CI: 14.0-15.3) for women and 16.8% (95%CI: 16.1-17.9) for men. Obesity was most prevalent among subjects aged 55-74 years and those with low educational status. The AC in the obesity prevalence during the study period was highest for men aged 75 years and older with high/middle educational levels (16.2%) and also high for subjects aged 55 years and older with low educational levels. The greatest dynamics for obesity were observed among the oldest men with high/middle educational levels. Educational inequalities for obesity were higher among women, but only increased among men. CONCLUSIONS: Since 1973, the prevalence for obesity was observed to be higher for men than women in Austria for the first time. Men showed the greatest increase in prevalence and risk for obesity during the study period. Further studies are needed to determine the drivers behind these trends.

A European perspective on GIS-based walkability and active modes of transport.

Background: The association between GIS-based walkability and walking for transport is considered to be well established in USA and in Australia. Research on the association between walkability and cycling for transport in European cities is lacking. The aim of this study was to test the predictive validity of established walkability measures and to explore alternative walkability measures associated with walking and cycling for transport in a European context. Methods: Outcome data were derived from the representative cross-sectional survey ( n  = 843) ‘Radfreundliche Stadt’ of adults in the city of Graz (Austria). GIS-based walkability was measured using both established measures (e.g. gross population density, household unit density, entropy index, three-way intersection density, IPEN walkability index) and alternative measures (e.g. proportion of mixed land use, four-way intersection density, Graz walkability index). ANCOVAs were conducted to examine the adjusted association between walkability measures and outcomes. Results: Household unit density, proportion of mixed land use, three-way intersection density and IPEN walkability index were positively associated with walking for transport, but the other measures were not. All walkability measures were positively associated with cycling for transport. Conclusion: The established walkability measures were applicable to a European city such as Graz. The alternative walkability measures performed well in a European context. Due to measurement issues the association between these walkability measures and walking for transport needs to be investigated further.

Attitudes among the general Austrian population towards neonatal euthanasia: a survey.

BACKGROUND: The Groningen Protocol aims at providing guidance in end-of-life decision-making for severely impaired newborns. Since its publication in 2005 many bioethicists and health care professionals have written articles in response. However, only very little is known about the opinion among the general population on this subject. The aim of this study was to present the general attitude towards neonatal euthanasia (NE) among the Austrian population and the factors associated with the respondents' opinion. METHODS: A cross-sectional study was conducted among the general Austrian population. Computer-assisted telephone interviews were performed with 1,000 interviewees aged 16 years and older. Binary logistic regression was performed in order to determine factors that are independently associated with the respondents' opinion about neonatal euthanasia. RESULTS: While 63.6% of the participants rejected the idea of neonatal euthanasia for severely impaired newborns, 36.4% opted either in favor or were undecided. Regression analysis has shown the respondents' educational level (p = 0.005) and experience in the care of terminally ill persons (p = 0.001) to be factors that are positively associated with the rejection of neonatal euthanasia, whereas a higher age was associated with a lower degree of rejection (p = 0.021). CONCLUSIONS: We found that the majority of the Austrian population rejects the idea of neonatal euthanasia for severely impaired newborns. However, given the increasing levels of rejection of NE among the younger generations and among people with a higher educational level, it cannot be precluded that the rejection rate might in future increase even further, rather than decrease.

[Analysis of type 2 diabetes-induced late effects based on administrative data of social insurance in Austria and implications for the evaluation of the DMP diabetes mellitus]. / Analyse Diabetes mellitus Typ 2-induzierter Spätfolgen auf Basis von Routinedaten der Sozialversicherung in Österreich und Implikationen zur Evaluierung des DMP Diabetes mellitus.

The present study analyses administrative data of medical services related to the distribution of diabetes mellitus type 2-induced late effects. Pseudonymous statutory health insurance data of all Austrian social security institutions for the years 2006/2007 in outpatient and inpatient (performance and diagnostic data) setting were used. Type 2 diabetics have been identified by prescribed medication. The specific late effects were defined as endpoints and the respective diagnoses and health performances were extracted. The study population included 7,945,774 insured. The percentage of the defined late effects was significantly higher in diabetics than in persons from the general population, with exception for kidney transplantation. The risk of a late effect was greatest among diabetics for an amputation. The results of this study can be used as a baseline for the evaluation of DMP diabetes. The administrative data used are limited for answering the defined research questions. Anyway, the data quality must be improved and unified in Austria.

Long-term trends in obesity among Austrian adults and its relation with the social gradient: 1973-2007.

BACKGROUND: The prevalence of obesity is steadily increasing. There is little empirical evidence for the development of obesity in Austria. Therefore, the present study investigated long-term trends in the prevalence of obesity across different age and educational groups in Austrian adults. METHODS: Self-reported data were derived from five nationally representative cross-sectional interview surveys (n = 178,818) in the years 1973, 1983, 1991, 1999 and 2006-07 in private homes and long-term care facilities for Austrian adults aged 20-99 years. An adjustment of the self-reported BMI was performed. Obesity was defined as BMI ≥ 30 kg m(-2). RESULTS: The age-adjusted prevalence of obesity was 11% during the study period (women: 11.3%, 95% CI 11.2-11.6; men: 9.9%, 95% CI 9.7-10.2). Obesity and a high mean BMI were most prevalent among subjects aged 55-74 years and among those with low educational status. The absolute change in obesity prevalence during the study period was significantly highest (P < 0.001) among women aged ≥ 75 years (3.0%), and among men aged 55-75 years (3.6%). Concerning educational level, the largest increase in obesity was seen in those with a low educational level (women: 4.1%, men: 2.6%; P < 0.001), whereas the aetiologic fraction was highest in middle-educated men. Relative inequalities for obesity showed a tendency to increase during the study period. CONCLUSION: Examining trends in subpopulations is important when planning accurate target group-specific prevention strategies. Therefore, in Austria targeted preventive measures should be designed according to age and educational level.

Factors associated with the rejection of active euthanasia: a survey among the general public in Austria.

BACKGROUND: In recent decades, the general public has become increasingly receptive toward a legislation that allows active voluntary euthanasia (AVE). The purpose of this study was to survey the current attitude towards AVE within the Austrian population and to identify explanatory factors in the areas of socio-demographics, personal experiences with care, and ideological orientation. A further objective was to examine differences depending on the type of problem formulation (abstract vs. situational) for the purpose of measuring attitude. METHODS: A representative cross-sectional study was conducted across the Austrian population. Data were acquired from 1,000 individuals aged 16 years and over based on telephone interviews (CATI). For the purpose of measuring attitude toward AVE, two different problem formulations (abstract vs. situational) were juxtaposed. RESULTS: The abstract question about active voluntary euthanasia was answered negatively by 28.8%, while 71.2% opted in favour of AVE or were undecided. Regression analyses showed rejection of AVE was positively correlated with number of adults and children in the household, experience with care of seriously ill persons, a conservative worldview, and level of education. Mean or high family income was associated with lower levels of rejection. No independent correlations were found for variables such as sex, age, political orientation, self-rated health, and experiences with care of terminally ill patients. Correlation for the situational problem formulation was weaker and included fewer predictors than for the abstract question. CONCLUSIONS: Our results suggest that factors relating to an individual's interpersonal living situation and his/her cognitive convictions might be important determinants of the attitude toward AVE. If and to the extent that personal care experience plays a role, it is rather associated with rejection than with acceptance of AVE.

Validity of self-reported weight and height in Austrian adults: sociodemographic determinants and consequences for the classification of BMI categories.

OBJECTIVE: Epidemiological studies have shown that adults tend to underestimate their weight and overestimate their height. This may lead to a misclassification of their BMI in studies based on self-reported data. The aim of the present study was to assess the validity of self-reported weight and height in Austrian adults. DESIGN: Data on weight, height, health behaviour and sociodemographic characteristics of adults were collected in a standardized procedure via a self-filling questionnaire and a medical examination including measurements of weight and height. SETTING: A publicly accessible out-patient clinic in southern Austria. SUBJECTS: Austrian residents (n 473) aged 18 years and older who attended a health check participated in the study. RESULTS: The mean difference between reported and measured BMI was not significant in younger adults (<35 years: mean difference -0·21 kg/m2; P < 0·08) but increased significantly with age (≥55 years: mean difference -0·68 kg/m2; P < 0·001). The prevalence of normal weight (BMI = 18·5-24·9 kg/m2) and overweight (BMI = 25·0-29·9 kg/m2) was overestimated based on the self-reported data on BMI, while that for underweight (BMI < 18·5 kg/m2) and obesity (BMI ≥ 30·0 kg/m2) was underestimated (P < 0·001). The self-reported data showed an obesity prevalence of 12·5 %, while measurement showed a prevalence of 15·4 % (P < 0·001). CONCLUSIONS: Our results indicate that prevalence rates of obesity are probably underestimated for Austrian adults when using self-reported weight and height information. The deviations from the measured data clearly increased with age. Analyses based on self-reported data should therefore be adjusted for the age dependency of the validity.

Changing attitudes towards euthanasia among medical students in Austria.

BACKGROUND: In most European countries the attitudes regarding the acceptability of active euthanasia have clearly changed in the population since World War II. Therefore, it is interesting to know which trends in attitudes prevail among the physicians of the future. METHODS: The present study analyses trends in the attitudes towards active euthanasia in medical students at the Medical University of Graz, Austria. The survey was conducted over a period of 9 years, enabling us to investigate trends regarding both attitudes and underlying motives. RESULTS: Acceptance of active euthanasia increased from 16.3% to 29.1% to 49.5% in the periods from 2001 to 2003/04 to 2008/09. CONCLUSIONS: The survey period from 2001 to 2009 reveals a massive change in medical students' attitudes towards active euthanasia under medical supervision. Ethical convictions of medical doctors seem to fall back behind a higher valuation of the autonomy of the patient.

A hierarchical analysis of social determinants of measles vaccination coverage in Austrian schoolchildren.

BACKGROUND: Numerous socio-economic and demographic factors have been identified as being associated with low vaccination coverage in children. However, the complex interrelation between these factors is not fully understood. We focused our study on the less well-established associations of familial resources for child care with vaccination coverage and their interrelationship with socio-demographic factors. METHODS: This cross-sectional study (n = 2386) focuses on parental social status and on resources for child care as determinants of measles vaccination coverage of schoolchildren aged 6-13 years in Styria, Austria. In order to reveal the relationships among these factors, an analysis based on a conceptual hierarchical model was performed. The so-called graphical modelling approach was used for the multivariate analysis of the hierarchically structured determinants. RESULTS: The findings indicate that vaccination coverage is directly associated with a large number of children in the family (P < 0.0001) and directly as well as indirectly associated with a low level of education of the father (P < 0.001). All other included child-care resources are only indirectly associated with a low coverage, whereby the number of children acts as main mediating factor. CONCLUSIONS: The results suggest that vaccination programmes should mainly focus on families with many children or parents of low educational level and not on the whole population.

Association of built-environment, social-environment and personal factors with bicycling as a mode of transportation among Austrian city dwellers.

OBJECTIVE: To determine the association of built-environment, social-environment, and personal-level factors with bicycling for transportation, among adult city dwellers. METHOD: Survey of a representative sample of 1000 inhabitants of the city of Graz, Austria, using a computer-assisted telephone interview addressing cycling behavior and associated personal, social and environmental factors. RESULTS: The prevalence of biking for transportation was 22.5%. After adjustment for gender, age, education, physical activity level and distance from home to destination, cycling was positively associated with the presence of bike lane connectivity (OR=2.09) and social support/modeling (OR=1.62), and negatively associated with the perceived barriers of "physical discomfort" (OR=0.49) and "an impractical transport mode" (OR=0.50). Analysis of interactions indicated that the effect of the perceived benefit of "rapidity" was stronger in physically active persons than inactive individuals, and the effect of the perceived barrier of "an impractical mode of transportation" was stronger among women than men. CONCLUSION: In addition to cycling-related social support and perceived benefits and barriers, bike lane connectivity may be an important determinant of cycling as a means of transportation among adult city dwellers.

Are residents of high-walkable areas satisfied with their neighbourhood?

AIM: While the association between walkability and walking for transport has been well established, less is known about the association between walkability and neighbourhood satisfaction. This study aims to examine the direction and strength of the association between objective measures of residential walkability and neighbourhood satisfaction, as well as the differences by sex. SUBJECTS AND METHODS: Using a cross-sectional study design, outcome data were derived from the representative cross-sectional survey (n = 843) 'Bicycle-friendly City' of adults in the city of Graz (Austria). Walkability was measured as gross population density, household unit density, entropy index, proportion of mixed land use, three-way intersection density, four-way intersection density and walkability indices. The outcomes were measured as general neighbourhood satisfaction and neighbourhood satisfaction with the general socio-environmental quality, social cohesion and local infrastructure. Logistic regression analyses were conducted, including age, socio-economic status and place of residence. RESULTS: Walkability was negatively associated with general neighbourhood satisfaction, neighbourhood satisfaction with general socio-environmental quality and social cohesion. It was positively associated with neighbourhood satisfaction with local infrastructure. Connectivity and the entropy index showed the weakest or no association with the outcomes. The strongest association was between walkability and neighbourhood satisfaction with socio-environmental quality. There were no differences by sex. CONCLUSION: These results contribute to the current limited understanding of the association between walkability and neighbourhood satisfaction, especially in a European context. More comparable, longitudinal research would be helpful to determine what impact walkability has on neighbourhood satisfaction and to identify the important mediating factors.

Rising prevalence of back pain in Austria: considering regional disparities.

BACKGROUND: Back pain is the most common form of musculoskeletal conditions and leads to high health care costs. Information about geographic variations in highly prevalent diseases/disorders represents important implications for public health planning to face structural challenges. The present study aims to investigate regional trends in the prevalence of back pain and the role of obesity and social inequalities among Austrian adults. METHODS: A secondary data analysis based on five nationally representative cross-sectional surveys (1973-2007) was carried out (N = 178,818). Back pain was measured as self-reported presence. Obesity (BMI ≥ 30 kg/m²) was adjusted for self-report bias. For the regional analyses, Austria was divided into Western, Central and Eastern Austria. A relative index of inequality (RII) was computed to quantify the extent of social inequality. RESULTS: A continuous rise in back pain prevalence was observed in the three regions and among all investigated subgroups. In 2007 the age-standardised prevalence was similar in Central (36.9 %), Western (35.2 %) and Eastern Austria (34.3 %). The absolute change in back pain prevalence was highest among obese subjects in Central Austria (women: + 29.8 %, men: + 32.5 %). RIIs were unstable during the study period and in 2007 highest in Eastern Austria. CONCLUSION: Variation and trends in back pain are not attributable to geographic variation in Austria: an assumed East-West gradient in Austria has not been confirmed. Nevertheless our study confirms that back pain dramatically increased in all Austrian regions and investigated subgroups. This worrying trend should be further monitored and public health interventions should be implemented increasingly, especially among obese women and men.

Trends in socioeconomic inequalities in self-assessed health in 10 European countries.

BACKGROUND: Changes over time in inequalities in self-reported health are studied for increasingly more countries, but a comprehensive overview encompassing several countries is still lacking. The general aim of this article is to determine whether inequalities in self-assessed health in 10 European countries showed a general tendency either to increase or to decrease between the 1980s and the 1990s and whether trends varied among countries. METHODS: Data were obtained from nationally representative interview surveys held in Finland, Sweden, Norway, Denmark, England, The Netherlands, West Germany, Austria, Italy, and Spain. The proportion of respondents with self-assessed health less than 'good' was measured in relation to educational level and income level. Inequalities were measured by means of age-standardized prevalence rates and odds ratios (ORs). RESULTS: Socioeconomic inequalities in self-assessed health showed a high degree of stability in European countries. For all countries together, the ORs comparing low with high educational levels remained stable for men (2.61 in the 1980s and 2.54 in the 1990s) but increased slightly for women (from 2.48 to 2.70). The ORs comparing extreme income quintiles increased from 3.13 to 3.37 for men and from 2.43 to 2.86 for women. Increases could be demonstrated most clearly for Italian and Spanish men and women, and for Dutch women, whereas inequalities in health in the Nordic countries showed no tendency to increase. CONCLUSIONS: The results underscore the persistent nature of socioeconomic inequalities in health in modern societies. The relatively favourable trends in the Nordic countries suggest that these countries' welfare states were able to buffer many of the adverse effects of economic crises on the health of disadvantaged groups.

Prevalent Long-Term Trends of Hypertension in Austria: The Impact of Obesity and Socio-Demography.

BACKGROUND: Globally there are only less long-term-studies on hypertension available to provide reliable estimates and identify risk groups. This study aims to analyse the prevalence and long-term-trend of hypertension in Austria, recognize affected subpopulations and investigate social inequalities. METHODS: This representative population-based study is based on self-reported data of adults (mean age: 47.7 ± 17.5; n = 178,818) that were taken from five health surveys between 1973 and 2007. An adjustment of self-reported BMI was performed based on a preliminary validation study. Absolute changes (AC) and aetiologic fractions (AF) were calculated from logistic regressions in order to measure trends. To quantify the extent of social inequality, a relative index of inequality (RII) was computed. RESULTS: During the study period the age-standardized hypertension prevalence increased from 1.0% to 18.8%, with a considerable rise from 1991 onwards. There was a positive trend in all subpopulations, with the highest AC among obese women (+50.2%) and obese subjects aged 75 years and older (+54.4%), whereas the highest risk was observed among the youngest obese adults (AF: 99.4%). The RII for hypertension was higher for women than men, but in general unstable during the investigation period. CONCLUSIONS: Obesity and older age are significant factors for increased morbidity of hypertension. The most undesirable trends occurred in obese women and obese subjects aged 75 years and older. These risk groups should be given special attention when planning hypertension prevention programs. The high increase in the prevalence of hypertension is due to different aspects, e.g. a demographic change and a change in the definition of hypertension. These findings help to understand why hypertension is becoming more common in the Austrian population.

Determinants of Public Attitudes towards Euthanasia in Adults and Physician-Assisted Death in Neonates in Austria: A National Survey.

BACKGROUND: Euthanasia remains a controversial topic in both public discourses and legislation. Although some determinants of acceptance of euthanasia and physician-assisted death have been identified in previous studies, there is still a shortage of information whether different forms of euthanasia are supported by the same or different sub-populations and whether authoritarian personality dispositions are linked to attitudes towards euthanasia. METHODS: A large, representative face-to-face survey was conducted in Austria in 2014 (n = 1,971). Respondents faced three scenarios of euthanasia and one of physician assisted death differing regarding the level of specificity, voluntariness and subject, requiring either approval or rejection: (1) abstract description of euthanasia, (2) abstract description of physician-assisted suicide, (3) the case of euthanasia of a terminally-ill 79-year old cancer patient, and (4) the case of non-voluntary, physician assisted death of a severely disabled or ill neonate. A number of potential determinants for rejection ordered in three categories (socio-demographic, personal experience, orientations) including authoritarianism were tested via multiple logistic regression analyses. RESULTS: Rejection was highest in the case of the neonate (69%) and lowest for the case of the older cancer patient (35%). A consistent negative impact of religiosity on the acceptance across all scenarios and differential effects for socio-economic status, area of residence, religious confession, liberalism, and authoritarianism were found. Individuals with a stronger authoritarian personality disposition were more likely to reject physician-assisted suicide for adults but at the same time also more likely to approve of physician-assisted death of a disabled neonate. CONCLUSION: Euthanasia in adults was supported by a partially different sub-population than assisted death of disabled neonates.

How are physical activity behaviors and cardiovascular risk factors associated with characteristics of the built and social residential environment?

BACKGROUND: The aim of our study was to identify perceptions of built and social residential characteristics and their association with behaviors such as physical activity (PA), nutrition and smoking and with cardiovascular risk factors (elevated BMI and fasting blood glucose). METHODS: Among participants of a preventive medical checkup at an Austrian District Health Insurance Fund (n=904, response rate = 82.2%, 42% women, 18-91 years) self-reported and measured data were collected. RESULTS: Total PA was positively associated with the presence of trees along the streets and high levels of pro-physical activity social modeling (SM) and it was negatively related to perceived safety from crime. More leisure-time PA was associated with higher levels of cycling/walking infrastructure and high levels of SM. PA for transportation was positively related to high levels of connectivity and high levels of SM. Better behavioral cardiovascular risk factor profiles (smoking and nutrition) were associated with high levels of SM and high levels of total PA. Lower BMI values were associated with high levels of infrastructure and high levels of SM. CONCLUSIONS: Both built and social residential characteristics are important correlates of PA as well as of major cardiovascular risk factors besides PA.

Nutrition and health: different forms of diet and their relationship with various health parameters among Austrian adults.

Population-based studies report a beneficial health effect and a lower mortality rate for diets rich in fruits and vegetables. Therefore, the aim of our study was to analyze differences between various forms of diet and health-related variables. The sample for this study was taken from the Austrian Health Interview Survey 2006/07 (N = 15,474). Multivariate analyses of variance adjusted by sex, age, and socioeconomic status (SES) were conducted to examine health-related behavior, health, and quality of life depending on different forms of diet. Additionally, differences in the SES and body mass index (BMI) were analyzed. Our results show that a vegetarian diet is associated with a better health-related behavior, a lower BMI, and a higher SES. Subjects eating a carnivorous diet less rich in meat self-report poorer health, a higher number of chronic conditions, an enhanced vascular risk, as well as lower quality of life. In conclusion, our results have shown that consuming a diet rich in fruits and vegetables is associated with better health and health-related behavior. Therefore, public health programs are needed for reducing the health risks associated with a carnivorous diet.

A 35-year trend analysis for back pain in Austria: the role of obesity.

BACKGROUND: The prevalence of back pain is constantly increasing and a public health problem of high priority. In Austria there is a lack of empirical evidence for the development of back pain and its related factors. The present study aims to investigate trends in the prevalence of back pain across different subpopulations (sex, age, obesity). METHODS: A secondary data analysis based on five nationally representative cross-sectional health surveys (1973-2007) was carried out. Face-to-face interviews were conducted in private homes in Austria. Subjects aged 20 years and older were included in the study sample (n = 178,818). Obesity was defined as BMI≥30 kg/m2 and adjusted for self-report bias. Back pain was measured as the self-reported presence of the disorder. RESULTS: The age-standardized prevalence of back pain was 32.9% in 2007; it was higher among women than men (p<0.001), higher in older than younger subjects (p<0.001) and higher in obese than non-obese individuals (p<0.001). During the investigation period the absolute change in the prevalence of back pain was +19.4%. Among all subpopulations the prevalence steadily increased. Obese men showed the highest increase of and the greatest risk for back pain. CONCLUSION: These results help to understand the development of back pain in Austria and can be used to plan controlled promotion programs. Further monitoring is recommended in order to control risk groups and plan target group-specific prevention strategies. In Austria particular emphasis should be on obese individuals. We recommend conducting prospective studies to confirm our results and investigate causal relationships.

Moderate- and vigorous-intensity exercise behaviour according to the Transtheoretical Model: associations with smoking and BMI among Austrian adults.

BACKGROUND: Regular physical activity leads to a number of physiological benefits, such as reduced risk of coronary heart disease, diabetes mellitus and obesity. In Austria, there is little information about the prevalence of physically inactive people, as well as about who is more likely to belong to the inactive or irregularly active groups. The aim of this study is to describe the socio-demographic distributions across the stages of behavioural change for moderate- and vigorous-intensity physical activity, according to the Transtheoretical Model, and to identify associations with smoking and body mass index (BMI). METHOD: Data were collected in a standardised procedure using a self-report questionnaire from 489 adults who attended a health check in an outpatient clinic in southern Austria. Height and weight were measured by physicians. The subjects were categorised into the five stages of change (pre-contemplation, contemplation, preparation, action, maintenance), separately assessed for moderate- and vigorous-intensity physical activity. RESULTS: The likelihood of being in the stage of maintenance of moderate-intensity physical activity was highest in older subjects (p < 0.05). Participants of a high educational level showed the highest likelihood of being physically active in vigorous-intensity physical activity (p < 0.05). Furthermore, the lowest stages of change behaviour were associated with higher BMI levels for vigorous-intensity physical activity (p < 0.05). Smokers were significantly (p < 0.05) more likely not to perform vigorous-intensity physical activity than non-smokers. CONCLUSION: Our findings contribute to a better understanding of behavioural correlates of regular physical activity. The results may prove useful for developing promotion programmes for physical activity, allowing targeting of the identified risk groups.

Self-perceived health, quality of life, and health-related behavior in obesity: is social status a mediator?

BACKGROUND: Obesity prevalence is increasing worldwide and is associated with a high health risk. Unfavorable psychological factors, lower self-ratings of health, and worse health-related behavior can be found in individuals with a low socioeconomic status (SES). Therefore, the aim of this study is to investigate whether obese subjects with a high SES differ from those with a low SES depending on these outcomes. METHODS: Data of the Austrian Health Interview Survey (ATHIS) 2006/2007-precisely of 760 obese subjects with a low SES and 851 with a high SES-were analyzed stratified by sex and adjusted by age with regard to differences in self-perceived health, quality of life (regarding physical and psychological health, environment, and social relationships), and health-related behavior (smoking, alcohol consumption, eating behavior, physical exercise). RESULTS: The results have shown that obese subjects with a low SES differ significantly from those with a high SES in terms of self-perceived health, quality of life, and intensity of physical activities. Furthermore, differences were found in obese women as to smoking behavior, alcohol consumption, and continuance of physical exercise. CONCLUSION: It seems that not only obesity but also the socioeconomic status plays a role in health, and the risk assessment of obese individuals in the primary health care setting should include socioeconomic factors. Furthermore, public health programs which focus on obese subjects with a low SES are urgently needed.