title: Socioecological Risk Predictors of Physical Activity and Associated Mortality.
abstract: OBJECTIVE
  To assess (1) the cumulative effect of socioecological factors (social risk) on objectively measured physical activity, (2) the cumulative socioecological risk on all-cause mortality, (3) the potential interaction effects of social risk factors on physical activity and mortality, and (4) whether physical activity mediates the relationship between social risk and mortality.
  
  
  METHODS
  Cross-sectional and prospective.
  
  
  METHODS
  Laboratory- and survey-based testing of the general US population.
  
  
  METHODS
  Five thousand five hundred seventy-four adult participants of the National Health and Nutrition Examination Survey 2003 to 2006.
  
  
  METHODS
  Social risk was assessed from 4 variables, namely poverty level, education, minority status, and social living status. Moderate-to-vigorous physical activity (MVPA) was assessed via accelerometry. Mortality was assessed via linkage with the National Death Index, with follow-up through 2011.
  
  
  METHODS
  Negative binomial regression and Cox proportional hazard model.
  
  
  RESULTS
  Compared to those with 0 social risk factors, those with 1 and 2+ social risk factors engaged in 11% and 10% less MVPA, respectively. Those with 1 (vs 0) social risk factor had a 2.0-fold increase in mortality risk, and those with 2+ (vs 0) social risk factors had a 2.3-fold increase in mortality risk. Interaction effects for various socioecological factors on both MVPA and mortality were observable.
  
  
  CONCLUSIONS
  Cumulative social risk is associated with less MVPA and increased all-cause mortality risk. Given the interaction effects of socioecological factors, targeted interventions in identified populations may be needed.
authors.affiliation: 1 Jackson Heart Study Vanguard Center of Oxford, The University of Mississippi, Oxford, MS, USA.|2 Center for Health Behavior Research, The University of Mississippi, Oxford, MS, USA.|3 Department of Health, Exercise Science and Recreation Management, The University of Mississippi, Oxford, MS, USA.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Loprinzi
authors.affiliation: 2 Center for Health Behavior Research, The University of Mississippi, Oxford, MS, USA.|3 Department of Health, Exercise Science and Recreation Management, The University of Mississippi, Oxford, MS, USA.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Davis
mesh_terms: D061725:Accelerometry; D000328:Adult; D002423:Cause of Death; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D011446:Prospective Studies; D012307:Risk Factors; D057185:Sedentary Behavior; D012931:Social Environment; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States
keywords: epidemiology; exercise; social risk; survival