Knowledge grows, participation does not: a decade of changes in access to public physical activity programs among older adults
1
Departamento de Medicina Preventiva da Faculdade de Medicina, Universidade de São Paulo, São Paulo / São Paulo, Brazil
2
Departamento de Epidemiologia da Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo / São Paulo, Brazil
3
Departamento de Política, Gestão e Saúde da Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo / São Paulo, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):A95
ABSTRACT
BACKGROUND:
Public physical activity programs are key strategies to promote healthy ageing. However, awareness of and participation in these programs vary across population groups and urban territories, reflecting selective social and territorial inequalities and posing challenges for physical activity policies in large cities. Evidence on how these inequalities have evolved over time remains limited. This study aimed to analyze changes in awareness of and participation in public physical activity programs among older adults living in São Paulo, Brazil, over a decade.
METHODS:
Data were drawn from representative samples of older adults (60 years or more) participating in two population-based health surveys conducted in São Paulo (ISA-Capital) in 2015 (n=1,019) and 2024 (n=1,490). Outcomes included awareness of and participation in public physical activity programs. Sociodemographic characteristics and area of residence were also assessed. Prevalence estimates, 95% Confidence Intervals (95% CI), and percentage changes over time were calculated. Associations were examined using adjusted Prevalence Ratios (PR), estimated through Poisson regression.
RESULTS:
Between 2015 and 2024, awareness of public physical activity programs increased from 22.5% to 30.6%, representing a 36% increase. In contrast, participation increased by only 3.3%. Awareness increased without increased participation. In adjusted analyses comparing 2024 to 2015, greater increases in awareness were observed among individuals with up to three years of schooling (PR=1.56; 95%CI 1.05–2.30) and among residents of the southern region of the city (PR=2.02; 95%CI 1.15–3.52). No significant differences were observed by age group, sex, or race/skin color, indicating that inequalities were selective rather than widespread.
CONCLUSIONS:
Although awareness of public physical activity programs increased over a decade, this did not translate into meaningful gains in participation. These findings highlight the need for strategies that go beyond dissemination to address structural and territorial barriers and ensure effective and equitable access to public programs within large urban settings.
Public physical activity programs are key strategies to promote healthy ageing. However, awareness of and participation in these programs vary across population groups and urban territories, reflecting selective social and territorial inequalities and posing challenges for physical activity policies in large cities. Evidence on how these inequalities have evolved over time remains limited. This study aimed to analyze changes in awareness of and participation in public physical activity programs among older adults living in São Paulo, Brazil, over a decade.
METHODS:
Data were drawn from representative samples of older adults (60 years or more) participating in two population-based health surveys conducted in São Paulo (ISA-Capital) in 2015 (n=1,019) and 2024 (n=1,490). Outcomes included awareness of and participation in public physical activity programs. Sociodemographic characteristics and area of residence were also assessed. Prevalence estimates, 95% Confidence Intervals (95% CI), and percentage changes over time were calculated. Associations were examined using adjusted Prevalence Ratios (PR), estimated through Poisson regression.
RESULTS:
Between 2015 and 2024, awareness of public physical activity programs increased from 22.5% to 30.6%, representing a 36% increase. In contrast, participation increased by only 3.3%. Awareness increased without increased participation. In adjusted analyses comparing 2024 to 2015, greater increases in awareness were observed among individuals with up to three years of schooling (PR=1.56; 95%CI 1.05–2.30) and among residents of the southern region of the city (PR=2.02; 95%CI 1.15–3.52). No significant differences were observed by age group, sex, or race/skin color, indicating that inequalities were selective rather than widespread.
CONCLUSIONS:
Although awareness of public physical activity programs increased over a decade, this did not translate into meaningful gains in participation. These findings highlight the need for strategies that go beyond dissemination to address structural and territorial barriers and ensure effective and equitable access to public programs within large urban settings.
| eISSN: | 2654-1459 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
