Associations of socioeconomic position and self-rated physical fitness in Finnish population

Several health indicators establish that those in higher socioeconomic position (SEP) have longer and healthier lives. Health behaviour, such as physical activity (PA), is an important explaining factor for health inequalities. Physical fitness as predictor of morbidity and mortality emphasizes the health-enhancing character of PA, while taking into account also other health-influencing factors such as obesity, smoking, chronic diseases and genetic variability. However, physical fitness is a rarely used measure in population level studies. The association of SEP and physical fitness is hardly studied at all. The aim of this thesis is to study the socioeconomic differences in self-rated physical fitness (SRPF) in Finnish population. The data were received from The National Institute for Health and Welfare, that collected the data in spring 2007 for a cross-sectional population based National FINRISK Study. The participants were from 25 to 74 years old. The total sample size was 10 000 and 6258 persons filled out the questionnaire and participated in the health examination. The final analyses included 5830 persons, 2722 men and 3108 women. The statistical method was ordinal logistic regression analysis. Longer educational career was associated with better SRPF, but the differences were largely mediated by health behaviour related factors. The mediating factors were different among men and women. Leisure-time PA mediated fully and body mass index (BMI) partly the fitness-related educational differences among men. The combination of BMI, history of chronic diseases and smoking mediated the SRPF differences between education thirds fully among men and partly among women. The full model with adjustments for age, employment status, commuting PA, leisure-time PA, occupational PA, BMI, history of chronic diseases and smoking mediated all educational differences in SRPF in both genders.In health promotion, special attention should be paid to those with low levels of leisure-time PA. Including measures of SRPF to epidemiological research is likely to produce more accu-rate information especially from the participants’ physical health level. This thesis provided preliminary information for decision makers in social and health welfare and future studies. More research is needed to specify the character of SRPF and its relation to objectively measured physical fitness and other health indicators