Municipal resources to promote adult physical activity ‑ a multilevel follow‑up study

Kuvaja‑Köllner et al. BMC Public Health (2022) 22:1213

https://doi.org/10.1186/s12889-022-13617-8

RESEARCH

Municipal resources to promote adult

physical activity ‑ a multilevel follow‑up study

Virpi Kuvaja‑Köllner1*, Eila Kankaanpää1

, Johanna Laine1

, Katja Borodulin2,3, Tomi Mäki‑Opas3,4 and

Hannu Valtonen1

Abstract

Background: In Finland, local authorities (municipalities) provide many services, including sports and physical activ‑

ity facilities such as pedestrian and bicycle ways and lanes, parks, sports arenas and pools. This study aimed to deter‑

mine whether local authorities can promote physical activity by allocating resources to physical activity facilities.

Methods: The data on municipality expenditure on physical activity and sports, number of sports associations

receiving subsidies from the municipality, kilometers of ways for pedestrians and bicycles and hectares of parks in

1999 and 2010 were gathered from national registers. These data were combined using unique municipal codes with

individual survey data on leisure-time physical activity (N=3193) and commuting physical activity (N=1394). Panel

data on physical activity originated from a national health survey, the Health 2000 study, conducted in 2000–2001 and

2011–2012. We used the data of persons who answered the physical activity questions twice and had the same place

of residence in both years. In the data, the individuals are nested within municipalities, and multilevel analyses could

therefore be applied. The data comprised a two-wave panel and the individuals were followed over 11 years.

Results: The resources for physical activity varied between municipalities and years. Municipal expenditure for

physical activity and total kilometers of pedestrian ways increased signifcantly during the 11 years, although a clear

decrease was observed in individuals’ physical activity. In our models, individual characteristics including higher

education level (OR 1.87) and better health status (OR 7.29) increased the odds of increasing physical activity. Female

gender was associated with lower (OR 0.83) leisure-time physical activity. Living in rural areas (OR 0.37) decreased

commuting physical activity, and age (OR 1.05) increased it. Women (OR 3.16) engaged in commuting physical activ‑

ity more than men.

Conclusions: Individual-level factors were more important for physical activity than local resources. A large part of

the variation in physical activity occurs between individuals, which suggests that some factors not detected in this

study explain a large part of the overall variation in physical activity.

Keywords: Physical activity, Population survey, Municipality, Resource allocation, Panel data, Multilevel model

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Background

Physical inactivity is a contributory cause for a number

of chronic conditions, such as cardiovascular diseases

and type 2 diabetes [1–3]. Physical inactivity not only has

a negative impact on health and quality of life, but also

increases health care costs [4, 5]. For example, in Swit￾zerland, physical inactivity was estimated to be respon￾sible for 2% of disability-adjusted life years lost and 1.2%

Open Access

*Correspondence: [email protected]

1

Department of Health and Social Management, University of Eastern

Finland, POB 1627, FIN‑70211 Kuopio, Finland

Full list of author information is available at the end of the article