Cardiovascular Journal of Africa: Vol 30 No 5 (October 2019)

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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 30, No 5, September/October 2019 262 AFRICA
Ellisras Longitudinal Study 2017: patterns of physical
activity in an urban and rural setting among black South
African adults (ELS 23)
Z Smart Mabweazara, L Lloyd Leach, Mario Smith, Lungiswa Tsolekile, Thandi Puoane
Abstract
Background: Understanding patterns of physical activity
among adults can lead to targeted approaches to improve
activity levels in the African population. This study aimed
to determine whether age, gender, location and employment
status could predict physical activity among rural and urban
South African adults, and to determine the participants’ risk
of developing cardiovascular disease (CVD).
Methods: A cross-sectional design was conducted on 319
participants of mean age 57 ± 10.43 years. Participants were
sampled using a stratified random-sampling procedure from
an urban township in Langa, Western Cape Province, and a
rural township in Mt Frere, Eastern Cape Province, South
Africa. A researcher-generated questionnaire was used to
collect sociodemographic and physical activity data. Linear
regression analysis was used to test predictive relationships.
Results: Gender and geographical location were significant
predictors (p = 0.001) of physical activity. Rural participants
engaged more in physical activity (91.5%) than urban partici-
pants (84.2%) and were more likely to meet the physical activ-
ity recommendations to promote cardiovascular fitness (p =
0.000). The most frequent physical activities in rural partici-
pants were walking (15.4%), household chores (18.8%) and
household chores + gardening (15.4%). The most frequent
physical activities in urban participants were household
chores (34.2%), and household chores + walking (33.7%). In
terms of duration of physical activity, rural participants spent
longer periods engaging in activities lasting up to two hours
(21.4%), compared to 5.9% in urban participants (p = 0.000).
Conclusions: Gender and geographical location were signifi-
cant predictors of physical activity among black South
African adults. Overall, rural adults engaged in more physical
activity than urban-dwelling adults. Males also engaged in
more physical activity and at a higher intensity than females.
Most rural participants met the American College of Sports
Medicine recommendations for cardiovascular fitness and
therefore were at minimal risk for developing CVD compared
to their urban counterparts.
Keywords: black South African adults, physical activity
Submitted 13/4/18, accepted 11/4/19
Cardiovasc J Afr 2019; 30: 262–267
DOI: 10.5830/CVJA-2019-018
Ecological models of health behaviour emphasise the importance
of sociodemographic and psychological factors, as well as the
physical environment in explaining the behavioural patterns of
physical activity (PA).1 In most cases, urban neighbourhoods
are built in such a way that they are pedestrian orientated, with
high walkability that encourages physical activity and active
transportation.2 On the other hand, rural neighbourhoods
are said to be more automobile dependent with poor street
connectivity.3 Therefore, given the differences in environmental
characteristics, physical activity levels may be lower in rural
environments compared to urban environments.4 Indeed,
geographical location may play a role in the physical activity of
individuals.
A Belgian study showed that urban adults took more steps
per day, walked and cycled more often as a means of transport,
and engaged in more recreational walking compared to rural
adults.5 Similarly, some studies in the USA have investigated
differences in physical activity between urban and rural adults.4
As in the van Dyck et al.1 study, the results showed that urban
adults were more active than rural adults. In Africa, a similar
trend was noted. Rural South African adults were reported to
lead sedentary lifestyles compared to their counterparts residing
in urban areas.5
However, contrasting results have been reported in some
studies. In India, Tripathy et al .6 assessed the differences in
dietary habits, physical activity levels and obesity among urban
and rural adults. They found no significant differences in work-,
transport- and recreation-related physical activity between urban
and rural participants.6 An interesting finding of the Tripathy et
al .6 study was that females residing in a rural area were reported
to engage in more vigorous-intensity physical activity than those
residing in an urban area.
There are important gender differences in the motives for
engaging in physical activity in males and females.7 Males
have been found to be motivated by intrinsic factors (strength,
competition and challenge), whereas females by extrinsic factors
(body weight management and physical appearance).8,9 Khan
et al.10 found that gender was a significant predictor of health-
School of Public Health, University of the Western Cape,
Cape Town, South Africa
Z Smart Mabweazara, PhD,
Lungiswa Tsolekile, PhD
Thandi Puoane, PhD
Department of Sports Recreation and Exercise Science,
University of the Western Cape, Cape Town, South Africa
Z Smart Mabweazara, PhD
L Lloyd Leach, PhD
Department of Psychology, University of the Western Cape,
Cape Town, South Africa
Mario Smith, PhD