Abstract Introduction:<\b>
Findings from middle-income countries (MIC) support that necessity (vs. choice) drives physical activity (PA). This study examined the role of socioeconomic status (SES) and motor vehicle ownership (MVO) on transport-based PA in Cuernavaca, Mexico (MEX), and Chennai, India (IND). Methods:<\b>
Cross-sectional analysis of 674 and 367 adults (≥18 years) from MEX (2011), and IND (2015), respectively. Data were collected using standardized procedures of the International Physical Activity Environment Network study. Outcomes (yes/no) were: public transit use; active travel, ≥150 minutes/week of transport-based PA (TPA). Three logistic regression models were run per outcome: SES (income) as single-independent variable, MVO as single-independent variable, and SES plus MVO as mutually-adjusted independent variables. Models were adjusted for age, sex, marital status, and neighborhood cluster. Results:<\b>
In both sites, SES was inversely associated with public transit use, active travel, and TPA. After adjusting for MVO, the relation between SES and public transit use was no longer significant. In both sites, SES (IND: OR=0.1, 95%CI=0.1-0.4; MEX: OR=0.7, 95%CI=0.5,1.0) and MVO (IND: OR=0.2, 95%CI=0.0,0.6; MEX: OR=0.2, 95%CI=0.2,0.4) remained independently and inversely associated with active travel, and with TPA only in IND ([SES]OR=0.1, 95%CI=0.1,0.2, [MOV]OR=0.3, 95%CI=0.1,0.8). In MEX, only MOV remained significantly associated with TPA (OR=0.7, 95%CI=0.5,1.0).CONCLUSIONS: Findings suggest that drivers of transport-based PA in MICs may be both necessity- and choice-driven. The independent effect of MVO on active travel implies that necessity is an important contributor. Sociocultural norms such as status, social stigma, and cultural beliefs also appear to influence transport-based PA in MICs. External funding details This work was supported by an NCD Prevention Training Grant from the CDC Foundation (Mexico site), and by an International Dissertation Award from the Brown School of Washington University in St. Louis (India site).
