ABSTRACT

Objective:

The aim of this study was to analyze the prevalence of leisure-time physical activity in 2013 and 2019 according to sociodemographic characteristics in Brazilian adults.

Methods:

We analyzed data from the National Health Surveys conducted in 2013 and 2019. Prevalence of leisure-time physical activity (150+ minutes per week in physical activities) was calculated according to gender, age, education, race/skin color, Federative Units, and regions of Brazil in 2013 and 2019. Poisson regression models and 95% confidence intervals (95%CI) were used to compare leisure-time physical activity across different groups in 2013 and 2019.

Results:

The proportion of Brazilian adults active in leisure-time increased from 22.7% (95%CI 22.06–23.34) in 2013 to 30.1% (95%CI 29.44–30.67) in 2019. The prevalence of leisure-time physical activity increased between 2013 and 2019 in 23 of the 27 Federative Units in Brazil. Both in 2013 and in 2019, the proportion of active people during leisure time was higher in men, young people, with a high level of education and individuals with white skin color. Overall, the magnitude of the observed differences in leisure-time physical activity between sociodemographic groups slightly decreased from 2013 to 2019.

Conclusions:

Despite the increase in the prevalence of leisure-time physical activity among Brazilian adults in the last six years, marked sociodemographic inequalities persist. The success of future public policies to promote physical activity in leisure must be evaluated from the perspective of social determinants of health and the reduction of inequalities in the practice of physical activity.

Keywords:
physical activity; exercise; population surveys; health promotion

INTRODUCTION

Physical activity (PA) is an important protective factor against numerous non-communicable chronic diseases, in addition to being associated with positive aspects in socialization, stress reduction, and mental illnesses¹1. Bull FC, Al-Ansari SS, Biddle S, Borodulin K, Buman MP, Cardon G, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med 2020; 54 (24): 1451-62. https://doi.org/10.1136/bjsports-2020-102955
https://doi.org/10.1136/bjsports-2020-10... . Globally, it is estimated that approximately one in four adults do not do at least 150 minutes of moderate to vigorous intensity PA per week²2. Sallis JF, Bull F, Guthold R, Heath GW, Inoue S, Kelly P, et al. Progress in physical activity over the Olympic quadrennium. Lancet 2016; 388 (10051): 1325-36. https://doi.org/10.1016/S0140-6736(16)30581-5
https://doi.org/10.1016/S0140-6736(16)30... , as recommended by the World Health Organization¹1. Bull FC, Al-Ansari SS, Biddle S, Borodulin K, Buman MP, Cardon G, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med 2020; 54 (24): 1451-62. https://doi.org/10.1136/bjsports-2020-102955
https://doi.org/10.1136/bjsports-2020-10... .

Due to the benefits of PA, in 2013, the goal of reducing physical inactivity by 10% by 2025 was included in the Global Action Plan for the Prevention and Control of Non-communicable chronic diseases proposed by the World Health Organization. The Global Action Plan for Physical Activity 2018-2030³3. World Health Organization. Global action plan on physical activity 2018–2030: more active people for a healthier world. Geneva: World Health Organization; 2018. was launched, which aims to reduce physical inactivity by 10% by 2025 and by 15% by 2030. This bold and innovative plan aims to globally and locally promote a framework of viable policy actions that can be universally implemented.

The Global Action Plan for Physical Activity 2018–2030 addresses the cultural, environmental, and individual determinants of PA³3. World Health Organization. Global action plan on physical activity 2018–2030: more active people for a healthier world. Geneva: World Health Organization; 2018., and recognizes that, for the successful implementation of the plan, the design and maintenance of public policies focused on promoting PA in the population scope need to consider the sociodemographic distribution, as well as population groups with lower levels of PA, for example, women, aged people, and individuals in a position of socioeconomic disadvantage⁴4. Mielke GI, Silva ICM, Kolbe-Alexander TL, Brown WJ. Shifting the physical inactivity curve worldwide by closing the gender gap. Sports Med 2018; 48 (2): 481-89. https://doi.org/10.1007/s40279-017-0754-7
https://doi.org/10.1007/s40279-017-0754-... –⁶6. Crochemore-Silva I, Knuth AG, Mielke GI, Loch MR. Promotion of physical activity and public policies to tackle inequalities: considerarions based on the Inverse Care Law and Inverse Equity Hypothesis. Cad Saude Publica 2020; 36 (6): e00155119. https://doi.org/10.1590/0102-311X00155119
https://doi.org/10.1590/0102-311X0015511... .

In Brazil, a country with continental dimensions, accentuated economic inequalities⁷7. The World Bank. Labor force, female (% of total labor force). 2021 [cited on Jun. 17, 2021]. Available at:https://data.worldbank.org/indicator/SL.TLF.TOTL.FE.ZS
https://data.worldbank.org/indicator/SL.... and in health indicators⁸8. Malta DC, Bernal RT, Souza MF, Szwarcwald CL, Lima MG, Barros MBA. Social inequalities in the prevalence of self-reported chronic non-communicable diseases in Brazil: national health survey 2013. Int J Equity Health 2016; 15 (1): 153. https://doi.org/10.1186/s12939-016-0427-4
https://doi.org/10.1186/s12939-016-0427-... persist across the five macro-regions. Specifically in relation to leisure time physical activity (LTPA), data from the 2013 National Health Survey showed that, despite the small variations in the prevalence of LTPA among the five macro-regions, important differences between population subgroups are observed⁵5. Mielke GI, Malta DC, de Sa GB, Reis RS, Hallal PC. Regional differences and correlates of leisure time physical activity in Brazil: results from the Brazilian National Health Survey-2013. Rev Bras Epidemiol 2015; 18 (Suppl 2): 158-69. https://doi.org/10.1590/1980-5497201500060014
https://doi.org/10.1590/1980-54972015000... . For example, in 2013, the proportion of the population active in leisure time ranged from 22% in the South to 24% in the Midwest, with men and young people being more active than women and individuals aged 75+ years old⁷7. The World Bank. Labor force, female (% of total labor force). 2021 [cited on Jun. 17, 2021]. Available at:https://data.worldbank.org/indicator/SL.TLF.TOTL.FE.ZS
https://data.worldbank.org/indicator/SL.... . Furthermore, these differences were more accentuated in the North Region, which suggests the need for actions to promote physical activity with different approaches in different population groups and in each of the five macro-regions of Brazil.

Brazil has substantially evolved with regard to monitoring risk factors for chronic non-communicable diseases, including different domains of PA⁹9. Silva ICM, Mielke GI, Bertoldi AD, Arrais PSD, Luiza VL, Mengue SS, et al. Overall and leisure-time physical activity among brazilian adults: national survey based on the global physical activity questionnaire. J Phys Act Health 2018; 15 (3): 212-18. https://doi.org/10.1123/jpah.2017-0262
https://doi.org/10.1123/jpah.2017-0262... –¹¹11. Mielke GI, Hallal PC, Malta DC, Lee IM. Time trends of physical activity and television viewing time in Brazil: 2006-2012. Int J Behav Nutr Phys Act 2014; 11: 101. https://doi.org/10.1186/s12966-014-0101-4
https://doi.org/10.1186/s12966-014-0101-... . Among the investments, population surveys at the local level stand out¹²12. Hallal PC, Cordeira K, Knuth AG, Mielke GI, Victora CG. Ten-year trends in total physical activity practice in Brazilian adults: 2002-2012. J Phys Act Health 2014; 11 (8): 1525-30. https://doi.org/10.1123/jpah.2013-0031
https://doi.org/10.1123/jpah.2013-0031... ,¹³13. Silva IC, Knuth AG, Mielke GI, Azevedo MR, Goncalves H, Hallal PC. Trends in leisure-time physical activity in a southern Brazilian city: 2003-2010. J Phys Act Health 2014; 11 (7): 1313-7. https://doi.org/10.1123/jpah.2012-0460
https://doi.org/10.1123/jpah.2012-0460... , as well as surveys and surveillance systems nationwide⁵5. Mielke GI, Malta DC, de Sa GB, Reis RS, Hallal PC. Regional differences and correlates of leisure time physical activity in Brazil: results from the Brazilian National Health Survey-2013. Rev Bras Epidemiol 2015; 18 (Suppl 2): 158-69. https://doi.org/10.1590/1980-5497201500060014
https://doi.org/10.1590/1980-54972015000... ,⁹9. Silva ICM, Mielke GI, Bertoldi AD, Arrais PSD, Luiza VL, Mengue SS, et al. Overall and leisure-time physical activity among brazilian adults: national survey based on the global physical activity questionnaire. J Phys Act Health 2018; 15 (3): 212-18. https://doi.org/10.1123/jpah.2017-0262
https://doi.org/10.1123/jpah.2017-0262... ,¹⁰10. Ide PH, Martins MSAS, Segri NJ. Tendência dos diferentes domínios da atividade física em adultos brasileiros: dados do Vigitel de 2006-2016. Cad Saude Publica 2020; 36 (8): e00142919. https://doi.org/10.1590/0102-311x00142919
https://doi.org/10.1590/0102-311x0014291... ,¹⁴14. Mielke GI, Hallal PC, Rodrigues GBA, Szwarcwald CL, Santos FV, Malta DC. Physical activity and television viewing among Brazilian adults: National Health Survey 2013. Epidemiol Serv Saude 2015; 24 (2): 277-86. https://doi.org/10.5123/S1679-49742015000200010
https://doi.org/10.5123/S1679-4974201500... . Thus, the aim of this study was to describe the prevalence of LTPA in 2013 and 2019 in Brazilian adults according to sociodemographic characteristics.

METHODS

In 2013, the sample size was calculated at approximately 80 thousand households and information was collected from 64,348 households. In 2019, the sample was calculated in 108,525 households; data were collected from 94,111 households, with a response rate of 93.6%. To allow comparison of surveys, this study used data from selected residents aged 18 years old or older, totaling 60,202 individuals in 2013 and 88,531 individuals in 2019. The PNS was conducted in accordance with the guidelines of Resolution No. 466/2012 of the National Health Council, which deals with research involving human beings. PNS databases are available for public access and use. Both editions of the PNS were approved by the National Research Ethics Committee of the MoH, under opinions No. 328.159 (2013) and No. 3.529.376 (2019). More details about the methodology can be found in specific publications¹⁵15. Szwarcwald CL, Malta DC, Pereira CA, Vieira MLFP, Conde WL, Souza Júnior PRB, et al. Pesquisa Nacional de Saúde no Brasil: concepção e metodologia de aplicação. Cien Saude Colet 2014; 19 (2): 333-42. https://doi.org/10.1590/1413-81232014192.14072012
https://doi.org/10.1590/1413-81232014192... ,¹⁶16. Stopa SR, Szwarcwald CL, Oliveira MM, Gouvea ECDP, Vieira MLFP, Freitas MPS, et al. Pesquisa Nacional de Saude 2019: histórico, métodos e perspectivas. Epidemiol Serv Saude 2020; 29 (5): e2020315. https://doi.org/10.1590/S1679-49742020000500004
https://doi.org/10.1590/S1679-4974202000... .

A weekly physical activity score was calculated based on the time spent in physical activities, number of days, and type of activity. Running, aerobics/spinning/step/jump, soccer, basketball or tennis were considered vigorous physical activities. Thus, individuals who reported these activities had their weekly time multiplied by two. This strategy was adopted to incorporate the current PA recommendations of at least 150 minutes per week of moderate activities or 75 minutes per week of vigorous activities, or a combination of moderate and vigorous activities equivalent to 150 minutes per week of moderate physical activities. Participants who reported at least 150 minutes per week of LTPA were classified as active during leisure time.

Initially, the prevalence of leisure-time PA and respective 95% confidence intervals (95%CI) were calculated for each of the sociodemographic groups in 2013 and 2019. To verify the association of leisure-time PA with sociodemographic variables, Poisson regression models with robust variance were used, and the crude and adjusted prevalence ratios (PR) were estimated. Adjusted analysis models included mutual adjustment for all sociodemographic variables analyzed (gender, age, education, race/color, and region). Due to the number of comparisons performed and to reduce the possibility of type 1 error, 95% confidence intervals were used in the interpretation and comparison of physical activity estimates for different population groups in 2013 and 2019. All analyses were conducted in the statistics package Stata, version 16.1.

Ethics committee: The National Health Survey (Pesquisa Nacional de Saúde) was approved by the National Research Ethics Committee of the Ministry of Health, Opinion No. 3.529.376 (2019).

RESULTS

The prevalence of LTPA according to gender, age, education level, and race/color for Brazil, five major regions, in 2013 and 2019, is presented in Table 1. The proportion of Brazilian adults who reported at least 150 minutes per week of moderate to vigorous physical activity increased from 22.7% (95%CI 22.06–23.34), in 2013, to 30.1% (95%CI 29.44–30.67), in 2019, which represents a 33% increase in the proportion of adults who are active in leisure. Both in 2013 and in 2019, the proportion of active people in leisure time was higher in men, young people, with a high level of education, and white individuals.

As observed in Figure 1, the prevalence of leisure-time PA increased from 2013 to 2019 in 23 of the 27 states in Brazil (Rondônia, Acre, Pará, Amapá, Tocantins, Maranhão, Piauí, Ceará, Rio Grande do Norte, Paraíba, Pernambuco, Alagoas, Sergipe, Bahia, Minas Gerais, Espírito Santo, Rio de Janeiro, São Paulo, Paraná, Mato Grosso do Sul, Mato Grosso, Goiás, and the Federal District). Both in 2013 and 2019, the highest prevalence of leisure-time PA was observed in the Federal District.

Table 2 shows the crude and adjusted prevalence ratio for the association of leisure-time PA with sociodemographic variables in 2013 and 2019. In 2013, the prevalence of physical activity among men was higher when compared to women (PRa=0.66; 95%CI 0.62–0.70). This difference was slightly reduced in 2019 (PRa=0.75; 95%CI 0.73–0.78). In 2013 and 2019, there was a reduction in the prevalence of PA during leisure time and an increase in age. In 2013, participants with the highest level of education (complete higher education) were nearly three times more active in leisure time (PRa=3.23; 95%CI 2.96–3.52) than those with no education and incomplete elementary/middle education. In 2019, this difference was smaller (PRa=2.85; 95%CI 2.69–3.02). The differences in LTPA observed in relation to race/color were similar in 2013 and 2019. Overall, no marked differences were observed in LTPA among the five Brazilian macro-regions.

DISCUSSION

The results of this study showed that, over a period of six years, there was a considerable increase in the proportion of Brazilian adults who reached the recommendations for leisure-time PA. However, only one in three adult Brazilians is active in leisure and, as expected, men, younger people, and those with higher education are more active in leisure. Furthermore, the present study showed that there was progress in reducing the great sociodemographic inequalities that exist in the LTPA.

A number of national and international studies show that LTPA is more frequent among men than in women⁹9. Silva ICM, Mielke GI, Bertoldi AD, Arrais PSD, Luiza VL, Mengue SS, et al. Overall and leisure-time physical activity among brazilian adults: national survey based on the global physical activity questionnaire. J Phys Act Health 2018; 15 (3): 212-18. https://doi.org/10.1123/jpah.2017-0262
https://doi.org/10.1123/jpah.2017-0262... ,¹⁷17. Bauman AE, Reis RS, Sallis JF, Wells JC, Loos RJF, Martin BW, et al. Correlates of physical activity: why are some people physically active and others not? Lancet 2012; 380 (9838): 258-71. https://doi.org/10.1016/S0140-6736(12)60735-1
https://doi.org/10.1016/S0140-6736(12)60... . A number of sociocultural factors can explain this pattern¹⁷17. Bauman AE, Reis RS, Sallis JF, Wells JC, Loos RJF, Martin BW, et al. Correlates of physical activity: why are some people physically active and others not? Lancet 2012; 380 (9838): 258-71. https://doi.org/10.1016/S0140-6736(12)60735-1
https://doi.org/10.1016/S0140-6736(12)60... ,¹⁸18. Althoff T, Sosic R, Hicks JL, King AC, Delp SL, Leskovec J. Large-scale physical activity data reveal worldwide activity inequality. Nature 2017; 547 (7663): 336-9. https://doi.org/10.1038/nature23018
https://doi.org/10.1038/nature23018... ,¹⁹19. Brown WJ, Heesch KC, Miller YD. Life events and changing physical activity patterns in women at different life stages. Ann Behav Med 2009; 37 (3): 294-305. https://doi.org/10.1007/s12160-009-9099-2
https://doi.org/10.1007/s12160-009-9099-... ,²⁰20. Brown WJ, Mielke GI, Kolbe-Alexander TL. Gender equality in sport for improved public health. Lancet 2016; 388 (10051): 1257-8. https://doi.org/10.1016/S0140-6736(16)30881-9
https://doi.org/10.1016/S0140-6736(16)30... , including intrinsic sexist structures in society²¹21. King DK. Multiple jeopardy, multiple consciousness: the context of a black feminist ideology. Signs 1998; 14 (1): 42-72. https://doi.org/10.1086/494491
https://doi.org/10.1086/494491... , which can impact men and women differently in the decision and enjoyment of physical activity in different periods of life²²22. Mielke GI, Brown WJ. Physical activity and the prevention of chronic illness in the BRICS nations: issues relating to gender equality. J Sport Health Sci 2019; 8 (6): 507-8. https://doi.org/10.1016/j.jshs.2019.08.001
https://doi.org/10.1016/j.jshs.2019.08.0... . For example, from childhood onward, boys are encouraged to play ball and participate in group games, while girls are more often encouraged to stay at home and play with dolls. These incentives are lifelong²³23. Azevedo MR, Araujo CLP, Reichert FF, Siqueira FV, Silva MC, Hallal PC. Gender differences in leisure-time physical activity. Int J Public Health 2007; 52 (1): 8-15. https://doi.org/10.1007/s00038-006-5062-1
https://doi.org/10.1007/s00038-006-5062-... . Furthermore, the practice of physical activity by women of reproductive age is impacted by pregnancy, which may delay the return to pre-pregnancy levels of LTPA for up to four years after childbirth²⁴24. Mielke GI, Crochemore-Silva I, Domingues MR, Silveira MF, Bertoldi AD, Brown WJ. Physical Activity and Sitting Time From 16 to 24 Weeks of Pregnancy to 12, 24, and 48 Months Postpartum: Findings From the 2015 Pelotas (Brazil) Birth Cohort Study. J Phys Act Health 2021; 18 (5): 587-93. https://doi.org/10.1123/jpah.2020-0351
https://doi.org/10.1123/jpah.2020-0351... . Data from the present study indicated that, although the difference in LTPA between men and women persists, this difference reduced from 34% in 2013 to 25% in 2019. More actions are still needed to promote equity in LTPA among men and women and, thus, improve public health indicators at global levels²⁰20. Brown WJ, Mielke GI, Kolbe-Alexander TL. Gender equality in sport for improved public health. Lancet 2016; 388 (10051): 1257-8. https://doi.org/10.1016/S0140-6736(16)30881-9
https://doi.org/10.1016/S0140-6736(16)30... .

It is not surprising in the scientific literature that younger individuals are more active¹⁷17. Bauman AE, Reis RS, Sallis JF, Wells JC, Loos RJF, Martin BW, et al. Correlates of physical activity: why are some people physically active and others not? Lancet 2012; 380 (9838): 258-71. https://doi.org/10.1016/S0140-6736(12)60735-1
https://doi.org/10.1016/S0140-6736(12)60... . In general, these differences can be explained by the fact that young people have more incentive to do physical activities during leisure time, as well as more opportunities for group practices and games with friends¹⁷17. Bauman AE, Reis RS, Sallis JF, Wells JC, Loos RJF, Martin BW, et al. Correlates of physical activity: why are some people physically active and others not? Lancet 2012; 380 (9838): 258-71. https://doi.org/10.1016/S0140-6736(12)60735-1
https://doi.org/10.1016/S0140-6736(12)60... . Furthermore, known biological aspects related to the aging process, such as reduced mobility and muscle capacity, may reflect less physical activity with advancing age²⁵25. Nelson ME, Rejeski WJ, Blair SN, Duncan PW, Judge JO, King AC, et al. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 2007; 39 (8): 1435-45. https://doi.org/10.1249/mss.0b013e3180616aa2
https://doi.org/10.1249/mss.0b013e318061... . Finally, aspects related to the environment, such as public safety, can also limit the practice of physical activity by aged people⁵5. Mielke GI, Malta DC, de Sa GB, Reis RS, Hallal PC. Regional differences and correlates of leisure time physical activity in Brazil: results from the Brazilian National Health Survey-2013. Rev Bras Epidemiol 2015; 18 (Suppl 2): 158-69. https://doi.org/10.1590/1980-5497201500060014
https://doi.org/10.1590/1980-54972015000... . The findings presented in this study reinforce the need for investment in public policies that create a favorable environment for the practice of physical activity, especially for aged people.

The nationwide data presented by the PNS showed an increase in the practice of leisure-time PA in Brazil and in all federative units. However, important regional differences persist. In 2019, the Southeast and Midwest regions, especially the Federal District, showed higher prevalence of leisure-time PA, a fact that may reflect the immense socioeconomic inequalities in the country. Once again, these data show the importance of implementing nationwide public policies that seek fair and democratic access to opportunities for the practice of physical activity in leisure time⁶6. Crochemore-Silva I, Knuth AG, Mielke GI, Loch MR. Promotion of physical activity and public policies to tackle inequalities: considerarions based on the Inverse Care Law and Inverse Equity Hypothesis. Cad Saude Publica 2020; 36 (6): e00155119. https://doi.org/10.1590/0102-311X00155119
https://doi.org/10.1590/0102-311X0015511... ,²⁶26. Malta DC, Silva JB. Policies to promote physical activity in Brazil. Lancet 2012; 380 (9838): 195-6. https://doi.org/10.1016/S0140-6736(12)61041-1
https://doi.org/10.1016/S0140-6736(12)61... ,²⁷27. Simoes EJ, Hallal PC, Siqueira FV, Schmaltz C, Menor D, Malta DC, et al. Effectiveness of a scaled up physical activity intervention in Brazil: a natural experiment. Prev Med 2017; 103S: S66-72. https://doi.org/10.1016/j.ypmed.2016.09.032
https://doi.org/10.1016/j.ypmed.2016.09.... .

Among the aspects that explain the increased practice in the period, there is the creation of the Health Academy Program (Programa Academia da Saúde – PAS) by the Ministry of Health in 2011²⁸28. Brasil. Ministério da Saúde. Panorama Nacional de Implementação do Programa Academia da Saúde: Monitoramento nacional da gestão do Programa Academia da Saúde. Brasília: Ministério da Saúde; 2018 [cited on Jun. 17, 2021]. Available at:http://bvsms.saude.gov.br/bvs/publicacoes/panorama_academia_saude_monitoramento_programa.pdf.
http://bvsms.saude.gov.br/bvs/publicacoe... . Through the PAS, approximately four thousand units were built in more than 2,700 Brazilian municipalities, providing spaces for community interventions to promote health, including the promotion of free physical activity²⁶26. Malta DC, Silva JB. Policies to promote physical activity in Brazil. Lancet 2012; 380 (9838): 195-6. https://doi.org/10.1016/S0140-6736(12)61041-1
https://doi.org/10.1016/S0140-6736(12)61... . A series of evaluations has shown that these programs are associated with the practice of leisure-time physical activity in several Brazilian cities and capitals, especially among women, aged people, and people with low education²⁷27. Simoes EJ, Hallal PC, Siqueira FV, Schmaltz C, Menor D, Malta DC, et al. Effectiveness of a scaled up physical activity intervention in Brazil: a natural experiment. Prev Med 2017; 103S: S66-72. https://doi.org/10.1016/j.ypmed.2016.09.032
https://doi.org/10.1016/j.ypmed.2016.09.... ,²⁹29. Faria TMTR, Brenner S, Deckert A, Florindo AA, Mielke GI. Health academy program and physical activity levels in Brazilian state capitals. Rev Bras Ativ Fís Saúde 2020; 25: e0133. https://doi.org/10.12820/rbafs.25e0133
https://doi.org/10.12820/rbafs.25e0133... .

In a country where the practice of physical activity for leisure is just one of the privileges of young, white, and highly educated men³⁰30. Knuth AG, Antunes PC. Práticas corporais/atividades físicas demarcadas como privilégio e não escolha: análise à luz das desigualdades brasileiras. Saude Soc 2021; 30 (2): e200363. https://doi.org/10.1590/S0104-12902021200363
https://doi.org/10.1590/S0104-1290202120... , advances in the fight against socioeconomic inequalities over the last two decades have been constantly threatened by the current Brazilian political context and for the implementation of austerity policies³¹31. Brasil. Casa Civil. Emenda constitucional nº 95, de 15 de dezembro de 2016. Altera o Ato das Disposições Constitucionais Transitórias, para instituir o Novo Regime Fiscal, e dá outras providências. Brasília: Casa Civil, 2016.. Socioeconomic inequalities are directly related to aspects that increase the chance of individuals to practice more or less physical activity, mainly because of issues related to opportunities to access adequate spaces for such practice. Thus, political efforts will be necessary so that the advances observed in access to PA practice, especially the continuity of the implementation of the National Health Promotion Policy and the PAS, and that their progress is not canceled³²32. Mielke G, Malta DC. Avaliação e futuro do Programa Academia da Saúde. Rev Bras Ativ Fís Saude 2020; 25: e0147. https://doi.org/10.12820/rbafs.25e0147
https://doi.org/10.12820/rbafs.25e0147... . Finally, these data confirm the need to understand the practice of PA as a social product and not just an individual choice.

In conclusion, despite the increase in the prevalence of leisure-time physical activity among Brazilian adults in the last six years, marked sociodemographic inequalities still exist. The success of future public policies to promote physical activity in leisure must be evaluated from the perspective of social determinants of health and the reduction of inequalities in the practice of physical activity.

REFERENCES

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