Exploring the Role of Physical Activity in Mediating the Association between Educational Level and Health-Related Quality of Life in an Adult Lifespan Sample from Madeira Island

Int J Environ Res Public Health. 2022 Jun 22;19(13):7608. doi: 10.3390/ijerph19137608.


Background: People more socioeconomically vulnerable tend to have a poorer health-related quality of life (HRQoL). Studies are trying to analyse the factors that may condition this relationship, including physical activity (PA), which may influence the relationship between socioeconomic status (SES) and HRQoL. This study aimed to analyse the relationship between SES and HRQoL through specific domains of PA. Methods: A total of 381 adults (≥18 years) from the Autonomous Region of Madeira completed the measurements. Mediation analyses using bootstrapping methods adjusted for confounding variables were performed to relate SES and HRQoL; the latter was evaluated using the physical component score (PCS) of the SF-12, the mental component score (MCS) of the SF-12, and the total score in the SF-12 questionnaire (SF-12 score), through physical activity. Results: Educational level was positively related to PCS and SF-12 score. Leisure-time PA (not including sports PA) and PA at work, as single mediating variables, did not mediate the relationship between SES and HRQoL. The total PA suppressed the socioeconomic gradient of HRQoL by 8-10%, 39-46%, and 15-16%, respectively, for the PCS, MCS, and the SF-12 score; sports PA mediated the relationship by 13-16%, 50%, and 15-21%, respectively. Conclusions: The results suggest that sports PA contributes to reducing the socioeconomic gradient of HRQoL.

Keywords: exercise; functioning; mediation analysis; perceived health; socioeconomic status; sport.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Exercise
  • Humans
  • Longevity*
  • Portugal
  • Quality of Life*
  • Surveys and Questionnaires

Grants and funding

This work was supported by the Madeira Regional Government and Regional Secretary of Education, Science and Technology via the Madeira Association of Sport for All. B.R.G. and E.R.G. acknowledge support from LARSyS—Portuguese national funding agency for science, research and technology (FCT) pluriannual funding 2020–2023 (Reference: UIDB/50009/2020). A.I. acknowledges support from the Swiss National Centre of Competence in Research LIVES— Overcoming vulnerability: life course perspectives, funded by the Swiss National Science Foundation (grant number: 51NF40-185901).