Stepping Up for All of Us: Data from the All of Us Research Program Reinforces Existence of Activity Inequality in the United States
Data from digital health technologies can provide insights into a population’s daily activity levels and behaviors. Using Fitbit wearable data from 7,431 participants enrolled in the Research Program, we examined activity inequality across the US and its association with obesity. We found that there were 660 fewer daily steps on average in the southern states than in the northeastern states. In addition, with every 0.01 increase in activity inequality, a metric used to quantify activity disparity, the predicted obesity prevalence of a state increased by 5%. Surprisingly, no association was discovered between a city's walkability and activity inequality, suggesting that extrinsic factors such as the built environment may not necessarily address the gap in activity levels in the US. This study demonstrates the value of digital health technologies in exploring and understanding public health while highlighting the need to examine complex confounding factors such as socioeconomic status, eating habits, and lifestyle that may contribute to activity inequality in the US.
