Graduation Date

Summer 8-19-2016

Document Type


Degree Name

Doctor of Philosophy (PhD)


Health Promotion and Disease Prevention Research

First Advisor

Dejun Su


Background: Physical activity has been continuously declining in China. At the same time, prevalence of hypertension has dramatically increased. The associations between leisure time physical activity preference, behavior, and development of hypertension in Chinese adults remained not fully understood and few studies have examined these associations using longitudinal data.

Objectives: This dissertation examined the interrelationships among leisure time activity preference, behavior, and the incidence of hypertension using longitudinal data from 2004 to 2011 in the China Health and Nutrition Survey. It also assessed the urban-rural disparities.

Methods: A total of 2,687 adults were included in the analysis. Multivariate logistic regressions and proportional hazard regressions were performed to assess the associations after adjusting for age, sex, ethnicity, marital status, community types, region of residence, education, employment status, annual household income, smoking status, alcohol consumption, current health status, health insurance coverage, and BMI. Urban-rural differences were also investigated by stratified analysis.

Results: In the sample, 62.3% were from urban, 47.4% were men, and the mean age was 40. Adjusted estimates show that leisure time activity preference was a significant predictor of actual behavior (OR = 1.05, 95% CI = 1.01-1.09); leisure time activity was a significant protector from developing hypertension (HR = 0.60, 95% CI = 0.41-0.87); changes in (reduced) leisure time activity preference were associated with higher incidence of hypertension (OR = 1.92, 95% CI = 1.13-3.28). These correlations were found to be significant among urban residents (OR = 1.06, 95% CI = 1.01-1.10, HR = 0.57, 95% CI = 0.38-0.87, and OR = 2.19, 95% CI = 1.04-4.60 respectively) not in rural participants.

Conclusions: Leisure time physical activity preference, behavior and development of hypertension were significantly correlated with each other. Changing people’s preference for leisure time activity may be helpful in hypertension prevention and control in China. In addition, health interventions in rural areas may increase residents’ access to exercise facilities and maintain their activity preference through social modelling. In urban areas, educating healthy diet and occupational physical activity pattern might be helpful.