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Physical Inactivity

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This indicator reports the percentage of adults aged 20 and older who self-report no leisure time for activity, based on the question: “During the past month, other than your regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening, or walking for exercise?” This indicator is relevant because current behaviors are determinants of future health and this indicator may illustrate a cause of significant health issues, such as obesity and poor cardiovascular health.

Note: County-level estimates for this indicator were re-estimated using an enhanced PLOW+ methodology in the 2025 CDC data release to improve comparability across years. Caution should be used when comparing results with analyses generated before this release.

Source

Centers for Disease Control and Prevention, CDC – Diabetes Atlas, 2023.

Source Description

The Centers for Disease Control and Prevention’s (CDC) National Center for Chronic Disease Prevention and Health Promotion monitors the health of the nation and produces publicly available data to support diabetes prevention and control efforts. Through the U.S. Diabetes Surveillance System, the CDC provides comprehensive information on the burden of diabetes and related risk factors in the United States, including national, state, and county-level estimates of diagnosed diabetes and selected health indicators. These data are intended to help public health practitioners, policymakers, and communities target and optimize resources for diabetes prevention and management.

Citation: Centers for Disease Control and Prevention. U.S. Diabetes Surveillance System: Diabetes Atlas Frequently Asked Questions (FAQ). (2023).

Methodology

Data for the total adult population and for populations defined by diabetes burden and selected risk factors are derived from the U.S. Diabetes Surveillance System, maintained by the Centers for Disease Control and Prevention (CDC). Estimates are produced by the CDC’s National Center for Health Statistics (NCHS) using data from the Behavioral Risk Factor Surveillance System (BRFSS) and population estimates from the U.S. Census Bureau’s Population Estimates Program.

Prevalence estimates for diabetes and selected risk factors are calculated as:

Percent Prevalence = (Risk Factor Population ÷ Total Adult Population) × 100

Incidence estimates for diabetes are calculated as:

Incidence Rate = (New Cases ÷ Total Adult Population) × 1000

County-level estimates are generated using the CDC’s enhanced small-area estimation method (PLOW+), a Bayesian hierarchical modeling approach designed to improve precision and comparability across counties. The PLOW+ method uses single-year BRFSS data, incorporates historical information as informative priors, accounts for the complex BRFSS survey design through sampling weights, and applies nearest-neighbor machine-learning techniques for validation.

The BRFSS is an ongoing, state-based telephone survey of noninstitutionalized adults aged 18 years and older that collects information on health behaviors and chronic conditions. For these estimates, results are restricted to adults aged 20 years and older to align with U.S. Census population estimates. Diabetes status, obesity, and physical inactivity are based on self-reported BRFSS responses using CDC-standard definitions.

Data Breakouts Available

  • Percentage of Adults Physically Inactive by Year, 2004 through 2023
  • Adults with No Leisure-Time Physical Activity by Sex, 2023
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