March 23, 2023

Daily step counts before, after COVID-19 pandemic

Editor's Note

This study from Vanderbilt University Medical Center, Nashville, Tennessee, finds a consistent, widespread, and significant decline in activity following the onset of COVID-19 in the US.

The analysis included 5,443 participants who wore a digital device tracking physical activity (Fitbit) for at least 10 days each month. Daily steps were examined from January 2018 through December 2021. Counterfactual analysis based on 2 years of activity data preceding COVID-19 was used to estimate postpandemic steps.

Among the findings:

  • Median daily step counts were 7,808 pre-COVID-19 and 7,089 post-COVID-19.
  • The counterfactual model estimated participants walked 575 fewer steps per day post-COVID-19, compared with observed daily steps.
  • The difference between observed and estimated post-COVID-19 steps was significantly explained by younger age, Northeast region compared with other regions, and higher deprivation index (standard of living, health, education, economic security, housing quality, and neighborhood quality).
  • Post-COVID-19 steps also were explained by vaccination status, depression, and psychological stress.
  • No association was found between reduced step counts and sex or comorbidities.

The study showed that vulnerable populations, including those at a lower socioeconomic status and those with worse mental health, were at the highest risk of reduced activity. A significant decline in daily steps persisted even after COVID-19 restrictions were relaxed, suggesting that COVID-19 affected long-term behavioral choices, the researchers note.

JAMA (healthcare publication) Network logo


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