Friday, February 24, 2017

Is Income Inequality Slowing Us Down Too?

"Beep" Test
A new study has found that kids from the United States are among the least fit in the world (out of 50 countries). And it may be due to their unequal income distribution as researchers found a correlation between income inequality and fitness.

Researchers pooled data from 177 previous studies conducted around the world to understand the link between a country's income inequality and youth fitness. They specifically compared a country's Gini Index (which measures how income is distributed throughout that country) with a 20 metre shuttle run test in that same country. 

When there's a large gap between the rich and poor in a country (i.e. higher Gini Index), there tend to be large sub populations of poor people within that country. And poverty is linked with a whole bunch of poor health outcomes. One of those outcomes is poor aerobic fitness in children.

The researchers found that the greater the Gini Index (i.e. the higher the number), the less likely their kids were to perform well in the shuttle run test (also know as the "beep" test or the multi-stage fitness test).

Two parallel lines are drawn 20 metres apart in the "beep" or multi-stage fitness test. The children must run back and forth between the two lines, reaching each line before a beep sounds.

The time between beeps decreases as the test goes on, forcing the kids to run faster. If a child fails to reach the opposite line before the "beep" sounds twice in a row, he / she is eliminated from the test.

This test is popular around the world as many people can be tested simultaneously and research scientists use it to draw conclusions about a country's level of fitness by pooling and comparing data.

Our Singapore readers may remember this "beep" test was highly unpopular among our "S" league footballers who had to achieved Level 13-2 before they can play in our professional league.

Now, you must be wondering what does income inequality have to do with obesity?

The data suggested that poverty tends to make people less fit primarily when they live in a relatively rich (or developed) country while the opposite is true in undeveloped countries.

Researchers suggest that for the young people in developed countries with low income, they tend to not have access to healthy food. They normally have access to cheap but very high calorie, energy-dense food. Being poor but surrounded by fast food, cars and television seems to be more detrimental than being poor in a rural environment where physical activity is a necessary part of life.

The young people in undeveloped countries differs in that they may not have access to parks, playgrounds, equipment and facilities. They tend to be physically active out of obligation as they have to walk or cycle to and from work. They may also need to walk greater distances to access fresh water or groceries.

No Singapore kids were included in this study, but our Gini coefficient is on the high side so does this mean the poorer kids are less fit in Singapore too?

Maybe it's timely that it's announced in today's Straits Times that all pre-school children will have at least one hour of physical activity a day including time spent in the sun (to reduce myopia) and also be served healthy meals including fruit.

Front page in today's Straits Times 240217

When it comes to being fit and healthy, it's good to start them young.


Lang JJ, Tremblay MS et al (2016). International Variability in 20 m Shuttle Run Performance In Children And Youth: Who Are The Fittest From A 50-country Comparison? A Systematic Literature Review With Pooling Of Aggregate Results. BJSM. Published online first :20 Sptember 2016. DOI:

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