COIOS
Behavioural science Item refines peer-reviewed

Adolescent movement behaviours explained 2.0 points of a 6.9-point CVD risk gap

In 6,608 US adolescents followed for over two decades, the 6.9 percentage-point gap in predicted 30-year cardiovascular risk by parental education fell to 4.9 points in a scenario removing all unhealthy physical activity, screen time and sleep, and the relative gap was unchanged.

Using the Add Health cohort, the authors classified adolescents' physical activity, screen time and sleep against the 24-Hour Movement Guidelines and decomposed the socioeconomic gap in predicted 30-year cardiovascular risk measured in adulthood. Adolescents whose parents had not completed college had a 6.9 percentage-point higher risk (RR 1.73), and a hypothetical intervention removing all unhealthy movement behaviours reduced the absolute gap by 2.0 points, almost all of it through physical activity, while the relative gap was unchanged (RR 1.76). Giving the lower group the same distribution of behaviours as the higher group had minimal effect, and the outcome is a predicted risk score rather than observed events.

Why it is interesting: Puts a size on how much of the socioeconomic gradient in cardiovascular risk adolescent behaviour could account for, which is under a third of the absolute gap and none of the relative one.

Source
American Journal of Epidemiology, 18 September 2026
DOI
10.1093/aje/kwag234
Type
Peer-reviewed article
Design
Causal decomposition (g-formula) in the Add Health cohort, n=6,608, enrolled 1994-95 and followed to 2016-18
Verdict
Refines prior evidence
Driver
Diet and physical activity
Driver
Inequalities in health and length of life