Demographic and occupational differences in physical activity and walking pace in UK healthcare workers: a nationwide longitudinal cohort study

Objectives: To examine how self-reported physical activity and walking pace in UK healthcare workers differ ethnicity, migration status, and job role. Design: Prospective cohort study with 6 waves of data collection between 2020 and 2025, analysed using multi-level logistic regression, informed by the UK REACH patient and professional advisory group. Setting: Healthcare settings across the UK. The United Kingdom Research study into Ethnicity And COVID-19 outcomes in Healthcare workers (UK-REACH) cohort. Participants: 18,721 healthcare workers employed in the UK: 28.2% Allied Health Professionals; 75% female; 34% from ethnic minority backgrounds; and 32% born overseas. Main outcome measures: Physical activity and walking pace, as measured by the General Practice Physical Activity Questionnaire (GPPAQ). A Total Physical Activity score, and a separate Exercise and Cycling score excluding occupational physical activity were derived. Results: Walking pace and physical activity varied significantly by ethnicity, migration status and job role. Compared to White UK-born staff, slower walking pace was reported in ethnic minority staff, with differences greater in staff born overseas (e.g. Asian UK (aOR 0.63, 95%CI 0.56 to 0.71, p<0.001), Asian overseas (aOR 0.38, 95%CI 0.35 to 0.42, p<0.001)). Compared to White UK-born staff, lower odds of reporting being physically active were reported in multiple ethnic groups. Differences were larger for Exercise and Cycling, indicating that occupational physical activity accounted for a large proportion of total physical activity in several groups (e.g. Total Physical Activity: Asian overseas-born (aOR 0.79, 95%CI 0.72 to 0.87, p<0.001); Exercise and Cycling: Asian overseas-born (aOR 0.61, 95%CI 0.56 to 0.67, p=<0.001). Compared toMedicalstaff, Nursing and Midwifery staff, Pharmacy staff, Dental staff, Other staff, and Healthcare Scientists hadsignificantly lower odds of reporting being physically active. Ambulance staff had higher odds of reporting being physically active when using the Total Physical Activity score (aOR 1.64, 95%CI 1.37 to 1.97 p<0.001), but lower odds for Exercise and Cycling (aOR 0.61 95%CI 0.53 to 0.72, p<0.001). Conclusions: Self-reported physical activity and walking pace vary significantly in UK healthcare workers, by ethnicity, migration status, and job role. Our findings have important implications for understanding workforce health and ethnic health inequalities.