Background: Perceived general health is a major dimension within the broader construct of health-related quality of life (HRQOL) and is associated with numerous outcomes such as chronic disease, disability, functional status, and mortality. Physical activity (PA) and muscular strengthening activity (MSA) are both known behaviors associated with improved HRQOL. However, post pandemic PA data are needed at the population level to examine the current relationships with HRQOL. The purpose of this study was to examine the extent to which PA and MSA relate to perceived general health in U.S. adults. Methods: Data for this study included 27,651 adult participants 18+ years of age from the 2022 National Health Interview Survey (NHIS). The main outcome variable was perceived general health, where participants responding as good or better were categorized as having good health and those responding fair or worse categorized as having poor health. The first predictor variable used was a 3 level PA measure of inactive, insufficiently active, and sufficiently active. The second predictor variable was a 4 level combined PA and MSA measure of meets neither, meets MSA only, meets PA only, and meets both PA and MSA guidelines. Covariates included age, sex, race/ethnicity, income, urban/rural status, and obese status. Poisson regression models with robust error variance were used to compute relative risk (RR) ratios and 95% confidence intervals (CIs). Results: Overall, 14.5% (95% CI: 14.0 – 15.1) of adults were categorized as having poor health, 24.3% (95% CI: 23.5 – 25.0) as meeting both PA and MSA and 46.5% (95% CI: 45.7 – 47.4) meeting neither PA or MSA guidelines. In the adjusted 3 level PA model, inactive and insufficiently active adults had RR = 2.58 (95% CI: 2.36 – 2.83) and RR = 1.70 (95% CI: 1.54 – 1.89) times greater risk of poor health, respectively, as compared to their sufficiently active counterparts. In the adjusted 4 level combined PA and MSA model, adults meeting neither PA or MSA, meeting MSA only and meeting PA only had RR = 3.27 (95% CI: 2.82 – 3.8813), RR = 2.70 (95% CI: 2.23 – 3.27), and 1.82 (95% CI: 1.54 – 2.15) times greater risk of poor health, respectively, as compared to those meeting both PA and MSA guidelines. Finally, slicing the last model by obese status, showed that non obese adults (RR = 4.05, 95% CI: 3.29 – 4.99) meeting neither PA or MSA had significantly greater RR of poor health than their obese counterparts (RR = 2.09, 95% CI: 1.70 – 2.57). Conclusion: These results indicate that meeting PA as well as combined PA and MSA guidelines protect adults against poor general health in the U.S. Health promotion planning efforts to increase PA should include perceived general health as a expectancy outcome.

Physical activity (PA), Muscle strengthening activity (MSA), NHIS, General health