Overall, 38.2% of the German adult population showed low/rather low physical activity-related health competence (PAHCO), with higher odds among older adults, those with lower education or income, poorer health status, and lower social support.
More than one third of German adults showed low or rather low physical activity-related health competence (PAHCO).
Adults aged 65 years and older had substantially higher odds of low PAHCO compared to those aged 18–29 years.
Lower formal education was independently associated with higher odds of low PAHCO.
Lower equivalent income was independently associated with higher odds of low PAHCO.
Poor self-rated general health, poor mental health, and chronic conditions were each associated with lower PAHCO levels.
Low social support was associated with higher odds of low PAHCO.
Gender differences in PAHCO were observed only for the movement competence sub-competency, not for the overall PAHCO score.
This research suggests that a substantial portion of German adults—about 38%—lack sufficient physical activity-related health competence (PAHCO), which refers to the personal skills needed to engage in health-enhancing physical activity. PAHCO covers three areas: the ability to move effectively (movement competence), the ability to manage and plan physical activity (control competence), and the ability to stay motivated and maintain activity over time (self-regulation competence). The study found that certain groups are much more likely to have low PAHCO, including older adults (especially those 65 and over), people with lower levels of formal education, people with lower incomes, those in poorer physical or mental health, and those with limited social support. The findings highlight that gaps in physical activity skills are not randomly distributed—they follow familiar patterns of social inequality and health vulnerability. Older age was the strongest risk factor, with people aged 65 and over nearly four times more likely to have low PAHCO than those aged 18–29. Education and income each roughly doubled the odds of low PAHCO when comparing the lowest to highest groups. Notably, gender differences only appeared in movement competence specifically, not in the broader PAHCO measure. This research suggests that physical activity promotion programs should be tailored to reach groups most at risk of low PAHCO, such as older adults, people with lower education or income, those living with chronic conditions or poor mental health, and people with limited social networks. Rather than one-size-fits-all approaches, strategies may need to address all three dimensions of PAHCO—movement skills, planning abilities, and self-motivation—in ways that are sensitive to the specific needs and life circumstances of these groups.
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Upload Your LabsDomanska O, Jordan S, Manz K, Buchmann M, Pfeifer K, Sudeck G, et al.. (2026). Physical activity-related health competence differs by social and health-related factors: findings from a nationwide population-based study in Germany.. BMC public health. https://doi.org/10.1186/s12889-026-29096-0