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The pandemic of physical inactivity: global action for public health

Colin ChambersUncategorized Leave a Comment

For a while I have been seeing evidence that governments are waking up to the notion that inactivity itself is its own risk factor for health problems and therefore something that needs to be addressed on its own. I have known this for a long time but found little support in the wider community and particularly in the health service itself.

Inactivity is such a severe problem that The Lancet released a white paper named The pandemic of physical inactivity: global action for public health that puts activity clearly in its own category as a risk factor independent of other risk factors. Expanding on this trend the related article effect of physical inactivity on disease worldwide provides statistics on the causes of disease through inactivity I am taking this as a clear sign that inactivity is now truly recognised as a direct contributor to serious disease. Meaning that governments must now build this into policy and infrastructure and make it easier for people to move around throughout the day.

It has taken decades to get this far and so it will take decades to see the full impact of this message. I just wanted to record this for any one like me who gets ignored or laughed at when they say that being inactive is dangerous. The best science journal in the world agrees and so do the major governments.

How to be active to improve your health is a whole other issue that this blog is dedicated to. This post is simply about the clear statement that inactivity is its own path to serious health problems.

If you don’t have time to read the report I’ve included some of its key aspects for you.

Some of the key messages include:

  • The high prevalence of physical inactivity, its harmful health and environmental consequences, and the evidence of effective physical activity promotion strategies, make this problem a global public health priority
  • Physical activity and public health is a new discipline, merging several areas of specialisation including epidemiology, exercise and sport science, behaviour science, and environmental health science, among others; these different areas are needed to tackle the global pandemic of physical inactivity because multidisciplinary work is essential
  • Early development of the discipline has been largely opportunistic and, as a result, physical activity has usually been coupled with other public health agendas and is often not a fully recognised, standalone, public health priority

The overview covers the main aspects:

Physical activity promotion to improve the health of populations, rather than individual behaviours, has only had an identifiable infrastructure since 2000. The reasons for this late start are myriad and complex.

First, there is a perception, albeit incorrect, that the science base for physical activity and health has lagged behind other important issues such as tobacco use and diet.

Second, as a result of a grafting of exercise science to public health science, the specialty of physical activity and public health has its roots in several areas. Exercise science, epidemiology, behavioural science, environmental health science, and others have each contributed to the emergence of the discipline of physical activity and public health and the absence of centralisation has resulted in diffuse and uncoordinated development. As such, early action in training and growth of infrastructure has often been opportunistic rather than systematic. 

Finally, physical activity has frequently been coupled with diet, to address obesity, rather than defined as a standalone public health issue, despite evidence for many independent health effects of physical activity and physical inactivity. Such opportunistic approaches by coupling or integration with other health determinants might have merit for the physical activity policy agenda for some health outcomes, but they unavoidably restrict the scope of action and impede a full approach to address all aspects of physical activity and inactivity. Further, such partnering for convenience should not to be confused with building of equally footed partnerships for action.

Finally the conclusions also make very interesting reading:

Physical inactivity is pandemic, a leading cause of death in the world, and clearly one of the top four pillars of a non-communicable disease strategy. However, the role of physical activity continues to be undervalued despite evidence of its protective effects and the cost burden posed by present levels of physical inactivity globally. There is an urgent need to build global capacity. 

Although progress has been made in policy and planning, leadership and advocacy, workforce training, and surveillance, much needs to be done to fully address this global issue. Advancement of global capacity needs intersectoral collaboration, improved understanding of what works, particularly in countries with low and middle incomes, comprehensive monitoring to assess progress in implementation of policies and action plans, and momentum in development of a highly skilled workforce in physical activity and public health. 

New partners, an expanded leadership base, resources at the country and local level, and expanded infrastructure are crucially needed to advance physical activity as a public health issue. 

Furthermore, a systems-based approach is needed to address the complex interactions between the various conditions that promote or impede population levels of physical activity. Understanding and application of complex systems to affect physical activity will allow infrastructure changes that will give individuals and populations the freedom to be more physically active and healthy.

At last I have a specific article I can point people to that says categorically that as hunter gatherers we need to get back to hunting and gathering in order to be healthy. It’s been a very long time coming but finally it’s here.

Further reading

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