Promoting physical activity in a public health context

Promoting physical activity in a public health contextIn this special issue of the Journal of Sport and Health Science entitled Physical Activity and Public Health, 5 papers, 1 commentary, and 1 research highlight discuss efforts using public health approaches to increase physical activity (PA) in global settings.Such efforts are warranted based on the prevalence of adults (23%) worldwide who are insufficiently active at levels recommended by the World Health Organization (WHO).This impact is substantial with 6%-10% of all deaths attributed to insufficient PA. 1,2 Insufficient PA also places adults at increased risk for a myriad of conditions, which include cardiovascular disease, type 2 diabetes, breast and colon cancer, bone and joint problems, among others.Steven Blair, known worldwide for his research on PA, aerobic fitness, and health refers to the physical inactivity pandemic as the "biggest public health problem of the 21st Century".3 This concern is mirrored by a recent report highlighting global increases in overweight and obesity and the impact on increased mortality and disability related to cardiovascular disease and type 2 diabetes.4 Accordingly, public health governmental agencies 5,6 and nongovernmental organizations [7][8][9][10] have called for stepped up efforts to increase PA on a global scale.Public health approaches to increasing PA often are organized into action plans based on the Ecological Systems Model, a framework used to understand the multiple levels of behavior, social systems, and interactions between people and their environments.11,12 In 2006, Sallis et al. 13 presented an ecological model of the 4 domains of active living (recreation, transport, occupation, and household) that recognizes the importance of multiple influences on decisions to be physically active or not.They identify social cultural environments, informational environments, built and natural environments, perceived environments, and policy environments.Social cultural environments relate to the importance of interpersonal modeling, social support, the social climate, and advocacy by individuals and organizations.Informational environments involve information dissemination, counseling, and mass media efforts.Built and natural environments include considerations of climate, open space, air quality, and structures built for PA purposes.Policy environments relate to ordinances and laws that enable active transport, sports and recreation opportunities, and land use.Traditionally, public health approaches have been focused on built, natural, and policy environments; however, all levels of Peer review under responsibility of Shanghai University of Sport.