Regular physical activity promotes both mental and physical health. It is beneficial for people of all ages and abilities, and it is never too late to start being more active and less sedentary to improve health. Yet 81% of adolescents and 27.5% of adults currently do not meet WHO’s recommended levels of physical activity and this affects not only individuals over their life span and also their families, but health services and society as a whole.
The COVID-19 pandemic revealed the vital importance of regular physical activity for both mental and physical health. It also, however, exposed inequities in access and opportunities for some communities to be physically active. The COVID-19 pandemic has shown that physical activity must be a core component of public policy, with all countries ensuring provision of equitable physical activity opportunities for all. To help countries increase levels of participation, WHO’s Global Action Plan on Physical Activity 2018–2030 (GAPPA) provides a set of evidencebased policy recommendations to increase levels of participation across four strategic policy areas: active societies, active environments, active people and active systems. Effectively implemented by all countries, GAPPA will accelerate action towards meeting the global target of a 15% relative reduction in population levels of physical inactivity by 2030.
The cost of physical inactivity
The economic burden of physical inactivity is large. Globally, almost 500 million (499 208 million) new cases of preventable NCDs will occur between 2020 and 2030, incurring treatment costs of just over US$ 300 billion (INT$ 524 billion) or around US$ 27 billion (INT$ 48 billion) annually if there is no change in the current prevalence of physical inactivity. Nearly half of these new cases of NCDs (47%) will result from hypertension, and 43% will result from depression. Three quarters of all cases will occur in lower- and upper-middle-income countries. The largest economic cost is set to occur among high-income countries, which will account for 70% of health-care expenditure on treating illness resulting from physical inactivity.
Main Findings
There are few areas in public health – such as
physical activity - where evidence on required action is so convincing, cost
effective and practical. While some countries have started to implement
different recommended GAPPA policy actions, overall global implementation since
its adoption 5 years ago has been slow and uneven, resulting in little progress
towards increasing population levels of physical activity. A consequence of
this “inaction” is that already stretched health systems are burdened with
preventable disease today and even more so in the future, and communities fail
to benefit from the wider social, environmental and economic benefits associated
with more people being more active.
Only two GAPPA policy indicators show
implementation by over three quarters of all countries: conducting national
surveillance of physical activity (among adults, and among children and
adolescents); and the presence of national road safety design standards for
safe crossings for pedestrians and cyclists. For nine GAPPA policy indicators,
between a half to two thirds of countries report implementation. For the
remaining 18 GAPPA policy indicators, less than half of countries report
implementation in 2021 (see Table 1). Uneven implementation across WHO regions
and country-income level results in inequities in people’s access to
opportunities and environments that support being regularly and safely active.
This first global assessment of policy actions to increase physical activity
reveals significant gaps in policy implementation. These gaps are demonstrated
by the overall modest level of GAPPA-recommended policy development and the
notable gap between the presence of a policy and its operational status. In the
majority of countries, policy development and implementation must be
strengthened and accelerated if global targets on physical activity are to be
met.
Gaps in policy are a result of multiple interconnected factors that fall
into five areas: political, technical, financial, collaboration and capacity
building, and data systems – all of which can either limit or accelerate policy
progress. When positively aligned, these “policy enabling” factors combine to
set and advance the national agenda. Conversely, the absence of one or more of
these factors can reduce, divert and even reverse policy progress. As the
national policy cycle for physical activity is not “one size fits all”, all
countries need to identify and strengthen the policy enablers to drive a
positive and virtuous cycle of collective action to enable more physical
activity.
GAPPA policy implementation: results by policy area
GAPPA
policy area – active systems: The number of countries reporting a national NCD
policy (including physical activity, or a standalone physical activity policy)
has increased since 2017 and 2019. However, this progress is tempered by the
28% of countries that report these policies are not being implemented in 2021
(i.e. reported as not “operational”). These results, combined with evidence
that less than 50% of countries report having a national NCD coordinating
mechanism to support multisectoral collaboration, are of major concern and
contribute to explaining the low level of policy implementation on physical
activity seen across the indicators presented in this report.
GAPPA policy area
– active societies: Just over half of countries report conducting at least one
communication campaign to raise awareness and knowledge around physical
activity in the past two years – a figure that has declined since 2019. About
half of countries implemented mass-participation events to engage people in
physical activity through free, community-wide events. This figure has also
declined since 2019, likely due to the COVID-19 pandemic.
GAPPA policy area –
active environments: Global progress in policy action to provide environments
that support physical activity is varied. National design standards for road
safety features that protect people when walking and cycling are present in
three quarters (76%) of countries for safe road crossings, and two thirds (66%)
of countries for design for the safe management of speed. Only half of
countries report national standards requiring separated infrastructure for walking
and cycling, and less than half report the presence of all three of these
national road safety design standards. Furthermore, while legislation on speed
limits and drink–driving is present in most countries, only a quarter (26%) of
these countries’ legislation meets WHO bestpractice standards. Low levels of
best-practice legislation combined with an absence of road design standards
presents increased risks to people walking and cycling in these local
communities.
GAPPA policy area – active people: Implementation of policies that
ensure opportunities for physical activity in key settings where people live,
work and play, and targeted programmes to support key population groups, is
reported by less than half of all countries. Notably, less than 40% of countries
report having national protocols for the management of physical activity in
primary health care, despite strong evidence of the protective benefits of
regular physical activity against leading NCDs and for mental health. Although
this indicator shows a modest increase since 2019, the slow level of
implementation of this recognized “best buy” policy is of particular concern
given the high number of people living with, or at risk of, NCDs.
Summary of results
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