As most developed countries in the world—including the United States—face rising obesity rates and skyrocketing health care costs, a recent report from international health researchers shows that interventions and policy changes by governments and urban planners can have significant impact on public health.
Dr. Gregory Heath
Dr. Gregory Heath, UTC Guerry Professor of Health and Human Performance and Assistant Provost for Research and Engagement, is the lead author of a study addressing effective strategies for the promotion of physical activity across the world.
The paper was published this month as part of a series on physical activity and health in the British journal, The Lancet. Heath’s work appears alongside that of 33 other research scientists from 16 countries.
Based upon their findings, researchers report that more than 5.3 million deaths might be avoided each year if all inactive people began exercising. This number of deaths approximates the same international death toll as the 5 million annual smoking related deaths.
“Because even moderate physical activity such as walking and cycling can have substantial health benefits, understanding strategies that can increase these behaviors in different regions and cultures has become a public health priority,” explains Heath.
The authors analyzed 100 reviews of clinical and community-based physical activity interventions published between 2001 and 2011 to identify a number of effective ways to promote exercise in people of different ages, social groups, and countries worldwide. Interventions include communication and information strategies, social and behavioral support initiatives, and modifications to environmental design and transportation policies.
Successful examples included promoting exercise and community events through mass media campaigns as well as decision prompts and signage to motivate people, for instance to use stairs instead of elevators.
Social support networks such as buddy systems and walking clubs were also important. Free exercise classes in public places such as parks that targeted populations who are less likely to manage recommended levels of activity, including women, those on lower incomes, and older adults were also found to be effective.
In children and adolescents, physical activity and fitness could be greatly increased through school-based strategies including physical education and after-school sports—already mandatory in many countries, according to the authors.
The scientists also recommend the creation of environments conducive to walking or biking—for instance, bike lanes and trails—and improved access to sport and recreational activities. Shaping policies for community and neighborhood design, land use—such as increasing green space—and improving public transport were also supported.
Evidence from studies in the U.S., Australia, Belgium, Canada, England, and Germany indicate that street-level strategies such as improved lighting and aesthetics can boost activity levels by as much as 50 percent.
Another potentially effective intervention that originated in Bogotá, Columbia, and has now spread to almost half of countries (100 cities) in the Americas, is known as Ciclovía. The program closes city streets to motorized vehicles for use by walkers, runners, skaters, and cyclists on Sunday mornings and public holidays.
The Ciclovía attracts about a million users, mostly people on lower incomes, and provides about 14 percent of the weekly recommended exercise target for weekly minutes of physical activity for Bogotá.
Pedometers, which measure the number of steps a person takes daily, were found to be highly effective in motivating people to walk and exercise.
“They give feedback, so people can see how much they’ve done and set targets,” said Heath.
“Overall, our findings showed the interventions to have consistent and significant effects on physical activity behaviors,” concluded Heath. “Even though in some instances the effects of these interventions were rather modest, they were large enough to translate into real population-level benefits if rolled out on a larger scale.”
