Powerful actors who undermine physical activity policy must be challenged

Recent data show that one in five adults in the UK have diabetes or pre-diabetes.1 Diabetes UK has issued a call for bold action to reverse this trend, placing emphasis on the role of unhealthy diets and the need to fix a “broken food environment.”2 While these certainly need to improve, regular physical activity is also critical for the prevention and management of diabetes and other non-communicable diseases.3 Yet physical activity rarely receives adequate recognition in the response to tackling major population health concerns. For example, the UK government’s obesity strategies over the past 20 years have been dominated by policies that target diet and suggest that the problem is behavioural, with relatively little attention given to improving levels of physical activity or addressing structural barriers to healthy lifestyles.4

Over a third of adults in the UK do not get enough physical activity,5 placing considerable burden on healthcare systems, people, and the economy through higher rates of non-communicable disease and poor health.6 Despite the World Health Organization’s global action plan on physical activity providing evidence informed solutions to guide government action on increasing levels of physical activity among the population,7 responses have been slow and largely inadequate to reverse trends.8

Evidence on risks and benefits of physical activity to population health is necessary but insufficient to achieve policy change.9 It would be naive to expect countries to adopt and implement policies simply because of global commitments and compelling evidence of the problem and consequences. Policy making is complicated, unpredictable, and involves government, civil society, academics, scientists, and others. At times the process is influenced by the private sector, which competes to ensure that its interests are reflected in government policy.10

Policy making begins with issues finding their way onto the policy agenda. Individuals, institutions, and corporations with good political connections wield their power to bring government attention to their issue, to keep issues off the policy agenda, or to shape societal views on how an issue should be governed. Their aim is to divert, dilute, or delay to ensure that policies do not include measures that would undermine their own interests.1112 There is therefore an urgent need to better understand the policy making process and power dynamics within various public arenas that affect policy responses to physical inactivity, diabetes, and non-communicable diseases.

To gain greater political traction on physical activity we must look at the actions and messaging of groups with competing interests. For example, the transport sector’s response to climate change has focused mitigation policy on scaling up electric vehicles. This serves the interests of the automotive and allied industries while undermining the opportunity to reorientate transport systems towards non-motorised travel. Active modes of travel, including walking and cycling, are better for people and the planet. To realise the health and wider benefits of physical activity, advocacy efforts must focus on integrating policy that promotes physical activity with wider global and national priorities, such as mitigating climate change, reducing air pollution, improving mental health, and tackling health inequalities. This shift in the framing would position physical activity as an unrealised solution to a range of health, social, environmental, and economic challenges.

The ultimate form of power is to influence and shape the thoughts or beliefs of the public and secure people’s acceptance of policy even when it runs contrary to their best interests. In the context of urban planning and traffic congestion, for example, we have been conditioned to accept that the policy solution is to build more roads. This serves to further the climate crisis and air and noise pollution while overlooking alternative policies that would support more active and sustainable travel and tackle both climate change and physical inactivity.13

The global community of physical activity scientists, advocates, and policy influencers must expose, debunk, and confront those who are shaping current narratives that devalue or obstruct physical activity related policy.14 We need to strengthen our advocacy focus on the political system and processes with global, regional, and national mobilisation that challenges powerful organisations who perpetuate inaction on physical inactivity. We must create desire, expectations, and demands to live in a world designed to promote and support physical activity. Physical activity for all is a human right.151617 We need to better leverage a rights framing to put pressure on policy makers and ensure they are held accountable to make “physical activity conscious” decisions. Such pressure will be most effectively applied if the physical activity community works together, as a unified voice, and collaborates with other groups with aligned agendas. Together we can, and should, demand the right to live in a world that values the wellbeing of people and planet.