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Physical Activity Affected By Social Status

Armen Hareyan's picture

As physical activity is a ticket to health and well-being, it should be easily accessible, culturally acceptable, appealing and convenient to everybody. Within countries and across the WHO European Region, all - the rich and the poor, the young and the old, the healthy and the infirm -should have opportunities and live in environments allowing them to be physically active. On Move for Health Day 2008, for the first time, WHO emphasizes the importance of physical activity for all. The WHO Regional Office for Europe is holding an event, in collaboration with Suhr's University College in Copenhagen, Denmark, to discuss social inequalities in physical activity and identify good practices for targeted interventions.

In the WHO European Region, one in five people takes little or no physical activity, with higher levels of inactivity in eastern countries. In the European Union (EU), two thirds of the adult population does not reach recommended levels of activity. As a result, physical inactivity is estimated to deprive Europeans of over 5 million days of healthy life every year, on average. Everybody is not affected in the same way, however.

Populations' socioeconomic status influences how active or inactive they are. People with lower incomes have disproportionately higher rates of the chronic diseases and obesity associated with less physical activity and unhealthy eating patterns. Although poorer people are more likely to walk or cycle to shops or work than those with higher incomes, they are less likely to be active in their leisure time. The mechanization of labour has brought about a general homogenization of levels of work-related physical activity among social groups. Thus, socioeconomic differences in overall physical activity are more likely to result from variations in leisure-time pursuits than in activities related to other areas of life.

Occupation, income, education and the environment in which people live greatly influence their choices in leisure time. Higher proportions of unemployed people are sedentary than those in employment, and white-collar workers are twice as likely as manual workers to take part in sports. Lack of nearby sports facilities, transport or sufficient money may stop those with low incomes from taking up leisure physical activities. Where potential activities are free or inexpensive, such as those in parks or the neighbourhood, people may live in places where the rates or fear of crime is inhibiting. Further, poorer people in general have less awareness of the benefits of an active lifestyle. Conversely, richer people may have the means to pay for costly activities, more leisure time, higher awareness of the benefits and more social pressure to exercise.

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People who are very young, very old or disabled, families in precarious circumstances, migrants, ethnic minorities and women are particularly vulnerable to physical inactivity. Children, especially among the poor, have more difficulty in affording the healthiest food choices and opportunities to be active; thus, they have a higher probability of unhealthy behaviour, such as spending more time watching television, increasing their risk of becoming obese. In the United Kingdom, the proportion of people engaging in physical activity declines with age; walking drops from 45% among men younger than 24 to 8% among men aged 75 and over. Eurobarometer surveys from 2003 and 2006 reveal that women tend to be less physically active than men across EU countries, and that the prevalence of obesity is highest among women from more disadvantaged groups, including immigrants.

In addition, opportunities to be physically active are unequally distributed between countries. Almost three quarters of EU citizens agree that they have many opportunities to be physically active in the area where they live. In new EU countries, however, only a minority of respondents shares the same belief. Countries in which respondents declare that they never engage in vigorous physical activity are also those where local opportunities are considered most inadequate.

All these factors have implications for policy responses and local governments' opportunities to create and maintain activity-friendly cities. Evidence from the health sector is compelling: at least 30 minutes of moderate-intensity physical activity taken 5 days per week reduces the risk of disorders related to inactivity (such as heart disease, adult diabetes and obesity) by about 50%, and substantially decreases hypertension and the psychological consequences of a sedentary life (stress, anxiety, depression and loneliness).

"Taking stock of the health benefits of active lifestyles, health systems can stimulate collaboration with other relevant sectors to make neighbourhoods more physical activity friendly," says Dr Marc Danzon, WHO Regional Director for Europe. "Liaising with urban planners and the transport sector, they can encourage building cycling paths in urban areas, rejuvenate inner-city areas and create safer and more attractive green spaces, safer playing areas and safer streets. In collaboration with the sport and the finance sectors, they can promote and increase the number of low-cost and after-school sports facilities."

The WHO Regional Office for Europe works to promote evidence-based good practice on physical activity that can reduce the socioeconomic inequalities in obesity. It advises and supports countries in the European Region in developing and implementing tailored policies and actions that promote an active lifestyle through multisectoral approaches. The Regional Office also advocates getting more people engaged in active lifestyles through raising their understanding of the importance and the opportunities of moving for health. The special focus of Move for Health Day 2008 on poorer and more vulnerable groups aims to help make access to physical activity a reality for all.