Social Determinants of Physical Inactivity

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Physical Inactivity/Sedentary Behaviour

Physical activity [PA] is known to have health benefits, including reduced risk of cardiovascular disease, Type 2 diabetes, several cancers and NCDs. Yet despite this, in many countries of the world a large number of adults display sedentary behaviour [SB], spending a large proportion of their waking hours sitting: often at a desk at work, on a sofa at home, and on transport, whether public transport or private vehicle. These sedentary behaviours have low energy expenditure, and are associated with health risks, independent of PA levels.

Social Determinants Definition

Factors in the social and physical environment which impose a direct influence on the opportunity to engage in physical activity; these are most often open to modification.

Social inequality includes: income inequality and education inequality, both of which may have an effect on activity levels and SB.

Community traits such as social cohesion, perceived benefits of PA and attitudes to age & gender restrictions may also play a role.

Environmental determinants include access to public green areas, provision of safe areas to walk in eg. on street, as well as the design of residential areas which may or may not include walkable neighbourhood routes, and provision of cycle routes.

Transportation

Transportation provision can promote PA by providing safe and attractive routes to walk or cycle in, which may be combined with public transport. If government policy can lead to improved infrastructure which promotes PA as part of the commute to work or travel to school, then the health benefits for the community should be substantial.

A study of infrastructure changes (including traffic-free bridges and walking/cycling routes) at 3 sites in the UK demonstrated sustained use over the 2 years following construction. However, despite this the authors caution "the infrastructure may primarily have attracted existing walkers and cyclists, and may have catered more to the socio-economically advantaged. This may limit its impacts on population health and health equity."

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