By Loretta DiPietro, PhD, MPH; JPAH Editor-in-Chief
In 1986, The Ottawa Charter of the World Health Organization clearly defined a plan for engaging citizens in strategies to mitigate their own individual risk factors, as well as the environmental conditions that affected their families and their entire communities.1 Unfortunately, the full potential of the Ottawa Charter with regard to directing public policies and private decisions relating to physical activity behaviors has lagged behind other important areas of public health, such as nutrition or tobacco and alcohol control. Until now, that is. Recently, the appearance of a number of key publications appear to indicate that we may be closer to realizing the charge of the Ottawa Charter as it relates to physical activity, exercise, and sport at the population level.
The Toronto Charter for Physical Activity was launched in May 2010 by the International Society for Physical Activity and Health as a call to action. The Toronto Charter was specifically designed to create sustainable opportunities for physically active lifestyles.2 It provided, for the first time, a framework for action across four key areas:
- implementation of national policies and action plans for physical activity
- introduction of policies that support physical activity
- reorienting services and funding to prioritize physical activity
- the development of partnerships for action.
A series of papers dedicated to the topic of global physical activity was published in the British medical journal The Lancet in July 2012. Central to that issue were two manuscripts that specifically addressed the pandemic of physical inactivity. Lee and colleagues provided an elegant analysis of the considerable non-communicable disease burden that can be attributed to physical inactivity throughout the world.3 These novel findings indicated that eliminating (or even simply reducing) global levels of physical inactivity would have a considerable impact on health and longevity worldwide. Kohl et al. summarized existing global efforts to minimize daily physical inactivity and further recommended a systems approach to dealing with this urgent public health problem. According to Kohl et al., the solution to curbing this global pandemic requires multiple-sector approaches throughout community and government infrastructure (e.g., efforts in planning, policy, leadership, advocacy, training, and surveillance).4
These two pieces of work, in combination with the other papers in that landmark issue of The Lancet, have markedly elevated the prominence of physical inactivity as a leading cause of morbidity and mortality. More importantly, physical inactivity appears now to be emerging as a public health concern in its own right, rather than as a factor co-existing with the obesity endemic. If physical activity was not relevant to public health in 1983 (as I was told by my academic advisor at Yale University when I started in this field), it certainly is now.
In the January 2013 issue of the Journal of Physical Activity and Health (JPAH), we published a novel commentary by Bauman, Murphy, and Matsudo,5 which questions the ability of mega international sporting events (such as the 2012 London Olympic Games) to create a legacy of growth in population-level physical activity within and outside the surrounding communities. Whereas the sustainable benefits of hosting the Olympic Games may be evident with regard to housing and community infrastructure development and community capacity-building, there appears to be a negligible impact on levels of activity and sport within those same communities. Bauman et al. address the need for an “action plan” to be devised well in advance of these mega-events, in order to advance such a legacy of population growth in physical activity. This call for an action plan is also stated in the recent United Nations General Assembly Political Declaration on the Prevention and Control of Non-communicable Diseases6, which reaffirmed the need for a global action plan for diet, physical activity, and health, and calls for a “whole-of-government and whole-of-society effort” in addressing the challenges of implementing it. Again, the charge is one comprising government commitment and leadership, as well as multiple-sector approaches (public health; health care; academia; mass media; business and industry; not-for-profit organizations; recreation, fitness, and sports; and transportation/community planning) to achieving a healthy and active lifestyle that acknowledge and utilize the contributions of the relevant stake-holders (i.e., individuals, families, and communities). In doing so, these plans should create consensus among a number of traditional and non-traditional public health partners to initiate a major social movement necessary to shift cultural knowledge, attitudes, beliefs, and practices with regard to the importance of an active lifestyle. Sadly, although a large proportion of World Health Organization member states report having an action plan regarding physical activity, many of these are not operational.7
JPAH continues to encourage the submission of manuscripts and white papers that describe physical activity policy-based action strategies at the local-, state-, or national-level, as well as manuscripts that provide sound evaluation of such policy-based efforts. To that end, in the March 2013 issue of JPAH (Volume 10, Issue 3) we published a white-paper by Bailey, Hillman, Arent, and Petitpas that is sponsored by Nike, Inc. and the Designed to Move Initiative.8 This extraordinary report, in discussing a Human Capital Model, extends the virtues of physical activity and sport away from the individual alone and toward what the 1986 Ottawa Charter had in mind for public health promotion. Indeed, this Human Capital Model comes the closest yet to realizing the basic components of health promotion as expressed in the Ottawa Charter: 1) enablement, 2) advocacy, 3) mediation, and 4) self-management. By using physical activity and sport for community capacity-building and for increasing social capital, we are empowering people and communities to have greater control over the determinants of their health. Collateral benefits of the Human Capital Model will no doubt include the providing of vital inertia for ongoing social and environmental justice movements, thereby minimizing existing disparities in these areas. These latter sentiments are echoed within the paper by Kohl et al.,4 which proposed that the population-level promotion of an active lifestyle (similar to access to clean water) needs to be considered a basic human right. The Journal of Physical Activity and Health fully endorses these ideas and remains committed to publishing research that furthers this movement.
- World Health Organization. Ottawa Charter for Health Promotion. First International Conference on Health Promotion: WHO/HPR/HEP/95.1,1986.
- The Toronto Charter for Physical Activity and Health: A Global Call to Action. Journal of Physical Activity and Health. 7: S370-373. 2010.
- Lee I-M, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT for the Lancet Physical Activity Series Working Group. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. The Lancet. dx.doi.org/10.1016/S0140-6736(12)61031-9; 2012.
- Kohl HW, Craig CL, Lambert EV, Inoue S, Alkandari JR, Leetongin G, Kahlmeier S for the Lancet Physical Activity Series Working Group. The pandemic of physical inactivity: global action for public health. The Lancet. dx.doi.org/10.1016/S0140-6736(12)60898-8; 2012.
- Bauman AE, Murphy N, and Matsudo V. Is a population-level physical activity legacy of the London 2012 Olympics likely? Journal of Physical Activity and Health. 10;1-4; 2013.
- United Nations General Assembly. Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases. 2011.
- WHO. Assessing national capacity for prevention and control of non-communicable diseases: the report of the 2010 global survey. WHO, 2012.
- Bailey R, Hillman C, Arent S, and Petitpas A. Physical activity as an investment in personal and social change: The Human Capital Model. Journal of Physical Activity and Health. 10:289-308; 2013.