PUBH5033 - Assessment 2 Physical Inactivity Problem Analysis Word Count: 1456 Problem magnitude Physical inactivity is significantly emergingas a concerning health problem worldwide[1,2,3]. The evidence suggests that inactivity knowingly increases the risks of a number of health concerns.In 2013, researchers estimated thatglobalphysical inactivity cost healthcare systems $53.8 billion dollars [4,5]. Physical inactivity influences the rising burden of the world’s main non-communicable diseases; which consists ofcoronary heart disease,breast and colon cancers, type 2 diabetes, stroke, obesity,and depression, with type 2 diabetes accounting for more than $37 billion dollars being the costliest diseaseassociated with physical inactivity [1,2,3,4] The latest data gathered from the World Health Organisation (WHO) estimated that due to physical inactivityin adults aged 15 and overapproximately31% were physically inactive, the prevalence for men was 28% and women 34% in 2008[3].10% of the burden of disease from breast cancer, 6% of coronary heart disease7% of type 2 diabetesand 10% of colon cancer was estimated that physical inactivity was responsible for globally [2,3]. The data gathered can be a significant means in the decision making process when it comes to promotion strategies for physical inactivity, however as this data back dates over 9 years, there can be many limitations to the accuracy of this data, however it there is evidence that it is significantly increasing in prevalence each year nonetheless more accurate up to date data needs to be gathered for this to prove accurate [2,3]. After applying the 2008 overall median PAF of 9% for all-cause mortality, it is estimated that more than 5•3 million deaths could be averted every year if all inactive people become active [6]. However as physical inactivity cannot be completely eradicated, it is further estimated that potential deaths can be averted, when assuming a decrease of inactivity prevalence by 10% or 25%, with effective public health interventions (elimination). Between 533 000 and 1•3 million deaths were potentially avoided worldwide each year by applying alternate scenarios [2,3]. Problem analysis Non-communicable diseases such as coronary heart disease, colon cancer, and diabetes, three diseases for which physical inactivity is an established causal factor increase and are responsible causes of mortality [2,6,7,8]. It is suggested that with the removal of physical inactivity, the world’s population of life expectancy could increase by 0•68 years [2] WHO estimates that 60 to 85% of people in the world, across both developing and developed countries, lead sedentary lifestyles, making it one of the more serious yet inadequately addressed contemporary public health problems [7]. Chronic disease rates for cardiovascular diseases, diabetes, and obesity have risen rapidly due to lifestyle factors such as physical inactivity, increasing tobacco use and poor diet and nutrition. These diseases are now one of the leading causes of death yet, for the most part, entirely preventable. Countries and individuals could save both lives and conserve resources by investing in the prevention of these diseases [7] Data indicates that urbanisation, economic, social change and computerisationdevelopment from the populations in most countries have been associated with the increase in sedentariness and physical inactivity, more recently with the significant shift from a healthy weight to being overweight [11]. The overall challenge of physical inactivity is further intensified by the risk it carries. [9] In view of the prevalence the change in obesity is credited by health professionals to suboptimal diet and physical inactivity [11]. The change in human behaviours and activities and the increasing social and economic transitions that affect populations have a substantial effect on health and health behaviour [9,11] There has been a rapid trend in some countries that have hauled away from undernutrition and micronutrient deficiencies to overnutrition and obesity, the evidence also suggests its concern in the prevalence of physical inactivity in low-income and middle-income countries,where their physical activities contribute more to overall energy expenditure and such large changes in physical activity demand analysis with a public health lens to evaluate the population-level causes, rather than a only clinical view, to understand the causes of inactivity among individuals. [9] A study was conducted to identify enablers and barriers between a racially/ethnically and geographically diverse groups, within this study they concluded that common enablers were positive outcome expectations, physical activity program access and social support [10]. The barriers were distinguished as health problems, inconvenience,the built environment and lack of knowledge about physical activity. Physical inactivity all though relatively new as a public health concern it is rapidly being recognised with the emphasized importance for control of the increase in non-communicable diseases, demonstrating the global pandemic issue of physical inactivity needs to be built on developing global information and communications technologies on physical activity [9,10,11]. Prevention of Physical Inactivity When addressing physical inactivity the most appropriate prevention level is primordial and primary prevention strategies. Whereby preventative measures protect against exposure to risk factors and promote health focusing on changing the community and environment, as well as, family and individual behaviors and life styles [12]. The focus should be largely on population-based interventions with lifestyle based preventative measures such as moderate physical activity for up to 30 minutes every day, tobacco cessation, and healthy nutrition [7]. Additionally, physical activity behaviors are affected by factors observed as social (family, network group, and work factors),personal (such as biological and psychological attributes), environmental and policy factors [17,18]. As physical inactivity is socially determined [17]. A study of particular social determinants will lead us to further approaches toward the promotion of physical activity. Governments and policy makers are urged to health promotion by implementing supportive measures including safer roads for walking and cycling; creating tobacco-free public buildings and spaces; building accessible parks, playgrounds and community centers; and promoting physical activity programs in schools, communities and health services and mass media health communications [7,13-18] Strategies to consider would include (1) mass media public communications and informative methods promoting physical activity including community-wide campaigns, and relaxed prompts encouraging the use of taking the stairs versus using the lifts. (2) Initiatives to promote community education and engagement along with social support for physical activity within communities, neighbourhoods, and worksites. (3) Extensive school-based strategies integrating physical education and after-school sports curricula. (4) Environmental and policy approaches with outreach events; infrastructural initiatives through urban proposal of land use and planning at community and active transport policy and practices and health-care organisations [17,18]. Health promotion values, principles and theories In addressing physical inactivity,health promotion values, principles and theories can be used to guide the strategy from needs assessment through to evaluation [19]. Fundamental to the health promotion groundwork is the health Promotion principles of empowerment,equity, behaviour and environmental change. The principle of change behaviour, explained as changing an individual’s health related behaviour or changing their characteristics [20,21]. Recent literature validates that health-related behaviour change or “changing people’s behaviour” is fundamental for health promotion [21].Approaches to the current case of physical inactivity are to reduce the risk of disease by influencing individuals through social, environmental and personal factors as mentioned above. This is particularly important for physical inactivity as social marketing is about influencing behaviours and it achieves this for both individual, community and social benefit giving positive effects [20]. The empowerment approach is important for physical inactivity as a state of individuals, groups, and communities,a ‘dynamic state’ that can change over time [20,21]. When it comes to empowerment interventions, it’s considered as having control over the determinants of quality of life and the more control one has over these determinants, the more empowered one is, and vice versa the less control one has, the less empowered one is.Rather than behaviour change, empowerment schemes with physical inactivity will target the cause of causes, for instance, the social or economic factors that contribute to the more precise problems. Noted above physical inactivity is socially determined this demonstrates that we need to gain more access to empowering factors such as better work environments , better transportation, and playgrounds and community centers and promoting physical activity programs in schools [7,13-18,20,21] Physical inactivity focuses both on ecological and social justice principles, this includes a large focus on promoting diversity and creating supportive environments, this includes the approach of community based strategies, where they protect the places we work and live from threats to our health and increase the ability of the individual to make health-promoting choices. The significance of these community based strategies addresses the risks of physical inactivity and promotes solving the social problems that are involved[7,13-18,20,21,22]. In conclusion, physical inactivity is an increasing healthissue and strategies need to be considered the most appropriate prevention level is primordial and primary prevention strategies. Looking at social empowerment and changing the community as a whole target, focusing on the individual behaviour to promote these incentives and live a healthy lifestyle. Reference list (1) Pratt M, Norris J, Lobelo F, Roux L, Wang G. The cost of physical inactivity: moving into the 21st century. Br J Sports Med 2014 02;48(3):171. (2) Lee I, Shiroma E, Lobelo F, Puska P, Blair S, Katzmarzyk P. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. The Lancet. 2012;380(9838):219-229. (3) WHO | Physical Inactivity: A Global Public Health Problem [Internet]. Who.int. 2017 [cited 9 April 2017]. Available from: http://www.who.int/dietphysicalactivity/factsheet_inactivity/en/ (4) Krisberg K. Physical inactivity costs billions globally. The Nation's Health 2016 10;46(8):15. (5) Torjesen I. Global cost of physical inactivity is estimated at $67.5bn a year. BMJ : British Medical Journal (Online) 2016 Jul 28;354. (6) Rütten A, Abu-Omar K, Gelius P, Schow D. Physical inactivity as a policy problem: applying a concept from policy analysis to a public health issue. Health Research Policy and Systems. 2013;11(1). (7) WHO | Physical inactivity a leading cause of disease and disability, warns WHO [Internet]. Who.int. 2017 [cited 13 April 2017]. Available from: http://www.who.int/mediacentre/news/releases/release23/en/ (8) Powell K, Blair S. The public health burdens of sedentary living habits. Medicine & Science in Sports & Exercise. 1994;26(7):851???856. (9) Kohl H, Craig C, Lambert E, Inoue S, Alkandari J, Leetongin G et al. The pandemic of physical inactivity: global action for public health. The Lancet. 2012;380(9838):294-305. (10) Mathews, Anna E., Sarah B. Laditka, James N. Laditka, et al. 'Older Adults' Perceived Physical Activity Enablers and Barriers: A Multicultural Perspective', Journal of Aging and Physical Activity, vol. 18/no. 2, (2010), pp. 119. (11) Blair SN. Physical inactivity: the biggest public health problem of the 21st century. Br J Sports Med 2009 01;43(1):1. (12) Bonita R, Beaglehole R, Kjellstrom T. Basic Epidemiology. 2nd ed: World Health Organization; 2006. (13) Mabry RM, Al-Busaidi Z, Reeves MM, Owen N, Eakin EG. Addressing physical inactivity in Omani adults: perceptions of public health managers. Public Health Nutr 2014 03;17(3):674-81. (14) Trost SG, Blair SN, Khan KM. Physical inactivity remains the greatest public health problem of the 21st century: evidence, improved methods and solutions using the '7 investments that work' as a framework. Br J Sports Med 2014 02;48(3):169. (15) Cecchini M, Sassi F, Lauer JA, Lee YY, Guajardo-Barron V, Chisholm D. Chronic Diseases: Chronic Diseases and Development 3: Tackling of unhealthy diets, physical inactivity, and obesity: health effects and cost-effectiveness. The Lancet 2010 Nov;376(9754):1775-84. (16) Naylor P, McKay HA. Prevention in the first place: schools a setting for action on physical inactivity. Br J Sports Med 2009 01;43(1):10. (17) Heath GW, Parra DC, Sarmiento OL, Andersen LB, Owen N, Goenka S, Montes F, Brownson RC. Evidence-based intervention in physical activity: lessons from around the world. Lancet 2012;380:272-81. (18) McLeroy KR, Norton BL, Kegler MC, Burdine JN, Sumaya CV. Community-based interventions. American Journal of Public Health 2003;93(4):529-33. (19) Gregg J, O’Hara L. Values and principles evident in current health promotion practice. Health Promotion Journal of Australia 2007;18(1):7-11. (20) Tengland P. Behaviour change or empowerment: On the ethics of health-promotion strategies. Public Health Ethics 2012; 5(2):140-53. (21) Kelly, M. (2006). Applications of models of behavior change. In M. Davies & W. Macdowall (Eds.), Health promotion theory. Maidenhead: Open University Press. (22) Chaput, Jean-Philippe, and Angelo Tremblay. "Obesity and Physical Inactivity: The Relevance of Reconsidering the Notion of Sedentariness." Obesity facts, vol. 2, no. 4, 2009, pp. 249. Literature search strategy Research question(s) What are the risk factors associated with physical inactivityand or; What are the barriers and or limitations to physical activity? Keywords/phrases 1. Exp physical inactivity 2. physical inactivity.mp. 3. “physical activity” AND “barriers” 4. 1 OR 2 OR 3 5. physical activity.mp. 6. “physical inactivity” OR “barriers” Databases searched • Medline • ProQuest • Google Scholar • PubMed Inclusion/exclusion criteria There was limited literature on the barriers and risk factors or physical inactivity, therefore all publication types were included, with no limit tosystematic reviews, narrative reviews, original research studies outcomes of interest, or population types.Government and non-government reports were also included. Other information There was no exclusion for time period in the search as there was limited evidence and old data collected. There was limits on English papers only however no limits on age groups or geographical locations. Google websites and literature was used to for the WHO website to obtain data and statistics for current trends in my search topic.