A technical package for increasing physical activity World Health Organization
A technical package for increasing physical activity
ACTIVE Acknowledgements ACTIVE was prepared by WHo Headquarters with input from WHO Regional Offices and assistance from a number of wHo Collaborating Centers, international experts and WHo Intern fellows, who assisted in the development of the global Action plan on physical Activity, including the specific assistance of: Professor Adrian Bauman, Dr Bill Bellew, Dr Nick Cavill. Ms Orana chandrasiri. Mr daniel friedman Dr Karen milton. Professor Harry Rutter, and Dr Justin Varney. WHO acknowledges the generous input from many stakeholders, across different disciplines and from all regions of the world in supporting the development of the Global Action Plan on Physical Activity and the accompanying ACTIVE technical package ACTIVE: a technical package for increasing physical activity lsBN97892-4-151480-4 a World Health Organization 2018 Some rights reserved. This work is available under the Creative Commons Attribution- Non Commercial Sharealike3.0igolicence(ccBy-nC-sa3.0igO:https://creatiy ns. org/ licenses/by-nc-sa/3.0/igo) Under the terms of this licence you may copy, redistribute and adapt the work for non- commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHo endorses any specific organization products or services. the use of the wHo logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation: This translation was not created by the world Health Organization (wHO). WHO is a ot responsible for the content or accuracy of this translation. the original English edition shall be the binding 8 Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the world Intellectual Property Organization. citation. ACTIVE: a technical package for increasing physical activity. Geneva: World Health Organization; 2018. Licence: CC BY-NC-SA30 IGO Cataloguing-in-publication(cip)data.cipdataareavailableathttp://apps.whoint/iris. SalesrightsandlicensingTopurchaseWhopublicationsseehttp:/apps.whoint/bookorders.Tosubmit requestsforcommercialuseandqueriesonrightsandlicensingseehttp://www.whoint/about/licensing use material from this work that is attributed to a third party tables, figures or images, it is your responsibility to determine whether permission is needed for that ret to obtain permission from the copyright holder the risk of claims resulting from infringement of any third- party-owned component in the work rests solely with the use imply the expression of any opinion whatsoever on the part of who concerning the legal status of any country and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by who in preference to others of a similar nature that are not mentioned Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. recautions have been taken by who to verify the information contained in this publicatio ished material is being distributed without warranty of any kind, either expressed or implied ity for the interpretation and use of the material lies with the reader. In no event shall WHo be s arising from its use Printed in Switzerland
ACTIVE ACTIVE 2 A technical package for increasing physical activity ACTIVE was prepared by WHO Headquarters with input from WHO Regional Offices and assistance from a number of WHO Collaborating Centers, international experts and WHO Intern fellows, who assisted in the development of the Global Action Plan on Physical Activity, including the specific assistance of: Professor Adrian Bauman, Dr Bill Bellew, Dr Nick Cavill, Ms Orana Chandrasiri, Mr Daniel Friedman, Dr Karen Milton, Professor Harry Rutter, and Dr Justin Varney. WHO acknowledges the generous input from many stakeholders, across different disciplines and from all regions of the world, in supporting the development of the Global Action Plan on Physical Activity and the accompanying ACTIVE technical package. ACTIVE: a technical package for increasing physical activity ISBN 978-92-4-151480-4 © World Health Organization 2018 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercialShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation: “This translation was not created by the World Health Organization (WHO). WHO is not responsible for the content or accuracy of this translation. The original English edition shall be the binding and authentic edition”. Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization. Suggested citation. ACTIVE: a technical package for increasing physical activity. Geneva: World Health Organization; 2018. Licence: CC BY-NC-SA 3.0 IGO. Cataloguing-in-Publication (CIP) data. CIP data are available at http://apps.who.int/iris. Sales, rights and licensing. To purchase WHO publications, see http://apps.who.int/bookorders. To submit requests for commercial use and queries on rights and licensing, see http://www.who.int/about/licensing. Third-party materials. If you wish to reuse material from this work that is attributed to a third party, such as tables, figures or images, it is your responsibility to determine whether permission is needed for that reuse and to obtain permission from the copyright holder. The risk of claims resulting from infringement of any thirdparty-owned component in the work rests solely with the user. General disclaimers. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by WHO in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by WHO to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall WHO be liable for damages arising from its use. Printed in Switzerland. Acknowledgements
ACTIVE CONTENTS ACTIVE: A TOOLKIT FOR ACTION FOUR POLICY ACTION AREAS ACTIVE SOCIETIES 566 ACTIVE ENVIRONMENTS ACTIVE PEOPLE ACTIVE SYSTEMS What is physical activity? What is sedentary behaviour? 8 What are the causes of physical inactivity? HOW MUCH PHYSICAL ACTIVITY IS NEEDED FOR GOOD HEALTH? CURRENT LEVELS OF PHYSICAL INACTIVITY WHERE TO START? A WHOLE SYSTEM APPROACH TO NATIONAL ACTION SCALING FOR SUCCESS <≌00乏 PARTNERSHIPS FOR ACTION CONNECTING HEALTH POLICY PRIORITIES PHYSICAL ACTIVITY AND THE SUSTAINABLE DEVELOPMENT GOALS 19 SUPPORTING COUNTRY IMPACT MONITORING PROGRESS REFERENCES APPENDIX WHO resources supporting policy action on physical activity
ACTIVE ACTIVE 3 A technical package for increasing physical activity ACTIVE: A TOOLKIT FOR ACTION FOUR POLICY ACTION AREAS ACTIVE SOCIETIES ACTIVE ENVIRONMENTS ACTIVE PEOPLE ACTIVE SYSTEMS What is physical activity? What is sedentary behaviour? What are the causes of physical inactivity? HOW MUCH PHYSICAL ACTIVITY IS NEEDED FOR GOOD HEALTH? CURRENT LEVELS OF PHYSICAL INACTIVITY WHERE TO START? A WHOLE SYSTEM APPROACH TO NATIONAL ACTION SCALING FOR SUCCESS PARTNERSHIPS FOR ACTION CONNECTING HEALTH POLICY PRIORITIES PHYSICAL ACTIVITY AND THE SUSTAINABLE DEVELOPMENT GOALS SUPPORTING COUNTRY IMPACT MONITORING PROGRESS REFERENCES APPENDIX WHO resources supporting policy action on physical activity 4 5 6 6 7 7 8 8 8 9 10 12 13 16 17 18 19 20 21 22 23 23
ACTIVE ACTNEA TOOLKIT FOR ACTION The Global Action Plan on Physical ACTIVE is one of several WHO technical Activity 2018-2030 provides a shared packages that support countries to vision of More active people for a prevent and reduce NCD risk factors healthier world and sets out goals to others include tobacco use(MPOWER) achieve a relative reduction in global salt reduction (SHAKE), elimination of levels of physical inactivity of 10% by transfat(REPLACE) and reduction in 2025 and 15% by 2030. The action alcohol (SAFER). plan outlines four objectives and 20 可>am recommended evidence-based policies Implementation of the ACTIVE applicable and adaptable to all country technical package will be supported contexts to increase levels of physical by of a series of "how to"toolkits activity () and provides countries each one addressing in more detail with a roadmap for implementing a the specific tasks and processes 00oaco national response to increase health necessary to implement each policy and wellbeing. Collectively, the 20 recommendation across different recommended policies form a "whole settings and the life course. Priority system" approach to increasing the areas for the"how to" resources opportunities for people of all ages and focus on promoting physical activity abilities to be more physically active through social marketing campaigns, every day, at home, work, school and in in primary health care and by using their local communities school-based approaches. "How to toolkits to support multisector planning This ACTIVE technical package is the of a whole systems approach, and on first of several implementation tools creating supportive environments fo that the World Health Organization physical activity, will be forthcoming WHO) will develop to support countries WHO will also be developing a global plan, implement and evaluate the monitoring framework and supporting implementation of the Global Action capacity building initiatives to accelerate Plan. It outlines four policy action areas, implementation across multiple sectors, which directly reflect the four objectives including health, sports, transport, of the Global Action Plan endorsed by urban design, civil society, academia, the World Health Assembly in May 2018, private sector and community-based and identifies the key policies within organizations each action area: ACTIVE SOCIETIES 2. ACTIVE ENVIRONMENTS 3. ACTIVE PEOPLE ACTIVE SYSTEMS
ACTIVE ACTIVE 4 A technical package for increasing physical activity ACTIVE The Global Action Plan on Physical Activity 2018–2030 provides a shared vision of More active people for a healthier world and sets out goals to achieve a relative reduction in global levels of physical inactivity of 10% by 2025 and 15% by 2030. The action plan outlines four objectives and 20 recommended evidence-based policies applicable and adaptable to all country contexts to increase levels of physical activity (1), and provides countries with a roadmap for implementing a national response to increase health and wellbeing. Collectively, the 20 recommended policies form a “whole system” approach to increasing the opportunities for people of all ages and abilities to be more physically active every day, at home, work, school and in their local communities. This ACTIVE technical package is the first of several implementation tools that the World Health Organization (WHO) will develop to support countries plan, implement and evaluate the implementation of the Global Action Plan. It outlines four policy action areas, which directly reflect the four objectives of the Global Action Plan endorsed by the World Health Assembly in May 2018, and identifies the key policies within each action area: 1. ACTIVE SOCIETIES 2. ACTIVE ENVIRONMENTS 3. ACTIVE PEOPLE 4. ACTIVE SYSTEMS ACTIVE is one of several WHO technical packages that support countries to prevent and reduce NCD risk factors - others include tobacco use (MPOWER), salt reduction (SHAKE), elimination of transfat (REPLACE) and reduction in alcohol (SAFER). Implementation of the ACTIVE technical package will be supported by of a series of “how to” toolkits, each one addressing in more detail the specific tasks and processes necessary to implement each policy recommendation across different settings and the life course. Priority areas for the “how to” resources focus on promoting physical activity through social marketing campaigns, in primary health care and by using school-based approaches. “How to” toolkits to support multisector planning of a whole systems approach, and on creating supportive environments for physical activity, will be forthcoming. WHO will also be developing a global monitoring framework and supporting capacity building initiatives to accelerate implementation across multiple sectors, including health, sports, transport, urban design, civil society, academia, private sector and community-based organizations. 4 A technical package for increasing physical activity
ACTIVE FOUR POLICY ACTION AREAS ACTIVE SOCIETIES Implement behaviour ACTIVE campaigns and build ENVIRONMENTS workforce capacity to change social norms. Promote safe. well maintained infrastructure, facilities and public open spaces that provide equitable access to places for walking cycling and other physical activity ACTIVE <≌00乏 PEOPLE Ensure access te opportunities ACTIVE across multiple settings to SYSTEMS engage people of all ag and abilities in regular Strengthen leadership physical activity governance, multisectoral partnerships, workforce research, advocacy and information systems to support effective coordinated policy implementation
ACTIVE ACTIVE 5 A technical package for increasing physical activity ACTIVE ACTIVE SOCIETIES Implement behaviour change communication campaigns and build workforce capacity to change social norms. ACTIVE PEOPLE Ensure access to opportunities, programmes and services across multiple settings to engage people of all ages and abilities in regular physical activity. ACTIVE SYSTEMS Strengthen leadership, governance, multisectoral partnerships, workforce, research, advocacy and information systems to support effective coordinated policy implementation. ACTIVE ENVIRONMENTS Promote safe, well maintained infrastructure, facilities and public open spaces that provide equitable access to places for walking, cycling and other physical activity
ACTIVE ACTIVE SOCIETIES Implement behaviour-change communication campaigns and build workforce capacity to change social norms. Action 1.1" Communications: Implement social marketing campaigns linked with community-based programmes. physical activity, particularly from walking and cycling omoro Action 1.2. Co-benefits: Build awareness, through ki dae-shari ampaigns of the multiple social, economic, and envir tal co-benefits of Action 1.3. Mass participation events: Implement regular mass participation initiatives Action 1.4. Capacity-building: Strengthen professional know ledge, within and outside the health sector as well as in grassroots community groups and civil society organizations 8 ACTIVE a ENVIRONMENTS Promote safe, well maintained infrastructure facilities and public open spaces that provide equitable access to places for walking, cycling and other physical activity Action 2. 1. Policy integration: Integrate urban and transport planning policies, and prioritize the principles of compact, mixed-land use to deliver highly connected neighbourhoods Action 2.2. Infrastructure: Improve walking and cycling network infrastructure Action 2.3. Safety: Implement and enforce road safety and personal safety measures to improve the safety of pedestrians, cyclists, and other vulnerable road users Action 2. 4. Public open spaces: Improve access to good-quality public and green open paces, green networks, recreational spaces(including river and coasta areas) and sports amenities. Action 2.5. Design: Strengthen the policy, regulatory and design guidelines to enable all occupants and visitors to be active in and around the public building ction 1.2 and 3.2 are recommended as'Best' and'Good'buys for the prevention and control of noncommunicable
ACTIVE ACTIVE 6 A technical package for increasing physical activity Implement behaviour-change communication campaigns and build workforce capacity to change social norms. Action 1.1* Communications: Implement social marketing campaigns linked with community-based programmes. Action 1.2. Co-benefits: Build awareness, through knowledge-sharing and information campaigns, of the multiple social, economic, and environmental co-benefits of physical activity, particularly from walking and cycling. Action 1.3. Mass participation events: Implement regular mass participation initiatives. Action 1.4. Capacity-building: Strengthen professional knowledge, within and outside the health sector, as well as in grassroots community groups and civil society organizations. Action 2.1. Policy integration: Integrate urban and transport planning policies, and prioritize the principles of compact, mixed-land use to deliver highly connected neighbourhoods. Action 2.2. Infrastructure: Improve walking and cycling network infrastructure. Action 2.3. Safety: Implement and enforce road safety and personal safety measures to improve the safety of pedestrians, cyclists, and other vulnerable road users. Action 2.4. Public open spaces: Improve access to good-quality public and green open spaces, green networks, recreational spaces (including river and coastal areas) and sports amenities. Action 2.5. Design: Strengthen the policy, regulatory and design guidelines to enable all occupants and visitors to be active in and around the public buildings. Promote safe, well maintained infrastructure, facilities and public open spaces that provide equitable access to places for walking, cycling and other physical activity. * Action 1.2 and 3.2 are recommended as ‘Best’ and ‘Good’ buys for the prevention and control of noncommunicable diseases (2)
ACTIVE ACTIVE PEOPLE Ensure access to opportunities, programmes and services across multiple settings to engage people of all ages and abilities in regular physical activity Action 3.1. Schools: Ensure provision of good-quality physical education and positive opportunities for physical activity across pre-primary to tertiary educationa set Action 3.2 Health care: Implement systems of patient assessment and counselling on physical activity in primary and secondary health care and social services. Action 3.3. Multiple other settings: Implement programmes in workplace, sport and faith based settings, and in public open spaces and other community venues, to increase opportunities for physical activity Action 3.4. older adults: Provide appropriately-tailored programmes and services to support older adults to start and maintain regular physical activity Action 3.5. Least active: Implement programmes and services that increase the opportunities for physical activity in the least active groups Action 3.6. Whole-of-community: Engage communities to implement comprehensive initiatives at the city, town or local level ACTIVE SYSTEMS og<°-0< trengthen leadership, governance, multisectoral partnerships, workforce, research, advocacy and information systems to support effective coordinated policy implementation Action 4.1. Governance: Strengthen national and subnational policies, recommendations and action plans and establish multisectoral coordination mechanisms Action 4.2. Data systems: Enhance information systems and digital technologies to strengthen monitoring and decision-making Action 4.3. Evidence: Strengthen research and evaluation capacity to inform effective policy solutions. Action 4. 4. Advocacy: Escalate advocacy efforts to increase awareness, knowledge and joint action Action 4. 5. Resources: Strengthen financing mechanisms to ensure sustainability Full details of each policy action are available in the global Action Plan on Physical Activity 2018-2030, with recommended roles for different stakeholders listed in Appendix 2
ACTIVE ACTIVE 7 A technical package for increasing physical activity Ensure access to opportunities, programmes and services across multiple settings to engage people of all ages and abilities in regular physical activity. Strengthen leadership, governance, multisectoral partnerships, workforce, research, advocacy and information systems to support effective coordinated policy implementation. Action 3.1. Schools: Ensure provision of good-quality physical education and positive opportunities for physical activity across pre-primary to tertiary educational settings. Action 3.2* Health care: Implement systems of patient assessment and counselling on physical activity in primary and secondary health care and social services. Action 3.3. Multiple other settings: Implement programmes in workplace, sport and faithbased settings, and in public open spaces and other community venues, to increase opportunities for physical activity. Action 3.4. Older adults: Provide appropriately-tailored programmes and services to support older adults to start and maintain regular physical activity. Action 3.5. Least active: Implement programmes and services that increase the opportunities for physical activity in the least active groups. Action 3.6. Whole-of-community: Engage communities to implement comprehensive initiatives at the city, town or local level. Action 4.1. Governance: Strengthen national and subnational policies, recommendations and action plans, and establish multisectoral coordination mechanisms. Action 4.2. Data systems: Enhance information systems and digital technologies to strengthen monitoring and decision-making. Action 4.3. Evidence: Strengthen research and evaluation capacity to inform effective policy solutions. Action 4.4. Advocacy: Escalate advocacy efforts to increase awareness, knowledge and joint action. Action 4.5. Resources: Strengthen financing mechanisms to ensure sustainability. Full details of each policy action are available in the Global Action Plan on Physical Activity 2018–2030, with recommended roles for different stakeholders listed in Appendix 2 (1)
ACTIVE What is physical activity? active and thus can either enable or hinder participation. Understanding There are many different ways to b these causes of inactivity in a community physically active: walking, cycling, sports is necessary for the development of and other active forms of recreation(for effective tailored policy response example, dance, yoga, tai chi). Physical activity can also be undertaken as a Of note, is that girls, women, older adults form of transport(walking and cycling), people of low socioeconomic position, at work and around the home(cleaning, people with disabilities and chronic carrying and care duties). All forms of diseases, and marginalized populations hysical activity can provide health are often less active than others because benefits if undertaken regularly and of they have less access to appropriate sufficient duration and intensity (3) places and programmes to support them What is sedentary Economic development and the behaviour? associated changes towards more sedentary occupations and Sedentary behaviour is characterized recreation, as well as the increasing by a very low energy expenditure, use of motorized transport, can such as sitting, reclining or lying down help explain the higher levels of (4). Extended periods of sedentary inactivity seen in some high-,as behaviour(for example sitting at well as middle-income, countries work, during travel, or for leisure)are Governments and communities must detrimental to health (5). All individuals, act to counterbalance these trends a d especially children, should be and provide the environments, facilities advised and supported to limit long and services that support people to periods of sedentary behaviour by be active through more walking and incorporating regular activity breaks cycling, sports and active recreation, throughout the day, and, in particular as well as through incidental physical to limit the amount of time spent using activity throughout each day screen-based devices such as phones and tablets, and watching television What are the causes of The global recommendations physical inactivity? on physical activity for health Participation in physical activity outline the type, intensity influenced not only by individual and frequency and duration of family characteristics, such as knowledge, physical activity for optimal motivation and social support, but also health benefits for youth, adult by wider social and cultural values, as and older adults (2). Regular well as environmental and economic participation in physical activity conditions. These factors determine how is recommended for all ages accessible, affordable acceptable and and abilities to provide multiple safe it is for individuals to be physically health benefits
ACTIVE ACTIVE 8 A technical package for increasing physical activity What is physical activity? There are many different ways to be physically active: walking, cycling, sports and other active forms of recreation (for example, dance, yoga, tai chi). Physical activity can also be undertaken as a form of transport (walking and cycling), at work and around the home (cleaning, carrying and care duties). All forms of physical activity can provide health benefits if undertaken regularly and of sufficient duration and intensity (3). What is sedentary behaviour? Sedentary behaviour is characterized by a very low energy expenditure, such as sitting, reclining or lying down (4). Extended periods of sedentary behaviour (for example sitting at work, during travel, or for leisure) are detrimental to health (5). All individuals, and especially children, should be advised and supported to limit long periods of sedentary behaviour by incorporating regular activity breaks throughout the day, and, in particular, to limit the amount of time spent using screen-based devices such as phones and tablets, and watching television. What are the causes of physical inactivity? Participation in physical activity is influenced not only by individual and family characteristics, such as knowledge, motivation and social support, but also by wider social and cultural values, as well as environmental and economic conditions. These factors determine how accessible, affordable, acceptable and safe it is for individuals to be physically active and thus can either enable or hinder participation. Understanding these causes of inactivity in a community is necessary for the development of effective tailored policy responses. Of note, is that girls, women, older adults, people of low socioeconomic position, people with disabilities and chronic diseases, and marginalized populations are often less active than others because they have less access to appropriate places and programmes to support them. Economic development and the associated changes towards more sedentary occupations and recreation, as well as the increasing use of motorized transport, can help explain the higher levels of inactivity seen in some high-, as well as middle-income, countries. Governments and communities must act to counterbalance these trends and provide the environments, facilities and services that support people to be active through more walking and cycling, sports and active recreation, as well as through incidental physical activity throughout each day. ACTIVE The global recommendations on physical activity for health outline the type, intensity, frequency and duration of physical activity for optimal health benefits for youth, adults and older adults (2). Regular participation in physical activity is recommended for all ages and abilities to provide multiple health benefits
ACTIVE HOW MUCH PHYSICAL ACTIVTY S NEEDED FOR GOOD HEALTH? FOR ADULTS AND OLDER ADULTS MINUTES PER WEEK More is better and provides 75-150 Something additional is better health benefits than nothing Vigorous Mode Intensit Intensity a combination of both FOR CHILDREN FOR OLDER ADULTS with poor mobility AIM FOR AT LEAST PERFORM PHYSICAL ACTIVITY 60 to enhance balance and prevent falls on Minutes everyday 3 ofore days per week EVERYONE PERFORM MUSCLE-STRENGTHENING ACTIVITIES Involving major muscle groups, on Start sma∥l 2 nd increas oore days a week
ACTIVE ACTIVE 9 A technical package for increasing physical activity AIM FOR AT LEAST PERFORM PHYSICAL ACTIVITY 3 or more days per week to enhance balance and prevent falls on FOR ADULTS AND OLDER ADULTS FOR CHILDREN FOR OLDER ADULTS with poor mobility ACTIVE 9 PERFORM MUSCLE-STRENGTHENING ACTIVITIES 2 or more days a week EVERYONE Start small and increase gradually Involving major muscle groups, on 75 150 MINUTES PER WEEK Vigorous Intensity Moderate Intensity OR OR a combination of both Something is better than nothing More is better and provides additional health benefits 60 Minutes everyday A technical package for increasing physical activity
ACTIVE CURRENT EVELS OF PHYSCAL INACTIVITY Worldwide, 28% of adults (1.4 billion) by 5% in high-income countries do not undertake sufficient physical between 2001 and 2016(Figure 1) activity to protect against common chronic diseases or to increase their The highest levels of physical inactivity physical, mental and social health and in men and women are observed in Latin America and the caribbean (39%),and high-income Western Economic development is associated countries(37%); the lowest levels in with increasing levels of physical East and South-East Asia (17%) and inactivity. Levels of insufficient physical Oceania(16%). globally, women are activity are more than twice as high in less active (32%)compared with men high-income countries compared with (23%)across all subregions except for low-income countries and increased East and South-East Asia(Figure 2) a FIGURE 1. Levels of physical inactivity in 2001 and 2016 by world Bank Income Group 40.0 36.8 300 26.0 Global aver 20.0 160162 2001 Middle income High income Source: Guthold et al. Lancet Global Health, 2016(6)
ACTIVE ACTIVE 10 A technical package for increasing physical activity Global average Worldwide, 28% of adults (1.4 billion) do not undertake sufficient physical activity to protect against common chronic diseases or to increase their physical, mental and social health and well-being (6). Economic development is associated with increasing levels of physical inactivity. Levels of insufficient physical activity are more than twice as high in high-income countries compared with low-income countries, and increased by 5% in high-income countries between 2001 and 2016 (Figure 1). The highest levels of physical inactivity in men and women are observed in Latin America and the Caribbean (39%), and high-income Western countries (37%); the lowest levels in East and South-East Asia (17%) and Oceania (16%). Globally, women are less active (32%) compared with men (23%) across all subregions except for East and South-East Asia (Figure 2). FIGURE 1. Levels of physical inactivity in 2001 and 2016 by World Bank Income Group % not meeting global recommendations Low income Middle income High income Source: Guthold et al., Lancet Global Health, 2016 (6). 16.0 28.3 31.6 36.8 26.0 16.2 40.0 30.0 20.0 10.0 0.0 2001 2016
