《世界卫生组织(WHO):2022年全球体育活动状况报告(英文版)(132页).pdf》由会员分享,可在线阅读,更多相关《世界卫生组织(WHO):2022年全球体育活动状况报告(英文版)(132页).pdf(132页珍藏版)》请在三个皮匠报告上搜索。
1、Global status report on physical activity 2022Global status report on physical activity 2022Global status report on physical activity 2022ISBN 978-92-4-005915-3(electronic version)ISBN 978-92-4-005916-0(print version)World Health Organization 2022Some rights reserved.This work is available under the
2、 Creative Commons Attribution-NonCommercial-ShareAlike 3.0IGO licence(CCBY-NC-SA3.0IGO;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
3、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 translatio
4、n 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 edit
5、ion”.Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization(http:/www.wipo.int/amc/en/mediation/rules/).Suggested citation.Global status report on physical activity 2022.Geneva:World Healt
6、h Organization;2022.Licence:CCBY-NC-SA3.0IGO.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 h
7、ttps:/www.who.int/copyright.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.Th
8、e risk of claims resulting from infringement of any third-party-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 conce
9、rning 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 ce
10、rtain 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 bee
11、n 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 f
12、or damages arising from its use.iiiContentsForeword vAcknowledgements viExecutive summary viiConclusion xiii1.Introduction 11.1 Physical activity and good health and well-being 31.2 The impact of COVID-19 on physical activity 41.3 Aim of this report 51.4 Who this report is for 52.Global burden of ph
13、ysical inactivity 62.1 The overall prevalence of physical inactivity 82.2 The economic burden of physical inactivity 103.Frameworks for action and monitoring progress 123.1 Framework for monitoring physical activity 164.Progress towards active systems 224.1 National policy and governance 264.2 Physi
14、cal activity guidelines 304.3 Physical activity targets 324.4 Physical activity surveillance 344.5 National NCD coordination mechanisms 37iv5.Progress towards active societies 405.1 Communication campaigns on physical activity 445.2 Mass-participation events on physical activity 476.Progress towards
15、 active environments 506.1 Policy on walking and cycling 546.2 National road-design standards and national road safety strategy 576.3 Road safety assessments 596.4 Safe road-user behaviour 617.Progress towards active people 647.1 In health care settings 687.2 In other key settings 727.3 Promoting ph
16、ysical activity to target populations 757.4 Mobile health and digital tools to promote physical activity 788.Global progress on GAPPA outcomes and impact 808.1 Progress in monitoring global and national levels of physical activity 828.2 Monitoring the impact of physical activity 849.Summary of key f
17、indings 869.1 Summary of key findings on GAPPA policy implementation 889.2 Limitations in data for global monitoring of GAPPA 9410.The way forward:five recommendations 98References 104Glossary 107Annex 1:Methodology to estimate the cost of physical inactivity 110Annex 2:Data sources 112Web Annex:Glo
18、bal action plan on physical activity monitoring framework,indicators and data dictionary https:/apps.who.int/iris/handle/10665/363531vSupporting people to be more active through walking,cycling,sport,and other physical activity has huge benefits not only for the physical and mental health of individ
19、uals,but also for societies,environments,and economies.However,this first Global status report on physical activity shows that progress towards the Global action plan on physical activity target of a 15%relative reduction in physical inactivity by 2030 is slow and unequal.The COVID-19 pandemic set t
20、hings back even further.This must change and change fast.That is why it is important to implement evidence-based,effective policies,as outlined in WHOs Global Action Plan on Physical Activity.For example,policies to encourage walking and cycling can reduce air and noise pollution and mitigate climat
21、e change.And increased participation in sport can help bring communities together and build valuable life skills.These actions can also help reduce the financial and systemic burden on national health systems through prevention and management of noncommunicable diseases.This report proposes five rec
22、ommendations for enhanced leadership,practical guidance,engaging communities,better data,and sustainable funding.To accelerate progress and achieve the physical activity targets for 2025 and 2030,all countries,especially low-and middle-income countries(who have the most to do and the least resources
23、),will require varying levels of financial and technical support.WHO provides global guidance and tools to support regional and country capacity-building and to strengthen country implementation.More training is needed to develop skills and capabilities to deliver programmes and services.Advocates a
24、nd influencers have a vital role to play,as does engaging with local communities and policy makers at all levels across multiple sectors about the need for change and the potential gains for improved health and well-being,sustainable environments,and socioeconomic development.Future global reports w
25、ill track progress towards reaching the physical activity targets for 2030.In the meantime,WHO urges all countries to promote physical activity in primary health care plans and NCD policies,sustainable mobility plans and sport policies,as well as national COVID-19 response and recovery plans.We hope
26、 countries and partners will use this report and its recommendations to build more active,healthier,and fairer societies for all.ForewordDr Tedros Adhanom GhebreyesusDirector-GeneralWorld Health OrganizationviThe Global status report on physical activity 2022 benefited from the contributions of a nu
27、mber of WHO staff and collaborators.Fiona Bull provided strategic direction and coordinated the writing of the report with contributions from May Cho,Daniel Friedman,Andreia Santos,and Juana Willumsen.Ridger Krech provided oversight of the project.Thanks to the technical units responsible for the or
28、iginal surveys that provided data and advice on data management and analysis,in particular Melanie Cowan and Kacem Iaych.Leanne Lester was responsible for data management and statistical analysis.Thanks also to the WHO internal steering group:Faten Ben Abdelaziz,Melanie Cowan,Regina Guthold,Thiago H
29、rick De Sa,Ivan Ivanov,Lindsay Lee,Alana Officer,Karen Reyes Castro,Leanne Riley,Yuka Sumi,Nhan Tran,and Cherian Varghese.The following WHO colleagues from regional offices provided inputs and feedback:Angela de Silva,Samar Elfeky,Fabio Gomes,Gyanendra Gongal,Wasiq Khan,Leo Nederveen,Binta Sako,Josa
30、ia Tiko,and Stephen Whiting.WHO also wishes to thank the following external peer reviewers who provided expert feedback and suggestions:Toyyib Abdulkareem(NCD Alliance),Shifalika Goenka(Centre for Chronic Disease Control,Public Health Foundation,India),Goh J-Ing(Health Promotion Board,Singapore),Nan
31、ette Mutrie(Physical Activity for Health Research Centre,University of Edinburgh,United Kingdom),Kate Oldridge-Turner(World Cancer Research Fund),Matias Portela(Health Promotion,Department of Public Health,Ministry of Health,Chile),Maryam Selk Ghaffari(Sports Medicine Research Center,Tehran Universi
32、ty of Medical Sciences,Iran(Islamic Republic of).Finally,WHO wishes to thank Germany,Japan,Norwegian Agency for Development Cooperation(NORAD)and DG for International Cooperation and Development(DEVCO),European Commission for their financial support for the development and publication of this report
33、.AcknowledgementsviiRegular physical activity promotes both mental and physical health.It is beneficial for people of all ages and abilities,and it is never too late to start being more active and less sedentary to improve health.Yet 81%of adolescents and 27.5%of adults currently do not meet WHOs re
34、commended levels of physical activity and this affects not only individuals over their life span and also their families,but health services and society as a whole.The COVID-19 pandemic revealed the vital importance of regular physical activity for both mental and physical health.It also,however,exp
35、osed inequities in access and opportunities for some communities to be physically active.The COVID-19 pandemic has shown that physical activity must be a core component of public policy,with all countries ensuring provision of equitable physical activity opportunities for all.To help countries incre
36、ase levels of participation,WHOs Global Action Plan on Physical Activity 20182030(GAPPA)provides a set of evidence-based policy recommendations to increase levels of participation across four strategic policy areas:active societies,active environments,active people and active systems.Effectively imp
37、lemented by all countries,GAPPA will accelerate action towards meeting the global target of a 15%relative reduction in population levels of physical inactivity by 2030.The cost of physical inactivity The economic burden of physical inactivity is large.Globally,almost 500 million (499 208 million)new
38、 cases of preventable NCDs will occur between 2020 and 2030,incurring treatment costs of just over US$300 billion(INT$524 billion)or around US$27 billion(INT$48 billion)annually if there is no change in the current prevalence of physical inactivity.Nearly half of these new cases of NCDs(47%)will res
39、ult from hypertension,and 43%will result from depression.Three quarters of all cases will occur in lower-and upper-middle-income countries.The largest economic cost is set to occur among high-income countries,which will account for 70%of health-care expenditure on treating illness resulting from phy
40、sical inactivity.Executive summaryviiiThe purpose of this reportThis first Global status report on physical activity presents a synthesis of global progress on implementation of GAPPA recommendations.The report was requested by Member States under World Health Assembly Resolution 71.6 and describes
41、the current situation and where possible,recent trends using the best available data and set of 29 indicators.Data for this report are drawn from two primary sources:the WHO Noncommunicable Disease Country Capacity Survey(2019 and 2022)and the WHO Global status report on road safety(2018).These data
42、 also offer the first insight into the impact of COVID-19 on countries capacity for,and progress towards,implementing policies related to physical activity.This report is for everyone involved in promoting and delivering national and subnational policies that provide the environments and programmes
43、that drive participation in physical activity.It provides five recommended actions to promote physical activity as the world continues to respond to,and recover from,the COVID-19 pandemic,and to accelerate action to achieve the SDGs particularly SDG 3 on health and well-being.Main findings There are
44、 few areas in public health such as physical activity-where evidence on required action is so convincing,cost effective and practical.While some countries have started to implement different recommended GAPPA policy actions,overall global implementation since its adoption 5 years ago has been slow a
45、nd uneven,resulting in little progress towards increasing population levels of physical activity.A consequence of this“inaction”is that already stretched health systems are burdened with preventable disease today and even more so in the future,and communities fail to benefit from the wider social,en
46、vironmental and economic benefits associated with more people being more active.Only two GAPPA policy indicators show implementation by over three quarters of all countries:conducting national surveillance of physical activity(among adults,and among children and adolescents);and the presence of nati
47、onal road safety design standards for safe crossings for pedestrians and cyclists.For nine GAPPA policy indicators,between a half to two thirds of countries report implementation.For the remaining 18 GAPPA policy indicators,less than half of countries report implementation in 2021(see Table 1).Uneve
48、n implementation across WHO regions and country-income level results in inequities in peoples access to opportunities and environments that support being regularly and safely active.This first global assessment of policy actions to increase physical activity reveals significant gaps in policy implem
49、entation.These gaps are demonstrated by the overall modest level of GAPPA-recommended policy development and the notable gap between the presence of a policy and its operational status.In the majority of countries,policy development and implementation must be strengthened and accelerated if global t
50、argets on physical activity are to be met.Gaps in policy are a result of multiple interconnected factors that fall into five areas:political,technical,financial,collaboration and capacity building,and data systems all of which can either limit or accelerate policy progress.When positively aligned,th
51、ese“policy enabling”factors combine to set and advance the national agenda.Conversely,the absence of one or more of these factors can reduce,divert and even reverse policy progress.As the national policy cycle for physical activity is not“one size fits all”,all countries need to identify and strengt
52、hen the policy enablers to drive a positive and virtuous cycle of collective action to enable more physical activity.ixGAPPA policy implementation:results by policy areaGAPPA policy area active systems:The number of countries reporting a national NCD policy(including physical activity,or a standalon
53、e physical activity policy)has increased since 2017 and 2019.However,this progress is tempered by the 28%of countries that report these policies are not being implemented in 2021(i.e.reported as not“operational”).These results,combined with evidence that less than 50%of countries report having a nat
54、ional NCD coordinating mechanism to support multisectoral collaboration,are of major concern and contribute to explaining the low level of policy implementation on physical activity seen across the indicators presented in this report.GAPPA policy area active societies:Just over half of countries rep
55、ort conducting at least one communication campaign to raise awareness and knowledge around physical activity in the past two years a figure that has declined since 2019.About half of countries implemented mass-participation events to engage people in physical activity through free,community-wide eve
56、nts.This figure has also declined since 2019,likely due to the COVID-19 pandemic.GAPPA policy area active environments:Global progress in policy action to provide environments that support physical activity is varied.National design standards for road safety features that protect people when walking
57、 and cycling are present in three quarters(76%)of countries for safe road crossings,and two thirds(66%)of countries for design for the safe management of speed.Only half of countries report national standards requiring separated infrastructure for walking and cycling,and less than half report the pr
58、esence of all three of these national road safety design standards.Furthermore,while legislation on speed limits and drinkdriving is present in most countries,only a quarter(26%)of these countries legislation meets WHO best-practice standards.Low levels of best-practice legislation combined with an
59、absence of road design standards presents increased risks to people walking and cycling in these local communities.GAPPA policy area active people:Implementation of policies that ensure opportunities for physical activity in key settings where people live,work and play,and targeted programmes to sup
60、port key population groups,is reported by less than half of all countries.Notably,less than 40%of countries report having national protocols for the management of physical activity in primary health care,despite strong evidence of the protective benefits of regular physical activity against leading
61、NCDs and for mental health.Although this indicator shows a modest increase since 2019,the slow level of implementation of this recognized“best buy”policy is of particular concern given the high number of people living with,or at risk of,NCDs.xtable 1 Key for colour codingGood progress 75%of countrie
62、sModerate progress 5175%of countriesPoor progress 050%of countriesNANo data availableKey for symbolsIncrease since 2019No change since 2019Decrease since 2019NANo data availableGAPPA POLICY ACTION AREA%OF COUNTRIESCHANGE SINCE 2019AREA 1:CHANGING KNOWLEDGE AND MINDSETSNational communication campaign
63、 on physical activity 52%National mass-participation events 58%Summary of results by GAPPA policy action area GAPPA POLICY ACTION AREA%OF COUNTRIESCHANGE SINCE 2019AREA 2:ENABLING ENVIRONMENTSNational policy on walking and cycling 42%NANational policy on public transport 73%NANational road design st
64、andards for separated infrastructure for pedestrians and cyclists 53%NANational road design standards for safe crossings for pedestrians and cyclists 76%NANational road design standards for management of safe speed 64%NANational road design standards for all three road safety features 46%NANational
65、road safety strategy80%NANational road safety strategy that is fully funded18%NANational road safety assessment of all new roads 48%NANational assessment of road safety of existing roads for all road users 64%NANational legislation of speed limits meeting best practice 26%NANational legislation on d
66、rinkdriving meeting best practice26%NANational legislation on distracted driving due to use of mobile phone 89%NANational legislation on distracted driving due to use of drugs87%NANational policy on public open space NANAxiGAPPA POLICY ACTION AREA%OF COUNTRIESCHANGE SINCE 2019AREA 3:PROVIDING OPPORT
67、UNITIES AND PROGRAMMES FOR PHYSICAL ACTIVITYNational protocols on the management of physical inactivity in primary health care 40%Promotion of physical activity in childcare settings 30%NAPromotion of physical activity in the workplace initiatives 36%NAPromotion of physical activity through communit
68、y-based and sports initiatives 47%NAPromotion of physical activity in public open spaces42%NAPromotion of walking and cycling 40%NAPromotion of physical activity as part of active ageing 40%NANational mobile health(mHealth)initiatives 37%Provision of quality physical education in schools NANAPromoti
69、on of physical activity for people living with disability NANAGAPPA POLICY ACTION AREA%OF COUNTRIESCHANGE SINCE 2019AREA 4:NATIONAL POLICY FRAMEWORKS AND GOVERNANCE National NCD policy including physical activity86%NANational NCD policy including physical activity that is operational 66%National phy
70、sical activity policy47%NANational physical activity policy that is operational 39%Either operational national NCD policy including physical activity or a standalone operational physical activity policy 72%National coordination mechanism for NCDs 46%National guidelines on physical activity for any a
71、ge group 46%National guidelines on physical activity for all age groups 30%National physical activity targets 53%National surveillance on physical activity in adults92%National surveillance on physical activity in youth75%National surveillance on physical activity in children under the age of 5 year
72、s29%Strengthening data for global and national GAPPA monitoring Monitoring GAPPA implementation,outcomes,and impact will help evidence-based decision-making and country and global progress.This report presents results based on the 29 policy implementation indicators identified in the GAPPA monitorin
73、g framework.While global data exist to monitor the presence of national policies,strategies and action plans covering NCDs,physical activity,walking and cycling,public transport and road safety,there are clear data gaps.These include a lack of detail such as on the policy content,and on policy reach
74、 and enforcement.At least two improvements are needed for future GAPPA monitoring.First,there is a need to develop additional indicators to ensure full coverage of all GAPPA policy recommendations.Second,there is a need to review and strengthen existing data collected for those indicators currently
75、identified.To address some of the identified gaps,new data collection systems and instruments may be needed.It is possible that conducting a periodic global survey to assess national progress on GAPPA implementation may be required.This approach is used for other NCD risk factors(for example tobacco
76、 use and unhealthy diet)and the applicability and feasibility to do the same for physical activity should be explored.Gaps were also identified in current global and national data systems to track levels of physical activity over time,across the life-course,and in key subpopulations.These include th
77、e absence of national surveillance of physical activity among people living with disability,as well as among children aged 69 years and children under the age of 5 years.In addition,there are no global data on sedentary behaviours and key domains of physical activity such as sport and active transpo
78、rt(walking and cycling).These deficiencies in global and national surveillance systems must be addressed.Multiple government departments can benefit from coherent and consistent data on trends in specific physical activity domains,and such data must be collected and harmonized to maximize use and ef
79、ficiency.Given the potential advantages of wearable and mobile devices to support tracking of physical activity,global consensus is needed on the technical tools and protocols for(as well as action to mitigate the financial barriers to)their use in national and global monitoring systems.Regular upda
80、tes on global levels of physical activity are needed to report on progress towards the primary GAPPA outcome of increasing physical activity by 15%by 2030.As GAPPA called for a multisectoral,whole-of-system policy response,monitoring GAPPA implementation and impact also requires a whole-of-system ap
81、proach.There is an urgent need to strengthen the methods and tools to capture the total health,social,and economic costs and returns of increasing physical activity.These data are vital to ensure and reinforce the engagement of all relevant sectors,not just sport and health,and include strengthening
82、 the use of impact assessment tools,particularly in transport and urban planning decision-making.The way forward:five recommendationsAccelerating physical activity policy implementation is vital to achieve targets set for 2030.It will require identifying opportunities across government and mitigatin
83、g policy constraints within each country.To assist countries,five actions aimed at closing the policy-implementation gap are recommended.1.Strengthen whole-of-government ownership and political leadership Establish and reinforce leadership on physical activity within and across all relevant governme
84、nt departments and at all levels.Invest in advocacy for policy action on physical activity.Increase awareness of the crosscutting contributions of physical activity policy to national development and to multiple global priorities as set out in the SDGs.xiixiii2.Integrate physical activity into relev
85、ant policies and support policy implementation with practical tools and guidance Review relevant national policies as well as regulations and standards to identify and strengthen the inclusion of physical activity,where relevant,and ensure policy coherence and accountability.Develop and disseminate
86、policy implementation tools and guidance,tailored to culture and context,combined with workforce training.3.Strengthen partnerships,engage communities and build capacity in people Ensure there is an appropriate national coordinating mechanism for physical activity to strengthen cross-government,mult
87、i-stakeholder collaboration and strengthen policy implementation.Effectively engage nongovernmental actors and the community to ensure policy and programmes are relevant and sustainable in local communities,with a priority focus on increasing opportunities for those who are least active,including pe
88、ople living with disabilities,older adults and young people.4.Reinforce data systems,monitoring,and knowledge translation Strengthen national and subnational(including city-level)monitoring and information systems to track policy progress and provide governments and stakeholders at all levels with i
89、nformation that can inform and drive the policy implementation cycle.Invest in and strengthen research capacity and scale knowledge-translation through partnerships between government and nongovernmental actors to design and evaluate policy implementation.5.Secure sustainable funding and align with
90、national policy commitments Review current national and subnational government funding allocation to policies that aim to increase physical activity and,where needed,revise future budget distributions to strengthen alignment of national budgets with policy commitments in all relevant ministries.Expl
91、ore and test innovative financing mechanisms to increase funding sources to support physical activity policy actions and programmes,particularly within national COVID-19 recovery plans and national development agendas.Conclusion This report serves as a clarion call for stronger collective action in
92、all countries to close the gap in policy implementation,and to advocate for accelerated political action.As the world responds to the impact of the COVID-19 pandemic on physical and mental health,promoting physical activity can save lives,improve health and support stronger,more resilient health sys
93、tems and communities.Introduction1Regular physical activity promotes and protects both mental and physical health.It is beneficial for people of all ages and abilities,and it is never too late to start benefiting from being more active.Yet more than one in four adults and more than 80%of adolescents
94、 do not meet WHOs recommended levels of physical activity for optimum health.Physical inactivity contributes not only to missed opportunities for children and adults to have better health,but also to the increasing burden of morbidity and mortality that results from noncommunicable diseases(NCDs).Wi
95、despread physical inactivity is also a major economic burden to national health systems,and to the economy worldwide.2GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 2022ANY IS BETTER THAN NONEMORE IS BETTERREPLACEwith some physical activitymulticomponent activities for balance and strength3daysa weekOn a
96、t leastmuscle strengthening activities2On at leastdaysa weekP150minutesER WEEK150300tominutesPER WEEKPER DAYminutes60LIMITsedentary timeminutesPER WEEK300more thanPREGNANT&POSTPARTUM WOMENADULTSOLDER ADULTSEVERYONE WHO CANCHILDREN&ADOLESCENTSOLDER ADULTSBeing active has significant health benefits f
97、or hearts,bodies and minds,whether youre walking,wheeling or cycling,dancing,doing sport or playing with your kids.EVERY MOVE COUNTSfigure 1Summary of recommended levels of physical activitySource:(2)WHO recognizes the promotion of physical activity as a public health priority and in 2018 launched t
98、he Global Action Plan on Physical Activity 20182030(GAPPA)(1).GAPPA raises awareness of the need for accelerated whole-of-government efforts around the world to achieve the global target of a 15%relative reduction in the prevalence of physical inactivity by 2030.GAPPA provides countries with a set o
99、f evidence-based policy recommendations that,if collectively implemented,can increase population levels of physical activity.GAPPA outlines the principles for effective implementation of the recommendations and encourages a systems approach to overcome the multiple barriers to being physically activ
100、e.Adopting a systems approach can help governments maximize the opportunities offered when the goals of different policies intersect,and the opportunities offered by working in partnership with stakeholders across multiple sectors.This Global status report on physical activity is WHOs first dedicate
101、d global assessment of countries progress in implementing GAPPA policy recommendations.Its findings reinforce the need and urgency to position physical activity as a shared,whole-of-government priority,and the need for strengthening coordination and partnership between government and nongovernmental
102、 organizations(NGOs)to promote physical activity.Given the health and economic impact of COVID-19 worldwide,this status report is both a timely situation assessment and a call for accelerated action.3GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 2022ANY IS BETTER THAN NONEMORE IS BETTERREPLACEwith some
103、physical activitymulticomponent activities for balance and strength3daysa weekOn at leastmuscle strengthening activities2On at leastdaysa weekP150minutesER WEEK150300tominutesPER WEEKPER DAYminutes60LIMITsedentary timeminutesPER WEEK300more thanPREGNANT&POSTPARTUM WOMENADULTSOLDER ADULTSEVERYONE WHO
104、 CANCHILDREN&ADOLESCENTSOLDER ADULTS1.1 Physical activity and good health and well-beingRegular physical activity is a key protective factor for the prevention and management of NCDs indeed,those who meet recommended levels of physical activity have a 2030%reduced risk of premature death(2).About 78
105、%of all cases of cardiovascular disease,depression and dementia,and about 5%of type-2 diabetes cases,could be prevented if people were more active.These preventable NCDs have an impact not only on individuals and their families,but also on health services and society as a whole.Physical activity als
106、o benefits mental health,including prevention of cognitive decline and symptoms of depression and anxiety,and improves childrens educational attainment.It can also contribute to the maintenance of healthy weight and general well-being.Physical activity can be undertaken in a variety of ways,such as
107、walking,cycling(for the purposes of this report,the term cycling includes other forms of personal mobility,such as the use of scooters or wheelchairs)and sport or active recreation(see Box 1).Meeting the recommended levels of physical activity,including among pregnant and postpartum women,and among
108、people living with chronic conditions or disability(see Fig.1),brings significant health benefits and can:prevent and help manage coronary heart disease,hypertension,and type-2 diabetes;reduce the risk of developing several cancers(including breast and colon cancer);reduce the symptoms of depression
109、 and anxiety;enhance brain health,including cognitive function and academic performance;strengthen muscles and bones;help prevent falls among older adults.Enabling more people to be more active not only benefits population health and well-being,it also brings societal,environmental and economic co-b
110、enefits.For example,walking and cycling can reduce air and noise pollution and contribute to healthy environments,while increased participation in sport can help bring communities together and build valuable life skills in individuals.4GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 20221.2 The impact of
111、COVID-19 on physical activityThe COVID-19 pandemic revealed the vital importance of regular physical activity for both mental and physical health.Walking and cycling became essential forms of exercise,and transport for short trips.Access to public open spaces was essential and provided opportunities
112、 to be active outdoors when sport and exercise facilities were closed.These factors were critical in helping people manage stress and maintain physical health through times of national constraints and movement restrictions in response to COVID-19.However,the pandemic also exposed and exacerbated exi
113、sting inequities in access and opportunities for some communities to be physically active.School closures denied many children one of the opportunities they had to be active in communities where options for physical activity,sport and recreation are absent or inaccessible.The pandemic highlighted ho
114、w many people live in communities where streets are poorly designed and unsafe for walking and cycling,and where there is limited access to public open spaces or affordable exercise or sport facilities that meet their needs.The response to the pandemic also revealed the importance of providing oppor
115、tunities that enable everyone to be regularly active no matter their age,gender,income,ethnicity or physical ability.The experience of the pandemic has made it clear that physical activity can no longer be viewed as a“nice to have”component of public policy.It highlighted that it is time for all cou
116、ntries to make policies that promote physical activity as a“must have”and to ensure provision of equitable opportunities to be active for all(5).Physical activity provides social,environmental and economic benefits.Box 1.Defining physical activityPhysical activity is defined as any bodily movement p
117、roduced by skeletal muscles that requires energy expenditure(3)and can be done at a variety of intensities,and accumulated through work,domestic chores,transportation or during leisure time,or when participating in sport,walking,cycling,active recreation,and active play.What is physical inactivity?P
118、hysical inactivity is defined as doing insufficient physical activity to meet current physical activity recommendations.What is sedentary behaviour?Sedentary behaviour is defined as any waking behaviour while in a sitting,reclining or lying posture with low energy expenditure(4).See the glossary for
119、 further information.5GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 20221.3 Aim of this report The Global status report on physical activity presents the first dedicated synthesis of global progress on implementation of the recommended policy actions outlined in GAPPA across four strategic policy areas,
120、namely active societies,active environments,active people and active systems.The report was requested by Member States under World Health Assembly Resolution 71.6(1),and presents a picture of the current situation and(where possible)recent trends using the best available data and an existing set of
121、agreed global indicators.As we approach the halfway mark for achieving Sustainable Development Goal(SDG)3 on good health and well-being,including target 3.4 on reducing premature mortality resulting from NCDs,this report serves as a clarion call and advocacy tool to accelerate political action.It al
122、so serves as a resource to guide policy implementation by government actors,including ministries of health,sport,education,transport and finance;local authorities;and all other relevant stakeholders.The objectives of the report are to:summarize the health benefits of physical activity,current levels
123、 of physical activity,and current global recommendations;provide new global estimates on the economic cost of physical inactivity to health systems;present an assessment of current GAPPA policy implementation;highlight areas of progress and identify gaps in GAPPA implementation;identify data needs t
124、o strengthen future reporting on global progress on physical activity;and present five recommendations on how countries can accelerate progress on policy implementation to increase physical activity.1.4 Who this report is forEffective action to promote physical activity in all its forms across multi
125、ple settings requires all key sectors to work in partnership in order to strengthen their collective impact.This report is intended for all stakeholders involved in promoting and delivering national and subnational policies that provide the environments and programmes that drive physical activity pa
126、rticipation.This includes:policy-makers and officials across national and subnational government sectors,including health,welfare,education,transport,urban planning,sport,tourism,and finance;NGOs,civil society organizations(CSOs)and social enterprises;the private sector and employers;sport and exerc
127、ise organizations;academics and researchers;teachers and training institutions;and public health advocates on NCD prevention,mental health,healthy ageing,road safety,and health promotion.These key advocates and decision-makers may work at global,regional,national,or community level to integrate acti
128、on on physical activity into stronger health systems,as well as COVID-19 recovery plans,environmental and urban health mitigation agendas and national development plans.6Global burden of physical inactivity7Globally,there are inequalities in levels of physical activity between women and men,girls an
129、d boys,old and young,and the socioeconomically advantaged and disadvantaged this is unfair and unjust.8GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 20222.1 The overall prevalence of physical inactivityLatest global estimates show that 1.4 billion adults(27.5%of the worlds adult population)do not meet t
130、he recommended level of physical activity to improve and protect their health(6).Worryingly,this figure has remained largely unchanged(7).Of particular concern are the wide differences in levels of physical activity between regions,countries,age groups and sexes.In adults in 2016,levels of inactivit
131、y in high-income countries(36.8%)were double those in low-income countries(16.2%)(6).In most countries women are less active than men particularly in the Eastern Mediterranean Region and the Region of the Americas(see Fig.2).Across all WHO regions,both women and men become less active as they get ol
132、der,despite clear evidence that being active benefits older adults in relation to preventing falls,remaining independent,reducing isolation and maintaining social links to improve psychosocial health(see Fig.2).And despite their natural inclination for active play and recreation,by adolescence young
133、 people are far less active than might be expected.The most recent global data reveal that the majority(81%)of boys and girls aged 1117 years spend less than one hour a day doing moderate-to vigorous-intensity physical activity;and more girls are inactive than boys in most countries(85%and 77.6%resp
134、ectively)(8).Where modest improvements in physical activity levels for adolescents have been achieved,these have been among boys rather than girls(see Fig.3),further entrenching the sex differences in physical activity that persist throughout the life-course.Alarmingly,if this trend continues,the gl
135、obal target of a 15%relative reduction between 2018 and 2030 will not be met for adults,as shown in Fig.4.There is therefore an urgent need to scale and redouble efforts so that the full contribution of physical activity to health,well-being and the economy is realized.figure 2 Prevalence(%)African
136、RegionRegion of the AmericasEastern Mediterranean RegionEuropean RegionSouth-East Asia RegionWestern Pacific RegionWHO regionsFemales,18-44 yearsFemales,45-69 yearsFemales,70+yearsMales,18-44 years Males,45-69 yearsMales,70+years020406080Prevalence of adults aged 18+years not meeting WHO physical ac
137、tivity guidelines,by WHO region,201020169GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 2022Prevalence of school children aged 1117 years not meeting WHO physical activity guidelines,by WHO region,2010 and 2016figure 3 Prevalence(%)WHO regionsGirls,2010Girls,2016Boys,2010Boys,2016African RegionRegion of
138、the AmericasEastern Mediterranean RegionEuropean RegionSouth-East Asia RegionWestern Pacific Region020406080100Two scenarios for future global physical activity trends business as usual or accelerated action to achieve the global target for adults by 2030 figure 4 Prevalence(%)20013201420
139、002242025202620272028202920302030035FemaleMaleBusiness as usual,FemaleBusiness as usual,MaleAccelerated action,FemaleAccelerated action,Male10GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 20222.2 The economic burden of physical inactivityPhysical inactivity is
140、 associated with a range of chronic diseases and premature deaths(2)that carry not just a human but also an economic cost.Estimating the economic burden of physical inactivity is important to inform policy and decide resource prioritization.Previous global estimates of the economic burden of physica
141、l inactivity,undertaken in 2016,showed a global cost in 2013 of INT$67.5 billion per year due to health care expenditure and productivity losses(9).2.2.1 Methods for estimating the burdenUsing standard methods(9,10)the directly attributable health care costs of physical inactivity to the health syst
142、em were estimated using the best data available for 142 countries,representing 93.2%of the worlds population.Direct costs were estimated for the period 20202030 for coronary heart disease,stroke,type-2 diabetes,hypertension,six cancers(breast,colon,endometrial,gastric,oesophageal,renal,and bladder),
143、and,for the first time,two mental health outcomes,namely dementia and depression(11).National estimates of the prevalence of physical inactivity from countries in 2016(6)were used to calculate population-attributable fractions(PAFs)associated with physical inactivity for each disease outcome.More de
144、tailed description of the methods are provided in Annex 1(11).2.2.2 The cost of physical inactivity The economic burden of physical inactivity is large.Globally,almost 500 million(499 208 million)new cases of preventable NCDs will occur between 20202030,incurring treatment costs of just over US$300
145、billion(INT$524 billion)or around US$27 billion(INT$48 billion)annually if there is no change in the current prevalence of physical inactivity.The burden of new cases will largely fall on lower-and upper-middle-income countries,which are set to account for nearly three quarters 74%of estimated new c
146、ases of NCDs,with the Western Pacific Region predicted to be hardest hit(see Fig.5)(11).Globally,nearly half of new NCD cases(47%)will result from hypertension,and 43%will result from depression.The new cases of these two diseases will account for 22%and 28%respectively of total direct health care c
147、osts.Meanwhile,21%of costs will be incurred for the treatment of dementia,even though this only accounts for 3%of total preventable cases(see Fig.6).This high cost is due to the nature of dementia management treatment,and the duration for which it is needed.As might be expected,and similar to findin
148、gs in 2016(9),the economic burden of physical inactivity is unequally distributed across regions and is disproportionate in relation to the disease burden.The largest economic cost is set to occur among high-income countries,which will account for 70%of expenditure on treatment for illness resulting
149、 from physical inactivity.These estimates show that society is paying the price for not acting to reduce levels of physical inactivity.Moreover,these estimates are conservative.The inclusion of other important health outcomes,for example costs of treatment and management of preventable cases of fall
150、s and their associated injuries,would provide a comprehensive estimate of the impact of physical inactivity on health systems.In addition,if models were extended to include productivity losses due to morbidity and mortality,they would reveal the even greater economic costs associated with physical i
151、nactivity(12).11GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 2022Number and proportion of preventable new NCD cases attributed to physical inactivity,by country-income level,20202030 Distribution(%)of total number of cases and costs by type of NCD attributed to physical inactivity,20202030figure 5 figu
152、re 6 Millions of preventable cases NCDLowLower MiddleUpper MiddleHigh05005%41%28%26%CasesCostsPercentage of cases and costsDepressionDementiaCancersStrokeCoronary heart diseaseType 2 diabetesHypertension01020504030Globally,physical inactivity costs health systems US$27 billion a year and
153、by 2030,US$300 billion.12Frameworks for action and monitoring progress13To increase levels of physical activity,GAPPA recommends four strategic policy areas:active societies,active environments,active people and active systems.Countries are encouraged to address all four policy areas using a whole-o
154、f-system approach,in which all relevant government departments provide leadership in their areas of influence and stakeholders are engaged from across multiple sectors,including health,sport,education,transport,and urban planning.14GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 2022The four strategic GAP
155、PA policy areas are:Active societies:these require sustained,community-wide communication campaigns using diverse mass-media communication channels and inclusive messages and images(tailored to communities)to effectively reach large numbers of people to inform,motivate and engage them in more physic
156、al activity.Active environments:these require safe,affordable places and spaces that invite,support and enable people of all ages and abilities to be active in different ways.For example,green public open spaces provide places for sport and play,while separated cycle lanes invite more people to cycl
157、e for short trips.Active people:these require access to programmes,services and equipment that provide affordable,enjoyable and inclusive opportunities for all people to be active where they live,work and play,including in schools,at work,in parks and in other community venues.Active systems:these r
158、equire governance and policy enablers that provide leadership,relevant policy,legislative and regulatory frameworks,multisectoral coordination and partnerships;a trained workforce;and information systems to support policy implementation and evaluation.To achieve these four policy objectives,GAPPA se
159、ts out 20 policy actions(allocated among the four strategic policy areas)as an interconnected system,offering multiple opportunities for joined up and synergistic action(see Fig.7 and Table 2).Numbers shown refer to the recommended policy actions.For full details refer to the main report.4.14.44.54.
160、34.23.43.33.13.53.63.22.42.32.22.12.51.21.3CREATEACTIVE CREATEACTIVESOCIETIESENVIRONMENTSCREATEACTIVE PEOPLESYSTEMS1.4Promote the co-benefits Build workforce capacityProvide mass participation events Improve access to public open spaces Strengthen road safetyImprove walking and cycling networksInteg
161、rate transport and urban planning policiesImplement proactive building policies 15GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 2022GAPPA policy recommendations as a systems approach to increasing physical activityfigure 7 4.14.44.54.34.23.43.33.13.53.63.22.42.32.22.12.51.21.31.1CREATEACTIVESOCIETIESENV
162、IRONMENTSCREATEACTIVE PEOPLESYSTEMS15%Implement social marketing campaignsBuild research and developmentDevelop innovative finance mechanismsExpand advocacy Strengthenpolicy,leadership and governanceImprove and integrate data systemsProvide programmesacrossmultiplesettings Improve provision for olde
163、r adults Enhance physical educa-tion andschool based programs Prioritize programmes for the least activeImplement community-wide initiativesIncorporate physical activity into health and social services RELATIVE REDUCTION IN PHYSICAL INACTIVITY16GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 2022figure 8
164、INDICATORS OF POLICY IMPLEMENTATIONWHOLE-OF-SYSTEM MONITORING AND EVALUATION INPUTS AND ENABLERS OF POLICY ACTION ON PHYSICAL ACTIVITY AND EFFECTIVE POLICY IMPLEMENTATIONDRIVERS OF PHYSCIAL ACTIVITYACTIVE ENVIRONMENTSsupportive environments and facilitiesACTIVE SOCIETYcommunity-wide campaigns and pr
165、omotion ACTIVE SYSTEMSgovernance,leadership,ownership,policy,regulations,data information systems,research,financing,partnershipsACTIVE PEOPLEprogrammes and services in all key settings3.1 Framework for monitoring physical activityTracking countries progress in implementing GAPPA-recommended policy
166、actions is essential to provide an assessment of global progress towards achieving the global target of a 15%reduction in physical inactivity by 2030.Global monitoring is important because it provides standard,robust,and comparable data to inform decision-makers and support global,regional and natio
167、nal priority setting and resource allocation.For this report,a GAPPA policy model and GAPPA monitoring framework have been developed(see Fig.8 and Table 2).As shown in Fig.8,an increased level of physical activity among people of all ages is set as the primary outcome of implementing GAPPA policy ac
168、tions.The wider impacts of change GAPPA policy model for increasing physical activity17GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 2022INDICATORS OF OUTCOME BEHAVIOURAL OUTCOMESSOCIETAL IMPACTINDICATORS OF IMPACTMORE PHYSICAL ACTIVITY(through walking cycling,sport,exercise,recreation and active play)B
169、y more people of all ages and abilitiesACTIVE ENVIRONMENTSsupportive environments and facilitiesACTIVE SOCIETYcommunity-wide campaigns and promotion HEALTHAND WELL-BEINGSOCIAL DEVELOPMENTSUSTAINABLEENVIRONMENTECONOMIC GROWTHREDUCEDINEQUALITIESACTIVE SYSTEMSgovernance,leadership,ownership,policy,regu
170、lations,data information systems,research,financing,partnershipsACTIVE PEOPLEprogrammes and services in all key settingsin levels of physical activity are monitored through macro-level indicators of population health,the environment,and the economy.These macro-level indicators are set as the impact
171、indicators of physical activity on society(see Fig.8).To fully understand whether recommended policies are being implemented at country level,a set of indicators to track policy implementation process is required.This set of indicators must capture the diversity of policy-related activities recommen
172、ded to countries in GAPPA,many of which require implementation by sectors outside of health.Therefore,consistent with GAPPA itself,the monitoring framework of GAPPA should adopt a systems approach and incorporate indicators of policy implementation outside the health sector.For this first global ass
173、essment,29 indicators were identified that align with the recommended policy actions in each of the four GAPPA policy areas(see Table 2).The process of selecting indicators is outlined in section 3.1.1.18GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 2022Summary of indicators by GAPPA policy action areat
174、able 2GAPPA POLICY ACTIONDATA AVAILABILITY SHORT INDICATOR NAMEDATA SOURCEACTIVE SOCIETIES1.1Conduct best practice communication campaigns,linked with community-based programmes,aimed at promoting and supporting behaviour change on physical activityYesNational communication campaigns on physical act
175、ivity:that link with community-based initiativesthat are supported by environmental improvementsthat promote the co-benefits of physical activityNCD Country Capacity Survey(CCS)1.2Conduct national and community-based campaigns linking to the social,economic,and environmental co-benefits of physical
176、activityYesNational physical activity communication campaigns promoting co-benefits of physical activityNCD CCS1.3Conduct free mass-participation physical activity events to encourage and celebrate participationYesNational mass-participation events on physical activityNCD CCS1.4Strengthen workforce
177、skills and knowledge through pre-and in-service training programmes across relevant disciplines both within and outside the health sectorNoGAPPA POLICY ACTIONDATA AVAILABILITY SHORT INDICATOR NAMEDATA SOURCEACTIVE ENVIRONMENTS2.1Strengthen integration of urban(land use)planning and transport plannin
178、g to provide compact and sustainable urban development and support non-motorized transportPartialNational policy on public transportRoad Safety Survey2.2Improve provision of walking and cycling infrastructure and networksPartialNational policy encouraging walking and cyclingRoad Safety Survey2.3Incr
179、ease access to safe public open spaces and sport/recreational facilitiesNoRoad Safety Survey19GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 2022GAPPA POLICY ACTIONDATA AVAILABILITY SHORT INDICATOR NAMEDATA SOURCE2.4Improve road safety to increase pedestrian and cyclist safetyNational road design standar
180、ds for separated infrastructureNational road design standards for safe crossingsNational road design standards for safe speedNational road safety strategy that is fully fundedRoad safety assessment of new road infrastructureRoad safety assessment of existing road networksLegislation on speed limits
181、meeting best practiceLegislation on drinkdriving meeting best practiceLegislation on distracted driving due to use of mobile phoneLegislation on distracted driving due to use of drugsRoad Safety Survey2.5Review building design and regulations to encourage activity in and around buildings such as in
182、public buildings,schools and educational facilities,health care settings and workplacesNoGAPPA POLICY ACTIONDATA AVAILABILITY SHORT INDICATOR NAMEDATA SOURCEACTIVE PEOPLE3.1Implement a whole-of-school approach to ensure quality physical education and physical activity opportunitiesNo3.2Integrate scr
183、eening and promotion of physical activity in primary and secondary health care servicesYesNational protocols on the primary health care management of physical inactivityNCD CCS3.3Implement initiatives across public open spaces and other settings to engage people of all ages and abilities to do regul
184、ar physical activity,prioritizing the least active and disadvantaged communitiesYesPolicy promoting physical activity in child carePolicy promoting physical activity in the workplacePolicy promoting physical activity through community-based sportPolicy promoting physical activity in public open spac
185、esPolicy promoting walking and cyclingNational initiatives to deliver health care via mobile devices(mHealth)NCD CCSGLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 2022GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY20GAPPA POLICY ACTIONDATA AVAILABILITY SHORT INDICATOR NAMEDATA SOURCE3.4Strengthen programmes an
186、d services aimed at older adultsYesPolicy promoting physical activity for older adultsNCD CCS3.5Increase the opportunities for physical activity in the least-active groups,such as girls,women,older adults and vulnerable or marginalized populationsNo3.6Implement whole-of-community(e.g.healthy city)pr
187、ogrammes that include promotion of physical activityNoGAPPA POLICY ACTIONDATA AVAILABILITY SHORT INDICATOR NAMEDATA SOURCEACTIVE SYSTEMS4.1Strengthen national policy,guidelines,leadership,and governanceYesNational NCDs policy including physical activityNational physical activity policy,strategy or a
188、ction planNational guidelines on physical activityNational physical activity targetsNational coordination mechanism for NCDsNCD CCS4.2Ensure strong data and information systems relevant to physical activity to support effective coordinated policy implementation and evaluationYesNational surveillance
189、 on physical activityNCD CCS4.3Support research and development,including the use of digital technologies,to promote physical activityNo4.4Strengthen advocacy on physical activityNo4.5Strengthen financing mechanisms to secure sustained implementation of national and subnational actionNoGLOBAL STATUS
190、 REPORT ON PHYSICAL ACTIVITY 2022213.1.1 Methods and indicator selection To minimize the burden on countries of new data collection and reporting requirements,and to ensure alignment with other relevant global monitoring frameworks,each GAPPA policy was mapped against identified existing global moni
191、toring indicators and their data sources(13,14)across key related areas,such as NCDs,road safety,urban and environmental health,healthy ageing,adolescent and school health,and nutrition(see Table 2).Monitoring frameworks used at WHO regional level(15,16)were reviewed,as well as similar frameworks us
192、ed by CSOs(see https:/ https:/www.activehealthykids.org/).Use of an existing indicator was considered only if an established mechanism to collect data was present in all 194 Member States,as well as a globally agreed,standardized measure used at national level.Indicators derived from sources with an
193、 established data collection mechanism not only provided an existing infrastructure for ongoing GAPPA monitoring,but also provided access to trend data that can likely track progress.In addition,indicators in use or under development for tracking global progress towards SDG targets(17)were also revi
194、ewed to identify relevant indicators for GAPPA.Alignment with UN SDG targets was identified for two GAPPA policy actions:the development of global indicators for public open space(SDG Target 11.7);and access to public transport(SDG Target 11.2).However,at the time of publication,data for both indica
195、tors are only available for some countries and only at the city not national level.As such,they were not suitable for inclusion in this first report on GAPPA implementation.A full list of the 29 final indicators included in the current monitoring framework is presented in Table 2.For full details fo
196、r each indicator,including the definition,computation,data source and technical notes,can be found in the GAPPA Monitoring Framework Indicator Data Dictionary,available as a web annex https:/apps.who.int/iris/handle/10665/363531.3.1.2 Data sourcesTwo primary sources provided data for the majority of
197、 indicators:the WHO Noncommunicable Disease Country Capacity Survey(NCD CCS)that provides data on all 194 Member States(13)and the WHO Global status report on road safety,providing data on 174 countries(14).Further information on these data sources is provided in Annex 2.22Progress towardsactivesyst
198、ems23Leadership,governance and multisectoral partnerships are key to making the improvement of physical activity participation a national priority.National governments have committed to developing and implementing policies to address physical activity,and by strengthening their policy framework can
199、provide the necessary guidance for coordinated action across sectors and stakeholders.Information systems across sectors can track progress against defined targets and in turn support resource mobilization.24GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 2022Chapter Summary25GLOBAL STATUS REPORT ON PHYSI
200、CAL ACTIVITY 2022National NCD plans,policies or strategies on physical activity set the agenda for action to improve physical activity.Only two thirds of countries have an operational NCD policy that includes physical activity.Just over one third of countries have an operational standalone physical
201、activity policy.About three quarters of countries have either an operational national NCD policy including physical activity,or an operational national,standalone physical activity policy.There has been a decline in the number of countries with either an operational NCD or physical activity policy s
202、ince 2019,which in part may reflect the impact of the COVID-19 pandemic and health system disruption.National guidelines provide recommendations on the amount and type of physical activity that will provide health benefits and inform national action on physical activity.Just over half of countries g
203、lobally do not have national guidelines on physical activity.There has been an increase in the number of countries with national guidelines.Just under one third of countries globally have national guidelines addressing all ages across the life-course.National physical activity targets set a clear co
204、mmon and measurable goal for action.Approximately two thirds of all countries have set national target(s)for physical activity.Physical activity targets were more frequently reported in lower-middle and upper-middle income countries compared to high-and low-income countries.National surveillance sys
205、tems for physical activity provide standard and consistent data to track changes in levels of physical activity and inform national policy and priorities Almost all countries have undertaken population-based surveillance of physical activity.The majority of countries track physical activity in adult
206、s,but only three quarters of countries reported monitoring physical activity among both children(aged 519 years)and adults,and only one third report assessing physical activity in children aged under 5 years.About half of all countries have not conducted physical activity surveillance for over 5 yea
207、rs.Governments have a central role in providing leadership,coordination and accountability for policy implementation and reporting on national policy commitments on physical activity.Just under half of countries reported an operational NCD mechanism and these were mostly high-and middle-income count
208、ries.Chapter Summary26GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 20224.1 National policy and governanceA national NCD policy,strategy or plan provides countries with an overarching national policy framework and sets the agenda for action on both the management and prevention of multiple chronic disea
209、ses through a combination of clinical health services and population-based approaches.WHO has been tracking countries development and operational status of national policies on NCDs and physical activity since 2013(13).1 An“operational NCD policy”is defined in the WHO NCD CCS survey as a policy,stra
210、tegy or plan of action that is being used and implemented in the country and has resources and funding available to implement it.4.1.1 NCD policy or planAll countries have committed to implementing or strengthening national policies and strategies to address the four leading NCD risk factors physica
211、l inactivity,tobacco,alcohol and unhealthy diet(18-20).In 2016,these commitments were reinforced in Transforming our World:The 2030 Agenda for Sustainable Development(21),in which countries agreed(as part of SDG Target 3.4)to achieve a one-third reduction in premature mortality from NCDs by 2030.Inc
212、reasing the level of physical activity is a core part of reaching this target,and contributes to reaching multiple other SDG targets.In 2021:The majority of countries(n=166,86%)report having a national NCD policy,strategy or action plan that includes physical activity as one of the four key NCD risk
213、 factors(see Fig.9).Between 2017 and 2019 there was a small increase in the number of countries reporting an operational1 NCD policy including physical activity(n=136,70%in 2017 to n=140,72%in 2019).However,this dropped in 2021(n=130,67%)(see Fig.10).The European Region,South-East Asia Region,and th
214、e Western Pacific Region report the highest proportion of countries with an operational NCD policy including physical activity(see Fig.10).Countries with a national NCD policy including physical activity,by region and country-income level,2021figure 9 NCD policy NCD policy operationalPercentage of M
215、ember StatesAfrican RegionRegion of the AmericasEastern Mediterranean RegionEuropean RegionSouth-East Asia RegionWestern Pacific RegionLow-incomeHigh-incomeLower-middle-incomeUpper-middle-incomeGlobalWHO regionsWorld Bank income groups02040608010027GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 2022Count
216、ries with an operational,national NCD policy including physical activity,by region and country-income level,2017,2019 and 2021 figure 10 Percentage of Member States201720192021WHO regionsWorld Bank income groupsAfrican RegionRegion of the AmericasEastern Mediterranean RegionEuropean RegionSouth-East
217、 Asia RegionWestern Pacific RegionLow-incomeHigh-incomeLower-middle-incomeUpper-middle-incomeGlobal0204060801004.1.2 Standalone physical activity policy or planDeveloping a specific,standalone national policy,strategy or action plan for physical activity can provide even more detailed policy actions
218、.It can also set out timelines;the roles and responsibilities of relevant stakeholders;and prioritize resource allocation and implementation,particularly where this involves sectors outside of the health sector and across multiple settings.Having either an NCD policy including physical activity,or a
219、 standalone physical activity policy,has been called for by GAPPA.In 2021:Just under half of countries(n=91,47%)report a standalone national physical activity policy,strategy,or action plan(see Fig.11).Of these,only 74 countries report that the physical activity policy,strategy,or action plan is ope
220、rational,representing only 38%of 194 Member States(see Fig.12).The European Region has the highest proportion of countries reporting an operational physical activity policy,strategy,or action plan(64%),followed by the Eastern Mediterranean Region(48%)and the Western Pacific Region(37%).More high-inc
221、ome countries(61%)have an operational standalone physical activity policy compared to lower-and middle-income countries.140 countries(72%)report either an operational NCD policy including physical activity OR an operational standalone national physical activity policy a fall from 153 countries(79%)i
222、n 2019.10 countries report an operational standalone physical activity policy but not a national NCD policy including physical activity.28GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 2022Countries with a national,standalone physical activity policy,strategy,or action plan,by region and country-income l
223、evel,2021Countries with operational standalone national physical activity policy,strategy,or action plan,by region and country-income level,2017,2019 and 2021 figure 11 figure 12 Physical activity policyPhysical activity policy,operationalPercentage of Member StatesWHO regionsWorld Bank income group
224、sAfrican RegionRegion of the AmericasEastern Mediterranean RegionEuropean RegionSouth-East Asia RegionWestern Pacific RegionLow-incomeHigh-incomeLower-middle-incomeUpper-middle-incomeGlobal020406080100Percentage of Member States201720192021WHO regionsWorld Bank income groupsAfrican RegionRegion of t
225、he AmericasEastern Mediterranean RegionEuropean RegionSouth-East Asia RegionWestern Pacific RegionLow-incomeHigh-incomeLower-middle-incomeUpper-middle-incomeGlobal02040608010029GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 20224.1.3 DiscussionOverall,data show that while the majority of countries have a
226、 national NCD policy,only two thirds(67%)report that the policy is operational a decrease since 2019.Almost half of countries(47%)have a standalone national physical activity policy but only around one third of countries(38%)report that the policy is operational.However,of particular concern is that
227、 about one quarter of countries(28%)have neither an operational national NCD policy including physical activity,nor an operational national standalone physical activity policy a figure that has risen from 21%since 2019.The absence of a national agenda for physical activity,set out in national policy
228、,is detrimental to country progress as it means there is no central vision or mandate for policy action to address physical inactivity,nor proper resource allocation towards the challenge.While having a national policy does not guarantee resources,a national policy framework is usually a pre-requisi
229、te for leveraging stakeholders and scaling action.The recent decline in countries that report having an operational policy on physical activity may be the result of existing policies expiring,and the significant disruption to health systems caused by COVID-19 throughout 2020 and 2021,including in re
230、ducing capacity in areas such as national health policy development.Earlier increases between 2017 and 2019 in the African Region,European Region,and the Western Pacific Region,and between 2019 and 2021 in the Region of the Americas,may reflect the rising visibility and policy attention afforded to
231、physical activity since GAPPA publication in 2018.It may also reflect the increased focus provided by the development of regional physical activity action plans to support countries in implementing GAPPA,for example in the African Region(22),the South-East Asia Region(23)and the Eastern Mediterranea
232、n Region(24).The European Region had the highest proportion of countries with a national policy addressing physical activity,which likely reflects the existence of a European strategy on physical activity since 2016(25).The notable gap between the presence of policy in countries and those policies b
233、eing reported as operational reveals a gap in either human resource capacity or resourcing constraints,or both.The financial constraints limiting policy implementation to address NCD prevention,including physical activity,was already well known(26)but appears to have been exacerbated by the COVID-19
234、 pandemic.There is a clear need to identify and address the barriers to policy implementation,and in recognition of this,WHO has called for collective action to identify more diverse and innovative financing mechanisms and a scaling up of investment in implementing national physical activity policie
235、s(5).Countries without a national policy to set the agenda for action on physical activity are encouraged to develop one(27).To support countries in developing or updating national strategies,WHO has developed a situational assessment tool aligned with GAPPA(GAPPA-SAT)to systematically appraise nati
236、onal progress against GAPPA policy recommendations(28).GAPPA-SAT(pilot version 6)is available on request and publication is planned in 2022.30GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 20224.2 Physical activity guidelinesNational physical activity guidelines represent a national consensus on the impo
237、rtance of physical activity.They outline the optimal duration,frequency and intensity of different types of physical activities,and the health benefits across the life-course,based on scientific evidence.National physical activity guidelines are used to inform national policy and action plans on phy
238、sical activity and support policy development in other related areas,such as sport and recreation,physical education,and active transport.WHO supports countries in maintaining up-to-date national physical activity guidelines by updating its global guidelines on physical activity and sedentary behavi
239、our across the life-course every 510 years,ensuring they reflect the latest scientific evidence.Since 2019,the WHO NCD CCS survey(13)has tracked countries progress in developing national physical activity guidelines by age group.In 2021:Just under half of all countries(n=90,46%)report having nationa
240、l guidelines on physical activity.This ranges from almost three quarters(n=38,72%)of countries in the European Region to less than 10%of countries(4 out of 47 countries)in the African Region(see Fig.13).There has been a 15%increase in countries reporting national guidelines on physical activity,risi
241、ng from 78 countries(40%)in 2019 to 90 countries(46%)in 2021.This increase has occurred in countries across all regions(except the Eastern Mediterranean Region)and across all income levels(except for low-income countries).WHO recommends that all countries establish and update national guidelines tha
242、t cover all age groups and key subpopulations,such as older adults and people living with disability.figure 13 National guidelines on physical activity by region and income level,2019 and 2021Percentage of Member States206080100WHO regionsWorld Bank income groupsAfrican RegionRegion of th
243、e AmericasEastern Mediterranean RegionEuropean RegionSouth-East Asia RegionWestern Pacific RegionLow-incomeHigh-incomeLower-middle-incomeUpper-middle-incomeGlobal31GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 2022In 2021:Just under one third of countries(n=58,30%)report having national guidelines that
244、address all age groups across the life-course.About one third of countries(n=61,31%)report having guidelines for children aged under 5 years of age a rise from 40 countries(21%)since the launch of the WHO Guidelines on Physical Activity,Sedentary Behaviour and Sleep in children under 5 years of age
245、in 2019.Just under half of countries(44%)report having guidelines for children and adolescents aged 519 years,with the same percentage for adults;fewer countries(41%)report having guidelines that cover older adults aged 65 years and above.About three quarters of high-income countries report having n
246、ational guidelines for children,adults and older adults,compared to only half of upper-middle,and one quarter of lower-middle-income countries(see Fig.14).National guidelines on physical activity by age,region,and globally,2021figure 14 AdultsOlder adultsAll age groupsUnder 5y5-19yPercentage of Memb
247、er StatesWHO regionsWorld Bank income groupsAfrican RegionRegion of the AmericasEastern Mediterranean RegionEuropean RegionSouth-East Asia RegionWestern Pacific RegionLow-incomeHigh-incomeLower-middle-incomeUpper-middle-incomeGlobal0204060801004.2.1 Discussion Despite an increase in the number of co
248、untries reporting having national guidelines since 2019,over half of countries globally have no national guidelines on physical activity.Globally,only one third of countries(30%)have national guidelines addressing all four age groups across the life-course.The greatest progress is seen in the develo
249、pment of national guidelines for children aged under 5 years,which has increased by 53%from 40 countries in 2019 to 61 countries in 2021(2019 data not shown in graphs).Conversely,there has been only a modest increase in the development of guidelines for other age groups,indicating a clear need for m
250、ore support and an acceleration of efforts in countries across all regions.To avert the costs and burden of developing new scientific guidelines,WHO recommends that countries convene relevant stakeholders to review and adopt its global guidelines on physical activity and sedentary behaviour(2).These
251、 enable countries to undertake rapid and cost-effective steps to update or establish national guidelines;to adapt and tailor national guidelines to local contexts;and to ensure multisectoral engagement in this process,and wider dissemination and use.32GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 20224.
252、3 Physical activity targetsNational guidelines on physical activity provide the basis for setting national goals and targets by establishing standards and benchmarks that enable consistent tracking of physical activity and inactivity among different populations.In 2013,nine voluntary targets were es
253、tablished as part of the monitoring framework to track global progress in the prevention and control of NCDs and their key risk factors(see Fig.15).The target set for physical inactivity was a 10%relative reduction in prevalence of insufficient physical activity among adults and adolescents by 2025,
254、using 2010 data as the baseline.In 2018,countries extended the global target for physical activity by 5 years and agreed on a 15%relative reduction by 2030.This aligns GAPPA with global and national efforts to achieve the SDGs by 2030 and sets out a vision for countries to increase participation ove
255、r a period of 12 years(20182030)through policy action and implementation.In 2021:Around two thirds of countries(n=126,65%)report having time-bound national targets for NCDs based on the nine voluntary global targets from the NCD Global Monitoring Framework(https:/www.who.int/publications/i/item/ncd-
256、surveillance-global-monitoring-framework).Just over half of countries(n=102,53%)have a specific national target for physical activity.A reported 91%of countries(10 out of 11)in the South-East Asia Region have a target on physical activity,compared to 67%in the Western Pacific Region.Approximately ha
257、lf of countries in the African Region(51%)have a target,with the figure standing at 54%of countries in the Region of the Americas,52%in countries in the Eastern Mediterranean Region,and only 38%of countries in the European Region.Physical activity targets are more frequently reported by lower-and up
258、per-middle-income countries(63%and 60%respectively),compared to high-and low-income countries(39%and 48%respectively).33GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 20224.3.1 DiscussionDespite their importance,only around half of countries have set national targets for physical activity.Targets are rep
259、orted more frequently by low-income countries than might be expected,although this aligns with a similar proportion of low-income countries reporting an NCD policy including physical activity.Many countries establishing an NCD policy for the first time and following WHO guidance have also adopted th
260、e voluntary target for physical activity of a 10%reduction by 2025.WHO recommends all countries establish specific,time-bound targets for physical activity as part of national monitoring frameworks and accountability.Countries whose target expires in 2025 may adopt the agreed global target set out i
261、n GAPPA,namely at 15%relative improvement by 2030,or adapt this to country context and their own national policy timeframes.National time-bound targets related to nine voluntary NCD targets and a national physical activity target,by region and country-income level,2021 figure 15 NCD targetPhysical a
262、ctivity targetPercentage of Member StatesWHO regionsWorld Bank income groupsAfrican RegionRegion of the AmericasEastern Mediterranean RegionEuropean RegionSouth-East Asia RegionWestern Pacific RegionLow-incomeHigh-incomeLower-middle-incomeUpper-middle-incomeGlobal02040608010034GLOBAL STATUS REPORT O
263、N PHYSICAL ACTIVITY 20224.4 Physical activity surveillanceMonitoring physical activity at population level enables countries to assess progress towards meeting national physical activity targets;supports evidence-based advocacy by identifying priority populations;and is an important mechanism for en
264、suring accountability.A core set of national data supports the process of developing a shared understanding among stakeholders on the levels and patterns of participation in physical activity,and helps identify and track differences in overall population levels,between subpopulations,and across geog
265、raphies.WHO recommends that all countries undertake NCD risk factor surveillance,including on physical activity,among all age groups,and report regularly on progress(for example,every 5 years).WHO also recommends that countries strengthen their reporting of disaggregated data to enable tracking of t
266、rends within subpopulations(such as by sex,age,ethnicity,socioeconomic status,disability),and to identify and track efforts to reduce inequalities in physical activity participation(29).In 2021:Almost all countries(n=185,95%)report conducting population-based surveillance of physical activity in the
267、 past 5 years;the Eastern Mediterranean Region,the South-East Asia Region and the Western Pacific Region have the highest proportion of countries reporting physical activity surveillance(100%),while the African Region has the lowest proportion of countries(87%)(see Fig.16).There has been no change i
268、n the proportion of countries reporting surveillance of physical activity between 2019(95%)and 2021.Most countries report surveillance of physical activity among adults(92%);three quarters of countries(n=146,75%)report surveillance of physical activity among children and adolescents;while one third
269、of countries(n=57,29%)report surveillance of physical activity in children under the age of 5 years(mostly countries in the European Region)(see Fig.17).Globally,just under one third of countries(n=52,27%)report surveillance of physical activity in all three age groups(under 5 years,children and ado
270、lescents,and adults including older adults).Surveillance of children and adolescents is highest in high-income and upper-middle-income countries(89%and 90%respectively),compared to lower-middle and low-income countries(67%and 32%respectively).Around one third of countries report that data on physica
271、l activity were last collected more than 5 years ago,and around 10%of countries report that their data were last collected more than 10 years ago(see Fig.18).35GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 2022Trend in national surveillance of physical activity by region and country-income level,2017,20
272、19 and 2021National surveillance of physical activity by age group,region and country-income level,2021Percentage of Member States201720192021African RegionRegion of the AmericasEastern Mediterranean RegionEuropean RegionSouth-East Asia RegionWestern Pacific RegionLow-incomeHigh-incomeLower-middle-i
273、ncomeUpper-middle-incomeGlobalWHO regionsWorld Bank income groups020406080100AdultsAll age groupsUnder 5y5-19yAfrican RegionRegion of the AmericasEastern Mediterranean RegionEuropean RegionSouth-East Asia RegionWestern Pacific RegionLow-incomeHigh-incomeLower-middle-incomeUpper-middle-incomeGlobalWH
274、O regionsWorld Bank income groupsPercentage of Member States020406080100figure 16 figure 17 36GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 20224.4.1 Discussion National surveillance on physical activity shows relatively good coverage(92%)in adult populations,with only 16 countries not collecting data i
275、n the past 5 years.Monitoring of physical activity in children and adolescents also appears relatively high(75%).It should be noted,however,that in the majority of these countries,data are collected for children aged 1117 years and only on those attending school.This means that the data do not accur
276、ately represent levels of physical activity in children(for example those aged under 10 years)nor physical activity levels among children not in formal education.Given the global health priority to address rising levels of overweight and obesity in children and adolescents,there is an urgent need to
277、 disaggregate these data and also to establish global standards and guidance on measurement of physical activity in children under the age of 10 years.Only 30%of countries report monitoring physical activity among children under the age of 5 years.The lower coverage in this age group may be due to t
278、he relatively recent publication of global guidelines on physical activity for this group of children(30),and the absence of a global standard instrument for monitoring early years physical activity,sedentary behaviour and sleep.Most data for this age group are collected on children aged 4 years and
279、 current methods include surveys of parents and/or wearable sensor devices.Developing global standards and suitable,affordable,age-appropriate sensor instruments is necessary to advance country adoption.Globally,only one third of countries monitor physical activity among all three age groups.Countri
280、es without national monitoring systems that cover all ages are encouraged to identify and address any gaps.Consistent and sustained tracking of physical activity across the life-course is required to inform national and subnational policy,as well as guide investment in infrastructure and programme i
281、mplementation.The most frequently reported approach to national assessment of physical activity is through use of self-report instruments(data not shown)integrated in a larger NCD(or other)health survey(31).This is a relatively inexpensive method as examples of physical activity can be tailored to c
282、ultural and country contexts and combined with show cards of different physical activities to ensure common understanding of the behaviours of interest.The emergence of more affordable digital and wearable technologies to measure and track physical activity is advancing,but their use remains limited
283、 within national surveillance systems(see Chapter 8).Number of years since last survey of population-level physical activity by region and globally,2021figure 18 Adolescent survey 10y agoAdult survey10y agoNumber of Member StatesWHO regionsWorld Bank income groupsAfrican RegionRegion of the Americas
284、Eastern Mediterranean RegionEuropean RegionSouth-East Asia RegionWestern Pacific RegionLow-incomeHigh-incomeLower-middle-incomeUpper-middle-income01020304037GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 20224.5 National NCD coordination mechanisms Government has a central role in coordinating and cohere
285、ntly implementing the multiple policy actions aimed at managing and preventing NCDs.As many of these policy actions are the responsibility of either the health sector,other sectors,or both,robust coordination of the planning,implementation and evaluation of multisectoral action is vital.WHO recommen
286、ds that countries establish a national coordinating mechanism such as a steering committee or task force to ensure all relevant stakeholders are engaged in the implementation of a national policy or plan to address NCDs and their risk factors(19).The national mechanism should comprise all relevant g
287、overnment departments and include non-state actors,as appropriate,to ensure a coherent and cost-effective national response is implemented.WHO has been tracking countries progress on establishing a national multisectoral commission since 2013.In 2021:Just under half of countries(n=89,46%)report an o
288、perational National NCD Coordination mechanism this is unchanged since 2019.More countries in the South-East Asia Region report having national NCD coordinating mechanisms(73%in 2019 and 91%in 2021),while less than a quarter of countries in the African Region report these mechanisms(23%)(see Fig.19)
289、.Fewer low-income countries report having a national NCD coordinating mechanism(19%)than middle-income and high-income countries(4755%).38GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 2022GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY4.5.1 Discussion Data show that only about half of countries(46%)have estab
290、lished a national coordinating mechanism under the NCD agenda to support and harmonize multisectoral action,relevant policy and practice.A systems approach to increasing physical activity requires multiple sectors to engage and cooperate to implement a comprehensive and coherent set of policy and pr
291、ogrammes and they should interconnect for maximum effectiveness.Countries that have not already done so should therefore prioritize the establishment of a coordination mechanism.National coordination mechanism,by region,globally,and country-income level,2019 and 2021figure 19 Percentage of Member St
292、ates206080100WHO regionsWorld Bank income groupsAfrican RegionRegion of the AmericasEastern Mediterranean RegionEuropean RegionSouth-East Asia RegionWestern Pacific RegionLow-incomeHigh-incomeLower-middle-incomeUpper-middle-incomeGlobal39GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 202240Pro
293、gress towards active societies41Meeting the global target for physical activity can only be achieved by more people becoming more active.Promoting physical activity through public communication campaigns and mass-participation events that raise awareness of the benefits of physical activity and the
294、multiple different ways in which people can be active according to ability and at all ages provide opportunities to strengthen understanding,change mindsets,and create more active societies.42Chapter Summary43Community-wide communication campaigns provide clear and consistent messages on the benefit
295、s of physical activity and can shift cultural norms and support behaviour change.Just over half of countries conducted at least one communication campaign on physical activity in the last 2 years,representing a decline since 2019.Most countries reporting a campaign also report linking with community
296、 programmes and environmental improvements.Mass-participation events provide free,enjoyable and social opportunities to be physically active and can engage and motivate large numbers of people to be more active.Just over half of countries report holding at least one mass-participation event involvin
297、g physical activity in the last 2 years.Implementation of mass-participation events declined between 2019 and 2021 likely due to the impact of movement restrictions related to the COVID-19 pandemic.Chapter SummaryGLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 2022GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY
298、 2022445.1 Communication campaigns on physical activity Community-wide communication campaigns provide consistent,sustained and clear messages about the benefits of physical activity and have been identified as a cost-effective approach.They are also recommended as a“best buy”for the prevention of N
299、CDs(32).Successful campaigns employ social marketing techniques and use multiple mass-media communication channels,including traditional(for example,print,television,radio)as well as social and digital platforms.Communication campaigns can work at multiple levels.They raise peoples knowledge and und
300、erstanding of physical activity,change attitudes,increase intention and stimulate behaviour change,thereby increasing participation.Campaigns can also influence the policy agenda through stimulating community discussion and debate,for example about community access or road safety for walking and cyc
301、ling.WHO started monitoring countries progress in implementing physical activity communication campaigns in 2013.In 2017 it strengthened the independent validation process and in 2019 amended the definition of a communication campaign to ensure alignment as a policy recommendation in GAPPA(1)and an
302、NCD“best buy”(33).In 2021:Just over half of countries(n=101,52%)report implementing a communication campaign to promote physical activity in the past 2 years(see Fig.20).The European Region reports the highest use of communication campaigns(98%),followed by the South-East Asia Region(55%)and the Reg
303、ion of the Americas(51%).Less than half of countries in all other regions use communications campaigns.A higher proportion of high-income and upper-middle countries(82%and 62%respectively)report conducting communication campaigns in the past 2 years compared to lower-middle and low-income countries(
304、29%and 16%respectively).Globally,fewer countries report conducting communication campaigns to promote physical activity in 2021(n=101,52%)compared to 2019(n=124,64%).The Region of the Americas,the European Region and the Western Pacific Region show a sharp increase in reporting communication campaig
305、ns to promote physical activity between 2017 and 2019;in 2021 this rise continued only in the European Region.The African Region and the Eastern Mediterranean Region show a decline in countries reporting communication campaigns between 2017,2019 and 2021.Successful communication campaigns are those
306、implemented as part of a comprehensive communications strategy,as standalone,short-term mass-media campaigns are less effective.In addition,communication campaigns with clear links,or“signposts”to community programmes,are more likely to help people respond to the call to start,or be,more active.Comb
307、ining education campaigns with structural improvements will also support more individuals to act on the information provided by the campaign and are considered to be more effective than solely using educational and health slogans about the benefits of physical activity(33,34).Examples include improv
308、ing local public open spaces and walking and cycling infrastructure,or adding street signage indicating the walking distance and time to local destinations.GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 202245National physical activity communication campaigns,by region and country-income level,2017,2019
309、and 2021 Percentage of Member States201720192021WHO regionsWorld Bank income groups020406080100African RegionRegion of the AmericasEastern Mediterranean RegionEuropean RegionSouth-East Asia RegionWestern Pacific RegionLow-incomeHigh-incomeLower-middle-incomeUpper-middle-incomeGlobalfigure 20 In 2021
310、:About three quarters of countries report communications campaigns that include community-based initiatives(89%)or environmental changes(73%)(see Fig.21).About three quarters of countries(81%)report campaigns that promote the co-benefits(such as social,environmental and/or economic benefits)of physi
311、cal activity.All campaigns in low-income countries include community-based initiatives and environmental changes,and across all country-income groups,about three quarters of campaigns promoted co-benefits.5.1.1 Discussion Just over half(52%)of countries report implementing at least one communication
312、 campaign in the past 2 years.Reported campaigns on physical activity have declined since 2019(when the figure was 64%).While the time period for reporting of campaigns included 2019,the impact of COVID-19 on campaigns is not fully known.While movement restrictions and government capacity may have l
313、imited conducting campaigns,COVID-19 may also have acted as a catalyst for new campaigns on physical activity,informing populations on the benefits of staying active for mental and physical health benefits as well as providing ideas and examples of ways to be active in and around the home.The data r
314、eported on implementation of physical activity communication campaigns were independently validated by reviewing submitted supporting evidence provided by each country.This analysis revealed considerable diversity across the 105 countries reporting physical activity campaigns in terms of their durat
315、ion,scale,target audiences,type of media channels,and other aspects.Digital communication channels are widely reported(such as websites,SMS,Facebook,Twitter and others),as well as the traditional channels of television,radio and supporting health education materials.GLOBAL STATUS REPORT ON PHYSICAL
316、ACTIVITY 202246While promoting the health benefits of physical activity is their most common purpose,communication campaigns also promoted other benefits to motivate people to start or increase their physical activity.For example,some campaigns promoted walking and cycling as an alternative to perso
317、nal motorized transport,bringing benefits such as reduced traffic congestion,road accidents,air and noise pollution and fossil fuel consumption.As campaigns frame an issue and when necessary“reframe”an issue they are useful to shift how communities perceive and understand physical activity,to addres
318、s biases and/or cultural barriers(for example on womens participation),and improve the social desirability and norms associated with being more active(for example,to youth audiences).Although it has been more than 8 years since WHO recognized physical activity communication campaigns as a cost-effec
319、tive“best buy”intervention for NCD prevention(33),there are no agreed global standards or“best practice”criteria by which to assess the quality of such campaigns.These standards do exist for tobacco campaigns(35)and WHO is undertaking the development of similar criteria for physical activity,and pla
320、ns to publish them in late 2022.All countries will be encouraged to apply these criteria to future campaigns and those countries not implementing physical activity campaigns are recommended to start to do so.Future reporting on global progress be it within the global monitoring of countries action t
321、o prevent NCDs and tracking of country progress in implementing GAPPA will apply these criteria to encourage all countries to implement communication campaigns that meet best practice and increase campaign effectiveness.figure 21 National physical activity communication campaigns with links to commu
322、nity-based initiatives,supported by environmental changes and promoting co-benefits,by region and country-income level,2021Percentage of Member StatesLinked to community initiativesSupported by environmental changesPromotes co-benefitsWHO regionsWorld Bank income groups020406080100African RegionRegi
323、on of the AmericasEastern Mediterranean RegionEuropean RegionSouth-East Asia RegionWestern Pacific RegionLow-incomeHigh-incomeLower-middle-incomeUpper-middle-incomeGlobalGLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 2022475.2Mass-participation events on physical activityConducting national mass-particip
324、ation events can engage large numbers of people in physical activity and provide free opportunities for individuals,groups and families to have an enjoyable and social experience while being physically active.Events can provide new experiences and an informal opportunity for people of all ages to tr
325、y out new or different physical activities.National events such as a“car free day”,and national physical activity days,can engage those who are not regularly active and contribute to raising awareness and shifting attitudes,intentions and behaviours towards participating more often.Mass physical act
326、ivity events are usually held in easily accessible locations such as city centres,major parks or public open spaces,or in local streets that are closed to exclude motorized traffic.Events focus on providing an inclusive opportunity and enjoyment,and can attract significant media coverage,thus provid
327、ing additional opportunities and wider reach of health communication messages.Implementing mass physical activity events can foster national and local partnerships and leadership,and support advocacy calls for policy change.It can also potentially mobilize resources to provide tailored initiatives i
328、n local communities.They can be implemented on their own or as part of a larger communication campaign.In 2019 WHO started monitoring countries progress in implementing mass events after its inclusion as a GAPPA policy recommendation(1).In 2021:Just over half of countries(n=108,56%)report implementi
329、ng a national or subnational mass-participation event in the past 2 years to encourage participation in physical activity(see Fig.22).Countries in the European Region(91%),the Western Pacific Region(59%)and the Region of the Americas(51%)report mass-participation events more frequently compared to a
330、round a third of countries in the African Region,the Eastern Mediterranean Region and the South-East Asia Region.The number of countries that report implementing mass-participation events between 2019(n=115,59%)and 2021(n=108,56%)declined in all regions except the European Region.Low-income countrie
331、s report conducting mass-participation events much less(just over 20%)in both 2019 and 2021 compared to all other income groups.GLOBAL STATUS REPORT ON PHYSICAL ACTIVITY 202248figure 22 Trend in national mass-participation events on physical activity,by region,globally and country-income level,2019
332、and 2021Percentage of Member States206080100WHO regionsWorld Bank income groupsAfrican RegionRegion of the AmericasEastern Mediterranean RegionEuropean RegionSouth-East Asia RegionWestern Pacific RegionLow-incomeHigh-incomeLower-middle-incomeUpper-middle-incomeGlobal5.2.1 Discussion Just
333、over a half(56%)of countries report implementing at least one mass-participation event aimed at promoting physical activity in the past 2 years.Holding mass-participation events can provide significant opportunities for engaging the local community and specific populations,capturing national media attention and raising political interest and visibility.The data reported on implementation of mass-p