Skip to main content
Top
Published in: Sports Medicine 4/2019

01-04-2019 | Current Opinion

Equity in Physical Activity: A Misguided Goal

Author: James L. Nuzzo

Published in: Sports Medicine | Issue 4/2019

Login to get access

Abstract

Rates of participation in physical activity are often not the same between groups in a given demographic category. These differences have been termed ‘inequities,’ and major health organizations are advocating large-scale initiatives to create ‘equity’ in physical activity. The aim of this paper is to explain why equity in physical activity is a misguided goal. Equity is a misguided goal because it ignores absolute rates of physical activity (i.e., it is a metric of how one group compares with another), and because it is an automated goal that ignores sizes of ‘gaps’ between groups. Moreover, equity initiatives incorrectly assume that groups with relatively high physical activity rates are always at lower health risk; that non-targeted groups will remain static in their levels of physical activity; that individuals are part of only one demographic category; that complete equity can be achieved; that the causal relationship between equity initiatives and their desired outcome can be known; and that differences in physical activity rates between groups are due to differences in ‘opportunity.’ Due to these issues, health organizations should abandon the goal of equity. Instead, they should aim to increase physical activity in groups that are most sedentary and/or at greatest health risk to a level that is as high as is feasible and possible, irrespective of how that new level compares with other groups. This goal is objective and not based on the misguided premises that underpin the current equity narrative.
Literature
1.
go back to reference Pedersen BK, Saltin B. Exercise as medicine—evidence for prescribing exercise as therapy in 26 different chronic diseases. Scand J Med Sci Sports. 2015;25(Suppl 3):1–72.CrossRefPubMed Pedersen BK, Saltin B. Exercise as medicine—evidence for prescribing exercise as therapy in 26 different chronic diseases. Scand J Med Sci Sports. 2015;25(Suppl 3):1–72.CrossRefPubMed
2.
go back to reference Centers for Disease Control and Prevention. Adult participation in aerobic and muscle-strengthening physical activities—United States, 2011. MMWR Morb Mortal Wkly Rep. 2013;62(17):326–30. Centers for Disease Control and Prevention. Adult participation in aerobic and muscle-strengthening physical activities—United States, 2011. MMWR Morb Mortal Wkly Rep. 2013;62(17):326–30.
3.
go back to reference Hasson RE, Brown DR, Dorn J, Barkley L, Torgan C, Whitt-Glover M, et al. Achieving equity in physical activity participation: ACSM experience and next steps. Med Sci Sports Exerc. 2017;49(4):848–58.CrossRefPubMed Hasson RE, Brown DR, Dorn J, Barkley L, Torgan C, Whitt-Glover M, et al. Achieving equity in physical activity participation: ACSM experience and next steps. Med Sci Sports Exerc. 2017;49(4):848–58.CrossRefPubMed
6.
go back to reference World Health Organization—Regional Office for Europe. Physical activity strategy for the WHO European Region 2016–2025. Copenhagen, Denmark: World Health Organization—Regional Office for Europe; 2016. World Health Organization—Regional Office for Europe. Physical activity strategy for the WHO European Region 2016–2025. Copenhagen, Denmark: World Health Organization—Regional Office for Europe; 2016.
7.
go back to reference Coen S, Subedi RP, Rosenberg MW. Working out across Canada: is there a gender gap? Can Geogr. 2016;60(1):69–81.CrossRef Coen S, Subedi RP, Rosenberg MW. Working out across Canada: is there a gender gap? Can Geogr. 2016;60(1):69–81.CrossRef
8.
go back to reference Mielke GI, da Silva ICM, Kolbe-Alexander TL, Brown WJ. Shifting the physical inactivity curve worldwide by closing the gender gap. Sports Med. 2018;48(2):481–9.CrossRefPubMed Mielke GI, da Silva ICM, Kolbe-Alexander TL, Brown WJ. Shifting the physical inactivity curve worldwide by closing the gender gap. Sports Med. 2018;48(2):481–9.CrossRefPubMed
9.
go back to reference World Health Organization. Social determinants approaches to public health: from concept to practice. Geneva: World Health Organization; 2011. World Health Organization. Social determinants approaches to public health: from concept to practice. Geneva: World Health Organization; 2011.
10.
11.
go back to reference Loprinzi PD, Loenneke JP, Ahmed HM, Blaha MJ. Joint effects of objectively-measured sedentary time and physical activity on all-cause mortality. Prev Med. 2016;90:47–51.CrossRefPubMed Loprinzi PD, Loenneke JP, Ahmed HM, Blaha MJ. Joint effects of objectively-measured sedentary time and physical activity on all-cause mortality. Prev Med. 2016;90:47–51.CrossRefPubMed
12.
go back to reference Moore SC, Lee IM, Weiderpass E, Campbell PT, Sampson JN, Kitahara CM, et al. Association of leisure-time physical activity with risk of 26 types of cancer in 1.44 million adults. JAMA. Intern Med. 2016;176(6):816–25. Moore SC, Lee IM, Weiderpass E, Campbell PT, Sampson JN, Kitahara CM, et al. Association of leisure-time physical activity with risk of 26 types of cancer in 1.44 million adults. JAMA. Intern Med. 2016;176(6):816–25.
13.
go back to reference Schnohr P, Lange P, Scharling H, Jensen JS. Long-term physical activity in leisure time and mortality from coronary heart disease, stroke, respiratory diseases, and cancer. The Copenhagen City Heart Study. Eur J Cardiovasc Prev Rehabil. 2006;13(2):173–9.CrossRefPubMed Schnohr P, Lange P, Scharling H, Jensen JS. Long-term physical activity in leisure time and mortality from coronary heart disease, stroke, respiratory diseases, and cancer. The Copenhagen City Heart Study. Eur J Cardiovasc Prev Rehabil. 2006;13(2):173–9.CrossRefPubMed
14.
go back to reference Villeneuve PJ, Morrison HI, Craig CL, Schaubel DE. Physical activity, physical fitness, and risk of dying. Epidemiology. 1998;9(6):626–31.CrossRefPubMed Villeneuve PJ, Morrison HI, Craig CL, Schaubel DE. Physical activity, physical fitness, and risk of dying. Epidemiology. 1998;9(6):626–31.CrossRefPubMed
15.
go back to reference Arias E, Heron M, Xu J. United States life tables, 2014. Natl Vit Stat Rep. 2017;66(4):1–64. Arias E, Heron M, Xu J. United States life tables, 2014. Natl Vit Stat Rep. 2017;66(4):1–64.
16.
go back to reference Wang H, Dwyer-Lindgren L, Lofgren KT, Rajaratnam JK, Marcus JR, Levin-Rector A, et al. Age-specific and sex-specific mortality in 187 countries, 1970–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2071–94.CrossRefPubMed Wang H, Dwyer-Lindgren L, Lofgren KT, Rajaratnam JK, Marcus JR, Levin-Rector A, et al. Age-specific and sex-specific mortality in 187 countries, 1970–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2071–94.CrossRefPubMed
17.
go back to reference Heron M. Deaths: leading causes for 2015. Natl Vit Stat Rep. 2017;66(5):1–76. Heron M. Deaths: leading causes for 2015. Natl Vit Stat Rep. 2017;66(5):1–76.
18.
go back to reference Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, et al. Heart disease and stroke statistics-2017 update: a report from the American Heart Association. Circulation. 2017;135(10):e146–603.CrossRefPubMedPubMedCentral Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, et al. Heart disease and stroke statistics-2017 update: a report from the American Heart Association. Circulation. 2017;135(10):e146–603.CrossRefPubMedPubMedCentral
19.
go back to reference Schnohr P, Scharling H, Jensen JS. Changes in leisure-time physical activity and risk of death: an observational study of 7,000 men and women. Am J Epidemiol. 2003;158(7):639–44.CrossRefPubMed Schnohr P, Scharling H, Jensen JS. Changes in leisure-time physical activity and risk of death: an observational study of 7,000 men and women. Am J Epidemiol. 2003;158(7):639–44.CrossRefPubMed
20.
go back to reference Wannamethee SG, Shaper AG, Walker M. Changes in physical activity, mortality, and incidence of coronary heart disease in older men. Lancet. 1998;351(9116):1603–8.CrossRefPubMed Wannamethee SG, Shaper AG, Walker M. Changes in physical activity, mortality, and incidence of coronary heart disease in older men. Lancet. 1998;351(9116):1603–8.CrossRefPubMed
21.
go back to reference Hasson RE, Brown DR, Dorn J, Barkley L, Torgan C, Whitt-Glover M, et al. Response. Med Sci Sports Exerc. 2018;50(6):1342–3.CrossRefPubMed Hasson RE, Brown DR, Dorn J, Barkley L, Torgan C, Whitt-Glover M, et al. Response. Med Sci Sports Exerc. 2018;50(6):1342–3.CrossRefPubMed
22.
go back to reference Asano M, Duquette P, Andersen R, Lapierre Y, Mayo NE. Exercise barriers and preferences among women and men with multiple sclerosis. Disabil Rehabil. 2013;35(5):353–61.CrossRefPubMed Asano M, Duquette P, Andersen R, Lapierre Y, Mayo NE. Exercise barriers and preferences among women and men with multiple sclerosis. Disabil Rehabil. 2013;35(5):353–61.CrossRefPubMed
23.
go back to reference Bopp M, Wilcox S, Oberrecht L, Kammermann S, McElmurray CT. Correlates of strength training in older rural African American and Caucasian women. Women Health. 2004;40(1):1–20.CrossRefPubMed Bopp M, Wilcox S, Oberrecht L, Kammermann S, McElmurray CT. Correlates of strength training in older rural African American and Caucasian women. Women Health. 2004;40(1):1–20.CrossRefPubMed
24.
go back to reference Burton E, Farrier K, Lewin G, Pettigrew S, Hill AM, Airey P, et al. Motivators and barriers for older people participating in resistance training: a systematic review. J Aging Phys Act. 2017;25(2):311–24.CrossRefPubMed Burton E, Farrier K, Lewin G, Pettigrew S, Hill AM, Airey P, et al. Motivators and barriers for older people participating in resistance training: a systematic review. J Aging Phys Act. 2017;25(2):311–24.CrossRefPubMed
25.
go back to reference Joseph RP, Ainsworth BE, Keller C, Dodgson JE. Barriers to physical activity among African American women: an integrative review of the literature. Women Health. 2015;55(6):679–99.CrossRefPubMedPubMedCentral Joseph RP, Ainsworth BE, Keller C, Dodgson JE. Barriers to physical activity among African American women: an integrative review of the literature. Women Health. 2015;55(6):679–99.CrossRefPubMedPubMedCentral
26.
go back to reference Zunft HJ, Friebe D, Seppeit B, Widhalm K, Remaut de Winter AM, Vaz de Almeida MD. Perceived benefits and barriers to physical activity in a nationally representative sample in the European Union. Public Health Nutr. 1999;2(1A):153–60.CrossRefPubMed Zunft HJ, Friebe D, Seppeit B, Widhalm K, Remaut de Winter AM, Vaz de Almeida MD. Perceived benefits and barriers to physical activity in a nationally representative sample in the European Union. Public Health Nutr. 1999;2(1A):153–60.CrossRefPubMed
27.
go back to reference Egli T, Bland HW, Melton BF, Czech DR. Influence of age, sex, and race on college students’ exercise motivation of physical activity. J Am Coll Health. 2011;59(5):399–406.CrossRefPubMed Egli T, Bland HW, Melton BF, Czech DR. Influence of age, sex, and race on college students’ exercise motivation of physical activity. J Am Coll Health. 2011;59(5):399–406.CrossRefPubMed
28.
go back to reference Allan JD, Mayo K, Michel Y. Body size values of white and black women. Res Nurs Health. 1993;16(5):323–33.CrossRefPubMed Allan JD, Mayo K, Michel Y. Body size values of white and black women. Res Nurs Health. 1993;16(5):323–33.CrossRefPubMed
29.
go back to reference Harris MB, Walters LC, Waschull S. Gender and ethnic differences in obesity-related behaviors and attitudes in a college sample. J Appl Soc Psychol. 1991;21(19):1545–66.CrossRef Harris MB, Walters LC, Waschull S. Gender and ethnic differences in obesity-related behaviors and attitudes in a college sample. J Appl Soc Psychol. 1991;21(19):1545–66.CrossRef
30.
go back to reference Kemper KA, Sargent RG, Drane JW, Valois RF, Hussey JR. Black and white females’ perceptions of ideal body size and social norms. Obes Res. 1994;2(2):117–26.CrossRefPubMed Kemper KA, Sargent RG, Drane JW, Valois RF, Hussey JR. Black and white females’ perceptions of ideal body size and social norms. Obes Res. 1994;2(2):117–26.CrossRefPubMed
31.
go back to reference Stevens J, Kumanyika SK, Keil JE. Attitudes toward body size and dieting: differences between elderly black and white women. Am J Public Health. 1994;84(8):1322–5.CrossRefPubMedPubMedCentral Stevens J, Kumanyika SK, Keil JE. Attitudes toward body size and dieting: differences between elderly black and white women. Am J Public Health. 1994;84(8):1322–5.CrossRefPubMedPubMedCentral
32.
go back to reference Baker LC. Differences in earnings between male and female physicians. N Engl J Med. 1996;334:960–4.CrossRefPubMed Baker LC. Differences in earnings between male and female physicians. N Engl J Med. 1996;334:960–4.CrossRefPubMed
Metadata
Title
Equity in Physical Activity: A Misguided Goal
Author
James L. Nuzzo
Publication date
01-04-2019
Publisher
Springer International Publishing
Published in
Sports Medicine / Issue 4/2019
Print ISSN: 0112-1642
Electronic ISSN: 1179-2035
DOI
https://doi.org/10.1007/s40279-018-0959-4

Other articles of this Issue 4/2019

Sports Medicine 4/2019 Go to the issue