As part of the nine global noncommunicable disease targets, WHO member states in 2013 committed to reducing insufficient physical activity by 2025. The hope was to decrease the prevalence of NCDs such as cardiovascular disease, hypertension, diabetes, and breast and colon cancer.
While combating NCDs is a global task, regional contexts cause unique challenges. In this visual series, we explore a few of these challenges through the stories of health care workers and individuals living with NCDs in three different countries.
“Overall these targets were set to reduce the global burden of NCDs because it’s getting bigger and bigger. Most of the people that die worldwide die from an NCD,” said Regina Guthold of WHO’s Department for Prevention of Noncommunicable Diseases, a lead author on the study.
“Many of them die prematurely or suffer for many years from an NCD, so of course we want to help the world relieve this burden, so physical activity is one way of addressing it.”
The study, published in the Lancet, compiled data from 358 surveys across 168 countries that included 1.9 million participants. Only studies that tracked all forms of physical activity — at work, at home, for transport, and during leisure time — were used to ensure the data could be compared in a scientifically sound way. WHO defines sufficient physical activity as 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity physical activity, or a combination of the two, each week.
“Before we did this study, we didn’t know much about where the world or where regions are actually going with their activity levels. Nothing was known about global or regional trends, so we couldn’t make any statements if we were on track to meet this target or not,” Guthold said. “The study, first of all, has shown that very many adults worldwide are not active enough, which [means] one in four men and one in three women are not reaching the WHO recommendations.”
Women had lower activity levels than men, with 23.4 percent of men versus 31.7 percent of women reporting insufficient levels of physical activity. Guthold said there are many possible explanations for this, including the fact that in many countries, women still occupy traditional roles that require them to be home caring for children and the house, and the cultural belief that women are not supposed to be physically active.
“Another reason is that with the global urbanization and some other developments, sometimes the environment, especially in bigger cities, for example, is too dangerous for women to go out and be active,” Guthold said, noting that bigger cities in particular need to make a conscious effort to create environments safe for women.
The highest levels of insufficient physical activity in 2016 were women in Latin America and the Caribbean (43.7 percent), South Asia (43 percent), and high-income Western countries (42 percent). The lowest levels were found in men in Oceania (12.3 percent), East and Southeast Asia (17.6 percent), and sub-Saharan Africa (17.9 percent). Prevalence of insufficient activity was more than twice as high in high-income countries (36.8 percent) than low-income countries (16.2 percent).
In June, WHO published the Global Action Plan for Physical Activity 2018-2030. The plan notes that in addition to the reduction in NCDs that comes from increased physical activity, it can also help in meeting other Sustainable Development Goals by reducing use of fossil fuels and safer, less congested roads. The action plan was created after WHO member countries expressed a desire for more direct guidance on reducing insufficient physical activity, and provides a framework for policy actions that can be taken to assist those efforts.
Guthold said the study was an indicator that more data needed to be collected to understand where global trends in physical activity are heading. It found that “accelerated action” is needed to reverse increasing trends in insufficient physical activity in high-income Western countries, Central and Eastern Europe, Latin America and the Caribbean, and South Asia.
“This is something that not the health sector alone can do. It needs to involve the transport sector, for example, to build roads that are friendly for cyclists and people who want to walk, urban planners need to be engaged. The education sector needs to be engaged in order for children to be more active,” Guthold said. “So it’s a whole range of sectors that need to be involved in this work.”
For more coverage of NCDs, visit the Taking the Pulse series here.