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Beyond Exercise
Prescription to Advocating for Active Living Why
Aren’t Canadians More Active? Despite the irrefutable evidence linking
physical activity with physiological and psychosocial health benefits for
people of all ages (Bouchard, 2001), Canadians find little time to be
physically active. Approximately 57–64% of all Canadians are not active
enough to reap health benefits (Canadian Fitness and Lifestyle Research
Institute, 1999; Federal, Provincial, and Territorial Advisory Committee
on Population Health, 1999). Of all the health practices needing change in
their lives, Canadians cite physical activity the most often (Federal,
Provincial, and Territorial Advisory Committee on Population Health,
1999). Canadians seem to know that they should be more physically active, but concerns of cost, safety, time, accessibility (as well as a lack of opportunities appropriate to culture, gender, age, and skill) thwart even the best intentions (Canadian Fitness and Lifestyle Research Institute, 1999). As McGinnis points out, much of the difficulty lies in the “paradox of self-responsibility: even if we know the power of regular physical activity with respect to physical and mental health benefits, formidable barriers may reside in our work, family, neighborhood, and cultural circumstances” (McGinnis, 2001, p. 393). The
Bigger Picture As Lyons and Langille (2000) suggest, fostering a physically active lifestyle requires much more than simply giving people knowledge and information about the right thing to do. Greater success comes from more comprehensive approaches that combine creating supportive environments through advocacy and public policy and community-level initiatives that involve multiple stakeholders and citizens’ participation. Rather than focusing on risk factors, we need to emphasize coping skills and resources and to strengthen community policies and opportunities that facilitate and support decisions to be physically active (e.g., Frisby & Fenton, 1998; Wharf Higgins & Reed, 2001). Social policies to create subsidized recreation services, quality daily physical education, community playgrounds, or bike paths are all examples of community-wide “interventions” that can nurture an active population. In BC, Surrey’s urban environment supports recreational and commuter walking and cycling—an initiative that has increased levels of physical activity (Hunter, 2001). Similarly, an American study found that developing walking trails fostered active living among previously sedentary single parents (Brownson et al., 2000). The
Social-Determinants Approach
We also need to acknowledge that physical activity may not be a priority for some people experiencing poverty, abuse, discrimination, or social exclusion/isolation. While physical activity can help people to work through such issues, they may be more likely to attend for the supportive and social aspects—not to lose weight or lower blood pressure. The traditional principles guiding exercise prescription (frequency, intensity, and duration) have worked wonders in encouraging motivated Canadians (who have access to the required resources) to adopt an active lifestyle. Yet, if we do not consider the broader circumstances that influence life choices, these traditional principles can become simply a set of external rules or expectations imposed on people. Achieving a positive prognosis for active living means expanding our role as practitioners to advocate for changes in the physical, social, and economic settings that influence physical activity. |
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In
addition to overcoming personal, social, and psychological hurdles, policy
and environmental factors may also hinder efforts to be active (Centers
for Disease Control and Prevention, 2001; Canadian Fitness and Lifestyle
Research Institute, 1999; Wen et al., 2002). Although we don’t really
know much about the impact of minimizing environmental barriers, such as
building design and safety (Booth et al., 2001; Centers for Disease
Control and Prevention, 2001), the very few studies on the links between
physical settings and physical activity have emphasized the importance of
exercise equipment in homes (Sallis, Johnson, Calfas, Caparosa, &
Nichols, 1997), and issues of aesthetics, safety, and proximity to
facilities (Pikora, Giles-Corti, Bull, Jamrozik, & Donovan, in press).