Physical activity security: is it time to "change the conversation" for environmental justice in Lower- and Middle-Income Country Settings?
1
School of Health and Medical Sciences, Faculty of Health, Engineering and Sciences,, University of Southern Queensland, Ipswich, Australia
2
Research Centre for Health through Physical Activity, Lifestyle and Sport, University of Cape Town, Newlands, South Africa
3
School of Public Health, Faculty of Medicine,, University of Queensland, Queensland, Australia
Popul. Med. 2026;8(Supplement Supplement 1):A1386
ABSTRACT
INTRODUCTION:
While the relationship between physical activity (PA) and health has been well-established. the link between PA and sustainable development is more recent phenomenon. PA has been described as “choice-based” or “necessity-driven”(1), but we argue that environmental justice is needed for PA security(2) to be achieved in LMICs.
METHODS:
We conducted a brief review (SCOPUS,1994-2024), in which “Physical Activity” was used in combination with terms “Health”,”Behaviour”,“Environment”,“Policy”,“Social determinants”,“Equity”,“Sustainable development”and“Human Rights”. Secondly, we explored publicly available data (143 countries;LMIC/UMIC,N=99,HIC,N=44) including: GINI,HDI,%urban,% living in slums,life expectancy, obesity, %,deaths due to cardiovascular disease (CVD),road deaths, personal violence%,pollution, public open space (POS),human rights indices and physical inactivity (PiA). Regression analyses were conducted on factors related to environmental justice that may explain differences in PiA in HIC vs LMIC/UMIC settings.
RESULTS:
In 1994,858 manuscripts related to PA were cited compared to 30565 in 2024.PA and health articles comprised 40-41% overall,whereas those related to the environment were 3.9% and 6.4%,respectively. Policy-related outputs comprised <4%,social determinants <2% and human rights <1%,even in 2024. PiA prevalence was higher in HIC (33%) vs LMIC/UMIC (25%,P<0.001). Urbanisation,POS,obesity,CVD deaths%,and life expectancy were also significantly higher. In LMIC/UMIC,deaths from air pollution, violence and road incidents were higher (P<0.001); PiA was inversely correlated to %slum dwelling (P<0.001) and positively correlated to %urbanisation. In HIC,PiA was inversely associated with POS (r=-0.46)but in LMIC/UMIC was positively associated with POS (r=0.37, P<0.001). PiA in HIC was positively mediated by %urbanisation, whereas, in LMIC/UMIC,PiA was inversely mediated by %slum dwelling and personal violence(P<0.001).
CONCLUSIONS:
Results suggest that built environment attributes impact on PiA differently in HIC vs LMIC/UMIC settings.Slum dwelling persons from vulnerable communities in LMIC/UMIC settings are more physically active, reflecting “necessity-driven vs “choice-based” PA. Further, POS may not address environmental equity in LMIC/UMICs. PA security should be considered as a rights-based issue for urban planners and policy makers.
While the relationship between physical activity (PA) and health has been well-established. the link between PA and sustainable development is more recent phenomenon. PA has been described as “choice-based” or “necessity-driven”(1), but we argue that environmental justice is needed for PA security(2) to be achieved in LMICs.
METHODS:
We conducted a brief review (SCOPUS,1994-2024), in which “Physical Activity” was used in combination with terms “Health”,”Behaviour”,“Environment”,“Policy”,“Social determinants”,“Equity”,“Sustainable development”and“Human Rights”. Secondly, we explored publicly available data (143 countries;LMIC/UMIC,N=99,HIC,N=44) including: GINI,HDI,%urban,% living in slums,life expectancy, obesity, %,deaths due to cardiovascular disease (CVD),road deaths, personal violence%,pollution, public open space (POS),human rights indices and physical inactivity (PiA). Regression analyses were conducted on factors related to environmental justice that may explain differences in PiA in HIC vs LMIC/UMIC settings.
RESULTS:
In 1994,858 manuscripts related to PA were cited compared to 30565 in 2024.PA and health articles comprised 40-41% overall,whereas those related to the environment were 3.9% and 6.4%,respectively. Policy-related outputs comprised <4%,social determinants <2% and human rights <1%,even in 2024. PiA prevalence was higher in HIC (33%) vs LMIC/UMIC (25%,P<0.001). Urbanisation,POS,obesity,CVD deaths%,and life expectancy were also significantly higher. In LMIC/UMIC,deaths from air pollution, violence and road incidents were higher (P<0.001); PiA was inversely correlated to %slum dwelling (P<0.001) and positively correlated to %urbanisation. In HIC,PiA was inversely associated with POS (r=-0.46)but in LMIC/UMIC was positively associated with POS (r=0.37, P<0.001). PiA in HIC was positively mediated by %urbanisation, whereas, in LMIC/UMIC,PiA was inversely mediated by %slum dwelling and personal violence(P<0.001).
CONCLUSIONS:
Results suggest that built environment attributes impact on PiA differently in HIC vs LMIC/UMIC settings.Slum dwelling persons from vulnerable communities in LMIC/UMIC settings are more physically active, reflecting “necessity-driven vs “choice-based” PA. Further, POS may not address environmental equity in LMIC/UMICs. PA security should be considered as a rights-based issue for urban planners and policy makers.
| eISSN: | 2654-1459 |
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