Time to tackle the physical activity gender gap
Authors: None The Lancet Public Health
Journal: The Lancet Public Health (2019)

2019 might well be the year of women's sport. While coverage has long been overshadowed by the male leagues, viewing opportunities and public engagement has been growing. Public excitement perhaps peaked during the Women's Football World Cup, with television audiences across the world increased by millions on previous years. As female athletes challenge inequalities over pay and investment and shift social expectations, could their example be used to tackle the gender gap in physical activity in the wider population? Insufficient physical activity is a leading risk factor for non-communicable diseases and can also negatively affect mental health and quality of life. WHO recognises physical inactivity as a serious and growing public health problem and aims to reduce it by 10% by 2025. An analysis published in The Lancet Global Health, in 2018, found that more than a quarter of adults globally are insufficiently physically active. Across most countries, women are less active than men (global average of 31·7% for inactive women vs 23·4% for inactive men). Policies that tackle the gender gap in physical activity could therefore have a substantial impact on overall population health. The barriers to women's involvement in sports are numerous and complex. The physical activity gap between boys and girls begins early. A report from Sport England found that girls aged 3–11 years experienced less enjoyment from being physically active and less confidence in their sporting ability than boys as they got older. Children's exposure to narrow gender norms around boy's versus girl's activities and a failure to adapt the types of sports offered can instil this lack of enjoyment and body confidence, and in turn shape attitudes to physical activity into adulthood. Indeed, many women are put off by certain physical activities over concerns about stereotypes, because of insecurities around body image, or feeling constrained by cultural acceptability. Women and girls' sport generally receives less investment at the grassroots level—including access to equipment, transport, and coaching, and to safe and welcoming facilities. Women still often play the lead role in childcare and managing households—for many, in addition to paid work—which means they generally have less leisure time. Addressing the gender gap in physical activity could therefore start with better access, investment, and shifting sociocultural norms. Changes to the built environment and providing exercise facilities to the public is one approach, and some evidence suggests that more walkable cities had lower gender gaps in physical activity. However, built environment is not the whole picture. The study by Claire Nightingale and colleagues in this issue of The Lancet Public Health found that residents who moved to a neighbourhood created along active design principles (the former London 2012 Olympic and Paralympic Games Athletes' Village) showed no significant increase in their average physical activity. Changes in urban environment should probably be accompanied by community and behavioural public health interventions. One example of a promising intervention has been the This Girl Can campaign in England. Launched in 2015, the multimedia campaign focused on projecting an inclusive, positive message about physical activity and could have helped an estimated 3 million women and girls become more physically active. However, such campaigns still face the challenge of widening participation to reach women from low income and from ethnic minority backgrounds. Adapting interventions and opportunities to these groups will be important. It is also unclear to what extent such a campaign might be adapted to low-income or middle-income countries—and this should be the focus of future research. The universality of sport offers an opportunity to challenge social and cultural norms on a large scale and narrow the gender gap. By making female athletic success more visible, girls and their parents can aspire for them to be professional athletes or simply to take part in whatever physical activity they enjoy. A greater audience for women's professional sport could mean more investment in grassroots and crucially, visibility of women at all sporting levels. Ultimately, if current trends continue, the 2025 global physical activity target of a 10% relative reduction in insufficient physical activity will not be met. Multi-sectoral approaches to increase physical activity need to be prioritised urgently. Public health professionals and policy makers should capitalise on moments like the Women's World Cup to encourage and support all to be physically active. It can't be a missed opportunity. Increasing physical activity and equity in urban regenerationThe rising burden of non-communicable diseases has prompted greater consideration of the physical environment in both causing and preventing disease. WHO attributed 23% of global deaths in 2012 to the environment, including modifiable exposures such as air and noise pollution, poor-quality housing, and land use patterns.1 The construction of new homes and communities marks an important opportunity to integrate health promoting design measures at several scales: within buildings, across a neighbourhood, and through the design of new settlements. Full-Text PDF Open AccessThe effect of moving to East Village, the former London 2012 Olympic and Paralympic Games Athletes' Village, on physical activity and adiposity (ENABLE London): a cohort studyDespite large improvements in neighbourhood perceptions and walkability, we found no clear evidence that moving to East Village was associated with increased physical activity. Improving the built environment on its own might be insufficient to increase physical activity. Full-Text PDF Open Access