1193
COMMENTARY
Pratt (michael.pratt@emory.edu) is with the Hubert Dept of Global Health,
Rollins School of Public Health, Emory University, Atlanta, GA. Ramirez
and Martins are students with the Post-graduate program in Epidemiol-
ogy, Universidade Federal de Pelotas, Brazil. Bauman is with the Sydney
School of Public Health, University of Sydney, Australia. Heath is with the
University of Tennessee College of Medicine Chattanooga. Kohl is with the
Dept of Kinesiology and Health Education, Michael and Susan Dell Center
for Healthy Living, University of Texas at Austin. Lee is with the School
of Medicine, Harvard Medical School, and the Harvard T.H. Chan School
of Public Health, Brigham and Women’s Hospital, Boston, MA. Powell
is with the Division of Public Health, Georgia Dept of Human Resources,
Atlanta, GA. Hallal is with the Post-graduate program in Epidemiology,
Universidade Federal de Pelotas, Brazil.
Journal of Physical Activity and Health, 2015, 12, 1193 -1194
http://dx.doi.org/10.1123/jpah.2015-0569
© 2015 Human Kinetics, Inc.
127 Steps Toward a More Active World
Michael Pratt, Andrea Ramirez, Rafaela Martins, Adrian Bauman, Gregory Heath,
Harold Kohl III, I-Min Lee, Kenneth Powell, Pedro Hallal
On December 4, 2015, The Global Observatory for Physi-
cal Activity (http://www.globalphysicalactivityobservatory.com/)
released the irst ever comprehensive country-by-country report
on the status of physical activity surveillance, research, and policy
activities for 127 countries around the world.
1
These countries
account for 81% of the global population and 76% of the world’s
physical activity research publications in PubMed. The 127 country
cards (available in English and 26 of the original languages
I
) include
data on mortality attributable to physical inactivity; as well as the
prevalence of adults participating in physical activity suficient to
promote health, research productivity, and national public health
policy for physical activity (eg, Appendix Figure 1: Country Card
from Japan in English and Japanese).
Physical inactivity accounts for more than 5 million deaths
each year globally.
2
The country cards demonstrate that this
enormous burden of mortality is spread across low, middle, and
high-income countries. The estimated proportion of mortality
due to physical inactivity ranges from a high of 19% in Malta
to 1% in Bangladesh. Self-reported physical activity levels vary
substantially around the world as well, with 6 countries reporting
90% or more of the adult population reaching the 150 minutes/
week recommended by the World Health Organization and 16
countries reporting 40% or less of the population meeting the
physical activity recommendation.
An encouraging 114 countries have at least 1 national survey
on physical activity, although only 31 have some degree of ongoing
surveillance. As physical activity has moved into the mainstream
of public health, the quantity and quality of research has grown. In
2013, papers on physical activity from 105 countries were published.
However, fully 52% of scientiic publications on physical activity
come from only 6 countries (United States, Australia, Canada, Neth-
erlands, Spain, and Germany). The leading 20 countries accounted
for 82% of global physical activity research productivity in 2013,
and the only low- or middle-income countries (LMIC) appearing
on this list were Brazil and China.
Public health action to reduce physical inactivity is manifest
in the incorporation of physical activity into national public health
plans and surveillance systems. Thirty-ive countries have speciic
national plans for physical activity and another 68 countries include
substantive attention to physical activity within their national non-
communicable disease (NCD) prevention or health promotion plans.
Unfortunately, only 12 of the 64 countries classiied as LMIC in
the irst release of country cards have a speciic national plan for
physical activity. Seventy-nine percent of these countries do include
physical activity in their national NCD plans.
The initial release of 127 country cards clearly demonstrates the
scale and extent of the global pandemic of physical inactivity. There is
also good news: half of the countries in the world engage in research
on physical activity, and 103 countries (81%) have initiated public
health efforts to address physical inactivity as evidenced by inclusion
of physical activity within national public health plans or policies.
In terms of surveillance, 114 (90%) have included physical activity
at least once in a national survey. These are important initial steps
along a dificult path. The Global Observatory for Physical Activity
will continue to monitor progress against the pandemic of physical
inactivity and will release country-speciic cards every 2 years.
Acknowledgments
Without the input, review, and support of the contact persons in each of the
included countries, the country cards could not have been completed. We
also acknowledge important support from Cíntia Borges, Silvia Pinto, and
Paulo Ferreira of the Federal University of Pelotas, Brazil, and the Board
of the International Society for Physical Activity and Health.
Notes
I
All the country cards are available in English and also, if the contact agreed,
each card was translated into its original language (26 original languages: Arabic,
Bulgarian Chinese, Croatian, Czech, Danish, Dutch, French, German, Greek,
Greenlandic, Hungarian, Italian, Japanese, Lithuanian, Macedonian, Maori,
Nepalese, Polish, Portuguese, Rumanian, Russian, Spanish, Swedish, Slovak,
Welsh). Although this commentary appears in the September issue of the Journal
of Physical Activity and Health, the actual timing of publication followed that
of The Global Observatory for Physical Activity’s release of country cards.
References
1. Hallal P, Martins R, Ramírez A. The Lancet Physical Activity Observa-
tory: promoting physical activity worldwide. Lancet. 2014;384:471–
472. PubMed doi:10.1016/S0140-6736(14)61321-0
2. Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk
PT. Effect of physical inactivity on mayor non-communicable dis-
eases worldwide: an analysis of burden of disease and life expec-
tancy. Lancet. 2012;219:219–229. PubMed doi:10.1016/S0140-
6736(12)61031-9