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However, we do need a paradigm shift in the way we think about hospitals. On a one-to-one level they can use their many contacts with patients to encourage activity that is appropriate to the individual’s needs.(15) Also, as members of groups, employers, and leaders in communities doctors could act as advocates for change both in relation to the population and the environment.Ī key recommendation in the BMA report and one that we fully endorse is that the NHS should act as an “anchor institution to encourage and facilitate active travel and set an example for other employers.”(2) If this was undertaken, we believe that there would be health dividends for many including staff, patients and other community members.
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There are many NHS staff who could be involved in promoting and supporting physical activity, and doctors could play leading roles in the fight against sedentary lifestyles.(5,7,15) They are unique in being trusted and often see individuals at critical times. However, in relation to women, much more still needs to be done in a range of settings including schools, workplaces and hospitals.(9,14) They are also working to improve the funding landscape. One organisation that has been working hard to use the power of sport to accelerate gender equality and stimulate social change is the Women’s Sport Trust.(13) Since its inception this charity has helped to increase positive media coverage of a diverse group of female athletes and this is likely to encourage more to participate in a range of sports. Schools can encourage participation through structured activity in the curriculum including physical education and sport, but also those other physical leisure activities available in school and in the community should be promoted.(10,11) Any activity which enables children and young people to be warm and breathless for significant periods of time which they enjoy, and overcomes the barriers to participation brought about by disability, gender, religion and culture, should be valued.(12) The BMA report quite rightly highlights the considerable inequalities in the levels of physical activity that people undertake and these include ones in relation to age, disability, ethnic group and gender.(2) The physical environment and social barriers (both real and perceived), need to be changed so that individuals are more likely to take part in activities.
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The current case for promoting physical activity is strong.(5-9) Regular exercise can bring dramatic health benefits: generally promoting health preventing many serious and common conditions and improving the health of those with certain chronic conditions.(2,7) There is now evidence for a wide range of conditions including cardiovascular health, obesity, diabetes, dementia, osteoporosis and falls in the elderly.(2,7) The BMA is right to call for urgent changes to improve low levels of physical activity and we fully agree that sufficient effective national action is now required to reduce disparities.(1,2) In line with the Ottawa Charter for Health Promotion, what is needed is policy actions aimed at improving social, economic and environmental factors that support physical activity, combined with individually focused approaches.(3,4)