Policy priorities

Priority 1: Transform environments through a multi-system approach to promote equitable opportunities for increased physical activity among all Australians.

To effectively boost physical activity participation, comprehensive and multifaceted policy approaches are essential.^1,2 A holistic approach to promoting physical activity includes various sectors such as health, urban planning, sports, transport, education, and private sector, with the most up-to-date evidence supporting this approach. Studies have demonstrated participation in physical activity is influenced by where people live, their socioeconomic status, and the presence of appropriate spaces for physical activity. A well-designed physical environment supports increased physical activity levels and promote public health, including reducing cancer risk.³ Environmental approaches to promoting an active lifestyle are particularly efficacious as they can be introduced across various settings and environments to reach those at greater risk of inactivity due to their socioeconomic status.⁴

The development of infrastructure and policies that transform the physical environment and facilitate active transport is crucial for promoting physical activity and achieving sustainability goals. Implementation of Sustainable Urban Mobility Plans (SUMPs) are effective at increasing physical activity as well as preventing cancer, obesity, and chronic diseases.^5,6

Consistent evidence suggests that built environment attributes plays a significant role in encouraging active transport among adults and children.^7-10 This includes urban planning elements, green spaces, street-level features, dedicated walking and cycling paths and safe road crossing infrastructure throughout the community that connects schools, workplaces, shopping areas and recreational spaces.

Evidence suggests that 'walkable' environments are associated with decreased rates of obesity and higher levels of physical activity which have been established as protective factors for cancer.⁹ Key characteristics of a walkable environment include mixed land use to increase destinations within a walkable distance, higher residential density, street connectivity and design, availability of footpaths, attractive surrounds, and perceptions that the environment is safe.^7,11-13 Walkable environments may be especially important for increasing physical activity in older adults (65 years and older).¹⁴

Furthermore, numerous studies strongly support the idea that active transport such as walking or cycling to school or other destinations has positive effects on the health of children and adults.^6,15 Active journeys to school and work are low-cost and introduce activity before and after significant time spent sitting in most schools and workplaces. Active transport can also improve air quality (with its own benefit to health).¹⁶

Achieving a more supportive environment for walking and cycling requires investment in transport infrastructure to provide safe and pleasant options. Active transport investment is found in transport budgets and is often justified by the co-benefits of mitigating climate change through the reduction in carbon emissions and conservation of energy.¹⁷ Prioritising active transport infrastructure and policies, ensuring they are accessible and desirable, is a fundamental step towards healthier, more sustainable, and more liveable communities for all.

A key aspect when creating a supportive environment for physical activity participation is ensuring it features sun protection measures to avoid harmful exposure to UV radiation. Organisations, such as schools, sporting and community groups, and workplaces have a duty of care to provide a safe environment for everyone involved. ^18,19 Sun protection policies are a useful tool to ensure an organisation is supporting the community to improve their own sun protection behaviours and reduce their risk of skin cancer. It should feature the key elements of scheduling training, events and games outside of peak UV times, promoting sun safety when UV levels are 3 or above, utilising available shade structures as well as encouraging people to bring their own and the provision of sun protection items.^19,20

Supporting healthy food environments by ensuring unhealthy food marketing and persuasive content of marketing messages is limited, particularly in the sporting environment can considerably contribute to better health outcomes for all Australians. Food marketing is effective at directing an individual’s preferences, choices and consumption of products, while exposure to alcohol marketing has the potential to encourage hazardous alcohol consumption in young people.^21,22 Sport sponsorship forms part of a broader marketing strategy to boost sales, amplify corporate image and establish brand awareness by linking the positive feelings towards a particular sport, event or team with the sponsoring brand.²³

Research has found that children can frequently identify the junk food, alcohol and gambling brands associated with various sporting teams, and exposure to food sponsorship increases positive attitudes to brands in young people.^24-25 A 2015 Australian study found that 27% of the brands sponsoring cricket included unhealthy food and drink products, alcohol products and gambling.²⁶ There have been targeted calls for action to restrict sponsorship by brands of health-harming products in Australian sport settings.^27,28 In Australia, there is public support for action of governments to restrict sports sponsorships by brands of health-harming products.^29-33 If enacted these restrictions will align with the United Nation’s Sustainable Development Goal Three to ensure good health and wellbeing.³⁴

Priority 2: Promote Australia’s physical activity guidelines

It is important to create a culture of holistic health promotion alongside the existing exercise recommendations to effectively encourage physical activity in Australia. Australia has demonstrated a strong commitment to the promotion of healthier lifestyles and the well-being of its citizens across all age groups.¹ However, presently a significant proportion of Australians fail to meet recommended guidelines for physical activity, resulting in significant health concerns.¹ To enhance public health and mitigate the burden of cancer and other diseases, Australia must prioritise the implementation and promotion of the physical activity and exercise guidelines for all Australians as a fundamental component of its public health initiatives.^2,3 Encouraging Australians to adopt this comprehensive approach of balancing physical activity, sedentary behaviour, and sleep (for children) can lead to improved overall health and well-being while recognising that physical activity should not be limited to specific durations or intensities.^2-4

Addressing the concerning issue of physical inactivity in Australia requires implementing extensive public awareness campaigns targeting individuals of all ages, families, schools, workplaces, and communities. Developing programs that encourage students, from childhood through adulthood, to adopt healthy sleep patterns, minimise screen time, and engage in age-appropriate physical activities is crucial.^5,6 Moreover, collaboration with educational institutions at all levels is vital to integrate 24-hour movement education into curricula seamlessly.⁵

Workplace health promotion is key to encouraging the adoption of policies that support the well-being of employees of all ages. This includes promoting initiatives that allow people to incorporate breaks for physical activity, manage sitting time, and create a work environment that prioritises health across the lifespan.⁷ Healthcare integration is another critical aspect, ensuring that healthcare providers are well-informed about Australia’s physical activity guidelines and their relevance to patients of all ages. Routine assessments should include evaluating physical activity levels, screen time habits and sleep patterns, providing tailored guidance for patients to improve their overall health.

Priority 3: Improve and update National children's physical activity data collection in a timely manner

Allocating resources for physical activity and sedentary behaviour surveillance and research across different age groups is essential. Ongoing surveillance provides insights into the effectiveness of changes to the physical and social environments, and broad-reach health promotion campaigns.¹ Australia's commitment to the promotion of healthier lifestyles and well-being must encompass these comprehensive strategies to combat physical inactivity effectively and reduce the burden cancer.¹

There is a need to re-run a comprehensive and recurrent national children's physical activity study to fill the gap in current data, as the most recent data on children's physical activity is the ABS National Nutrition and Physical Activity Survey 2011–12 (NNPAS).² Accurate and up-to-date information on physical activity levels among Australian children and adolescents is needed to identify areas for improvement.² More effective and regular monitoring can assist with identifying and understanding what may or may not be working and start to address gaps in the collection of physical activity data for children.²

Priority 4: Foster collaboration and strategic partnerships that prioritise equitable access to physical activity.

Promoting intersectoral collaboration and strategic partnerships among diverse stakeholders, including government bodies, civil society organisations, political and professional entities, the private sector, media, and other concerned parties is crucial for addressing widespread physical inactivity across Australia.¹ These partnerships can ensure both the integration of physical activity promotion into public health policies, alongside incorporating it into various other aspects of public policy, such as urban planning, transportation, and the development of recreational facilities.^1,2 Utilising a Health in All Policies (HiAP) approach enables the promotion of physical activity by integrating health considerations into various policy decisions and acknowledges that health is determined by a wide range of social, economic and environmental factors.⁴

Interventions implemented within educational institutions, particularly schools, can be influential in promoting physical activity among students. The World Health Organisation's 2018-2030 action plan identifies schools as key settings for implementing physical activity interventions for children and adolescents.^2,4

Although the Australian health promotion community has been a leader in physical activity promotion, there is a recognised need to further emphasise the importance of physical activity and strengthening intersectoral collaboration. The Australian Government Department of Health, Disability and Ageing has launched several campaigns to encourage Australians to adopt a comprehensive approach of balancing physical activity, limiting sedentary behaviour, and prioritising sufficient sleep across the lifespan,³ with work from other government agencies needed to further support equitable access to physical activity across the community.

Priority 5: Embed physical activity promotion within all health care settings through education and training, on appropriate assessment, counselling and referrals to healthcare professionals.

Embedding physical activity promotion in all health care settings has the potential to successfully improve the health and wellbeing of all Australians.¹ Addressing physical inactivity requires a ‘whole of society’ approach that utilises action across various sectors.² Leveraging this approach in the health sector requires implementing and strengthening patient assessment and counselling on supporting physical activity participation and reducing sedentary behaviour by suitably trained healthcare professionals (HCPs).² This will enable opportunities for, and the provision of appropriately tailored services and programmes aimed at increasing physical activity among the general population.³

HCPs are optimally positioned to promote physical activity through both opportunistic and structured contact,^4,5 serving as important sources of information with a wide reach to patients who are in most need of physical activity advice.^6,7 Incorporating physical activity counselling and referral as part of routine assessments in healthcare, particularly primary care settings, is identified as a ‘best buy’ with established efficacy in reducing the burden of non-communicable diseases and enhancing quality of life outcomes. ^7,8 The success of this strategy is conditional to addressing the existing barriers preventing HCPs from confidently integrating this in routine practice, which includes knowledge and skill deficits on appropriate counselling and referral.⁹ Therefore, continuous training for HCPs, the implementation of physical activity prescription and referral programmes as general standard treatments and the integration of physical activity in healthcare services may serve as useful tools for supporting individual levels of physical activity.⁹ Collectively, these initiatives can help to achieve the WHO targets for reducing physical inactivity, morbidity and mortality.¹⁰