The physical environment and physical activity: moving from ecological associations to intervention evidence

Abstract

Can we improve population levels of physical activity? Focusing research efforts on improving the evidence base from (whole community) interventions is a necessary first step. Recent interest in the physical environment is reminiscent of the pre-individualist era of 19th century public health, when sweeping environmental changes, particularly around sanitation, hygiene, and food supply produced large scale population health effects.1 Current interest in the environment and its role in chronic disease prevention has positively influenced the tobacco control agenda, and more recently, been shown to be associated with population obesity, inappropriate nutrition, and physical inactivity rates. One driver for environmental research is interest in the causal role of community level variables in health promotion; these include measures of social capital, urban connectedness, social isolation, health literacy, and poverty. This has pervaded recent public health investigation at the community and small area level.2,3 Another reason is scientific curiosity to better understand the determinants of physical activity and obesity. In the 1980s, researchers examined individual cognitions, beliefs, and motivations around diet and exercise. This comprised correlational studies that identified associations between behaviours and a range of theoretical variables derived from …

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