PHYSICAL ACTIVITY FOR GLOBAL HEALTH: A REVIEW OF TRENDS, DETERMINANTS AND POLICY RESPONSES

Physical inactivity remains one of the most significant, and most persistently under-addressed, risk factors for premature mortality and non-communicable disease worldwide. This review synthesises literature published on global trends in physical activity, the health and economic burden of inactivity, the determinants of activity behaviour, and the policy responses developed to address them. Drawing on World Health Organization surveillance data, Lancet Physical Activity Series findings, and empirical research on mental health, the built environment and national policy, the review shows that global age-standardised prevalence of insufficient activity among adults has risen rather than fallen since 2000, that the health-care and productivity costs of inactivity run into hundreds of billions of dollars annually, and that the burden falls disproportionately, in absolute terms, on middle-income countries even though relative risk is highest in high-income settings. It further shows that physical activity yields substantial benefits for mental as well as physical health, that built environment and policy interventions can meaningfully increase population activity levels, and that implementation of the World Health Organization's Global Action Plan on Physical Activity 2018 to 2030 remains markedly uneven, with low-income countries the least likely to have a costed, monitored national policy in place. The review concludes that closing the gap between the evidence base and its translation into practice, particularly in low- and middle-income countries, is the central unresolved challenge for physical activity as a global health priority, and it sets out implications for surveillance, policy design and future research. Therefore, it recommended that Governments should strengthen and adequately fund national physical activity policies, with clear implementation strategies, measurable targets, dedicated resources and regular monitoring and evaluation.