WHO physical activity strategy launched

At the «Vienna conference on nutrition and noncommunicable diseases in the context of Health 2020» and by organising a meeting of experts, the Federal Office of Public Health (FOPH) had made an important contribution to developing the WHO's physical activity strategy. The meeting of experts was held in Zurich at the beginning of 2015 and was chaired and financially supported by the FOPH. Eighty delegates from 47 Member States of WHO/Europe discussed and improved the draft of the physical activity strategy.  

Switzerland is already active

The WHO's physical activity strategy now defines five priority areas and a set of specific measures designed to promote physical activity. These will serve as a basis for drawing up national physical activity strategies. In Switzerland, many of the measures called for by the WHO are already being implemented in the five priority areas. Some examples are presented below:    

Priority area 1: Providing leadership and coordination  

According to WHO/Europe,

– European governments should ensure high level leadership to promoting physical activity and assign a key role to the health sector.

– intersectoral cooperation is indispensable in the promotion of physical activity.

– not only is the provision of information on environments that support physical activity important, but also regulations, financial incentives and better coordination of different sectoral policies.

– the roles and responsibilities of the individual players must be clearly defined and cooperation sought with NGOs and the private sector.

– in addition, Member States should enter into cross-border alliances with networks and international organisations.  

In Switzerland

– securing nationwide coordination is the number one main goal of the “National Programme on Diet and Physical Activity” (NPDPA). The NPDPA's strategic management team consists of representatives of the Federal Office of Public Health (FOPH), Federal Office for Sport (FOSPO), Swiss Conference of Cantonal Directors of Public Health, Health Promotion Switzerland and the Federal Food Safety and Veterinary Office (FSVO).

– the FOPH and the federal offices responsible for Roads (FEDRO), Spatial Development (ARE), the Environment (FOEN), Sport (FOSPO), Transport (FOT), Energy (FOE), Statistics (BFS), Agriculture (FOAG) and Housing (FHO), along with the State Secretariat for Economic Affairs (SECO), cultivate intersectoral cooperation (new: comprehensive health policy) in order to promote active mobility and an environment conducive to physical activity. This is achieved either through interministerial working groups (e.g. Federal Coordination Board of human powered mobility) or by promoting projects that encourage physical activity and active mobility (e.g. the Service Centre for Innovative and Sustainable Mobility). The FOPH is interested in further expanding intersectoral cooperation of this kind.

– cooperation with NGOs (e.g. the NGO Alliance) is good.

– thanks to the "actionsanté" initiative of the FOPH and the FSVO, the private sector helps to promote a physical activity-friendly environment by implementing voluntary measures.

– Switzerland has a network of organisations (HEPA Switzerland) that support health-enhancing physical activities and sports at the national, cantonal or local levels.

– the FOPH has supported and participated in a range of international conferences in Switzerland in terms of both funding and content.

– together with other federal offices, the FOPH has helped to develop the «Transport, Health and Environment Pan-European Programme» (THE PEP) and still participates in exchanges of experience and funds interesting projects.  

Priority area 2: Supporting the development of children and adolescents  

WHO/Europe calls for

– more support provided to (future) parents and in day-care settings regarding the benefits of physical activity.

– an appropriate number of physical education lessons in schools and preschools.

– physical education lessons to include information on physical activity and mobility.

– collaboration between the education, health and sports sectors to develop a curriculum for physical education lessons that communicates the enjoyment of physical activity to all children regardless of their training levels.

– raising awareness in all teachers of the need to promote physical activity and health.

– legislation that underpins the promotion of physical activity in schools and preschools.

– subsidies and regulatory or tax-based measures that benefit children from socio-economically disadvantaged groups and children with disabilities.

– greater integration of adolescents in the efforts to promote physical activity (e.g. youth associations).

In Switzerland

– in the framework of the "cantonal intervention programmes” and a dedicated promotional fund, Health Promotion Switzerland supports projects that encourage physical activity in pregnant women and mothers of young children (www.buggyfit.ch), in day-care settings, kindergarten, schools and during leisure time (www.radix.ch and www.muuvit.ch).

– specific projects focus on adolescents, for instance “Gorilla”, which promotes free-style sport (www.gorilla.ch), or “Défi Velo”, in which students can discover new facets of cycling (www.defi-velo.ch).

– compulsory schooling must include at least three physical education lessons a week.

- at vocational schools, regular physical education lessons are mandatory for students attending two- to four-year vocational training courses.

– as part of the “Youth + Sport programme”, the FOSPO offers over 55,000 courses and camps a year in more than 70 different types of sport, which are attended by around 700,000 five-to-20 year olds every year. Currently in the development stage the “Youth + Sport programme” for schools aims atbridging the gap between compulsory physical education lessons and voluntary club-based sport (www.jugendundsport.ch).

– the national "Schools on the Move" (Schule bewegt) programme promotes physical activity in schools (www.schulebewegt.ch).    

Priority area 3: Promoting physical activity for adults 

An enabling environment for physical activity  

To encourage physical activity among adults, WHO/Europe proposes

– promoting active mobility by setting up walking and cycling infrastructures and taking legislative measures (raising fees on private motorised transport, traffic congestion and parking).

– creating affordable, low-barrier and culturally acceptable incentives and schemes to promote physical activity among vulnerable groups (physical activity-friendly spaces).  

In Switzerland

–feesare levied on certain car-parking spaces.

– the Federal Law on Footpaths and Hiking Trails (SR 704) regulates the planning, creation, maintenance and signposting of safe, attractive and joined-up networks of footpaths and hiking trails.

– the Federal Roads Office (FEDRO) has been mandated with the task of establishing active mobility as the third pillar of the passenger transport system, on an equal level with private motorised transport and public transport.

– seven federal offices have collaborated in establishing “set of guidelines on open-space development in agglomerations".

– as part of the "Sustainable Spatial Development Model Project”, support is also being provided for pilot projects aimed, among other goals, at increasing the number of physical activity-friendly open spaces in agglomerations (www.modellvorhaben.ch).

– the FOPH has for years been supporting the further development of the “Health Economic Assessment Tool” to quantify the economic health benefits of active mobility (www.heatwalkingcycling.org).

– together with its partners, the FOSPO has played an active role in training coaches and leaders for the activities organised by the “Swiss Adult Sport Programme” (www.erwachsenen-sport.ch).    

Promoting physical activity at the workplace  

To encourage physical activity at the workplace, WHO/Europe calls for

– measures to promote active mobility or public transport for the commute to the workplace (accessibility, affordability and safety).

– appropriate infrastructure such as adjustable desks, showers or cycle racks, etc. and incentives for physical activity such as reductions on membership fees for gyms, or company-run sports facilities

– also for vulnerable groups such as older people.  

In Switzerland

– the FOPH, SUVA (Swiss National Accident Insurance Fund) and Health Promotion Switzerland have developed tripartite cooperation on health promotion at the workplace. This involves pooling of skills and resources to enable joint services to be created that promote the health of employees. Adoption of an innovative and global approach that covers the four main action areas is envisaged: physical activity, ergonomics, nutrition and mental health (www.bag.admin.ch/themen/ernaehrung_bewegung/betriebliche gesundheitsfoerderung).    

Recommendations on physical activity and therapy  

According to WHO/Europe,

– the Member States should adopt recommendations on physical activity based on the “WHO Global Recommendations on Physical Activity for Health”.

– health professionals should also play an important role in the promotion of physical activity, through early identification, counselling and medical referral (particularly of older people).

– the costs incurred by low-barrier sport and physical activity classes should be reimbursed by the medical insurance companies or national health systems.

– the training curricula for all health professionals should be improved so as to teach them the benefits of physical activity for health.  

In Switzerland

– the “Swiss Recommendations on Physical Activity” revised since 2013 apply (www.hepa.ch).

– the role of family doctors in promoting physical activity in their patients should be enhanced and upgraded (cf. Ticino pilot project "Girasole"– integrated primary health care: www.bag.admin.ch/themen/ernaehrung_bewegung).

– the new “Ordinance on Services Covered by Compulsory Health Insurance” enables all-round care to be given to overweight and obese children and for the illnesses associated with them. This applies to both group and individual treatment settings.    

Priority area 4: Promoting physical activity among older people  

According to WHO/Europe,

– efforts to promote physical activity should use existing social structures such as community centres, NGOs, etc. to reach older people, in particular those from socially disadvantaged backgrounds.

– opportunities for older people to engage in affordable active tourism should be created to encourage them to socialise and become more physically active. To achieve this end, the health, sports and tourism sectors should step up cooperation.

– greater recognition should be given to the intergenerational voluntary contributions of older people to the community.  

In Switzerland

– since 2011, Health Promotion Switzerland has supported the "Via" project aimed at promoting an independent, autonomous lifestyle, health and better quality of life among older people. It focuses on factors that have an impact on their health and disseminates this knowledge in the form of recommendations and practical aids.

– Health Promotion Switzerland also provides its partner cantons with corresponding advice on the implementation of projects and programmes.

– additionally, it maintains close partnerships with the “Swiss Council for Accident Prevention” (bfu), the “Pro Senectute” senior citizens' association and other specialist organisations (www.gesundheitsfoerderung.ch/via).    

Priority area 5: Monitoring, evaluation and research  

Monitoring and evaluation  

WHO/Europe would like

– Member States to adjust and extend existing national and international systems of physical activity surveillance. The “WHO Global Monitoring Framework for the prevention and control of noncommunicable diseases” contains specific physical activity indicators and a related target to which the Member States have committed themselves.

– to support Member States in accurately analysing surveillance data and interpreting it for use in evidence-based policy recommendations. A common surveillance tool would also allow data comparisons between countries.  

In Switzerland

– in tandem with a large number of partners, the FOPH runs the “Nutrition and Physical Activity Monitoring System” (www.moseb.ch) which has, for years, been monitoring the indicators of physical activity behaviour laid down by the “WHO in the Global Monitoring Framework.”

– the FOPH will in the future focus on other indicators of physical activity besides the prevalence of inactivity among children/adolescents and adults. In addition, physical activity has been integrated into an indicator used in the general risk assessment for noncommunicable diseases (NCD).  

Research  

WHO/Europe would like

– future research to be conducted on the following topics: integration of vulnerable population groups into the promotion of physical activity across the life-course, innovative approaches to promoting physical activity for adolescents, the role of sedentary behaviour as an independent health risk factor and the relationship between physical activity and other risk factors such as unbalanced diet or smoking.  

In Switzerland

– in May 2014, the then “Institute of Social and Preventive Medicine” of the University of Zurich (now the “Epidemiology, Biostatistics and Prevention Institute”) published an empirical long-term study on the relationship between the four risk factors nutrition, physical activity, alcohol and tobacco, and the mortality risk

– the 2011 “Omnibus survey” and the “2012 Swiss Health Survey” of the Swiss Federal Statistical Office (BFS) constitute two representative and current sources of data that include findings on sedentary behaviour (www.sgb12.bfs.admin.ch).A study commissioned by the FOPH evaluated these data in terms of criteria such as the social background, health status and health-related behaviour of the people surveyed (www.bag.admin.ch/auf-stehen).  

Although Switzerland has already done a lot to encourage people to engage in more physical activity, the new NCD strategy will enable the FOPH and its partners to determine in which areas further action needs to be taken. The WHO Europe's physical activity strategy is helpful in this respect. In addition, it highlights, at both the national and the international level, the importance of promoting physical activity in efforts to combat noncommunicable diseases.