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Researchers argue: “Does every movement count towards better health?”

Unethical factors such as childhood and/or strenuous labor or a dangerous environment may lead to increased physical activity but not necessarily better health, a dilemma called “the necessity versus choice paradigm.”

Assistant Professor of Epidemiology and Center for Health Equity researcher, Andrea Ramirez Varela, PhD, MD, MPH
Assistant Professor of Epidemiology and Center for Health Equity researcher, Andrea Ramirez Varela, PhD, MD, MPH

A 2020 press release from the World Health Organization (WHO) stated that “every move counts towards better health”, suggesting that 5 million deaths per year could be averted if physical activity increased throughout the globe. Offering a new perspective and published in June’s open access journal of The Lancet Global Health is Assistant Professor of Epidemiology and Center for Health Equity (CHE) researcher, Andrea Ramirez Varela, PhD, MD, MPH, who poses a counter to the statement, that context is key.

Along with co-author, Pedro Hallal, PhD, MPH, professor at the University of Illinois-Champaign/Urbana, the authors argue that further analysis is needed to provide context-specific measures. While measuring physical activity and inactivity has significantly improved over the course of a decade, Ramirez-Varela and Hallal suggest that unethical factors such as childhood and/or strenuous labor or a dangerous environment may lead to increased physical activity but not necessarily better health, a dilemma called “the necessity versus choice paradigm.” The commentary acknowledges that physical activity can lead to improved health, though, more analysis is needed to provide context-specific measures.

The authors emphasize the need for further analysis to more clearly distinguish physical activities by necessity and choice. Visual examples were included in the publication depicting strenuous labor, such as standing for prolonged periods or extreme lifting and pulling. Such movement types can account for increased movement but do not necessarily represent populations engaged in healthy physical activity. Ramirez Varela and Hallal propose including location-specific indicators in movement monitoring, and analyzing physical activity research and policy separately. The focus on leisure-time activity is part of the upcoming Global Observatory for Physical Activity (GoPA!) efforts, allowing stakeholders to address the needs of individuals in labor-intensive occupations to achieve health-enhancing physical activity goals globally.

While analyzing physical activity trends of adults, authors noted physical inactivity rates will likely not meet the WHO intended goal of 15 percent by 2030.

Ramirez Varela joined the CHE in late Spring 2024, and serves as assistant professor and physician-scientist at UTHealth Houston School of Public Health, Department of Epidemiology and McGovern Medical School, Department of Pediatrics. She works at the intersection of public health, physical activity epidemiology, and health policy research. Her research interests include epidemiology, public health monitoring, health policy research, preventive medicine, and global public health capacity for disease prevention, especially in Latin America. She also serves as Managing Director of GoPA!.

To find out more about these efforts related to global physical activity epidemiologic surveillance, go to the GoPA! website.

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