122 Kinesiology Final - Physical Inactivity

Social determinants of health

Living and working conditions.

The primary factors that shape the health of Canadians are not medical treatments or lifestyle choices, but rather the living and working conditions they experience.

Other aspects of social determinants of health

They help explain the wide health inequalities that exist in Canada.

Canada is identified as one of the best countries to live in, yet not everyone has the same experience.

Canada is said to be wealthy enough to mask the realities of poverty, social exclusion and discrimination, the erosion of employment quality, its adverse mental health outcomes, and youth suicides.

Living conditions relate to life expectancy, chronic disease risk, susceptibility to injury, and illness.

5 key categories of the social determinants of health

• education - literacy, language skills, educational attainment

• health care access and quality - access to health services, insurance, quality of care

• neighbourhood and built environment, housing quality, neighbourhood safety, access to parks and recreational facilities

• social and community context - social support networks, community engagement, discrimination

• economic stability - income, employment, expenses

Social determinants of health connected to physical activity

• Education

Knowledge and awareness - higher education often correlates with greater understanding of physical activity services.

Health literacy - education could influence how people access and understand health information.

• Health care access and quality

Preventative health services - regular checkups, insurance to cover paramedical services.

Guidance and counselling - access to health professionals can provide personalized recommendations and coaching for physical activity.

• Neighbourhood and built environment

Access to facilities - proximity to parks, gyms, and walking paths.

Safety - perceptions of safety can affect our comfort in engaging in outdoor activities.

Environmental design - walkable neighbourhoods and urban planning that promotes physical activity.

• Social and community context

Social support - encouragement from family and friends.

Community engagement - leisure center, sport league, community associations, and other organizations offering sports leagues, running clubs, exercise groups, etc.

• Economic stability

Access to resources - affordability of gym memberships, recreational classes, equipment.

Time constraints - multiple jobs or financial stress can limit time for activity.

Disability

Any long term impairment that restricts a persons ability to perform daily activities.

Often seen as a medical issue, not a social issue.

Even in wealthy areas, benefits and supports for persons with disabilities are limited.

There are few opportunities for employment, or earning less when employed.

Issue - limited playgrounds for persons with a disability.

Strategies to address social determinants of health

• Policy interventions

Public policy - advocate for policies that promote access to safe and affordable recreational spaces.

Funding - support for programs that subsidize gym memberships or community fitness programs.

• Community programs

Local initiatives - develop programs that engage communities in physical activities and promote active living.

Partnerships - collaborate with local businesses and organizations to support physical activity initiatives.

• Education, access, advocacy

Health education - integrate physical activity education into school curriculums and community outreach programs.

Workplace wellness - encourage employers to implement workplace wellness programs that include physical activity opportunities.

Access - consider outreach programs to improve access to services for all people.

Canadian 24hr movement guidelines - early years

0 - 4 years of age.

• infants (less than 1 year) should be physically active several times per day (tummy time, reaching for toys, interactive floor based play, and crawling)

• toddlers (1 - 2 years) should accumulate a minimum of 180 minutes of physical activity per day, including energetic play spread throughout the day.

• pre-schoolers (3 - 4 years) should accumulate a minimum of 180 minutes of physical activity per day, at least 60 minutes is energetic play. (playing outside, crawling, dancing, hopping, jumping, skipping)

Canadian 24hr movement guidelines - children and youth

Children (5 - 11 years) and youth (12 - 17 years) should be getting at least 60 minutes of moderate - to - vigorous intensity physical activity daily. Vigorous intensity activities at least 3 days per week and activities that strengthen muscle and bone at least 3 days per week.

Canadian 24hr movement guidelines - adults

Adults (18 - 64 years) should get at least 150 minutes of moderate - to - vigorous intensity aerobic physical activity per week.

Can be achieved in bouts of 10 minutes or more.

Beneficial to add muscle and bone strengthening activities at least 2 days per week.

Canadian 24hr movement guidelines - older adults

Older adults (65+ years) should get at least 150 minutes of moderate - to - vigorous intensity aerobic physical activity per week.

Can be achieved in bouts of 10 minutes or more.

Beneficial to add muscle and bone strengthening activities at least 2 days per week.

Those with poor mobility should choose activities to enhance balance and prevent falls.

Moderate intensity physical activity

Cause little sweating and you will breathe harder with a noticeable increase in heart rate.

Examples - bike riding, playground activities, brisk walking.

Vigorous intensity physical activity

Will cause sweating and being “out of breath” with a substantial increase in heart rate.

Examples - running, swimming, jogging, cross - country skiing.

Benefits and costs of physical activity

Benefits

• fitness

• reduced risk of chronic disease

• psychological outcomes

Costs

• takes time

• inconvenient

• fatigue

• risk of injury

• financial demand

Physical activity intervention

The goal is to help people change their behaviour and replace sedentary pursuits with active ones.

Effective interventions are required to promote the adoption and maintenance of active lifestyles.

3 levels of intervention

• downstream

• midstream

• upstream

Downstream

Individual level intervention for those who possess the risk factor or suffer from risk-related diseases or conditions.

There is an emphasis on changing rather than preventing health-damaging behaviours.

Midstream

Population level interventions that target defined populations for the purpose of changing and/or preventing health-damaging behaviours.

Involve mediation through important organizational channels.

Upstream

Macro-level public policy or environmental interventions to strengthen social norms and supports for healthy behaviours and to redirect unhealthy societal counterforces.

“Blanket” interventions for anyone who wants to use them.

RE - AIM Framework

• reach

• effectiveness

• adoption

• implementation

• maintenance

Physical Activity messages (PA messages)

To motivate individuals to be regularly active, persuasive messages must be used that convey information about the “how” and “why.”

Messages - all of the information to be conveyed to the public.

Messaging - the process of getting the message to the public. Using media that the target audience is most likely to use.

Messaging about PA

A variety of dissemination methods all have the potential as effective strategies for communicating PA messages.

Examples - print, television, telephone, online platforms, radio.

4 strategies to enhance PA messages

• include certain message qualities (novel, vivid, salient)

• create relevance (tailored, targeted)

• choose appropriate message framing (gain-framed, loss-framed)

• create accessible messages (obtain, process, understand)

Tailored

Making message content relevant for a specific individual based on their goals or individual data.

Not as suitable for mass-media campaigns.

Targeted

Making message content relevant for a specific group, based on a common characteristic of that group.

Allow for implementation at a larger group.

Gain-framed

The emphasis a message has on the benefits of adopting physical activity behaviour.

Typically more effective.

Increased intentions to become active and increased physical behaviour.

Loss-framed

The emphasis a message has on the costs of failing to adopt physical activity behaviour.

Evaluating messaging campaigns

Planning provides the blueprint, evaluation provides the evidence.

Evaluation should occur at all phases of campaign planning and implementation.

Evaluation is cyclical, providing insight into successful and unsuccessful elements.

Formative evaluation

Pre-testing messages prior to the actual campaign.

Process evaluation

Monitoring campaign reach and progress.

Outcome evaluation

Assess if the campaign has achieved its goals.

Negative media images - women

• more pressure to be a particular shape, commonly thinner

• expectation to work on your body

• diet, exercise, cosmetic surgery

Associated with:

• decreased self-esteem

• body related anxiety

• body size distortion

• dieting and restrictive eating practices

• drive for thinness

• social comparisons

• body weight and shape dissatisfaction

• increased levels of body dysmorphia and disordered eating

Negative media images - men

• bodies are now objectified with great concern of body image

• either wanting to be thinner or heavier

• tending to exercise, rather than diet, to change their body

Associated with:

• decreased self-esteem

• body weight, shape, and muscularity dissatisfaction

• increased insecurity and self-consciousness

• disordered eating and body dysmorphia

Negative media images - non-binary/transgender

Beauty norms and the ideal body are predominantly gendered even with recent focus on inclusion of non-sexualized models.

Face additional stressors of their sex and gender not aligning.

Associated with:

• gender incongruence

• negative body image

• disordered eating behaviour

• eating disorders

• excessive exercise

Positive media imagery - body positivity

Body acceptance of all shapes and sizes.

Images reject unattainable ideal body image.

Media literacy

Media literacy training - focus on unrealistic standards and the tricks used to create unrealistic images, how to counter them.

Cognitive behavioural therapy - change the way incoming social information is interpreted. Change thoughts from irrational to rational. Includes self-monitoring to know when you’ve changed thoughts.