Physical activity — an answer still looking for its question
Public health, sport, and community connectedness and why the evidence is more complicated than advocates would have you believe.
I was recently invited to present at the Western Sydney Moving community of practice. This group meets monthly and is, generally, made up of people who believe that physical activity is good for us — academics, health professionals, exercise physiologists, and strategy makers trying, in their own way, to improve population health by advocating for regular exercise. A laudable cause.
I have sat in other sessions and observed the collective head nods from audience members signalling their approval of messages conveyed. They were, at least in my view, preaching to the converted — something I have become more and more aware of in recent years, at conferences which are attended not to learn or be challenged, but to have preconceptions and biases confirmed.
It was for this reason I wanted to present a series of counter points to the movement toward physical activity as a universal good and highlight areas where the consensus doesn’t seem to align with practice or, dare I say, the view of the common person in the street. This is not to say I don’t value the impact that physical activity has on health — I do. The message however often gets hijacked by the modern disease of overstating benefits and extrapolating data to such an extent that the claims made become quite unbelievable.
What follows draws together three interconnected threads: the changing rationale for physical activity in public health, the complicated relationship with sport, and the question of whether being active really does bring communities closer. The short answer to all three is: it’s complicated.
A changing rationale
The case for physical activity, as I see it, has always been two-pronged. Firstly, there is the need to convince those who hold the purse strings at the government level that initiatives which promote physical activity represent value for money and have at least some return on investment. Secondly, there is a need to appeal to the hearts and minds of the general population, so they understand the benefit, and are empowered, to be physically active. The arguments made by advocates have shifted considerably over time.
The early rationale, focused on national security, at least in England: the country could not wage war if recruits were physically unfit. The Fitzroy Report, published in 1904, detailed the physical condition of army recruits with alarming frankness — noting that between forty and sixty per cent of men presenting for enlistment were found to be physically unfit for military service. The authors, with a profound degree of prescience, highlighted the futility of simply continuing to describe the problem. Once identified, they argued, efforts should be redirected to address it.
I wonder, reading that now, how much progress has been made in the intervening 122 years.
By the 1980s and 90s, the rationale had shifted to reducing the financial burden of lifestyle-related disease on the welfare state. In the 2000s, it morphed again — physical activity became a lever by which the broader benefits of sport could be realised, a tool for inclusivity, and a means of tackling loneliness and isolation. One might be forgiven for thinking it warranted the title of panacea.
The problem, of course, is that the evidence has rarely kept pace with the ambition. Poverty, ill health, and a lack of opportunity to be physically active remain as intrinsically linked today as they were in 1904. Changing the story told about physical activity has not changed the underlying conditions that shape who benefits from being active and who does not.
What actually improved life expectancy
Population health data would suggest that life expectancy has increased exponentially since 1904. Good news, clearly. But those improvements have largely been brought about by improvements in infrastructure in the 1940s and 50s, and more recently by the march of technology — not by changes in physical activity levels.
In the late 1800s, many English cities developed large swathes of green space — genuinely egalitarian in design, intended to benefit everyone from richest to poorest. The ribbon of parks across Liverpool, my home city, is one example. Sefton Park was purchased in 1867 for £250,000 from the Earl of Sefton and continues to provide opportunities for the local community to be active. That improved access to community green and blue space contributed to improving life expectancy. As did the mechanisation of labour-intensive jobs and the introduction of the 5-day working week, providing more time and opportunity for leisure activities.
A bigger shift came after the Second World War. The UKs welfare state — the NHS, improved housing, better sanitation, slum clearances, new towns — did more to improve public health than physical activity ever managed. The data, if you trace the trend lines, is fairly clear on this point. Physical activity has, at best, played a bit part role, challenging the long-held notion that it is a key component in improving or at least maintaining public health.
Technology, meanwhile, is doing what physical activity could not. GLP-1 drugs — you may be more familiar with the brand name Ozempic — are revolutionising diabetes care and how patients are supported to lose weight. E-bikes are changing the face of active travel and doing more to promote cycling than even the most well-intentioned cycleway infrastructure could have hoped to achieve. The problem that physical activity was supposed to solve is being addressed by other means. This leaves physical activity in a genuinely tricky spot, especially where garnering support for its continued funding is concerned.
Is sport the same as physical activity?
Having struggled to find its question in public health, physical activity in the 2000s began to co-opt sport as a vehicle. Whether that has been to the benefit of either is, I think, a genuinely open question.
Growing up in Widnes — a town just outside Liverpool — there always seemed to be an abundance of green space on which to play. School playing fields, at least those attached to secondary schools, were generally open, and many had permanent goalposts and rugby posts in place, great for informal use with friends. Fast forward to today and that abundance has, in many places, disappeared. Not necessarily because the land was sold for development (although some was) but because schools and clubs who previously allowed open access have since secured their fields for private use. Fences have been erected and the community locked out. The premise is understandable — dog fouling and motorbikes tearing up the turf were impacting the enjoyment of club members and ability to use the facility as intended. The broader impact however is less positive. Large swathes of green space have been withdrawn from general use in the name of sport, which strikes me as at odds with sports own rhetoric about physical activity, inclusion and accessibility for all.
The same tension exists in the built environment. The UK opened its first indoor leisure centre in 1964. By 1981 the number had grown to over 600, spawning — as a cultural footnote — the popular sitcom The Brittas Empire (worth a watch if you are unfamiliar). These centres were lauded for their community amenity: swimming pools, gymnasiums, sports halls. You might reasonably have expected that this rapid expansion in access to sporting facilities would have increased physical activity levels. It didn’t. Levels have continued to decline.
The reason, when you look closely, seems obvious. In most local government areas, the community reports that walking, gardening, and cycling are the most popular means by which constituents engage in regular physical activity. Leisure centres — recipients of millions in public investment, with a stated rationale of improving health — do very little to serve that need. Most lock out anyone not paying to use the facility, which, for the hard-to-reach groups so often cited in physical activity research, is a barrier that prevents engagement.
Sport England’s own research suggests that if everyone with one or more inequality characteristics could be as active as those with none, there would be 4.9 million more active adults, generating over £15 billion in additional social value. The characteristics identified include people with a disability, those aged over 65, lower socioeconomic groups, parents with children under 1 year of age, and adults from certain ethnic backgrounds. These are not new barriers — they are, in many ways, the same ones identified in 1904 especially when we consider those from lower socioeconomic groups. It is hard to see how the rapid expansion of sport centres during the 1970s and 80s, or since, has meaningfully addressed them.
A recent UK government press release announced £85 million for new and refurbished sporting facilities — synthetic fields, floodlights, pavilions — with the suggestion this investment would give families affordable ways to stay healthy and deliver an NHS fit for the future. The claim, to put it gently, assumes rather a lot. There is, as far as I am aware, no robust evidence that investment in synthetic fields or floodlights has a significant impact on health outcomes for the groups most likely to burden the NHS with lifestyle-related disease. I am open to being proved wrong.
That is not to say sport has no value. It clearly does, particularly for young people and for those who remain active into later life through sporting participation. But those people are the minority. If you take a slightly more cynical view — which I occasionally permit myself — the framing of sport as a vehicle for health outcomes begins to look less like a genuine public health strategy and more like another method of justifying the expenditure of public funds.
There is also a risk that sport itself pays a price for this realignment. The push toward inclusivity, diluted competition, and modified rules to create a fun environment for everyone is, in many respects, admirable. But it carries a cost. Most sports experience a significant drop in participation around the age at which young people hit their adolescent growth spurt — more marked in females, but visible in both sexes. Those who remain involved in their teenage years are, generally, committed, more competitive, and willing to invest significant time in developing their skills. These are the people that most sports depend on to fill competitive leagues, populate performance pathways, and sustain professional versions of the game (a significant revenue source via TV rights for at least some sporting codes). If the sport they experience at a young age is modified to such a degree that it no longer appeals to them, we may find ourselves — in time — with a dearth of athletes willing or able to compete to a standard people are willing to pay to watch. To coin a phrase from the great leap forward, don’t kill the sparrows.
Can physical activity really bring us together?
Beyond health and sport, advocates have increasingly leaned on social connectedness as a rationale for physical activity. This is harder to argue against, but I’ll give it a go.
The development of public parks in England’s industrial cities was built on the premise that being active in green space alongside your neighbours was good not just for health, but for humanity — an observation that has stood the test of time. Whether physical activity remains the best vehicle for connecting communities in 2026, though, is a different question.
Technology is reshaping how we connect. As populations expand, communities are pushed further from city centres into new towns and suburbs offering more space and, in many cases, more affordable housing. Sydney is a useful illustration: the cost of living on the eastern seaboard has placed it beyond the reach of many Sydneysiders. The response — a plan for three cities, the second and third being built to the west of the Opera House — means tens of thousands of people now live in areas where supporting infrastructure is playing catch-up. Extensive travel to enjoy leisure time is, of course, something the groups most likely to benefit from physical activity rarely have the luxury of.
The online environment, however, is a different matter entirely. Computer games, social media, and virtual worlds have removed the geographical barriers that access to green space cannot, despite the best efforts of government to create 15-minute cities. At the population level, we are arguably better connected than at any point in human history — and it is technology, not the local park, we should thank.
You may argue, reasonably, that the explosion in digital connection is precisely why loneliness and isolation is growing. That may well be true. But even when we do come together to be physically active, it would be optimistic to suggest the result reflects harmony between the disparate groups clamouring for access to facilities and infrastructure.
Sporting teams competing for the same patch of grass is hardly a new phenomenon. A recent report in the Sydney Morning Herald highlighted a dispute over access agreements for a new sporting field in Wentworth (https://tinyurl.com/2p9r9a4k) — the sort of conflict that plays out in local councils across the country with a regularity that rarely makes the news. Cyclists bemoan sharing paths with pedestrians; pedestrians have begun directing their frustration at e-bike riders on footpaths (on this, I tend to agree). Even Park Run — one of the great success stories of grassroots participation — is not universally welcomed by those whose regular walking route is swallowed up by enthusiastic runners on a Saturday morning.
In a small town in England’s north west, the Park Run route winds around a small lake along a path narrow enough that it becomes all but inaccessible to anyone else for the duration of the event. This might seem a small grievance. But if you are not a runner, and that lake is one of the only areas of blue space within easy reach of where you live, you could be forgiven for feeling that a movement celebrated for its inclusivity is, for an hour each week, anything but.
Where to from here
If physical activity struggles to find its question in public health, sport, or social connectedness, what should those who advocate for it actually be doing? I would suggest three things, none of which require a conference paper.
Open the doors. Most community sport and leisure facilities remain closed unless you pay to use them. This is particularly frustrating given these are often the very facilities — the ones charging admission — that have invested in the most accessible and inclusive amenities: feeding rooms, family changing, and accessible bathrooms. These are precisely what would benefit the groups most likely to gain from greater physical activity. How many more people might be encouraged to walk, cycle, or run if they knew a clean and accessible bathroom was available at the start or end of their session? My guess is quite a few. The same logic applies to outdoor facilities gifted to clubs and fenced off to protect the surface. Organisations that benefit from public investment should be required to open the gates at least once a week to the community they serve, for free.
Pass the pub test. If physical activity were as beneficial — or as popular — as its advocates suggest, it really ought to have had a more measurable impact on public health in the fifty years since it became a policy priority. Recent attempts to quantify the economic value of physical activity have produced figures so large they lack credibility when viewed through the lens of common sense (or the pub test, to coin a phrase).
Eye-watering headlines tend to reinforce the suspicion of the unconvinced rather than resolve it. A better approach is to focus on qualitative outcomes: the benefit delivered at the local, human level. Initiatives that have opened school playgrounds to the community after hours have produced results that are tangible to anyone who lives nearby. People are far more likely to support that kind of work than a report quantifying its value using an advanced statistical technique that produces an arbitrary figure hard to understand, let alone conceptualise.
A grassroots movement, led from the ground up. Physical activity, as a movement, has become too academic. Its prescription is debated at conferences, in journals, and at strategic meetings removed from the communities most likely to benefit. This is not where change happens.
The success of the Victorian public parks was not that they were designed using robust scientific inquiry or were part of a national strategic initiative. They worked because they met a community need: a safe, accessible place to come together in nature. That remains the blueprint for any successful participation initiative. It begins with a groundswell of support from those who stand to benefit, driven by leaders within the community who are themselves already part of it.
When the City of Liverpool purchased Sefton Park, it did not keep the gates closed until a participation strategy had been agreed. The activities that took root were built from the ground up — exactly as they should be. Government and NGOs would do well to remember that their most useful role is often to create the conditions for this to happen, then step back.
None of this is to say that physical activity lacks value. It clearly does. But its advocates have sometimes done it a disservice by overpromising and under-delivering at scale.
The most credible case for physical activity is not the one made in a conference hall. It is the one made on a Tuesday evening when a community has turned up, of its own accord, to use a space that is open, free, and built with them in mind.
That, I think, is something most people would get behind.