Abstract
The rising global burden of noncommunicable diseases (NCDs) among people with low socioeconomic status (SES) has heightened awareness of the need for primary prevention programs in low-SES neighborhoods. Social inequity in health is apparent in mental, social and physical aspects of health among people living in low-SES neighborhoods. Viewing this problem from a life course perspective and adopting a vulnerable population approach points to the importance of inducing sustainable health behavior changes in children and young people living in low-SES neighborhoods. One important factor in lowering the risk of many NCDs while improving mental health is the promotion of physical activity (PA). In this paper, we argue that lowering the risk of many NCDs and improving mental health is best achieved through setting-based programs that facilitate long-term PA behavior changes in children and adolescents living in marginalized neighborhoods. Empirical evidence indicates that extrinsic motives for participating in physical activities, such as improving health, are insufficient when long-term participation is the goal. Therefore, we argue that interventions with the aim of affecting long-term PA in low-SES neighborhoods and thereby reducing social inequities in health should include activities that aim to create more intrinsic and autonomous motivations by building on more broad and positive understandings of health and participation. Here, we advocate that sports-based recreation (SR) holds several advantages. If implemented well, SR has the potential to be a health-promoting activity that is meaningful and motivating in itself and that involves physiological health-promoting aspects (e.g., PA), a social aspect (e.g., positive relations with others), and a psychological aspect (e.g., positive experiences of oneself). Further, we suggest four practicalities that should be considered when conducting interventions: the cost of participating, the location, the facilities required, and the suitability of the SR activities.
Highlights
Noncommunicable diseases (NCDs), such as diabetes, cancer, and cardiovascular and chronic respiratory diseases, constitute a major and increasing public health challenge in both high, low- and middle-income countries [1]
The rising global burden of NCDs, which are most prominent among people living in low-socioeconomic status (SES) neighborhoods, has heightened awareness regarding the increasing social gradient in health and the need for primary risk prevention programs in low-SES neighborhoods
When adopting a combination of a life course, a setting and a vulnerable population approach to health promotion, we suggest that a feasible solution involves developing health promotion programs that facilitate better conditions for lifelong behavior changes in children and adolescents in low-SES neighborhoods
Summary
Noncommunicable diseases (NCDs), such as diabetes, cancer, and cardiovascular and chronic respiratory diseases, constitute a major and increasing public health challenge in both high-, low- and middle-income countries [1]. A nationwide longitudinal study in Canada found that social inequity was especially apparent when comparing organized sports to an informal context: “The effects of SES were much stronger for organized sport involvement than for participation in an informal context” [44] This result was found to be the case in Denmark [42], indicating that reducing the barriers to participating in SR among children and youth with a low socioeconomic background should be a prime assignment for interventions with the goal of increasing equality in health and PA. Based on the advantages of the three health-promoting approaches introduced and described earlier, we propose and advocate that four practicalities are central in interventions aimed at reducing barriers for sustainable engagement in SR among children and youth living in low-SES neighborhoods: the cost of participating, the location, the facilities required, and the suitability of the SR activities. Only the imagination limits the possibilities, examples could be using trees/bushes/bins as goals in soccer, practicing basketball passing in places with uneven ground or using a parking lot for a dancing lesson
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