In an evolving health landscape, emerging research continues to highlight concerns that could impact everyday wellbeing. Here’s the key update you should know about:
A global analysis shows that who gets the chance to exercise is shaped by wealth and gender, while mounting evidence reveals that regular movement protects far more than the heart – extending benefits to immunity, mental health, and cancer survival.
Study: Physical activity for public health in the 21st century. Image Credit: New Africa / Shutterstock
In a recent paper combining original global inequality analyses with narrative evidence syntheses published in the journal Nature Medicine, researchers synthesized more than a decade of global surveillance data alongside hundreds of scientifically validated publications to elucidate the holistic impacts of physical activity on human health. The study further analyzed this data to evaluate the role of socioeconomics and gender in global physical activity patterns.
Review findings revealed that regular movement is associated with improvements in immune function, with current evidence demonstrating that higher levels of physical activity are associated with lower risks of certain infectious disease outcomes and depression. Furthermore, the review highlights that while routine physical activity has been linked to improved survival among people diagnosed with several cancers, present-day socioeconomic and gender disparities are stark and need to be addressed for a holistically healthier tomorrow.
Physical inactivity remains a major global health challenge
Physical inactivity is a concerning and increasingly prevalent global health crisis, currently estimated to account for approximately 7.2% (greater than 5 million) of all-cause deaths worldwide. While the physiological merits of physical activity have been recognized for decades, the popular “every move counts” mantra and traditional public health messaging have largely focused on emphasizing the importance of movement for preventing metabolic (e.g., obesity) and cardiovascular diseases (CVDs).
A growing body of evidence, however, suggests that this narrow messaging focus may overlook the broader health benefits of physical activity beyond cardiometabolic disease, including potential effects on infectious diseases, mental health disorders, and some cancers.
Furthermore, this literature highlights that current paradigms fail to differentiate between choice-based physical activity (e.g., sports or jogging) and activity driven by economic or infrastructural necessity (e.g., manual labour or walking or cycling to work due to a lack of reliable transportation), which may occur in conditions that are not always optimal for health, safety, or wellbeing.
Review combines global surveillance data with scientific evidence syntheses
The present review sought to address these messaging discrepancies and inform future public physical health initiatives by presenting scientifically validated evidence on the current inequality prevalent in global exercise patterns. It simultaneously aimed to highlight the broader spectrum of benefits associated with staying active beyond cardiometabolic health.
The review began by synthesizing data from the World Health Organization (WHO) STEPwise approach to surveillance of non-communicable disease (NCD) risk factors (WHO STEPS). The WHO STEPS dataset comprises nationally representative surveys collected between 2008 and 2019 from 68 countries, which the researchers categorized into three physical activity domains: active leisure (recreational exercise), active transport (walking or cycling to commute), and active labor (occupational exertion).
The review subsequently classified participants’ social identities into gender and socioeconomic status, and assessed how these identities intersect with physical activity, potentially driving observed activity patterns across different national income levels.
Finally, the review aggregated data from previous systematic reviews and meta-analyses evaluating the impacts of physical activity on three major health endpoints: immunity and infectious diseases (specifically COVID-19 pandemic data), clinical depression and associated mental health conditions, and cancer incidence and survival outcomes.
Together, the analyses of these data sources allowed the review to simultaneously elucidate both the social determinants of physical activity and its expansive physiological impacts on modern populations.
Stark socioeconomic and gender gaps shape global exercise patterns
The review’s most notable finding was the unexpectedly large gap in active leisure participation between the most socioeconomically privileged group (wealthy men in high-income countries) and the most disadvantaged (poor women in low-income countries). This gap was estimated at approximately 40 percentage points and highlighted that in high-income nations, over 30% of total physical activity comes from choice-based leisure.
In contrast, in low-income nations, only 10% of physical activity is choice-based, with the remaining 90% being attributed to occupational and transport necessities.
Physical activity is linked to lower risks of infection, depression, and cancer mortality
When analysing the effects of physical activity on physiological endpoints under investigation, the review summarized substantial evidence supporting the health benefits of movement. An analysis of COVID-19 pandemic data (a meta-analysis of 1.8 million adults) revealed that regularly active individuals had lower risks of hospitalization (36%), severe illness (34%), and COVID-19-associated mortality (43%) than their physically inactive counterparts.
Similarly, participants who met clinically prescribed physical activity guidelines were found to be at a 25% lower risk of developing depression than those who did not. Finally, epidemiological evidence suggests that high levels of aerobic activity can reduce the risk of several cancers (10% to 20%), while engaging in physical activity after diagnosis has been associated with a 37% reduction in cancer-associated mortality.
Researchers call for a shift toward “physical activity security”
The present review is among the first to combine global inequality analyses with evidence syntheses showing that physical activity’s physiological benefits extend well beyond improved cardiovascular and metabolic health. It provides robust clinical and epidemiological evidence linking routine movement to improvements in immune responses, mental health outcomes, and cancer-related outcomes.
It further identified insufficient physical activity as a potentially modifiable risk factor associated with depression, highlighting the importance of physical activity even in metabolically fit individuals.
Unfortunately, the review reveals that access to choice-based exercise is heavily skewed by wealth and gender, leading researchers to propose a reconceptualized public health model focused on “physical activity for health and wellbeing,” which emphasizes safe, voluntary, and equitable opportunities for movement rather than activity driven purely by necessity. The framework also introduces the concept of “physical activity security,” referring to equitable access to safe and enjoyable opportunities for movement that support overall health and wellbeing.
