Physical activity for health: framework

The challenge in Scotland

The most recent Scottish Health Survey reported that, in 2022, 65% of adults met recommended levels of physical activity in Scotland. This is within the range of 62-66% recorded between 2012 and 2019 prior to the pandemic. Overall levels of activity have thus remained broadly static since 2012 in line with the trend in other high income Western European countries. ^[10]

It is clear that significant inequalities exist between different groups and pose a persistent challenge. The 2022 Scottish Health Survey reported that:

• 10% fewer women met recommended levels than men. This was 9% in 2012 and has been relatively stable, fluctuating between 9% and 13% over the past 10 years.
• 37% of those aged 75 and over met recommended levels compared to 70% of adults aged between 16 and 64. This gap has actually improved over time from a peak percentage point gap of 45 in 2013 to a gap of 33 percentage points in 2022, but a substantial inequality remains to be addressed.
• 57% of adults living in the most deprived areas met recommended levels compared to 73% in the least deprived. This gap has remained relatively stable over the past 10 years.

We know from other data that disabled adults, those with mental health challenges and those belonging to ethnic minority groups are also less active. We also recognise that many of these characteristics interact with each other. A person may have several characteristics and some circumstances make other ones more likely, for example being disabled or from an ethnic minority (non-white) background is associated with higher likelihood of relative poverty.

Addressing inequalities in opportunities is a priority. The barriers faced by too many people must be removed to allow everyone in Scotland to gain the health benefits of being active.

The 2022 Health Survey also noted that 22% of adults in Scotland reported very low levels of physical activity (under 30 minutes per week). This has significant public health implications. The study commissioned by Public Health Scotland mentioned above noted that more than 80% of the 3,000 deaths attributable to inactivity, occur amongst those undertaking very low levels of activity.^[11]

This is a very important finding. We know that those who report very low levels of activity are most often older adults, people living in more deprived communities and those with disabilities or long term conditions. We can have the biggest impact on the burden of disease in Scotland through a focus on removing the barriers which prevent those who currently report the lowest levels of physical activity to sustain slightly higher levels of activity.

The PHS study further concluded that if people in the very low activity category increased their activity levels by just 15 minutes per week, an equivalent of around 1,000 years of life lost from premature ischaemic heart disease death alone in Scotland could have potentially been averted.