Health: Global physical activity levels have not improved over 20 years (Nature Medicine, Nature Health)
10 March 2026
Global levels of physical activity have not improved over the past two decades, despite widespread policy development and adoption, and large disparities persist across gender and socioeconomic groups. The findings from three papers published in Nature Medicine and Nature Health indicate that current efforts to promote participation in physical activity are insufficient and that coordinated action is needed to ensure that physical activity contributes to public health and wider societal goals, including climate resilience.
Globally, more than five million deaths per year are attributed to physical inactivity. Despite this, about one in three adults and eight in ten adolescents do not meet the World Health Organization’s recommended activity guidelines — this includes 150 minutes of moderate-intensity weekly physical activity for adults and 60 minutes daily for children. Understanding how gaps in physical activity exist across different demographics, such as geography, race, gender, and socioeconomic status, has been challenging. Also, it is unclear whether governments are prioritizing tackling this public health issue through policy.
Writing in Nature Medicine, Deborah Salvo and colleagues analysed physical activity data from 68 countries worldwide and found persistent inequalities in the ways in which people across the world are active. Access to active leisure, such as recreational exercise — the only activity type consistently driven by choice — was 40 percentage points higher among socially advantaged groups (wealthy men in high-income countries) than among less-advantaged groups (poor women in low-income countries). In contrast, activity driven by economic necessity (such as active labour) was higher in disadvantaged populations. The authors also found evidence that physical activity also supports immunity, reduces infectious disease risks, reduces depression symptoms, and is associated with improved cancer outcomes.
In Nature Health, Erica Hinckson and colleagues present a model showing how physical activity can support climate mitigation and adaptation. They outline how strategies that support walking, cycling, and public transport instead of driving may reduce emissions and how climate change can disrupt activity, because of events such as extreme heatwaves. Additionally, they show how some physical activity initiatives can themselves contribute to emissions and how unintended consequences of those initiatives, such as resident displacement in developing walkable cities, can occur. The authors note that climate and health challenges are deeply interconnected and argue that physical activity and climate change agendas should be aligned through shared goals, tools and metrics that reflect the priorities of those most affected. They note that addressing these issues requires an inclusive bottom-up approach involving indigenous and other vulnerable communities along with a coordinated, multisectoral action from governments and international bodies to support equitable, climate resilient development.
In another Nature Health paper, Andrea Ramírez Varela and colleagues assessed 661 national policy documents to promote physical activity from 200 countries worldwide from 2004 to 2025. They found that although most countries have developed and adopted physical activity policies, evidence of implementation remains limited. 38.7% (256) of the 661 policies analysed in the study assigned actions to three or more government sectors (including, for example, health and education), indicating a lack of cross-sectoral collaboration. Meanwhile, 26.5% (53) of countries with policy documents did not include measurable targets to determine their impact. Through interviews with 46 key stakeholders — including government officials, academics, policy leaders, and civil society representatives — the researchers identified low but rising political priority for physical activity as a key barrier to implementation. Participants described four interconnected challenges: no clear consensus on whether physical activity should be an outcome in its own right or a means to broader goals; continued framing of physical activity as an individual health behavior rather than a systems issue; the absence of an “official home” within governments, resulting in fragmented leadership and accountability; and weak cross-sector alliances, with social, economic, and commercial determinants undermining activity-supportive environments. The study recommends building policy consensus, broadening recognition of benefits, clarifying multi-sector leadership, and strengthening partnerships beyond traditional health sectors.
- Article
- Open access
- Published: 09 March 2026
Salvo, D., Crochemore-Silva, I., Wendt, A. et al. Physical activity for public health in the 21st century. Nat Med (2026). https://doi.org/10.1038/s41591-026-04237-5
- Article
- Open access
- Published: 09 March 2026
Hinckson, E., Reis, R., Romanello, M. et al. Benefit of physical activity initiatives for climate change mitigation and adaptation. Nat. Health 1, 300–315 (2026). https://doi.org/10.1038/s44360-026-00057-6
- Analysis
- Open access
- Published: 09 March 2026
Ramírez Varela, A., Bauman, A., Woods, C.B. et al. Low global physical activity despite two decades of policy progress. Nat. Health 1, 338–354 (2026). https://doi.org/10.1038/s44360-025-00044-3
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