Global Matrix 3.0 Theoretical Framework

The Global Matrix and the Report Card on Physical Activity for Children and Youth are two projects developed by researchers and stakeholders in response to the physical inactivity global health crisis. The aim of this document is to present the theoretical framework of these international initiatives.

In 2009, physical inactivity was identified as the fourth leading risk factor for non-communicable diseases (NCDs) (World Health Organization (WHO), 2009, p.V) behind high blood pressure, tobacco use and high blood glucose, and ahead of overweight and obesity. In 2008, physical inactivity was estimated to be responsible for 9% of premature mortalities or more than 5.3 million deaths worldwide (Lee et al., 2012). Based on these results, physical inactivity has been described as one of “the biggest public health problems of the 21st century” (Blair, 2009; Trost et al., 2014). The global prevalence of physical inactivity was estimated to be 31.1% for adults from 105 countries in 2012, (Hallal et al., 2012) and 81% for adolescents (11-to-17 years) in 2010 (WHO, 2014,).

In addition, some studies have shown that individuals who engaged in low levels of physical activity during childhood were more likely to continue these behaviours into adulthood, and thus, more likely to be obese as adults (Telama et al., 2005; Yang et al., 2006). Moreover, there has been an overall diminution in physical fitness in children and adolescents since 1975 (Tomkinson& Olds, 2007), and an increase in the prevalence of overweight and obesity for this age group in developed and developing countries between 1980 (8.1%) and 2013 (23.8%) (Ng et al., 2014). These findings provide compelling evidence that a significant increase in premature disease and disability can be anticipated if the physical inactivity crisis is not addressed (Lobstein et al., 2004).

An International Call To Action

In response to this alarming public health situation, the Global Advocacy for Physical Activity (GAPA; Titze&Oja, 2013), the advocacy council for the International Society of Physical Activity and Health (ISPAH), developed the Toronto Charter for Physical Activity. The Toronto Charter is a global call to strive for greater political and social commitment to support health-enhancing physical activity for all countries, regions and communities; and an advocacy tool that outlines four actions based upon nine guiding principles for a population-based approach to support health-enhancing physical activity for all (Bull et al., 2010). The concerted actions for successful population change include: implementing a national policy and action plan, introducing policies that support physical activity, and reorienting services and funding to prioritise physical activity and develop partnerships for action. The GAPA also proposed a position statement concerning the benefits of physical activity for global health, sustainable development, and economy: attaining enough physical activity leads to healthy growth and social development in children, reduces NCD risk, improves mental health in adults, and increases independence and decreases the risk of falls and fractures in older adults (Bull et al., 2010). Physical activity has also the potential to reduce harmful air pollution through active transportation, and to benefit economic development by preventing NCDs and increasing the health and quality of life (Bull et al., 2010). To date, 1,105 individuals and 265 organisations from 191 countries have registered their support for the Toronto Charter for Physical Activity (GAPA, 2017).

One year later, the United Nations [UN] hosted a high-level meeting of the General Assembly to discuss the prevention and management of NCDs. In their political declaration, the UN acknowledged that the global burden of NCDs is a major threat to the global economy and leads to increasing social inequalities, so is a major threat to development (UN, 2012). The UN declared that it is the responsibility of the governments and the international community to promote focused efforts and to engage all sectors of society to address the common risk factors of NCDs including physical inactivity. In addition, the UN underlined the importance for Member States to continue addressing common risk factors for NCDs through the implementation of the WHO’s 2008–2013 Action Plan for the Global Strategy for the Prevention and Control of NCDs.

The Action Plan for the Global Strategy for the Prevention and Control of NCDs was re-edited by the WHO with new goals and targets for 2013-2020 (WHO, 2013). The new action plan has six main objectives, including 1. raising priority for prevention and control of NCDs, 2. strengthen national capacity, leadership, governance, multisectoral action and partnerships, 3. reducing modifiable risk factors and underlying social determinants, 4. promoting and supporting high-quality research and development, 5. monitoring trends and determinants of NCDs, and 6. evaluating progress. Additionally, this action plan has nine main targets to achieve by the end of the period 2013 to 2020, which include a global relative reduction of 10% in the prevalence of insufficient physical activity levels (third target).

During a historic UN Summit on September 25th, 2015 in New York (USA), world leaders adopted a set of Sustainable Development Goals (SDGs) to end all forms of poverty, fight inequalities and tackle climate change, all while ensuring that no one is left behind as part of a new sustainable development agenda. The 17 SDGs, which are divided into 169 specific targets, are aimed to be achieved over the next 15 years (UN, 2015).

Building on those SDGs, the Bangkok Declaration on Physical Activity for Global Health and Sustainable Development was launched in Bangkok at the 2016 ISPAH Congress. The Bangkok Declaration was developed by delegates, ISPAH members and Congress co-hosts, and provides a new position statement on the importance of physical activity for global health, the prevention of NCDs and how the co-benefits of population-based actions on physical activity can contribute to achieving eight of the 17 SDGs (NCD Alliance, 2016).