Bellew Bill, Schöeppe Stephanie, Bull Fiona C, Bauman Adrian
School of Public Health, University of Sydney, Sydney, Australia.
Centre for Physical Activity and Health, Building K25, University of Sydney, Sydney, Australia.
Aust New Zealand Health Policy. 2008 Jul 31;5:18. doi: 10.1186/1743-8462-5-18.
This paper provides an historical review of physical activity policy development in Australia for a period spanning a decade since the release of the US Surgeon General's Report on Physical Activity and Health in 1996 and including the 2004 WHO Global Strategy on Diet, Physical Activity and Health. Using our definition of 'HARDWIRED' policy criteria, this Australian review is compared with an international perspective of countries with established national physical activity policies and strategies (New Zealand, Canada, Brazil, Scotland, Switzerland, the Netherlands and Finland). Methods comprised a literature and policy review, audit of relevant web sites, document searches and surveys of international stakeholders.
All these selected countries embraced multi-strategic policies and undertook monitoring of physical activity through national surveys. Few committed to policy of more than three years duration and none undertook systematic evaluation of national policy implementation. This Australian review highlights phases of innovation and leadership in physical activity-related policy, as well as periods of stagnation and decline; early efforts were amongst the best in the world but by the mid-point of this review (the year 2000), promising attempts towards development of a national intersectoral policy framework were thwarted by reforms in the Federal Sport and Recreation sector. Several well received reviews of evidence on good practices in physical activity and public health were produced in the period but leadership and resources were lacking to implement the policies and programs indicated. Latterly, widespread publicity and greatly increased public and political interest in chronic disease prevention, (especially in obesity and type 2 diabetes) have dominated the framework within which Australian policy deliberations have occurred. Finally, a national physical activity policy framework for the Health sector emerged, but not as a policy vision that was inclusive of the other essential sectors such as Education, Transport, Urban Planning as well as Sport and Recreation.
Despite some progression of physical activity policy in the decade since 1995/6, this review found inconsistent policy development, both in Australia and elsewhere. Arguably, Australia has done no worse than other countries, but more effective responses to physical inactivity in populations can be built only on sustainable multi-sectoral public health policy partnerships that are well informed by evidence of effectiveness and good practice. In Australia and elsewhere prerequisites for success are political support, long-term investment and commitment to program implementation and evaluation. An urgent priority is media and political advocacy for physical activity focussed on these factors.
本文回顾了自1996年美国卫生局局长发布关于体育活动与健康的报告至2004年世界卫生组织《饮食、身体活动与健康全球战略》发布这十年间澳大利亚体育活动政策的发展历程。依据我们对“根深蒂固”政策标准的定义,将澳大利亚的这一政策回顾与拥有既定国家体育活动政策和战略的国家(新西兰、加拿大、巴西、苏格兰、瑞士、荷兰和芬兰)的国际视角进行比较。方法包括文献和政策回顾、相关网站审核、文件检索以及对国际利益相关者的调查。
所有这些选定国家都采纳了多战略政策,并通过全国性调查对体育活动进行监测。很少有国家致力于为期三年以上的政策,且没有国家对国家政策实施进行系统评估。此次澳大利亚政策回顾突出了体育活动相关政策的创新和引领阶段,以及停滞和衰退时期;早期的努力在世界上处于领先水平,但到本次回顾的中期(2000年),建立全国跨部门政策框架的一些有前景的尝试因联邦体育和娱乐部门的改革而受阻。在此期间发表了几份关于体育活动和公共卫生良好实践证据的广受好评的综述,但缺乏实施所提及政策和项目的领导力和资源。最近,对慢性病预防(尤其是肥胖症和2型糖尿病)的广泛宣传以及公众和政治关注度的大幅提高主导了澳大利亚政策审议的框架。最后,出现了一个针对卫生部门的全国体育活动政策框架,但并非作为一个涵盖教育、交通、城市规划以及体育和娱乐等其他重要部门的政策愿景。
尽管自1995/96年以来的十年间体育活动政策有所进展,但本次回顾发现澳大利亚和其他地方的政策发展都不一致。可以说,澳大利亚并不比其他国家做得更差,但只有基于可持续的多部门公共卫生政策伙伴关系,且这些伙伴关系有充分的有效性和良好实践证据作为支撑,才能更有效地应对人群身体活动不足的问题。在澳大利亚和其他地方,成功的先决条件是政治支持、长期投资以及对项目实施和评估的承诺。当务之急是针对体育活动进行聚焦这些因素的媒体和政治宣传。