Hasson Rebecca E, Brown David R, Dorn Joan, Barkley Lisa, Torgan Carol, Whitt-Glover Melicia, Ainsworth Barbara, Keith Nicole
1Schools of Kinesiology and Public Health, University of Michigan, Ann Arbor, MI; 2Physical Activity and Health Branch, Division of Nutrition, Physical Activity and Obesity, Centers for Disease Control and Prevention, Atlanta, GA; 3City College of New York, New York, NY; 4Department of Clinical Medicine, College of Medicine, University of Central Florida, Orlando, FL; 5Kinetics Consulting, Bethesda, MD; 6Gramercy Research Group, Winston-Salem, NC; 7Department of Exercise and Wellness, School of Nutrition and Health Promotion, Arizona State University, Tempe, AZ; and 8Indiana University Center for Aging Research, Regenstrief Institute, Inc., Indianapolis, IN.
Med Sci Sports Exerc. 2017 Apr;49(4):848-858. doi: 10.1249/MSS.0000000000001161.
There is clear and consistent evidence that regular physical activity is an important component of healthy lifestyles and fundamental to promoting health and preventing disease. Despite the known benefits of physical activity participation, many people in the United States remain inactive. More specifically, physical activity behavior is socially patterned with lower participation rates among women; racial/ethnic minorities; sexual minority youth; individuals with less education; persons with physical, mental, and cognitive disabilities; individuals >65 yr of age; and those living in the southeast region of the United States. Many health-related outcomes follow a pattern that is similar to physical activity participation. In response to the problem of inequities in physical activity and overall health in the United States, the American College of Sports Medicine (ACSM) has developed a national roadmap that supports achieving health equity through a physically active lifestyle. The actionable, integrated pathways that provide the foundation of ACSM's roadmap include the following: 1) communication-raising awareness of the issue and magnitude of health inequities and conveying the power of physical activity in promoting health equity; 2) education-developing educational resources to improve cultural competency for health care providers and fitness professionals as well as developing new community-based programs for lay health workers; 3) collaboration-building partnerships and programs that integrate existing infrastructures and leverage institutional knowledge, reach, and voices of public, private, and community organizations; and 4) evaluation-ensuring that ACSM attains measurable progress in reducing physical activity disparities to promote health equity. This article provides a conceptual overview of these four pathways of ACSM's roadmap, an understanding of the challenges and advantages of implementing these components, and the organizational and economic benefits of achieving health equity.
有明确且一致的证据表明，规律的体育活动是健康生活方式的重要组成部分，对促进健康和预防疾病至关重要。尽管参与体育活动有诸多已知益处，但美国仍有许多人缺乏运动。更具体地说，体育活动行为存在社会模式差异，女性、少数族裔/种族群体、性少数青年、受教育程度较低者、身体、精神和认知残疾者、65岁以上的人以及居住在美国东南部地区的人参与率较低。许多与健康相关的结果呈现出与体育活动参与情况相似的模式。为应对美国体育活动和整体健康方面的不平等问题，美国运动医学学院（ACSM）制定了一项国家路线图，以支持通过积极的生活方式实现健康公平。构成ACSM路线图基础的可操作、综合路径包括以下几点：1）沟通——提高对健康不平等问题及其严重程度的认识，并传达体育活动在促进健康公平方面的力量；2）教育——开发教育资源，提高医疗保健提供者和健身专业人员的文化能力，并为非专业健康工作者开发新的社区项目；3）合作——建立伙伴关系和项目，整合现有基础设施，利用公共、私营和社区组织的机构知识、影响力和声音；4）评估——确保ACSM在减少体育活动差距以促进健康公平方面取得可衡量的进展。本文对ACSM路线图的这四条路径进行了概念性概述，阐述了实施这些组成部分所面临的挑战和优势，以及实现健康公平的组织和经济效益。
