This commentary by Pekka Puska, M.D., Ph.D., highlights both the societal and individual obligations of people to become more active. The author addresses the policy challenge of how to engage the segment of society that is currently least active, because the greatest public health impact is made by increasing physical activity in people who engage in it least. Puska recommends policies that find a balance between emphasizing restrictions (diets, restricting indoor activities and motorized transport, etc.) and incentives.
Another focus of this commentary is the need for global action. The WHO has developed an international instrument, the WHO Global Strategy on Diet, Physical Activity, and Health, and this instrument should be a guiding force for policy development. However, governments must shoulder the responsibility for improving public health in individual countries. Similarly, all policies—no matter who is implementing them—must have a strong theoretical basis in physical activity research. Research on theories and practices of societal and community-based interventions is urgently needed, as is a thorough understanding of how to implement the policies developed through such research.
Lastly, Puska describes a promising intervention undertaken in Finland, where cardiovascular disease mortality was lowered 85 percent from its high in the 1970s. However, although Finland has lowered its cardiovascular mortality, the population is growing more sedentary and heavier. Thus, a need for implementation of physical activity-promoting policies still exists. Health promotion globally must adapt its primary mission from conducting health education campaigns to "driving social change for health and being change agents for the diffusion of health innovations."