We read last month’s editorial on promoting physical activity with pleasure, but feel the authors should have gone further.1 If we discovered a drug that reduced the risk of cardiovascular disease, diabetes, and cancer by 20–50%, calls for more education and signposting would be seen as risible. Treating physical activity seriously is good for patients and has the potential to significantly reduce GP workload.
Lifestyle behaviours like smoking, drinking, eating too much, and moving too little cause around 40% of deaths in the UK,2 yet we spend a relatively small amount of time combating these major drivers of disease with patients. In our surgeries we should ensure that we have bike stands, good public transport connections, standing desks, and adverts for local physical activity opportunities such as walking groups, exercise classes, and sports. We should support our staff in stopping smoking and maintaining a healthy weight by encouraging subsidised physical activity opportunities for NHS employees and access to cessation services.
Beyond the practice car park there are a myriad of ways that GPs can make a real difference to our communities by influencing the physical, social, and policy environments. We should be politically engaged: lobbying councils for green space, safe streets, cycle lanes, improved pavement surfaces, investment in public transport, accessible and affordable facilities for physical activity (including new free-to-access activities such as outdoor gyms), organised sports and community events, and accessible and affordable fruit and vegetables.
We have a clear mandate to engage in community-oriented health promotion,3 but currently there are no incentives, no time, and no training. Virchow said, ‘If medicine is to fulfill her great task, then she must enter the political and social life.’4 Promoting physical activity in our local communities demands this approach, and has the potential to reduce workload, prevent disease, and ultimately save lives.
- © British Journal of General Practice 2016