The Toronto Charter for Physical Activity TOWARD POLITICAL COMMITMENT, POLICY ACTION AND SYSTEMS SUPPORT FOR PROMOTING AND SUSTAINING HEALTH ENHANCING PHYSICAL ACTIVITY process of developing this Charter which we hope will provide a clear call for action, to health and non health sectors, and activity be applicable and relevant to allprevents countries but particularly and connections middle income Regular physical promotes health and disease, improveslow social and countries.

quality of life, provides economic benefits and contributes to environmental sustainability. Communities that enhancing physical activity, in a variety ways, infrom different We aim to launch thesupport Charter health at the 3rd International Congress in Toronto, and of borrowing settings, and throughout life can achieve many processes, of these benefits. experience of other international health promotion have planned for extensive consultation on the content and format of the Charter prior to the Congress. In brief, our development process has 6 This Charter is a call for all countries, regions and communities to strive for greater political steps:

commitment and community action to achieve physical activity for all. 1. Peer consultations with a group of 20+ scholars and advocates throughout the world to provide initial “critical friends” feedback [this current stage] 2. A wider global consultation using web based interface with English, French, and Spanish versions of the Charter to collect feedback from a wider variety of stakeholders and potential users of this Charter from different regions. There is potential for revised version incorporating comments to be posted and for this to be an interactive phase over 2-3 months Throughout the world, technology, urbanization and automobile-focussed community design have 3. In Toronto in May we plan to capture further input from attending delegates during the first few days engineered physical activity of daily life. Opportunities for physicalofactivity continue toclosing decline through the a comment boxout on-site, culminating with the presentation the Charter in the while the of prevalence of sedentary lifestyles increases in most countries, resulting in major health, session the Congress. social and economic consequences. 4. Post-congress consultations are also ear marked for consideration dependent on the progress made before and at the congress. relation to of health, physical inactivity is the fourth leading risk factor associated with nonthe Charter 5.InPublication 6.communicable Disseminationdiseases Phase – wider circulation and promotion of thepreventable Charter and contributes to over two million deaths annually

Physical activity – a powerful investment in people

worldwide. Physical inactivity also contributes to increasing childhood obesity which in turn increases the likelihood of adult obesity and other chronic conditions. Physical activity benefits people of all ages. For older adults it is never too late to start physical activity, and the benefits of becoming physically active will be felt rapidly. For the economy, physical inactivity has been estimated to account for 1 to 3% of health care costs in high income countries and has a significant impact on low and middle-income countries in terms of lost productivity and lost healthy life years. For sustainable development, promotion of active modes of transport such as walking, cycling and public transport can reduce harmful exhaust and carbon emissions. These measures as well as healthy urban planning have been identified as important strategies for promoting physical activity and reducing dependence on motor vehicle use in all countries, and importantly, in those developing counties experiencing rapid urbanization. Actions that increase opportunities for physical activity are a powerful investment in reducing non-communicable diseases and improving health, as well as providing benefits for economic and sustainable development of countries throughout the world.

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Why a Charter on Physical Activity? This Charter for Physical Activity is both a call for action and a platform for advocacy to improve opportunities for physically active lifestyles for all. Organizations and individuals interested in promoting physical activity can use this Charter to influence decision makers at national, regional, and local levels. This Charter can be used to unite health, transport, sport and recreation, education and private sectors toward a shared goal, namely: To elevate physical activity as a policy priority and develop, adequately resource, and implement cross-sector policies, plans and intervention programs to increase population levels of physical activity throughout the world.

Guiding principles for a population-based approach to physical activity Countries and organizations working to increase participation in physical activity are encouraged to adopt the following guiding principles. These principles are consistent with the World Health Organization’s Global Strategy on Diet, Physical Activity and Health as well as other international health promotion charters. 1. Adopt evidence-based strategies for physical activity that target the whole population as well as specific population sub-groups. 2. Embrace an equity and human rights approach aimed at reducing social inequalities and disparities of access to physical activity. 3. Address the physical, social and environmental determinants of physical activity aggressively. 4 Implement actions that are sustainable at multiple levels and across multiple sectors to achieve greatest impact. 5. Undertake advocacy to gain support from decision makers and the general community to obtain an increase in resources and political commitment. 6. Support capacity-building in research, practice, and training, including capacity-building in public health systems. 7. Take a life-stage approach that addresses the needs of children, families, adults and older adults. 8. Ensure cultural sensitivity and recognise the need to adapt physical activity strategies to varying ‘local realities’ and resources.

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A framework for action This Charter calls for concerted action across five key areas. This action should involve governments, non-government organizations, professional associations, and other agencies, both within and, importantly, outside the health sector as well as communities themselves.

1. IMPLEMENT A NATIONAL ACTION PLAN process of developing this Charter which we hope will provide a clear call for action, to health and non health sectors, and be applicable and relevant to allfor countries but particularly low and middle income Develop and disseminate a national action plan physical activity promotion that makes countries. physical activity a health and social priority. National plans should: • Have from broad constituency representative of the target population. We aim toinput launch theaCharter at the 3rd International Congress in intended Toronto, and borrowing from experience other international health promotion have planned extensive consultation on • Provideof a framework for implementation that processes, can be articulated at thefor national, regional, the provincial, content anddistrict formatand/or of the Charter prior to the Congress. In brief, our development process has 6 local levels. steps: • Describe roles and actions that government, non-government and private-sector organizations can and should take to implement the plan and promote physical activity. 1. Peer consultations with a group of 20+ scholars and advocates throughout the world to provide initial • Define accountability for actions to ensure reasonable chance of implementation. Leadership “critical friends” feedback [this current stage] for physical activity planning may come from the health sector, the sport and recreation sector, 2. A wider global consultation using web based interface with English, French, and Spanish versions of andCharter other relevant froma awider cross-sector the to collectagencies feedbackorfrom variety ofcoalition. stakeholders and potential users of this Charter from different regions. There is potential for revised version incorporating comments to be ACTIONphase over 2-3 months 2.posted DEVELOP andPARTNERSHIPS for this to be anFOR interactive 3.Actions In Toronto in May we plan topopulation capture further from attending delegates theand first few days be during planned aimed at increasing levelsinput of physical activity should through the a comment box on-site, culminating with the presentation of the Charter in the closing performed through partnerships and collaborations involving different health and non-health session of the Congress. sectors at multiple levels. Successful partnerships are developed by fostering: 4. Post-congress consultations are also ear marked for consideration dependent on the progress made andacross at themissions, congress.values, and activities of organizations. • before Synergy 5.• Publication of the across Charterorganizations that encourages sharing information and best practices for Mutual support 6. Dissemination Phase – wider circulation and promotion of the Charter success.

• Promotion of shared responsibilities and shared resources in the development and implementation of policies and activities. Examples of partnerships that support the promotion of physical activity are: • Cross-level government working parties including representatives from national, regional, and local levels of government to implement action plans at each level in a synergistic manner. • Whole-of-government and community initiatives involving different departments and agencies (for example, transport, urban planning, economic development, environmental development, education, sport, recreation, and health) work in collaboration and sharing resources to achieve the common goal of promoting physical activity in the population they serve. • Coalitions of non-government organisations formed to advocate for and promote physical activity. • National or regional partnership forums with key agencies in health and non-health sectors, and public and private stakeholders to promote programs and policies.

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3. REORIENT SERVICES AND FUNDING TO PRIORITISE PHYSICAL ACTIVITY In most cases, successful action to promote a more active population will require a reorientation of priorities in favour of health-enhancing physical activity. Reorienting services and funding systems towards physical activity can deliver multiple benefits including: better health; cleaner air; reduced traffic congestion; cost-saving; and greater social connections. Examples of actions underway in many countries and which are potentially relevant for adoption elsewhere include: In health:

process of developing this Charter which we hope will provide a clear call for action, to health and non • Screening of patients for levels of physical activity at every primary care consultation, and health sectors, and be applicable and relevant to all countries but particularly low and middle income provision of brief, structured advice and referral to community programs for insufficiently active countries.

patients. • such as diabetes, cardiovascular disease, some cancers or We For aimpatients to launchwith the diseases/conditions Charter at the 3rd International Congress in Toronto, and borrowing from arthritis,ofscreening by healthhealth and exercise professionals contraindications and provision of on experience other international promotion processes, for have planned for extensive consultation advice on physical activity as part of treatment, management and review plans. the content and format of the Charter prior to the Congress. In brief, our development process has 6 steps: • Health sector funding for physical activity related health promotion campaigns and programs. education: 1.InPeer consultations with a group of 20+ scholars and advocates throughout the world to provide initial • “critical Education systems prioritizing high quality friends” feedback [this current stage] compulsory physical education in schools and physical education for allinterface teachers. wider global consultation usingtraining web based with English, French, and Spanish versions of 2. Aenhancing the Charter to collect feedback from a wider variety of stakeholders and potential users of this InCharter transportation: from different regions. There is potential for revised version incorporating comments to be • posted Transport and prioritizing and policies for this to beservices an interactive phasewalking, over 2-3 cycling monthsand public transit infrastructure roads. 3. Inover Toronto in May we plan to capture further input from attending delegates during the first few days • through Transportation departments fund programs to with promote the benefitsofofthe using theseinmodes of the a comment box on-site, culminating the presentation Charter the closing session of the Congress. transport. 4. Post-congress consultations are also ear marked for consideration dependent on the progress made Inbefore planning: and at the congress. • Planners 5. Publicationimplementing of the Charterevidence-based healthy urban design codes that support walking, cycling and recreational physical activity. 6. Dissemination Phase – wider circulation and promotion of the Charter • Planners prioritising urban design that provides opportunities for sport, recreation and physical activity by increasing access to public space where people of all ages and abilities can be physically active. In sport and recreation: • Continuing a focus on Sport for All promoting increased participation.

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4. INTRODUCE REGULATIONS AND POLICIES THAT ENCOURAGE PHYSICAL ACTIVITY Lessons learned from both developed and developing countries, show that a supportive policy framework and regulatory action are required to achieve sustainable changes in government and organisational ‘systems’. Policies that support health enhancing physical activity are needed across the health, transport, education, and sport/recreation systems and services. Examples of supportive policy and regulations include: • Clearofnational objectives for increasing population levels ofaphysical thattostate byand hownon process developing this Charter which we hope will provide clear callactivity for action, health much and by All sectors sharetocommon goalsbut and identify their contribution. An health sectors, andwhen. be applicable andcan relevant all countries particularly low and middle income countries. example of a national target might be: ‘to increase physical activity levels in adults from 25% to 30% by 2015’. We aim to planning launch thepolicies Charterand at the 3rd International Congress Toronto, cycling, and borrowing from • Urban design guidelines that supportinwalking, public transport, experience of other international health promotion processes, have planned for extensive consultation on sport and recreation with a particular focus on access and safety. the content and format of the Charter prior to the Congress. In brief, our development process has 6 • Transport policies that support non-motorized modes of transportation. steps:

• Fiscal policies such as subsidies, incentives and tax deductions that may support participation in physical activity. with a group of 20+ scholars and advocates throughout the world to provide initial 1. Peer consultations • “critical Labourfriends” and workplace policies that support feedback [this current stage] physical activity. • Education policies that support physical education, healthy school environments andversions active of interface with English, French, and Spanish 2. A wider global consultation using web based travel to school. the Charter to collect feedback from a wider variety of stakeholders and potential users of this Charter from different regions. There is potential for revised version incorporating comments to be for this to be an interactive phase over 2-3 months 5.posted ADOPTand COMMUNITY-LEVEL APPROACHES

3. In Toronto in May we plan to capture further input from attending delegates during the first few days Education programmes that inform, motivate and support the community to be through the a commentand boxenvironments on-site, culminating with the presentation of the Charter in the closing active should form key parts of any successful national approach to physical activity. Communitysession of the Congress. approachesconsultations that influence social built environmental are made 4.level Post-congress arebehavioural, also ear marked forand consideration dependentdeterminants on the progress necessary. can be implemented across settings and can include: before andThese at theactions congress. 5. Publication of the Charter schools: 6.InDissemination Phase – wider circulation and promotion of the Charter

• Good quality compulsory school physical education.

In cities and suburbs: • Walking and cycling programs in neighbourhoods. • Healthy urban design that supports opportunities for sport, recreation and physical activity by increasing access to places where people can be physically active. • Sustainable and efficient transport systems that prioritise walking, cycling and the use of public transport. In workplaces: • Workplace programs that encourage and support employees and their families to lead active lifestyles. In primary care: • Physical activity interventions and funding systems in primary care. In sport and recreation: • Sport and recreation policy that prioritises increased community participation.

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A call to action All those who are committed to improving the health and quality of life of individuals and populations must emphasize the important role of health-enhancing physical activity to achieving this objective. The Toronto Charter for Physical Activity provides a solid foundation and direction for the development and implementation of actions to increase population levels of physical activity. However, high level advocacy is required to obtain and maintain commitment to the full adoption implementation of these five areas of action inaction, all countries. process ofand developing this Charter whichprinciples we hope and will provide a clear call for to health and non health sectors, and be applicable and relevant to all countries but particularly low and middle income We encourage all interested stakeholders to use the Toronto Charter for Physical Activity as an countries.

advocacy tool and to engage with government representatives, across all sectors, to secure their We launch the Charter at population the 3rd International in Toronto, and borrowing roleaim andtosupport in advancing levels of Congress health enhancing physical activity. from experience of other international health promotion processes, have planned for extensive consultation on the and format thea Charter prior to thefor Congress. In brief, our development Wecontent encourage you to of play role in advocating greater recognition and action onprocess health-has 6 steps: enhancing physical activity and to use the Toronto Charter for Physical Activity to start and to scale

up action in your country and region. We welcome your support and ask you to act now!

1. Peer consultations with a group of 20+ scholars and advocates throughout the world to provide initial “critical friends” feedback [this current stage] 2. A wider global consultation using web based interface with English, French, and Spanish versions of the Charter to collect feedback from a wider variety of stakeholders and potential users of this Charter from different regions. There is potential for revised version incorporating comments to be For further aboutphase the over Charter please visit: posted and forinformation this to be an interactive 2-3 months 3.http://www.cflri.ca/icpaph/en/index.php In Toronto in May we plan to capture further input from attending delegates during the first few days through the a comment box on-site, culminating with the presentation of the Charter in the closing session of the Congress. 4. Post-congress consultations are also ear marked for consideration dependent on the progress made before and at the congress. 5. Publication of the Charter 6. Dissemination Phase – wider circulation and promotion of the Charter

To participate in the Global Consultation underway please visit www.econsultation.org.uk

February 12, 2010

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