Opinion
BRICS nations and the opportunities for community physical activity interventions
Carol Ewing Garber
Department of Biobehavioral Sciences,Teachers College,Columbia University,New York,NY 10027,USA Received 1 July 2019;revised 4 July 2019;accepted 10 July 2019 Available online 3 August 2019
Decreases in physical activity(PA)in the populations of developing countries have occurred alongside the rapidly changing urban form,greater availability of automobiles,pollution,shifts in the nature of work,and other factors.1,2 PA behavior varies among the countries of Brazil,Russia,India,China,and,more recently,South Africa(grouped together under the acronym BRICS),and this becomes more apparent when comparisons are made across age and sex.Nonetheless,these 5 countries share some common characteristics related to PA:insufficient PA is prevalent,PA decreases with age,women are less active than men,people living in rural areas are more active than urban dwellers,and higher incomes are associated with higher levels of PA.3 Furthermore,a global PA report card shows similarly depressing figures for children residing in these countries.4
The BRICS nations are a focus of the global public health community because more than 40%of the world's population resides in these countries and they encompass more than one-quarter of the world's landmass.5 Although the BRICS countries were thought to be similar economically and were poised to emerge as dominant economies at one time(and hence grouped together economically),the current reality is that the economies are more divergent than had been expected.For example,2 of the countries,China and India,have been growing at a rapid pace,while growth in Brazil and Russia have slowed because these 2 countries have experienced economic downturns.Furthermore,while sometimes viewed similarly from an economic perspective, these countries are different politically and socioculturally.Consequently,it is inappropriate to consider them as a block where a singular approach to address public health issues,such as PA,might be adopted.The disparate realities of these countries present different challenges to the people and the communities in which they live;therefore,different strategies for engaging these communities in promoting PA will be required.
In regard to PA,policies promoting economic growth in the BRICS countries have been accompanied by rapid urbanization—particularly in China,Southeast Asia,and Africa—hurtling them toward rapid population shifts at unprecedented levels.6 China has experienced the greatest shifts in urbanization,with one-half of its population now residing in urban areas, compared with 10%-20%in 1980.6 The prevailing wisdom that urbanization uniformly promotes economic growth and prosperity has been challenged.6 Although government officials and policy makers have generally accepted that more urbanization is a positive development,scholars suggest that this is not necessarily the case because the impact of urbanization is complex.6 From a public health perspective,rapid urbanization often results in damaging consequences to the environment,including increased pollution and carbon emissions,poor water quality and availability,and effects on human food sources and biodiversity.6-9 Urbanization is associated with many harmful effects on health(i.e.,communicable and noncommunicable diseases)and is associated with increased health risks,many of which result from stress,environmental hazards,poor sanitation,inadequate housing and overcrowding,income inequality,food insecurity,inadequate safety regulations,and poor health behaviors.6,9-11
The BRICS nations also have high rates of obesity.According to the Study on Global Ageing and Adult Health Survey of people over the age of 50 years,South Africa and Russia have the highest prevalence of obesity.For example,45.2%of adults over age 50 in South Africa are obese and 36%of older adults in Russia are classified as such.3 More concerning is the high prevalence of central adiposity,with rates among older men and women in the BRICS countries ranging from a low of 41.4%among Chinese men ages 50-59 years to a high of 86.7%among Indian women 60-69 years of age;in each BRICS country,more women than men have central obesity across all age groups.3 The high rates of obesity parallel a high prevalence of comorbid diseases,such as coronary heart disease,diabetes mellitus,and cancer.12-14 Chronic disease risk factors also are common(although the prevalence varies across countries)and include insufficient PA(e.g.,a high of 59.6%among older adults in South Africa),inadequate fruit and vegetable intake(e.g.,a high of 87.9%among older adults in India),tobacco abuse(e.g.,a high of 46.7%among older adults in India),hypertension(e.g.,a high of 78%among older adults in South Africa),and heavy drinking(e.g.,a high of 6.2%among older adults in China).People with multiple risk factors for chronic diseases are common in China,Russia,and South Africa,with a high of 15.3%among older adults in China.3
One thing is clear:it is important to develop infrastructures and institutions for urbanization and economic growth that simultaneously have positive effects on the health and wellbeing of a country's residents.This suggests that considering and planning for the potential positive and negative effects of urbanization and economic growth is crucial.Developing transitional strategies and capacities in infrastructures that will support public health,public services,job training,and other factors will make it more likely that positive economic growth will occur with urbanization,while attenuating the adverse effects on the population and environment.6 Urbanization presents many opportunities for planning that can enhance environmental and sociocultural supports for PA,but the challenge is to balance competing economic demands that may seem to be expeditious in the short term but that are not necessarily so in the long term.
Identifying with a social group can influence individual PA and is a key factor to consider when intervening at the community level.Identifying social groups and working with them as partners in community participation and engagement is a central element of successful community interventions.16 However,rapid urbanization can present a challenge to social cohesiveness and social identity because people may undergo disruptive moves from their original communities(e.g.,moving from a rural to an urban environment),resulting in social isolation caused by separation from family or religious and sociocultural groups to which they formerly belonged.Social identity is integrated into an individual's sense of self,which is a powerful correlate of PA behavior.16 Thus,the challenge in the rapidly changing BRICS countries is to reach out to people in ways in which they can identify and to use methods that will help to foster social identity.Stevens and colleagues17 provide a helpful review of applying social identity and selfcategorization theories to PA interventions,and they make the point that fostering social identities as part of interventions may be an effective,although not well-tested,strategy.
透视公安实训领域VR技术应用及发展，制约该项技术推广应用的核心因素，一方面源于VR技术本身发展水平限制，另一方面根植于公安教育理念、制度机制层面的障碍。
Communities can be an effective level at which to adopt and implement policies and interventions to promote PA.The communities with which individuals identify can include governmental,religious,and sociocultural communities.Social cohesion refers to how people work together to address an opportunity or a crisis,and it is a fundamental ingredient for successful implementation of community-level policies and interventions that promote PA.To engage communities,it is necessary that people have trust in relevant agencies or organizations,that they believe that the long-term benefits of programs will outweigh any short-term difficulties or losses,and that residents identify with leaders and believe that those leaders understand the community.15,16 Inclusiveness of all individuals seems to be vital to success,while exclusion based on class,racial,or other differences can inhibit success.15
我说完，把她领到家，最初，我什么想法也没有。只想领她到家看看，这是一栋新买的房子，在王母阁公园小区最好的位置，四居室，装修得不好不孬。我爸爸是个名气响当当的画家，妈妈在机关做财务，家庭条件还算不错。
The collaborative efforts initiated with the advent the BRICS Council of Exercise and Sport Science will provide further opportunities to share expertise and learn from other collaborators(including the global PA and public health communities)to identify successful community-based models that might be implemented in BRICS communities and across the globe.5 The BRICS countries provide exciting opportunities to apply scientific knowledge proactively to develop effective models of community PA promotion.This will require collaborations across the global community without preconceived notions about the “best”approaches,since each country and community is different,and of necessity will need tailored approaches and broad expertise.
The BRICS nations have many challenges,but they also have some exciting opportunities to proactively implement policies and infrastructures that can promote PA within their communities.These efforts can help to reverse the poorer health of residents in these countries and must go well beyond simply increasing health care expenditures.Additionally,they need to work to improve health behaviors, such as PA levels.9,18 Most of the BRICS countries have adopted goals consistent with the World Health Organization Global Action Plan for the Prevention of Non-communicable Diseases or have developed consensus guidelines.19-22 Although much of the published scientific work has focused on epidemiology of the populations and the development of valid and culturally relevant measurement tools,there are several examples of effective community approaches designed to improve PA in these countries,with more initiatives in progress(e.g.,Matsudo,23 Baker et al.,24 and Andrade et al.25).
于造模前及造模后第7、10、14、21、28天时采用排水法以自制足容积测量仪检测各组大鼠踝关节标记处以下部位的体积（V），考察其足跖肿胀度的变化情况[8]。
Competing interest
The author declares that she has no competing interests.
References
1.Koyanagi A,Stubbs B,Vancampfort D.Correlates of low physical activity across 46 low-and middle-income countries:a cross-sectional analysis of community-based data.Prev Med 2018;106:107-13.
2.Lear SA,Hu W,Rangarajan S,Gasevic D,Leong D,Iqbal R,et al.The effect of physical activity on mortality and cardiovascular disease in 130,000 people from 17 high-income,middle-income,and low-income countries:the PURE study.The Lancet 2017;390:2643-54.
3.Wu F,Guo Y,Chatterji S,Zheng Y,Naidoo N,Jiang Y,et al.Common risk factors for chronic non-communicable diseases among older adults in China,Ghana,Mexico,India,Russia and South Africa:the study on global AGEing and adult health(SAGE)wave 1.BMC Public Health 2015;15:88.doi:10.1186/s12889-015-1407-0.
4.Tremblay MS,Barnes JD,Gonz′alez SA,Katzmarzyk PT,Onywera VO,Reilly JJ,et al.Global Matrix 2.0:report card grades on the physical activity of children and youth comparing 38 countries.J Phys Act Health 2016;13(Suppl.2):S343-66.
5.Uvinha RR,de Oliveira NRC,Ridder JH,Chin MK,Durstine JL.The BRICS Council for Exercise and Sport Science(BRICSCESS)-a new era has dawned.J Sport Health Sci 2018;7:425-8.
6.Chen M,Zhang H,Liu W,Zhang W.The global pattern of urbanization and economic growth:evidence from the last three decades.PloS One 2014;9:e103799.doi:10.1371/journal.pone.0103799.
7.Zhu Q,Peng X.The impacts of population change on carbon emissions in China during 1978-2008.Environ Impact Assess Rev 2012;36:1-8.
8.Zhang YJ,Yi WC,Li BW.The impact of urbanization on carbon emission:empirical evidence in Beijing.Energy Procedia 2015;75:2963-8.
9.Gusmano MK,Rodwin VG,Weisz D,Ayoub R.Health improvements in BRIC Cities:Moscow,S~ao Paulo,and Shanghai,2000-10.World Med Health Policy 2016;8:127-38.
10.Gong P,Liang S,Carlton EJ,Jiang Q,Wu J,Wang L,et al.Urbanisation and health in China.The Lancet 2012;379:843-52.
11.Goryakin Y,Rocco L,Suhrcke M.The contribution of urbanization to non-communicable diseases:evidence from 173 countries from 1980 to 2008.Econ Hum Biol 2017;26:151-63.
12.Lachat C,Otchere S,Roberfroid D,Abdulai A,Seret FM,Milesevic J,et al.Diet and physical activity for the prevention of noncommunicable diseases in low-and middle-income countries:a systematic policy review.PLoS Med 2013;10:e1001465.doi:10.1371/journal.pmed.1001465.
13.Collingridge D.Three countries—half of the global cancer burden.Lancet Oncol 2014;15:483.doi:10.1016/S1470-2045(14)70107-X.
14.Allen L,Williams J,Townsend N,Mikkelsen B,Roberts N,Foster C,et al.Socioeconomic status and non-communicable disease behavioural risk factors in low-income and lower-middle-income countries:a systematic review.Lancet Glob Health 2017;5:e277-89.
15.Easterly W,Ritzen J,Woolcock M.Social cohesion,institutions and growth.Econ Polit 2006;18:103-20.
16.Rachele JN,Ghani F,Loh VH,Brown WJ,Turrell G.Associations between physical activity and the neighbourhood social environment:baseline results from the HABITAT multilevel study. Prev Med 2016;93:219-25.
17.Stevens M,Rees T,Coffee P,Steffens NK,Haslam SA,Polman R.A social identity approach to understanding and promoting physical activity.Sports Med 2017;47:1911-8.
18.Jakovljevic MB.BRIC's growing share of global health spending and their diverging pathways.Front Public Health 2015;3:135.doi:10.3389/fpubh.2015.00135.
19.Tan X,Zhang Y,Shao H.Healthy China 2030,a breakthrough for improving health.Glob Health Promot 2018;1:1757975917743533.doi:10.1177/1757975917743533.[Epub ahead of print].
20.Sebastiao E,Schwingel A,Chodzko-Zajko W.Brazilian physical activity guidelines as a strategy for health promotion. Rev Saude Publica 2014;48:709-12.
21.Misra A,Nigam P,Hills AP,Chadha DS,Sharma V,Deepak KK,et al.Consensus physical activity guidelines for Asian Indians.Diabetes Technol Ther 2012;14:83-98.
22.World Health Organization.Global action plan for the prevention and control of noncommunicable diseases 2013-2020.Geneva:World Health Organization;2013.
23.Matsudo V.The role of partnerships in promoting physical activity:the experience of Agita Sao Paulo.Health Place 2012;18:121-2.
24.Baker PR,Francis DP,Soares J,Weightman AL,Foster C.Community wide interventions for increasing physical activity.Cochrane Database Syst Rev 2015;1:CD008366.doi:10.1002/14651858.CD008366.pub3.
25.Andrade DR,Garcia LMT,Perez DCP.Local collaborations for physical activity promotion:a network analysis.Cad Saude Publica 2018;34:e00127517.doi:10.1590/0102-311X00127517.
Peer review under responsibility of Shanghai University of Sport.
E-mail address:ceg2140@tc.columbia.edu
https://doi.org/10.1016/j.jshs.2019.07.010
2095-2546/©Cite this article:Garber CE.BRICS nations and the opportunities for community physical activity interventions.J Sport Health Sci 2019;8:509-11.
(http://creativecommons.org/licenses/by-nc-nd/4.0/)
标签：BRICS论文; nations论文; and论文; The论文; Opportunities论文; for论文; COMMUNITY论文; PHYSICAL论文; activity论文; interventions论文; Department of Biobehavioral Sciences论文; Teachers College论文; Columbia University论文;