Standardisation of physical activity surveillance in Australia is overdue

Why we studied this topic

Physical inactivity continues to be a major contributor to chronic disease in Australia, but efforts to address it in Australia remain fragmented.

A stable surveillance system is necessary to monitor trends in physical activity and the factors that contribute to it. This provides essential information for assessing the magnitude of the problem and understanding its contribution to the burden of disease, and trends will be useful for understanding the impact of policies and programs to address the problem.

What this paper adds

We conducted a detailed audit of state and territory health sector surveys to determine and compare how they have measured the proportion of their adult populations who meet the recommended levels for being ‘sufficiently active’ over time. We focused on the definitions and questions that each jurisdiction used to determine ‘sufficient physical activity’.

The surveys used by the states and territories are either derived from, or are variations of, the Active Australia Survey – a self-report survey designed to support nationwide standardisation of measures for self-reported physical activity in adults.

There has been sustained and comparable usage of survey questions and definitions in several states, whereas others have used different definitions, age groups and questions over time.

The differences in state and territory survey systems have produced much greater variability than is suggested by tracking physical activity trends at the state-level using the Australian Bureau of Statistics’ National Health Survey. The variations that some jurisdictions have made to their survey questions and definitions have contributed to some of the observed changes in their trend data.

What was surprising?

From as early as 1987, there have been evidence-based calls for a standard surveillance system for monitoring physical activity in Australia, however physical activity surveillance in Australia remains disjointed and disparate.

What it means for policy

The lack of standardisation has prevented any comparison of prevalence rates within and between jurisdictions. Standardisation across Australia is required if physical activity trends are to be reliably interpreted. This could be achieved with physical activity coordination and leadership, and a clear physical activity national plan, with a consistent measurement system.

Beyond this, there needs to be a broader national discussion about a comprehensive physical activity surveillance system that not only measures physical activity levels, but also assesses underpinning and antecedent changes, and measures at organisational, environmental and policy levels. An integrated surveillance system should also incorporate estimates from non-health sectors such as transport, education and sport.