Physical activity policies

Background and key statistics on physical activity and cancer

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Physical activity is a strong protective factor against cancer

• Cancer is the leading cause of death in Canada, responsible for over 28% of all deaths.¹
• Physical inactivity is the second most common cancer risk factor, contributing to approximately 5% of all cancer cases.²
• Physical inactivity accounted for nearly 10,000 new cancer cases in Canada in 2018 and 11,000 new cases in 2021.³
• Estimates suggest that adherence to physical activity guidelines could reduce cancer risk by 10-25%.⁴
• Physical activity interventions could prevent cancer cases over the long-term, with estimates suggesting Canada could prevent 900 cancer cases by 2029 and 39,800 cases by 2042.^5,6
• Physical activity is linked to a decreased risk of colorectal cancer, bladder cancer, colon cancer, kidney cancer, stomach cancer, small intestine cancer, head and neck cancer, non-Hodgkin Lymphoma,⁷ postmenopausal breast and endometrial cancer.^8,9
• Emerging evidence suggests physical activity reduces esophageal, lung, prostate, ovarian, liver, pancreatic, and premenopausal breast cancer.^10,11

Policies promoting physical activity

The International Society for Physical Activity and Health (ISPAH) released Investments that Work for Physical Activity – a call to action for system-based approaches to increase physical activity levels at a population level.

Multi-faceted interventions with combinations of strategies impact physical activity levels more often than single component interventions.

• There is a need to understand what types of interventions – particularly those that can be applied at a population level through local, provincial/territorial, or federal policies – are most effective at increasing levels of physical activity.
• Effective physical activity policies need to be equitable, inclusive, and follow a health-in-all-policies framework.
• Regardless the aim of a policy, all levels of government should be notified and/or engaged. Maneuvering through multiple levels of government can present challenges but can often result in robust and sustainable policy decisions.
• The International Society for Physical Activity and Health (ISPAH) outlines eight investments for physical activity. Recognizing that there are numerous influences across domains, the Partnership focused on the five domains that are most influenced through government policy: active transport, active urban design, sport and recreation for all, whole-of-school programs and public education including mass media.

Physical activity policy analysis

The Partnership’s policy analysis includes a review of active policies from every province and territory along with 31 municipalities across Canada.

• Policies that create more supportive environments are generally more effective than individual approaches in improving population health, given their increased reach, scalability, and sustainability.
• Policy approaches tend to be more equitable than program interventions as they influence change at population levels versus individual levels.
• Policies generally encompass legislation, regulations, mandated school curriculums, local bylaws, and community or municipal plans.
• Policy can be enacted at federal, provincial/territorial, and/or municipal/local levels. In some cases, certain types of policy are in the jurisdiction of one level of government. More often, one level of government might be the most obvious actor for policy, but other levels might implement policy solutions along with, or instead of, the most obvious level.
• Less populated municipalities, such as rural areas, tend to have less developed policies in relation to physical activity. This could be due to a lack of perceived need, lack of funding, or lack of available sport and recreational infrastructure.
• Different policy approaches are needed across different settings and different population groups. For example, the city of Hamilton has responded to the different physical activity needs of urban and rural settings by adopting a Rural Official Plan and an Urban Official Plan.

Levels of adoption

Most policies reviewed by the Partnership are inclusive of multiple ISPAH domains, with many encompassing elements of active urban design, active transport, sport and recreation, and others. A level of adoption label has been assigned to each analyzed ISPAH domain to help illustrate strength and gaps within the Canadian physical activity policy landscape.

_{Note: Policy adoption were graded across ISPAH domains amenable to action at a regional or national policy level. The remaining ISPAH domains – healthcare, workplaces, and community-wide programming – are programmatic and/or influenced through organizational practices and were therefore not analyzed. The 31 municipalities include Canada’s largest cities plus additional municipalities ensuring an equitable sample across the country.
LOW = no or very few jurisdictions have adopted evidence-informed policy action, and/or the breadth of the policy action is limited in scope
MEDIUM = some, but not all jurisdictions have adopted evidence-informed policy action, and/or the breadth of the policy action is incomplete
HIGH = most jurisdictions have adopted comprehensive evidence-informed policy action}

• Adults should aim for at least 150 minutes of moderate intensity or at least 75 minutes of vigorous intensity physical activity each week, along with exercise that strengthens muscles at least two days per week.¹²
• Variation exists in reported physical activity levels among people in Canada: In 2018, 56% of adults engaged in over 150 minutes of physical activity in the past 7 days.¹³ Other studies suggest this number may be much lower at approximately 16%.¹⁴ Regardless of this range in reporting, more efforts are needed to increase physical activity levels among adults living in Canada.
• Children and adolescents should complete at least 60 minutes per day of moderate-to-vigorous physical activity, as well as vigorous intensity and muscle and bone strengthening activity at least three days per week.¹⁵
• Less than four out of ten (39%) children and youth (ages 5-17) meet Canadian Physical Activity Guidelines.¹⁶
• People born in Canada are more likely to meet or exceed the Canadian physical activity guidelines than people who immigrated to Canada.¹⁷
• In general, Indigenous people are more likely to meet or exceed the Canadian physical activity guidelines than non-Indigenous people.¹⁸

Percentage of people in Canada (aged 12+) reporting meeting the Canadian Physical Activity Guidelines (CPAG) ^*, by age group – 2017 and 2018 combined

The percentage of adults meeting Canadian Physical Activity Guidelines decreases with age. 69% of adults aged 18-24 meet the guidelines. This decreases to 55% aged 55-64 and only 28% for those over 75.

_{Text description and footnotes
*Youths should do at least 420 minutes, and adults, 150 minutes, of moderate to vigorous physical activity per week to meet guidelines.}

Percentage of people in Canada reporting going above guideline* of moderate to vigorous physical activity in the past 7 days, by jurisdiction – 2017 and 2018 combined

Among youth, the highest rates of exceeding guidelines of moderate to vigorous physical activity were in YT, BC and NU, with 73%, 63% and 62% respectively. The lowest rates were in PE, NB and NL, with 46%, 51% and 51% respectively. Among adults, the highest rates were in YT, and BC, with 72% and 65% respectively and the lowest rates were in NL, NU and NB, with 49%, 49% and 50% respectively.

_{Text description and footnotes
*Youths should do 420 minutes and adults should do 150 minutes of moderate to vigorous physical activity per week to meet guidelines.}

Average daily minutes spent in physical activity during the past 7 days in Canadian adults (aged 18+), by environment of physical activity – 2017 and 2018 combined

Adults in Canada report spending about 53 minutes participating in daily physical activity. 23 minutes of this activity occurs at home or work and about 15 minutes is achieved through active transportation or recreational pursuits. Males reported engaging in more minutes per day in physical activity than females.

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Average daily minutes spent in physical activities during the past 7 days in Canadian youth (aged 12-17), by environment of physical activity – 2017 and 2018 combined

Youth in Canada are active about 90 minutes per day; 33 minutes a day through recreational pursuits and about 28 minutes through active transportation and activities on school campus. Only 7 minutes of physical activity is achieved at home or at work. Males reported engaging in more minutes per day in physical activity than females.

_{Text description and footnotes
The average daily minutes for physical activities in school or campus are based on 5 days a week.}

Physical activity levels during the past 7 days for people in Canada, by geographic area* – 2017 and 2018 combined

A higher percentage of youth report being active in very remote areas (62%) compared with urban centres (58%). This is contrary to the adult population which report being more active in urban centres (57%) compared with very remote areas (51%). Regardless of environment, between 20-25% of adults report a sedentary lifestyle compared to only 5% of youth.

_{Text description and footnotes
*”Rural – very remote” includes territories
E: Interpret with caution due to large variability in the estimates}

Physical activity levels during the past 7 days among adults in Canada (aged 18+), by household income quintile* – 2017 and 2018 combined

Physical activity increases and sedentary behaviour decreases according to household income. 49% of individuals in households with low incomes engage in physical activity above recommended guidelines compared to 64% of individuals in households with the highest incomes. 26% of individuals in households with low incomes engage in sedentary behaviour compared to 15% of individuals in households with the highest incomes.

_{Text description and footnotes
*Data do not include territories}

• References
  1 - Statistics Canada. 2020. Table 1 Leading causes of death in Canada, 2019. https://www150.statcan.gc.ca/n1/daily-quotidien/201126/t001b-eng.htm
  2 - Canadian Partnership Against Cancer. OncoSim. Cited December 2021. https://s22438.pcdn.co/tools/oncosim/
  3 - Canadian Partnership Against Cancer. OncoSim. Cited December 2021. https://s22438.pcdn.co/tools/oncosim/
  4 - Wild, C.P., Weiderpass, E. and Stewart, B.W. Eds. 2020. World Cancer Report: Cancer Research for Cancer Prevention. International Agency for Research on Cancer. https://publications.iarc.fr/586
  5 - Canadian Cancer Society. ComPARe - Population Attributable Risk. Cited December 2021. https://prevent.cancer.ca/
  6 - Friedenreich, C.M., Barberio, A.M., Pader, J., Poirier, A.E., Ruan, Y., Grevers, X., … ComPARe Study Team. 2019. Estimates of the current and future burden of cancer attributable to lack of physical activity in Canada. Preventive Medicine 122: 65-72. https://pubmed.ncbi.nlm.nih.gov/31078174/
  7 - Canadian Cancer Society. ComPARe - Population Attributable Risk. Cited December 2021. https://prevent.cancer.ca/
  8 - World Cancer Research Fund. 2018. Physical activity and the risk of cancer. https://www.wcrf.org/wp-content/uploads/2021/02/Physical-activity.pdf
  9 - Wild, C.P., Weiderpass, E. and Stewart, B.W. Eds. 2020. World Cancer Report: Cancer Research for Cancer Prevention. Lyon, France: Centre international de recherche sur le cancer. https://publications.iarc.fr/586
  10 - World Cancer Research Fund. 2018. Physical activity and the risk of cancer. https://www.wcrf.org/wp-content/uploads/2021/02/Physical-activity.pdf
  11 - Wild, C.P., Weiderpass, E. and Stewart, B.W. Eds. 2020. World Cancer Report: Cancer Research for Cancer Prevention. Lyon, France: Centre international de recherche sur le cancer. https://publications.iarc.fr/586
  12 - Canadian Society for Exercise Physiology. 2021. 24-Hour Movement Guidelines. https://csepguidelines.ca/
  13 - Canadian Community Health Survey, 2018
  14 - Canadian Health Measures Survey, 2020
  15 - Canadian Society for Exercise Physiology. 2021. 24-Hour Movement Guidelines. https://csepguidelines.ca/
  16 - Statistics Canada. 2019. Tracking physical activity levels of Canadians, 2016 and 2017. https://www150.statcan.gc.ca/n1/daily-quotidien/190417/dq190417g-eng.htm
  17 - Canadian Community Health Survey, 2018
  18 - Canadian Community Health Survey, 2018