Equity and physical activity: An intersectoral assessment of policy implementation in 6 EU countries

Abstract Background Public policies across multiple sectors are crucial to creating healthy and active environments. However, while many countries have physical activity (PA) policies in place, little is known about their implementation. This study analyses the extent of PA policy implementation in 6 EU countries, as part of the ‘Improving Physical Activity Policies and their Impact on Health Equity’ (IMPAQT) project. Methods The study utilizes the Physical Activity Environment Policy Index (PA-EPI), a tool for assessing the extent of implementation of PA policies across different sectors. Based on a rapid review, document analysis, and expert consultation, an equity perspective has been systematically embedded in the indicators of the tool and the process of its application. In each country, data are collected by researchers, verified by government officials, and assessed by a coalition of non-government stakeholders. Results Country-specific evidence documents are generated for Germany, Ireland, Lithuania, Netherlands, Poland and Romania. The evidence documents include data on 45 indicators covering 8 policy domains (e.g., health, education, transport, sport) and 7 infrastructure support domains (e.g., leadership, governance, monitoring and intelligence). An equity focus has been embedded through the development of an equity module and the recruitment of dedicated equity councils (composed of representatives of socially disadvantaged population groups). Conclusions This study is the largest initiative to date to systematically assess the extent of PA policy implementation across political sectors and to compare differences between countries. Next steps will include the generation of country-specific scorecards and policy recommendations. From a public health perspective, elements of this study can contribute to discourses on health in all policies, health equity, and policy evaluation. Key messages • This study collected data on the implementation of physical activity policies in Germany, Ireland, Lithuania, Netherlands, Poland and Romania. • A special emphasis was placed on equity in physical activity policy, and on policies across multiple sectors (health in all policies).