Blueprint for an Active Australia

Action area 4: Priority populations

Authors: Carol Maher, Nicola D Ridgers, Lisa M. Barnett, Helen Brown, Joseph Carrello, Emiliano Mazzoli, Susan Paudel, Louisa Peralta.

Strategic priorities for physical activity and workplaces

Key strategic priorities that can make impactful change for priority populations:

• Strengthen national and state data systems to capture relevant information about priority populations, making inequities in physical activity participation visible and enabling disaggregated and intersectional analyses.
• Embed equity throughout planning, funding, delivery and evaluation of physical activity initiatives, including co-design with priority populations, community leadership, culturally safe approaches and locally relevant program design.

Sustainable Development Goals

The United Nations Sustainable Development Goals1 that relate to supporting physical activity for priority populations include:

For more information see Appendix 1

There is a critical need for equitable improvement in physical activity levels to benefit population health and wellbeing.3 Physical activity is important for priority populations for physical health and mental wellbeing, to strengthen social connection and inclusion, and to help reduce the individual, community and system-level barriers that limit participation.

Consider the case for change:

• Inequities exist in both physical activity participation and health.⁴ These inequities arise from the complex interactions between political, geographical, economic and structural factors, which underpin the social determinants of health. These determinants are broadly defined as the conditions in which people are born, grow, live, work and age, and people’s access to power, money and resources.5 Inequities in these determinants disproportionately affect some population groups and constrain their opportunities to be physically active.⁴
• Over the past 30 years Australia has seen a major shift in population demographics due to an ageing population, internal and overseas migration, urbanisation, and cultural diversity. For example, between 1994 and 2024, the proportion of people aged 65 years and over increased from 12% to 17%,6 and in 2022, 29.5% of people in Australia were born overseas.⁷ Overseas migration now accounts for more than half of population growth, and migrants typically settle in capital cities.⁶ Approximately one quarter of people in Australia use a language other than English at home.⁷ These shifts have influenced Australia's social, economic, and cultural landscape, and are important considerations for physical activity policy and practice.
• Priority populations experience an inequitable, and often avoidable, burden of heart disease and other chronic conditions.⁸ Data typically show that these groups have a greater risk of being insufficiently active than the general population, ^9-14 though this varies within population subgroups.
• Inequities in physical activity and health are not experienced in isolation by different priority population groups. Individual social attributes and factors such as gender identity, socioeconomic position, and disability overlap and interact.¹⁵ This may influence and compound the inequalities in different physical activity contexts due to discrimination and marginalisation.¹⁶ It is important to employ an intersectional lens to identify and address the systems, structures and attitudes that create unique barriers to engaging in all forms of physical activity.^16,17 Understanding the needs of priority populations will enable programs and strategies to be tailored to meet specific needs and lived experiences,³ ensuring the provision of inclusive opportunities for physical activity within the diverse communities in Australia.

• There is a growing emphasis on inclusion in sport, particularly in programs targeting women and girls, LGBTIQA+ communities, and people with disability. For example, Dippers is an inclusive aquatic skills program for neurodivergent children run by Autism Swim through Surf Life Saving Clubs (see case study for more information).¹⁸ Effective models typically include partnerships which link local government, community health organisations, and sports clubs to deliver physical activity initiatives for priority populations.¹⁹ Resources have been developed in consultation with priority populations to support inclusion (e.g. Proud2Play²⁰ and VicSport Rainbow Roadmap²¹ for LGBTIQA+ inclusion in sport) and cultural diversity (e.g. The Game Plan).²² These enable sporting organisations and communities to identify key target areas and develop different implementation strategies.
• Australian Government funding has been invested in equity-based sport and physical activity programs across Australia. This includes the $200 million Play Our Way sporting grant program,²³ and funding to support the Heart Foundation’s National Physical Activity and Walking Initiative since 2017.²⁴ These funding streams, and others, continue to provide dedicated support to ensure that access is targeted and focused on the needs of priority groups.
• There is increasing involvement of priority populations in the co-design of physical activity interventions that are safe, culturally responsive and sensitive, and are tailored to the needs of the community.^25,26
• Universal design principles and policies have been developed to create environments that are usable and accessible for people of all ages, abilities, genders and cultural backgrounds.^27-30 These principles were created to foster a culture of inclusive environments into compliance and regulations, with consumer involvement in the design of cities and neighbourhoods. Environments that include public open spaces, community facilities and buildings that are accessible, will encourage incidental and planned physical activity.³¹
• Citizen science approaches to urban design have created safer cities for women and girls. For example, an investment of $30 million over two years has been committed to address perceptions of safety in public and open spaces for women, girls and gender diverse people. Research will support creation of better public spaces to enhance safety in cities and towns through improved infrastructure, amenities and activations.³²
• Participation in community initiated and community led physical activity and sport programs is increasing (e.g. parkrun,³³ Fat Farmers Rural Health Initiative,³⁴ and Climbing QTs³⁵ an LGBTIQA+ social rock climbing and advocacy group). These programs provide supportive environments for diverse communities to be active and connect with others.

Policy, practice and leadership

• Embed equity across all policy and planning decisions, considering intersecting forms of disadvantage such as gender, disability, geographic location, cultural background, or chronic health conditions. Inequities in the social determinants of health constrain opportunities to be active,^4,5 and overlapping disadvantages can compound them.^15-17
• Strengthen collaboration across health services, schools, industry, non-government organisations (NGOs) and communities to co‑design local, accessible physical activity initiatives in trusted community settings (e.g. schools, libraries, places of worship, cultural venues). Effective models link local government, community health organisations and sports clubs,¹⁹ and co‑designed interventions are safer and more culturally responsive.^25,26
• Apply universal design principles to public spaces, parks, paths and facilities to ensure they are safe, welcoming and accessible for all ages, abilities and cultural backgrounds.^27-32
• Co-design spaces and programs with priority populations and local and cultural leaders from the outset, using approaches such as citizen science, to understand barriers and create low- or no-cost, accessible and culturally relevant initiatives that communities own and sustain.’ ^25,26,32
• Reorient service evaluation to monitor participation and impact in different populations, ensuring priority groups are involved in evaluation and that inequities are addressed.^3,16,17,36

Workforce

• Invest in building a diverse, skilled workforce that reflects community diversity and has competencies in inclusive communication, cultural safety, trauma-informed practice and equitable program design.^9,37
• Standardise training in cultural safety, accessibility and inclusive physical activity program delivery across all relevant workforce sectors.

Community awareness and engagement

• Tailor communication strategies and digital engagement tools to meet the needs of diverse communities, including those with low health or digital literacy.⁷ Around one quarter of people in Australia use a language other than English at home.⁷
• Ensure digital solutions are inclusive, accessible, affordable and functional in regional and remote areas, taking account of language, device access and connectivity barriers.⁹

Research, data and innovation

• A review of the evidence for this action area identified the following priorities for investment in research, data and innovation.
• Collect high-quality data on physical activity participation that can be disaggregated by relevant priority population characteristics, enabling inequities to be identified and intersectional analyses to be conducted.
• Investigate how intersectional disadvantage affects access to and engagement in physical activity.¹⁶
• Conduct audits of parks, recreational facilities and active transport infrastructure in low-income, remote and marginalised areas to guide equitable investment.
• Improve understanding of culturally safe and inclusive program delivery in mainstream sport and recreation settings.
• Explore the most effective community settings for place-based programs, including accessibility by active transport.
• Increase long-term investment in equity-focused research to understand cost-effectiveness, sustainability and impact of inclusive initiatives, and embed equity into funding and evaluation frameworks.

Heart Foundation related information for priority populations