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Sport and exercise: the public health challenge
  1. Liam J Donaldson
  1. Chief Medical Officer, Department of Health, 79 Whitehall, London SW1A 2NS, United Kingdom Liam.Donaldson@doh.gsi.gov.uk

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    John Dryden, in his poem, To my honoured kinsmen, writes: “The wise for a cure on exercise depend”. This is good advice that the NHS is only just beginning to take seriously.

    Current policy has rightly focused its attention on improving services to treat the big killers: coronary heart disease, stroke, and cancer. The challenge to reduce premature mortality from these diseases is huge—for example, the National Service Framework on Coronary Heart Disease,1 published earlier this year, has created a blueprint both for improving quality of services (from prevention to palliative care), and for improving access to these services across the country.

    In the drive to modernise the NHS more emphasis is being placed on the important role that prevention and early intervention can play. Many are aware of the risk to health from smoking, but far fewer realise that the relative risk from physical inactivity is of a similar order. People who are physically inactive carry twice the risk of coronary heart disease and three times the risk of stroke as their more active counterparts.2

    If it is to bring continued health benefits, physical activity needs to be embedded in the daily lives of many more people. Six out of ten men and seven out of ten women in England, between the ages of 16–74, are not physically active enough to benefit their health.3 The recently published National …

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