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This editorial is a call for action to make physical activity and sedentary behaviour messages inclusive. It focuses on disability. Numerous definitions of disability and ways of identifying as disabled exist across the globe. For example, some people, cultures, organisations and governments prefer for certain reasons to use the term ‘disabled people’, whereas others prefer ‘people with disabilities’ or ‘people with an impairment’.1 Respecting difference in terminology used around the world,1 we align with the social model and thus use the term ‘disabled people’ throughout this editorial. Disability refers to people who have long-term physical (eg, spinal cord injury), sensory (eg, visual impairment), cognitive (eg, learning difficulties) and/or mental impairments (eg, depression), which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others.2
Despite the benefits of physical activity, many disabled people live insufficiently active lifestyles. They are also more likely to be inactive when compared with non-disabled people.2 Recent UK physical activity guidelines for disabled people recommended doing strength activities on 2 or more days a week and at least 150 min of moderate-intensity aerobic physical activity each week for substantial health gains.2–4 It was also stressed in the UK guidelines that some physical activity is better than nothing as small amounts bring health benefits and the 150-min message alone can be daunting, especially for disabled adults who are mostly inactive.1–4 The new WHO global guidelines for physical activity and disability5 echoed the UK guidelines, providing support for its recommendations.
To maximise the impact of national and global physical activity guidelines, and reduce participation inequalities, inclusive and effective communication is vital.1 Communicating physical activity recommendations and how to reduce sedentary time often includes simple but compelling messages. When it comes to tackling sedentariness, messages like these have been and might be used: ‘Stand up, sit less’, ‘Sit less, move more’, ‘Move more. Sit less. Sleep better’, ‘Chairs are killers’, ‘Time to take a stand against inactivity’, ‘Get Britain standing’, ‘On your Feet Britain’, ‘Now is the time to get up and get moving!’, ‘Break up with your chair’ and ‘Swap sitting for moving’.6 7 However, such messages are ableist.
What is ableism?
Our physical environments and social conventions like communication are often designed with a non-disabled person in mind as they are assumed to be the ‘typical’ and ‘normal’ human being. Ableism is a form of prejudice and discrimination in which non-disabled people are viewed as ‘normal’ and superior to disabled people. The cited messages are infused with ableism because they favour certain individuals (eg, those who can stand or easily avoid sitting) and reinforce an ideal standard for mental health, intellect and health while stigmatising, alienating or excluding others (eg, wheelchair users, those in chronic pain, or those with mental health conditions and intellectual and developmental disabilities who find sitting or lying beneficial for their well-being). A message like ‘Sit less, move more’ is a form of prejudice and discrimination. If we use such messages, we are, even if unintentionally, stigmatising and harming disabled people.
We write this editorial as a call for action. Messages calling individuals to sit less and/or stand more must be dropped and replaced by alternative, more inclusive language, such as ‘Don’t be still for too long’, ‘Be active your way’, ‘Enjoy moving your body more’, ‘Unplug and play’ or ‘Remember to move your body often’.
Readers might respond to this call for action to drop messages like ‘Sit less, move more’ by insisting that I don’t mean to be ableist when I use them. It’s no big deal; it’s just language. We appreciate that the intended goal of such messages is to reduce sedentary time and promote health, not ableism. However, language acts in the world with an impact on people; it perpetuates taken-for-granted beliefs and values, and it creates, reveals and reproduces forms of prejudice and discrimination. Language is where people live, and ableist language is not liveable for disabled people. Imagine living in terms that exclude you and assume a lesser status for you. Language paints a picture of our world and the people in it, acting on them. Imagine painting a picture that sends a public health message that excludes an entire group of people, that acts on them by saying consciously or unconsciously—you are not part of our health policy. What does that also suggest to non-disabled people and, given unconscious biases, how might it play out in everyday life? Could it be that disabled people are (unintentionally) considered inferior and not worth caring about?
Language matters
If you doubt the capacity of language to oppress and discriminate, then consider the damaging impacts of racist, homophobic, ageist or sexist language in society. It is necessary for language to evolve as society does, such as moving away from racial stereotypes in advertising or re-claiming former homophobic slurs such as ‘queer’ for empowered self-identification. Just as language has adapted in an attempt to stop perpetuating racism, homophobia/transphobia and sexism, we must now also change our language to stop perpetuating ableism.
Some readers may also or alternatively respond to the call for action to drop messages like ‘Sit less, move more’ by insisting that We have used these messages for some time now and public health messages need to be consistent. We also cannot change messages as we now have a mantra across the physical activity world we are familiar with. It might be argued that the messages under the spotlight cannot be given up because consistency is important in public health. Should this be the case if consistency means reinforcing and naturalising ableism? If you witnessed someone using terms in messaging that were once widespread in society but now are deemed sexist, racist, classist or promote fatphobia, would you accept a defence that their use was justified to keep up with historically consistent messages? If the answer is ‘No’, why then would you accept terms in messaging that are infused with ableism? As part of tackling health inequalities and bringing intersectionality into our work, we must include disability much more in physical activity and sport work, and work against ableism.
A call for more inclusive messaging
Physical activity promotion messaging must be inclusive. As part of our call for action for inclusive messages, we call on others to speak out and challenge ableist messages like ‘Stand up/Sit less and move more’. Let the messenger gently know that his or her messages are ableist, even if unintentionally so. Describe the reasons why and offer suitable alternatives such as ‘Move more’. We also call on organisations, research groups, individuals and public health agencies to change their messages if they promote ableism. We recommend they work with disabled people to coproduce public health messaging. This process can make a big difference.
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Footnotes
Twitter @FosteratBristol
Collaborators Association for Applied Sport Psychology, British Association of Sport and Exercise Sciences, British Psychological Society Division of Sport and Exercise Psychology, The Disabled Colleagues Network from Bristol City Council, Disability Positive, Disability North, Disability Rights UK, European Disability Golf Association, European Federation of Adapted Physical Activity, European Network for Young Specialists in Sport Psychology, International Federation of Adapted Physical Activity, International Society of Qualitative Research in Sport and Exercise, International Society of Sport Psychology, Mixed Ability Sport, North American Federation of Adapted Physical Activity, North American Society for the Psychology of Physical Activity and Sport, North American Society for the Sociology of Sport, Para Dance UK, The Canadian Disability Participation Project, The United Nations Educational, Scientific and Cultural Organization (UNESCO) Chair ‘Transforming the Lives of People with Disabilities, their Families and Communities, Through Physical Education, Sport, Recreation and Fitness’, Welsh Association of ME and CFS Support, Wheels for Wellbeing and WomenSport International support the need for inclusive messages and challenging ableism.
Contributors All authors contributed to the development and writing of the letter.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests KM reports as the Chief Executive of Disability Rights UK. Disability Rights UK is the leading charity of its kind in the UK. We are run by and for people with lived experience of disability or health conditions.
Provenance and peer review Not commissioned; externally peer reviewed.