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Inequalities across the physical activity landscape: the need for ‘structural humility’ to optimise sports and exercise medicine
  1. Michael Cole1,
  2. Christopher James Holland2,
  3. Tyrone Cassius3
  1. 1 Schoolf of Health, Sport and Bioscience, University of East London, London, UK
  2. 2 School of Sport and Exercise Science, University of Worcester, Worcester, UK
  3. 3 NEEDSs, The Society of Sports Therapists, Glasgow, UK
  1. Correspondence to Dr Michael Cole, University of East London, London, UK; mcole{at}

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The ongoing issue of health inequity

Health inequalities are worsening across the UK and the wider world due to socioeconomic factors such as levels of education, income and poverty. These further disadvantage already marginalised demographics and communities, especially in low-income and middle-income countries.1 These social determinants of health are avoidable inequalities that exist due to systemic oppression such as sexism, racism, homophobia and transphobia that manifest as legacies of European colonialism2 embedded within capitalism. Sports and exercise medicine (SEM) is not devoid of these injustices; practitioners, professional bodies and research organisations must help to work towards SEM equity.

In 2020, the COVID-19 pandemic exacerbated existing social inequalities. There was a disproportionate increase in the physical, mental and financial burden experienced by female athletes, those with disabilities and those from low-income and middle-income countries,3 while exposing a strong association between death rates, area-level socio-economic deprivation and ethnic groups.4 COVID-19 exposed and highlighted the need for action and change. However, for change to take place, we need to know why the problems are …

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  • Contributors Editorial conception: MC; draft manuscript: MC, CJH and TC; preparation: MC, CJH and TC. All authors reviewed and approved the final version of the manuscript. MC, CJH and TC are responsible for the overall content as guarantors and accept full responsibility for the finished work and controlled the decision to publish.

  • 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 None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.