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Highlighting equity in physical activity, sport and clinical practice
  1. Jenna M Schulz1,2,
  2. Jane S Thornton1,2
  1. 1 Family Medicine, Western University Schulich School of Medicine & Dentistry, London, Ontario, Canada
  2. 2 Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada
  1. Correspondence to Dr Jenna M Schulz, Family Medicine, Western University Schulich School of Medicine & Dentistry, London, Canada; jschulz2{at}

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Health equity, as defined by the WHO, ensures that all participants, regardless of background or ability can access and benefit from the essential elements of health and well-being.1 For physical activity and sport, equity often involves breaking down barriers to participation, whether they be financial, cultural or physical. This edition of the BJSM focuses on these three key areas of equity within sport and exercise medicine (SEM).

Equity in physical activity

Equity in movement and physical activity prioritises fairness and equality of access across the physical activity continuum for all.2 Aldred and Mazumder (see page 635) present an intersectional approach to increase active travel for all using experiential equity, which seeks to quantify psychological and physiological stress experiences of marginalised persons in public spaces. They contend that to make active travel available for all, intersectional factors that create barriers to physical activity in public spaces need to be addressed. Using an intervention component analysis design, Dawson et al (see page 641) evaluate the effectiveness of fall prevention programmes in residential aged care and conclude that to prevent falls, delivering the right exercise that is sufficiently resourced and tailored to the individual is critical.

Equity in sport

Sport equity promotes fairness, equality of access and challenges us to engage each other with full dignity, honesty and respect.3 In this issue, several studies involve participants historically under-represented in SEM. Dycer et al (see page 655) conduct a Delphi consensus to determine if the Sport Concussion Assessment Tool version 5 (SCAT5) could be suitable for application in Para athletes. They determine that the SCAT5 is suitable for athletes with limb deficiencies or spinal cord injuries with some modifications but is not recommended for athletes with visual impairment. In our service spotlight, Anuar and Azizah Abd Rahman (see page 687) discuss the Regional Indigenous Sports Championship in Malaysia and the impact it can have on the community by drawing participants and spectators from diverse backgrounds and strengthening Indigenous community bonds. Finally, in a systematic review and meta-analysis conducted by Zhang et al (see page 674) , they seek to determine the efficacy of exercise-based sport injury prevention programmes in community settings. They determine that implementation can reduce risk of injury in adolescents but requires targeting key stakeholders for efficacy to be translated to the community.

Clinical practice

An equity-focused clinical practice ensures that healthcare services are accessible and responsive to the diverse needs of individuals, addressing disparities in healthcare outcomes. Physical activity prescription has evolved as a distinct discipline in clinical SEM practice and research. Thomsen et al (see page 636) provide a call to action to improve the evaluations of harms in clinical research to improve responsible physical activity prescription as medicine. On the musculoskeletal health side, Dadoo et al (see page 649) investigate the impact of demographic and socioeconomic factors in the management of isolated meniscus tears. They determine that patients of older age and increased neighbourhood disadvantage are more likely to undergo meniscectomy versus meniscal repair. Equity-informed clinical practice also calls on the voices of the patients themselves, and this issue includes a patient voices article by Zhang (see page 685) , who describes how the experience of a patient ultimately lead to a career in medicine.

Ensuring equity for all in SEM

The studies in this issue demonstrate that by promoting equity in physical activity, sport and clinical practice, we can create a more inclusive environment and advance the field in a meaningful way. By prioritising equity, we not only improve individual well-being but also foster stronger, more inclusive communities. When we break down barriers to participation and ensure fair access to healthcare services, we empower individuals to lead healthier lives and contribute more fully to their communities. By promoting equity, we not only address disparities but also promote individual success, fostering a society where everyone has the opportunity to learn and thrive. As leaders in the field, it is our duty to prioritise equity through research and practice, to ensure equitable opportunities for all.

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  • X @jennaschulz_1, @janesthornton

  • Contributors JMS conceptualised the article and drafted the manuscript. JST contributed to conception and critical revision of the article.

  • Funding JMS is funded by the Western’s Bone & Joint Institute Collaborative Training in Musculoskeletal Heath Program Trainee Award and Ontario Women's Health Scholars Postdoctoral Award.

  • Competing interests JST is an editor of BJSM.

  • Provenance and peer review Commissioned; internally peer reviewed.