Exercise as a poisoned elixir: inactivity, inequality and intervention

Abstract

In this article we theorise and explain Exercise is Medicine (EiM), as indicative of broader physical activity (PA) health promotion, from a sociological perspective through the lens of health equity. Data were collected through two independent ethnographic studies that bookend the EiM endeavour: the production of knowledge in the laboratory, and the creation and implementation of health policy and PA interventions. First, we demonstrate how conceptualising exercise as medicine assumes narrow pathology and (prescribed) solution a priori, which has given rise to a new form of movement intellectuals (Turner 2012). Within such context we explain how the study of physical (in)activity (especially by exercise scientists) is shaped by broader social and political contexts of the university sector and disciplinary legitimacy produced through alignment with other (medical) institutions. Second, we review the 'causes of the causes' of ill-health and wider social determinants of health as related to exercise. Presenting exercise as a therapy of freedom (Rose 1999) that is to some extent epiphenomenal (Coalter 2013) we examine the lifestyle drift (Hunter et al. 2010) which inhibits equitable access to this health promoting behaviour. We then outline an original qualitative methodological development: duoethnographic creative nonfiction, which has enabled the synthesis of two independent ethnographic studies. Findings of this accessible and engaging methodology, in the form of two stories, show the need for an alternative approach that values activity, prioritises equity, and underscores methodological collaboration. For this reason we conclude by proposing greater interdisciplinarity by aligning EiM with the Behavioural Justice Movement.

Football is/as medicine: the growth of a health promotion movement and a challenge for sociologists

“…Andersen et al, 2018;Bauman et al, 2016;. Such 'movement intellectualism' (Turner, 2012;Williams & Gibson, 2018) remains, for the most part, uncritical towards the potential negative effects of privileging sport over other health promotion programmes. Instead, a primary focus upon demonstrating the positive benefits of sport/exercise/physical activity behaviour has led to it being presented as a panacea, miracle cure or 'polypill' for multiple health and social problems (Khan et al, 2012;Pareja-Galeano, Garatachea, & Lucia, 2015;Sallis, 2009).…”

Theorizing physical activity health promotion: towards an Eliasian framework for the analysis of health and medicine

“…Thus, the development of the EiM paradigm is partly predicated on the existing failure of family practitioners to 'prescribe' physical activity (Sallis 2009), while PAHP provides considerable scope to grow the social influence of the sport and exercise medicine community, which has traditionally been relatively marginal within the profession (only attaining UK state license in 2005). The emotional gratification offered to the sports science community, particularly in relation to enhancing its status as an academic subject is, though, unequivocal (Williams and Gibson, 2017). Such pressures have both been evident in the transition towards a more health-oriented sport (and exercise) science, and supportive of the increasing social prominence of PAHP.…”

Exercise is medicine: critical considerations in the qualitative research landscape

“…Importantly, their essay is not a wholesale rejection of the therapeutic qualities of exercise, but rather an expose on what can be lost and found when the practice is viewed in overly constrictive and reductionist terms. Williams and Gibson (2018) next focus on an institutional analysis of EIM and how it has given rise to a class of 'movement intellectuals' (sic exercise physiologists, physical activity public health promoters) whose attempts to align with medicine serve to legitimise their practice. Through the use of social constructionist qualitative research methodologies, duoethnography and the construction of non-fiction stories that exemplify their own experiences of fieldwork and emersion in the literature, two tales of frustrated sociologists engaging with EIM proponents are offered.…”