Written by Gemma Spiers, Principal Research Associate

Being physically active is fundamental to healthy ageing. Globally, governments want us to be more active across the life course, because of the huge boost it brings to our mental and physical health.

As a concept, it sounds simple enough. But the reality is that opportunities to be active are not equal across populations. Many disadvantaged communities face barriers to being more active: costs, time, accessibility, caring responsibilities, language barriers, and stigma, are just some examples. Areas with greater levels of deprivation are also less likely to have the sort of infrastructure that supports outdoor activity (e.g. safe greenspace, good lighting). This means that disadvantaged people often struggle to meet the levels of physical activity recommended by the UK Chief Medical Officers and the World Health Organization. Public policy efforts to promote physical activity must therefore be sensitive to the sorts of challenges faced by disadvantaged groups. Crucially, interventions that are geared towards helping people to be more active must work well for everyone – not just the most advantaged in society.

To support policy developments in this space, the NIHR Healthy Ageing Policy Research Unit has looked at the evidence about what works to promote physical activity in disadvantaged populations. We took two approaches to this. In our first approach, we looked at interventions that target individuals and small groups. These interventions might include, for example, coaching and goal setting, or social groups that encourage walking. In our second approach, we looked at interventions that are geared to whole populations – whether local, regional or national. These might include, for example, changing aspects of the built environment to make it easier to exercise, or removing the costs of local leisure facilities. We looked at evidence for both approaches because it is likely that each will have a role in helping older people to be more active.

So what did we find? Here are three key take aways:

1. We identified a range of population approaches, but only some were able to promote physical activity among disadvantaged groups, whilst posing a low risk of widening the health gap between the most and least advantaged.
2. Evidence about interventions targeting individuals and small groups was generally poor quality. Overall, there was no clear indication about the best approaches to promote physical activity among disadvantaged groups of older people.
3. There’s a huge amount of evidence about what works to promote physical activity, but very little evidence about what approaches are equitable between the most and least advantaged. We sifted through a decade’s worth of evidence and found just 17 studies reporting evidence about intervention equity. Most of these studies (12) were evaluations of population level interventions.

In our upcoming webinar and publications, we discuss these findings in more detail and consider some of the implications for policy developments such as the 10 year plan and the upcoming Physical Activity strategy. We will also talk about the methodological implications for future monitoring and evaluation of approaches to promote physical activity. Interventions that disproportionately benefit the most advantaged groups will exacerbate health inequalities – an outcome that many policymakers wish to avoid. Going forward, evaluations of interventions to promote physical activity must tell us whether the resultant benefits are equivalent across the most and least advantaged populations.

Find out more about this topic at our webinar “What works to promote active ageing – reviewing the evidence for reducing inequalities in physical activity” being held via Teams on 15th October 2025 – visit our webpage to register.

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