ABSTRACT

This article constitutes the first holistic exploration of how neoliberalism permeates and manifests in Physical Activity Health Promotion (PAHP). It synthesises a critical analysis of neoliberalism with the sociological concepts of medicalisation and healthism and draws on three distinct phases and methods of data collection, to more adequately understand the development, prominence and largely uncritical acceptance of this domain of global public health. Specifically, it demonstrates how the World Health Organization’s (WHO) initial promotion of PAHP coincided with the organisation’s strategic re-alignment with neoliberal principles within a changing geopolitical landscape. Then, deploying a critical discourse analysis of the recent and globally significant WHO (2020) Guidelines on Physical Activity and Sedentary Behaviour, it shows how the underlying logics of neoliberalism continue to inform not only the intended policy goals but the inclusion and exclusion of certain types of evidence used to justify and evaluate policy. Subsequently, drawing on qualitative interview data and time-series survey data the article details how neoliberalism fosters the ideology of healthism, how this promotes forms of exercise which diverge from health maximising behaviours, and how this extends differences in physical activity uptake across the population, and therefore embeds the health inequalities PAHP is explicitly claimed to address. Outlining why PAHP, in particular, holds appeal for the WHO, we conclude that neoliberalism has both enabled the rapid development and broad political acceptance of PAHP, but concomitantly leads to outcomes which limit and confound the broader policy goals.

摘要

本文首次全面探讨了新自由主义如何渗透和体现在体育活动健康促进（PAHP）中。它将新自由主义的批判性分析与医疗化和健康主义的社会学概念相结合，并利用三个不同的阶段和数据收集方法，以更充分地理解全球公共卫生这一领域的发展、突出和很大程度上不加批判的接受。具体来说，它展示了世界卫生组织 (WHO) 对 PAHP 的最初推广是如何与该组织在不断变化的地缘政治格局中根据新自由主义原则进行战略重新调整的。然后，对最近具有全球意义的世界卫生组织（2020）进行批判性话语分析体力活动和久坐行为指南，它展示了新自由主义的基本逻辑如何不仅继续影响预期的政策目标，而且还包括和排除用于证明和评估政策的某些类型的证据。随后，文章利用定性访谈数据和时间序列调查数据，详细介绍了新自由主义如何培育健康主义意识形态，如何促进与健康最大化行为不同的锻炼形式，以及如何扩大全民体育活动吸收的差异，因此包含了 PAHP 明确声称要解决的健康不平等问题。概述了为什么 PAHP 尤其对 WHO 有吸引力，我们得出的结论是，新自由主义既促进了 PAHP 的快速发展，又促进了 PAHP 的广泛政治接受，