Sport, health and quality of life.

Social Studies Collection No. 26 26 Sport, health and quality of life David Moscoso Sánchez and Eduardo Moyano Estrada (coordinators) Lourdes Biedma Velázquez Rocío Fernández-Ballesteros García María Martín Rodríguez Carlos Ramos González Luís Rodríguez-Morcillo Baena Rafael Serrano del Rosal Published by the ”la Caixa” Foundation Av. Diagonal, 621 08028 Barcelona GOVERNING BODIES OF ”LA CAIXA” SOCIAL PROJECTS SOCIAL PROJECTS COMMITTEE Chairman Isidro Fainé Casas Deputy Chairmen Salvador Gabarró Serra, Jorge Mercader Miró, Manuel Raventós Negra Members Marta Domènech Sardà, Javier Godó Muntañola, Inmaculada Juan Franch, Justo B. Novella Martínez, Magín Pallarés Morgades Secretary Alejandro García-Bragado Dalmau Deputy Secretary Óscar Calderón de Oya Chief Executive Officer of ”la Caixa” Juan María Nin Génova Executive Director of ”la Caixa” Social Projects Jaime Lanaspa Gatnau BOARD OF TRUSTEES OF THE ”LA CAIXA” FOUNDATION Honorary Chairman José Vilarasau Salat Chairman Isidro Fainé Casas Deputy Chairmen Ricardo Fornesa Ribó (1st Deputy Chairman), Salvador Gabarró Serra, Jorge Mercader Miró, Juan María Nin Génova Trustees Ramon Balagueró Gañet, Mª Amparo Camarasa Carrasco, José F. de Conrado y Villalonga, Marta Domènech Sardà, Manuel García Biel, Javier Godó Muntañola, Inmaculada Juan Franch, Juan José López Burniol, Montserrat López Ferreres, Amparo Moraleda Martínez, Miguel Noguer Planas, Justo B. Novella Martínez, Vicente Oller Compañ, Magín Pallarés Morgades, Alejandro Plasencia García, Manuel Raventós Negra, Leopoldo Rodés Castañé, Luis Rojas Marcos, Josep Sala Leal, Francisco Tutzó Bennasar, José Vilarasau Salat, Nuria Esther Villalba Fernández, Josep Francesc Zaragozà Alba Secretary (non trustee) Alejandro García-Bragado Dalmau Deputy Secretary (non trustee) Óscar Calderón de Oya Managing Director Jaime Lanaspa Gatnau Social Studies Collection Director Rosa M. Molins Coordinator Mònica Badia Social Studies Collection No. 26 Sport, health and quality of life David Moscoso Sánchez (IESA-CSIC) Eduardo Moyano Estrada (IESA-CSIC) (coordinators) Lourdes Biedma Velázquez (IESA-CSIC) Rocío Fernández-Ballesteros García Autonomous University of Madrid María Martín Rodríguez Polytechnic University of Madrid Carlos Ramos González (IESA-CSIC) Luís Rodríguez-Morcillo Baena (IESA-CSIC) Rafael Serrano del Rosal (IESA-CSIC) Electronic Edition available on the Internet: www.laCaixa.es/ObraSocial © David Moscoso Sánchez and Eduardo Moyano Estrada (coordinators), Lourdes Biedma Velázquez, Rocío Fernández-Ballesteros García, María Martín Rodríguez, Carlos Ramos González, Luís Rodríguez-Morcillo Baena and Rafael Serrano del Rosal © The ”la Caixa” Foundation, 2009 Translated by: Jed Rosenstein Responsibility for the opinions expressed in the documents of this collection lies exclusively with the authors. The ”la Caixa” Foundation does not necessarily agree with their opinions. LOURDES BIEDMA VELÁZQUEZ, graduate in Political Science and Sociology of the University of Granada. Her areas of interest and specialization are welfare policies, the sociology of health, as well as techniques in social research. Since 2003 she has worked on diverse projects in the field of sociology of health and in the evaluation of public policies at the Instituto de Estudios Sociales Avanzados [Institute for Advanced Social Studies] (IESA-CSIC). ROCÍO FERNÁNDEZ-BALLESTEROS GARCÍA, Professor of Psychological Evaluation in the Department of Psychobiology and Health Psychology at the Autonomous University of Madrid. She has participated in various studies on active aging and quality of life among older persons. In this field she has worked as a consultant in the evaluation of programs for the World Health Organization and the United Nations. MARÍA MARTÍN RODRÍGUEZ, PhD in Physical Activity and Sports Sciences. She teaches and does her research work as part of the Faculty of Physical Activity and Sports Sciences/INEF at the Polytechnic University of Madrid. Her area of specialization is Sport and Quality of life within the field of the social sciences. Currently she is working on the project I+D+I MEC of national scope on seniors and sport. DAVID MOSCOSO SÁNCHEZ, PhD in Sociology. His research and teaching activity is at the Institute for Advanced Social Studies (IESA-CSIC) and the Pablo de Olavide University. He coordinated the publication of the monograph «Sociología del deporte» of the Revista Internacional de Sociología (2005) with Núria Puig, and co-edited the books Deporte y Desarrollo Rural (2006) and Comunicación y Deporte (2008). EDUARDO MOYANO ESTRADA, PhD in Agronomy (Rural Sociology) from the University of Cordoba. Graduate in Sociology from the Complutense University of Madrid. Currently he is Professor of Research at the Consejo Superior de Investigaciones Científicas [Science Research Council] (CSIC), and occupies the post of Vice director of the Institute for Advanced Social Studies (IESA). He is director of the Revista Internacional de Sociología. CARLOS RAMOS GONZÁLEZ, graduate in sociology. He has specialized in social science research using qualitative methodology. He has worked in diverse fields, such as health, analysis of consumer motivation and in the area of new technologies. He works in diverse public and private institutions including EASO, the OIA and Synovate. Currently he is working in the Qualitative Department of the IESA-CSIC and completing his doctorate in Sociological Theory. LUÍS RODRÍGUEZ-MORCILLO BAENA, graduate in Political Science and Sociology. He has maintained a professional relationship with the IESA since 1994. Since 1998 he has also worked with the municipal government of Córdoba and has participated in different qualitative studies on social groups and their problems. RAFAEL SERRANO DEL ROSAL, PhD in Sociology and «Científico Titular» (scientific staff) of the CSIC. Currently his work and research interests are centred on the confluence of three areas of research: design, analysis and comprehensive evaluation of public policies, subjective well-being and satisfaction, and sociology of health. In these fields he is author or co-author of various articles published in prestigious national and international journals. Table of contents Presentation 7 Note from the coordinators 9 Introduction 11 I. Sport and physical exercise in the shaping of lifestyles 1.1. The process of making Spanish society sportive 1.2. The place of sport and physical exercise in an era of sedentarism 1.3. Active persons and sedentary persons 1.4. The paradoxes of modernity and their impact on living conditions 18 18 21 47 54 II. Lifestyles and self-perceived health 2.1. Defining concepts 2.2. The relationship between active lifestyle and perceived health 2.3. The health benefits of physical activity 59 60 68 79 III. Lifestyles and well-being 3.1. What do we mean by quality of life? 3.2. Measuring the subjective quality of life and related concepts 3.3. The influence of lifestyle on the degree of well-being 3.4. The benefits of physical activity on quality of life IV. Quality of life, health and physical activity in the discourses of young people and seniors 4.1. Defining the problem 4.2. The quality of life in the social imaginary 4.3. Health in the subjectivity of the population studied 4.4. Sport and physical activity in discourses on health and quality of life 4.5. Barriers to the practice of sport and physical exercise 4.6. Sport and quality of life, a reciprocal relationship 83 84 86 89 100 103 103 105 116 124 139 142 V. Critical sense versus common sense. The discourse of the experts 5.1. Sport, health and quality of life: the scientific point of view 5.2. The practice of sport and physical activity among the population 5.3. Recommendations for promoting sport 145 146 164 175 Conclusions 190 Bibliography 204 Index of graphs and tables 210 Methodological appendix 213 Presentation There is a growing consciousness of the importance of physical activity and sport for a community’s health and quality of life. Far from the conception of sport as exclusively a stage for competition, in which the majority are spectators and very few actively participate, numerous studies indicate that the promotion of sporting habits among the population is an excellent measure for preventing and treating disease. Sport is also an alternative to lifestyles that are harmful to our health and a means to widen our network of social relations. The benefits of sport and physical activity pointed out by the specialists are now recognized by the majority of the population and the promotion of sport and physical activity has become a part of current public health policies. Despite this, there are numerous obstacles within our society for the effective incorporation of sport into our daily lives. Among young people for example, sport competes with other more sedentary types of leisure activities, such as nightlife or digital entertainment, in a context in which time dedicated to education and work further reduces free time. This lack of free time can also be seen among the middle-aged, who, during this period in life have to take on numerous work and family related responsibilities that can leave little time for the practice of sport. To this must be added the fact that work is becoming less physically demanding and therefore lives are increasingly sedentary. Although after retirement free time increases significantly, the generations that are now older were not educated to make the practice of sport a habit, nor did the majority have the opportunity to do so in earlier stages of their lives. As a result, although it is increasingly recognized that physical activity and sport are important and improve quality of life, many obstacles make it difficult for individuals to effectively get involved in sporting activities and impede 7 their taking advantage of the numerous benefits that sport has for our health, our mood and social relations. It is upon this dilemma where the present study is situated. In it the authors examine the degree to which sedentary lifestyles have become dominant among the population of our country and to what degree physical activity or sport contributes to persons feeling healthier, feeling that their well-being is increasing and, ultimately, that their quality of life is better. The focus of this book is eminently social, given that it situates exercise and sport within clear cultural coordinates and evaluates their effects not only on the body but on the mind and social relations. With this study, the ”la Caixa” Foundation intends to stimulate debate on the importance of sport for the health and quality of life of the population and, to the degree possible, make a contribution to the design of effective strategies and programs for the promotion of physical activity and sport. Jaime Lanaspa Gatnau Executive Director of ”la Caixa” Social Projects and Chief Executive Officer of the ”la Caixa” Foundation Barcelona, April 2009 8 Note from the coordinators The present study has been carried out under the scientific leadership of Dr. Eduardo Moyano Estrada (Professor of Sociology and Vice-director of IESA-CSIC) and under the technical direction of Dr. David J. Moscoso Sánchez (contracted researcher of IESA-CSIC). Although the book is a collective effort developed as a research project of the IESA-CSIC, it has included the collaboration of researchers from diverse institutions. The extent of participation of each one of them has varied from chapter to chapter depending on their areas of specialization. In the first chapter that deals with lifestyles and the practice of physical activities and sport among the Spanish population, David J. Moscoso Sánchez and María Martín Rodríguez are the primary authors. The second chapter, in which the influence of sport and physical activity on the perceived state of health is examined, was written principally by Rafael Serrano del Rosal and Lourdes Biedma Velázquez. Both, together with Rocío FernándezBallesteros García, were also responsible for the third chapter, which analyzes the impact of physical activity and sport on satisfaction, well-being and the quality of life. The fourth chapter, on the discourses of young people and older persons on quality of life and physical activity and sport, was written with the participation of David J. Moscoso Sánchez and Carlos Ramos González. Finally, Luís Rodríguez-Morcillo wrote the fifth chapter, dedicated to analyzing the opinions of experts and specialists in medicine and sports science. To all of them, we appreciate your participation and your cooperative attitude in the creation of this collective work, whose principal value is in having been the fruit of collaboration among disciplines and academic institutions. 9 The field work in the form of a survey and discussion groups was carried out by the Technical Unit for Applied Studies of the IESA-CSIC, in which the following researchers participated: Sara Pasadas del Amo, Manuel Trujillo Carmona, Juan A. Domínguez Álvarez, Micaela Soria Zambrano and Margarita Zarco Uribe-Echevarría. We would also like to express our gratitude to them. Finally, this study would not have been possible without the collaboration of those who unselfishly responded to the survey questions or formed part of the discussion groups. 10 Introduction Spanish society faces a great challenge. The spread of sedentary habits and behaviours raises one of the most serious problems for the country in the coming decades. The lack of physical exercise (in part due to the decrease in the use of physical force in work activities), the proliferation of diets high in calories, the increase in the ingestion of toxic substances and the predominance of what has been called «passive leisure» (tied to certain consumption practices and the use of new technologies) are all related to the leading cause of mortality in developed countries: cardiovascular and cerebrovascular illnesses, which in the case of Spain cause around 130,000 deaths per year (30 percent more than those caused by tumours and 96 percent more than those resulting from traffic accidents) (data from the INE, 2006). Professionals in the health sciences have demonstrated, through epidemiological and longitudinal studies, the importance of physical activity and sport in the maintenance of our health and quality of life (see, for example, Paffenbarger et al., 1986; Paffenbarger and Hide, 1988; Shephard, 1996; Alonso, 1997; Pieron, 2003; Mora et al., 2004, and Jiménez and Montil, 2006). Sport and physical exercise produce physical, biological, psychological and social benefits, and are important at both a therapeutic and preventive level. Regarding physical benefits, exercise improves motor functioning, the musculoskeletal and immune systems, positively activates the hormonal system and balances the body through homeostasis and the lymph of the blood, preventing the appearance of lesions and illnesses. At the psychological level, sport and physical exercise stimulate the production of hormones that improve personal well-being by increasing the psychomotor capacity of the individual and with this, the sensation of personal autonomy, which positively affects the mood, something necessary to face mental disorders and to strengthen emotional INTRODUCTION 11 control. At the social level, sport and physical exercise also help in improving sociability and individual social skills such as assertiveness and self-esteem, and among groups at risk they aid in preventing problems of social deviancy. Despite the recognized multiple benefits of sport, Spain continues being at the tail end of Europe in regard to its practice. In the Eurobarometer on Sport, produced by the European Commission in 2004 (Special Eurobarometer (2004): The Citizens of the European Union and Sport), Spain appears below the European average in number of persons who do sport. Only four of every ten persons practices sport, a figure far from that of other countries such as Finland or Sweden, where double the number of persons regularly do sport. In addition, among the Spanish that do practice a sport, barely half do so frequently (three or more times per week) – representing only two of every ten Spanish persons – which means the majority of the population do not enjoy the benefits of sport on health and quality of life. Some organizations, such as the American College of Sports Medicine (ACSM) or the United States Department of Health and Human Services point out that to obtain significant health benefits from physical activity and sport, they must be done for at least 30 minutes almost every day of the week. Regarding other issues, the importance of socio-demographic and socioeconomic inequalities which tend to be associated with the practice of sport should be highlighted. In Spain, only four of every ten persons that practice sport are women, and only one of every ten is older than 60 years of age. Likewise, among persons that earn less than 1,000 euros a month, only one third practice sport. This restrictive character that the practice of sport has, translates into poorer health and quality of life among disadvantaged sectors. Behind these variables, as numerous studies have demonstrated (García Ferrando, 1986 and 2001; Patriksson, 1996; Rhodes et al., 1999; Collins, 2003; Donnelly, 2003; Martínez del Castillo et al., 2006), exist socialization mechanisms which transmit values that either favour a positive attitude toward sporting activities or not, influencing in a decisive manner our willingness to practice sport. Physical activity being so important for our health and quality of life, it is predictable that inactivity provokes negative effects. The problems associated with the lack of physical exercise raise major concerns for two specific sectors of the population: youth and older persons. Regarding youth, they represent a 12 SPORT, HEALTH AND QUALITY OF LIFE generation in which sedentary lifestyles have begun to consolidate. Currently, Spanish youth increasingly consume too many high calorie foods and toxic substances; they are losing the habit of doing sport or exercising; they spend the majority of their time seated and participate in leisure activities which are much more passive than before. It is not strange, therefore, that according to the Observatorio Español de Sostenibilidad (OSE) the rate of obesity among the Spanish under 24 years of age is the highest in Europe (around four of every ten children or young persons suffers from obesity or overweight), and that Spain is undergoing a premature increase in illnesses that are caused by sedentarism. For the World Health Organization (WHO), obesity has reached pandemic dimensions. This illness provokes psychosocial alterations, orthopaedic, skin and respiratory problems, an increase in cholesterol and triglycerides, diabetes or glucose intolerance, and can lead to a reduction of up to ten years in life expectancy (Ayuso and López, 2007). Regarding the senior population, it should be pointed out that due to the increase in life expectancy, the number of persons that make it to old age is growing (some 7.5 million Spanish are older than 65 years of age according to data from the INE in 2007) and these people commence a new stage in their lives once they retire which is lasting increasingly longer. To maintain a good state of health during this stage of life depends on doing exercise and sport. Inactivity leads to a progressive deterioration of the state of health among this population group, which generates difficulties for the health system as it is becoming more and more difficult and costly to treat illnesses associated with aging. All these problems can be solved with the adoption of measures that are aimed at promoting and consolidating the practice of physical exercise. Some specialist point out in this sense that it is much more economical to promote the practice of sport among all age groups than to face the health costs that result from treating diseases caused by sedentarism. In fact, the health funds allocated in Spain to pay for health problems caused by obesity and overweight are 7 percent of the budget for healthcare, in other words, some 2.5 billion euros per year. As a result, in Spain as in other countries, the government is organizing programs aimed at promoting the practice of sport among the population. An example of this is the Campaign for the Prevention of Cardio and Cerebrovascular Diseases carried out by the Ministry of Health and Consumer Affairs between 2006 and 2007, or the Plan for the Promotion INTRODUCTION 13 of Physical Activity and a Balanced Diet developed between 2004 and 2008 by the Ministry of Health of the Government of Andalusia. At the European level similar initiatives also exist, such as those approved by the European Commission under the name The European network for the promotion of health-enhancing physical activity (HEPA Europe) or the EU Platform for Action on Diet, Physical Activity and Health. But these efforts do not seem to be enough. It is clear that these problems require the adoption of measures of greater reach; probably comprehensive and transversal policies will be necessary, in which health, educational, economic and environmental authorities and social services all participate. Perhaps public authorities could make a greater effort to raise the consciousness of the population on the necessity to integrate exercise into our daily routines. To do this it would be advisable to increase investments in schools (increasing the quality and number of hours dedicated to sport), in the health system (incorporating more professionals specialized in sports medicine in health centres), in businesses (raising the consciousness of employers about the benefits of sport in increasing performance at work and creating formulas to balance care of employees’ health and the working day), in the sports associations and federations (changing the orientation of many of them, overly based on competition, in favour of improving the health and well-being of participants in sports) and, of course, in the family (bringing the message to families that sport contributes to improving health and family relations). The growth in research in this area in different disciplines is another measure which will permit a better assessment of the dimension of the problems and aid in adapting the measures aimed to prevent or treat them. This present study aims to do this, as its objective is to analyze, from a sociological perspective, the issue of sport and physical exercise and their effects on well-being and the quality of life on those who practice them. From this standpoint, our interest is in focusing on analyzing the existing relationship between, on the one hand, behaviour and habits related to practicing sport and physical exercise in general, and, on the other, the subjective perceptions that people have about their state of health and personal well-being. This study goes deeply into the relationship between sport, health and the quality of life in two specific age groups: young people (defined in this study as those persons between the ages of 16 and 34) and older persons (those between 65 and 79 years of age). 14 SPORT, HEALTH AND QUALITY OF LIFE The methodological design of the research is based on a combination of quantitative and qualitative techniques for the gathering of primary information. In the quantitative phase of the research, carried out between October and November of 2007, a computer assisted telephone survey was done (CATI) of a sample of 2,018 persons selected randomly from the overall Spanish population (see Methodological appendix). This survey provided important information about lifestyles of the Spanish population, the practice of sport and its relationship to health and well-being. The process of elaborating the questionnaire began from a previous revision of instruments used in other studies to measure this relationship. Regarding the introduction of questions that are concerned with habits and behaviours toward sport and physical exercise, the model employed by García Ferrando between 1975 and 2005 in successive surveys on the sporting habits of the Spanish, was followed. The questionnaires employed by Martínez del Castillo et al. in various studies (2005 and 2006) supplied us with questions of great interest for measuring aspects related to the socialization of these habits, especially among older persons and women. In addition, from questionnaires from diverse surveys on the living conditions of the population and on health and healthcare employed by organizations like the CIS (Centro de Investigaciones Sociológicas [Centre for Sociological Research]) or the IESA-CSIC, we extracted key questions to evaluate the concepts of «perceived health» and «quality of life». The qualitative research was based on carrying out discussion groups in different Spanish cities. The participants were not only young and old people (the central object of our study), but also other social groups, such as parents or specialists in the fields of sports, health and quality of life. In this way the sources of information were widened. The qualitative field work was carried out during April and May of 2008, and served to both verify the results obtained through the survey as well as to go deeper into the issues of the perceptions and behaviour of the population regarding sport and physical exercise and their impact on individuals’ self-perception of health and quality of life. This combination of quantitative and qualitative techniques is also reflected in the structure of this book which has two parts. In the first part, the data obtained from the survey is analyzed. It begins with a chapter entitled «Sport and physical exercise in the shaping of lifestyles», in which the theoretical INTRODUCTION 15 bases of this study are presented. In this chapter the place of sport and physical exercise in the lifestyle of the Spanish population is analyzed. The weight of these activities is determined in three essential areas of our lives: in free time and leisure time, specifically in the area of sport, and at work and in daily routines. These elements serve to highlight the predominance of either a sedentary lifestyle or a physically active lifestyle within Spanish society. In the second chapter, entitled «Lifestyles and perceptions of health», we want to know how lifestyles impact on the perception that individuals have of their health, considered not in the strictly biomedical sense, but rather in the subjective sense of the term. This subjective conception of health is based on the definition given by the WHO on the concept of health, understood as «as a state of physical, mental and social well-being in relation to multiple areas that embrace the purely physical (for example, the environment, housing or the environment), the social (for example, safety and hygiene in the workplace, education and healthcare and equity in the distribution of available resources), lifestyle (for example, adequate food, physical exercise, consumption of tobacco and alcohol), the state of health itself (morbidity, mortality, life expectancy), the healthcare system (for example, physical and human resources, hospital care, medical insurance and research) and perceived health or the selfassessment of health». This approach permits us to demonstrate empirically, through the data from the survey, if having a physically active lifestyle or a sedentary lifestyle affects our self-perception, more or less positively or negatively, of our state of health. Another aspect that tends to be associated with our lifestyles in general, and with physical activity and sport in particular, is the subjective perception of the quality of life. Using data from the survey, this issue is dealt with in the third chapter of this first part, entitled «Lifestyles and well-being». In this chapter three distinct dimensions are analyzed: quality of life, satisfaction with life and well-being. The influence that socio-demographic variables such as age, sex, educational level or forms of cohabitation have on these dimensions is examined. The second part of the book gathers the results of the qualitative research and is divided into two chapters. In the first, corresponding to chapter four, entitled «Quality of life, health and physical activity in the discourses of young people and seniors», the discourses gathered in diverse discussion 16 SPORT, HEALTH AND QUALITY OF LIFE groups among young and old, residents of large cities (Barcelona and Madrid) and in medium-sized municipalities (Antequera in Málaga and Puente Genil in Córdoba) were analyzed. This chapter also looks at the discourse of parents related to the sporting practice of children which was gathered in a discussion group among parents who belong to school parent associations. The following chapter, entitled «Critical sense versus common sense. The discourse of the experts», presents the discourse of specialists based on a series of interviews with professionals in medicine and sports science with a great deal of experience in the field of physical activity oriented toward health. It analyzes the opinions of these specialists on the relationship of sport and physical exercise to health and quality of life, also taking into consideration their assessment of the situation of sport in Spain and their opinions on the strategies and resources that from their point of view are necessary to promote sport within Spanish society. Lastly, the book ends with a chapter of conclusions in which the principal objectives of the study are re-examined and reflections based on the results obtained are made regarding the relationship between physical activity and sport on the one hand, and subjective well-being and health on the other. In addition, these reflections include the implications that this relationship has for the designing of public and or private policies and actions centred on sport and physical activity and aimed at improving the quality of life and health of the population now and in the future. INTRODUCTION 17 I. Sport and physical exercise in the shaping of lifestyles 1.1. The process of making Spanish society sportive It is still not that long ago that sport was absent from the imaginary and the cultural practices of the majority of people. Although it is true that in the past traditional games were typical among the popular classes, they never had the reach that modern sport has acquired among us today. During centuries, the practice of so-called «modern sports» (track and field, cycling, rowing, basketball, etc.) only had social recognition within educational or associative spaces, to which only the most favoured classes could have access. As a consequence, these sports were only practiced by a small segment of the population. One would have to wait until the second half of the 20th century, thanks to the universalisation of public education and the development of the welfare state, for sport to become a generalized cultural practice. In this context, policies aimed at its promotion, such as the well-known «Sport for All» campaign – initiated with the signing in 1975 of the European Sport for All Charter – and the adoption of specific laws on matters of sporting and physical culture were a point of reflection on the way in which sport and physical exercise were thought of by public institutions and the public in general. At that point, we can say that the concept of a «sporting culture» was born in the midst of the public, and that public institutions took on the responsibility for guaranteeing its realization. The practice of sport stopped being the privilege of a minority and became an objective and necessity for each individual, a factor in human development that needed to be stimulated and maintained 18 SPORT, HEALTH AND QUALITY OF LIFE with public spending. In this scenario, the practice of sport has become incorporated into the lifestyles of the population. There are those that understand lifestyle as «the totality of patterns of behaviour that characterize the way of life of an individual or group» (Mendoza et al., 1994), or as «the particular ways of life that associate beliefs related to basic values with implicit attitudes, unconscious models of behaviour and habits» (Cathelat, 1985). From such premises, sport would not form part of the lifestyles of Spanish society until the last decades of the 20th century because of the circumstances previously mentioned. By the 1990s the presence of sport had acquired such an importance in our lifestyles that it would be impossible to today understand Spanish society without seeing this activity as an essential part of the culture. Events such as the celebration of the soccer World Cup in 1982 – popularly known in Spain as «Los Mundiales de Naranjito» [the World Cup of Little Orange] for its popular mascot – and the Olympic Games of Barcelona in 1992, remind us that sport is a referent in our recent history. Not in vain do we make note of the fact that newspapers like MARCA, specializing in sports news, are today the newspapers with the greatest sales in Spain, surpassing others such as El País, El Mundo or ABC. In short, as Lagardera Otero expressed it (1991): «men and women today have learned to live running behind a ball, watching the Olympic finals on the television, filling out the columns of the football lottery or using sweat suits and sport shoes as their normal attire in their physical activities or during their weekend leisure time». This means that sport as part of our lifestyles goes beyond the fact that a greater or lesser number of persons practice it. What is important to understand is that the sporting phenomena has ended up conquering our cultural imaginary, and is seen positively by the majority of the population. The sportive process in Spanish society is not exclusively due to the normalization of the sporting system. The transformations in the organization of the state, the economic model and the cultural paradigm have had a determining influence on the institutionalization of sports. In the process of the transformation of the country, a phenomenon which is essential to understand the spread of sporting activity is the growing importance acquired by free time and leisure; which in turn, derives from SPORT AND PHYSICAL EXERCISE IN THE SHAPING OF LIFESTYLES 19 changes in the organization of work. The new model of work organization is characterized by the reduction in the working day and a progressive decrease in the use of physical force – thanks to the implementation of technology in productive tasks –, as well as by the progressive development of the service sector and, with it, professional specialization – which implies the substitution of blue collar workers by white collar workers. The practice of sport in this situation has supplanted thousand year old habits in our civilization, and the motivations and form of practicing it provide it with a new dimension in today’s world. Proof of this is the regularity with which the Spanish population has expressed, since 1980, that the principal motive for practicing sport is «to get physical exercise» and that the meaning of sport which comes closest to the idea that they have of this activity is «doing sport keeps you in shape» (García Ferrando, 2001). Together with free time and leisure, the process of cultural change has constituted a decisive factor in the normalization of sport. Once sport is normalized in our society and the instruments of the state facilitate the means necessary for its realization, its attributes and values are transmitted through distinct channels of socialization (for example, the family, the educational system, the media, etc.), contributing in this way to its reproduction (Moscoso, 2005; Moscoso and Alonso, 2005). The spread of sport on the path toward advanced modernity will see it affected by the predominance of post material values, which will serve to endow this activity with a certain idealist morality, granting it attributes related to health, physical and psychological well-being, social relations, escape, etc. In this context, sport even appears as a response to the paradoxes produced by modernity (environmental consciousness versus increased environmental degradation; advances in innovation and knowledge in the health field versus the emergence and spread of new diseases; concerns for our physical and psychological health versus increases in sedentarism and obesity, etc.), acquiring a functionality that goes beyond the strictly sportive. Today, doing sport is synonymous with being in shape, improving our health and relating with others, something that connects directly with the concern that this study raises: What type of relationship can be established between lifestyles, particularly habits and behaviours related to practicing sport and physical exercise, and the subjective perception of health and personal well-being? 20 SPORT, HEALTH AND QUALITY OF LIFE In the following chapters we will have the opportunity to go more deeply into this issue, supported by evidence about the relationship that health and personal well-being have with the practice of sport in the Spanish population. In this chapter we will limit ourselves to taking a brief look at this relationship, providing some snapshots of the place that sport and physical exercise occupy in the collective imaginary and in the totality of daily habits and behaviours of the population. 1.2. The place of sport and physical exercise in an era of sedentarism To respond to the question raised in this study we must ask what place does sport and physical exercise occupy in Spanish society. In this sense, an aspect frequently pointed out in other studies on this issue (see, for example, García Ferrando, 2001 or 2006; Martínez del Castillo et al., 2005) is the divergence shown between the elevated value that the Spanish give to sport and physical exercise and their scant participation in this activity. In other words, the Spanish give a lot of importance to physical exercise and sport, but in reality, only a minority actually do exercise in their daily life. To understand the degree and the determinants of this imbalance is one of the concerns behind this study. This knowledge can, in addition, help the managers and specialists of organizations in charge of planning the sporting activities available in our country in their job of promoting these activities. To achieve this objective this analysis looks into the area of referential values and personal choice in the practice of sport and physical exercise through distinct spaces: the ludic, the strictly sportive and in the workplace. The choice of this order was taken in consideration of the structure habitually employed in studies which analyze this issue (García Ferrando, 1986, 1991, 1996, 2001 and 2006), in this manner serving as a vehicle for comparison with some of the results analyzed here. Sport and physical exercise in free time and leisure practices In the first part of this analysis, we begin by placing sport within a wider grouping of free time and leisure activities. The reason for this stems from, as we have argued, free time having become an increasingly important part of our lives over the last decades. This is a result of the changes produced SPORT AND PHYSICAL EXERCISE IN THE SHAPING OF LIFESTYLES 21 in the organization of work. In addition, it can’t be forgotten that sport is an inseparable part of a wider field of social activities, those of leisure and free time. As a consequence, its analysis must be undertaken in this context. Free time is a temporal dimension which has variable meanings and characteristics. Evidently, there are distinctive aspects of this dimension that are atemporal, that have not changed over time, such as it consists in the realization of activities not connected to employment – the practices of leisure, activities of a diverse nature such as reading or music, participation in NGOs, tourist travel or the practice of sports. Often both terms, free time and leisure, are confused, given that a good part of leisure activities are done during our free time. But, apart from this, there are characteristics of free time that seem to have changed in recent history: the very way to understand it, the form it occupies and the type of leisure activities that are developed in this temporal space. One of the aspects that influences our changing conceptions and the use of our free time is the growing regulatory density and intense bureaucratization of recent decades. In effect, the modernization of public institutions, following the beginning of democracy, has meant that the majority of Spanish have lived a gradual increase in non-productive time dedicated to formal administrative tasks within the family (banking activities, applications for aid, declarations of income, inscriptions in registries, schooling, demographic procedures, etc.), which condition the time dedicated to personal interests. The change in the economic model has also been decisive in the use of free time. The greater specialization demanded in labour markets has driven a process of access to and promotion in employment through the acquisition of merits. This translates into an increase in the time not spent working dedicated to training and the acquisition of knowledge. This tendency is clearly illustrated in the organization of time among the school-aged, who have busy agendas with their classes in languages, computers, music, etc. in detriment to leisure time dedicated to play and peer relations outside of school. Another area that has had influence on the transformation of free time is the change produced in the family system. In recent years we have seen the disappearance of the extended family in favour of the growth in nuclear families, and, subsequently, an increase in single-parent families – related to the access of women to the labour market and, above all, to the loss of 22 SPORT, HEALTH AND QUALITY OF LIFE the importance of traditional cultural paradigms. This has led to, within the framework of the circumstances mentioned previously, a greater amount of time dedicated to domestic tasks among the few people that now make up the new model of families and therefore a significant reduction in time available for the enjoyment of leisure activities. Finally, the forms of leisure themselves have changed in recent decades. To the traditional activities that took up this time (being with family, watching television, listening to music, watching and practicing sports, spending time with friends, taking trips, etc.) we must now add others, many tied to the use of new technologies, what is called «digital entertainment» (surfing the web, chatting, sending SMSs, etc.),(1) and to new patterns of consumption (shopping in shopping malls). Many of these new activities can be described as sedentary activities. In fact, there are specialists who refer to these activities as «sedentary leisure» and «passive leisure». Added to work habits already lacking in physical effort, they are contributing to an eminently sedentary lifestyle in Spanish society. It must be asked what place sport occupies in this picture we have drawn of the new patterns in the spending of free time. The study’s survey includes a series of questions which intend to provide a response to this question. Specifically, one of the questions is the following: «In general, how do you tend to spend your free time?». In contrast to other studies on free time and sport – for example, the studies done by the Centre for Sociological Research (CIS) every five years on the sporting habits of the Spanish – here a system of open answers has been used with the aim of avoiding any type of conditioning. In table 1.1 we can see the percentage of the Spanish population that does different leisure and free time activities as gathered from the answers. To present the results of these answers the schema proposed by Roger Sue (1982) is followed because it distinguishes between leisure activities of a social, cultural, physical and practical character (tables 1.1 and 1.2). Following this schema, this study confirms that free time activities of a social character, those that are fundamentally based on the maintenance of interpersonal relations, occupy the greatest part of the free time of the Spanish. Among these are (1) For more information on this recent concept, see Gallego (2002) and Bofarull (2003). SPORT AND PHYSICAL EXERCISE IN THE SHAPING OF LIFESTYLES 23 TABLE 1.1 Leisure activities of the Spanish population By percentage of mentions CATEGORIES TOTAL Taking walks 24.2 Being with the family 21.7 Being with friends/partner 19.1 Reading 15.1 Sports 14.8 Watching TV 11.5 Doing nothing, resting 11.5 Household and family tasks 9.9 Handicrafts 8.1 Going to the cinema or watching movies 7.4 Going out for drinks, going out, having «tapas» 6.2 Nature activities 5.0 Digital entertainment 4.3 Listening to music 3.1 Traveling 2.9 Studying 2.8 Tablegames 2.2 Cultural activities 1.9 Dancing 1.6 Working 1.4 Playing a musical instrument 0.7 Other activities 5.4 Have no free time 1.7 Source: Study E0727 IESA-CSIC. found, in first place, «being with the family» (22 percent) and «being with friends/partner» (19 percent), followed at a distance by «going out for drinks, going out, going out for “tapas”» (6 percent), «table games» (2 percent) and «dancing» (2 percent). The free time activities of a cultural character, oriented toward intellectual and artistic activities and entertainment, are distributed among «reading» (15 percent), «watching television» (12 percent), «going to the cinema or watching films» (7 percent), «digital entertainment» (4 percent), 24 SPORT, HEALTH AND QUALITY OF LIFE TABLE 1.2 Leisure activities of the Spanish population by type of activity By percentages of groupings mentioned CATEGORIES Leisure activities of social character ANSWER (TOTAL SAMPLE) 51.8 Leisure activities of physical character 47.7 Leisure activities of cultural character 37.7 Leisure activities of practical character 23.6 Source: Study E0727 IESA-CSIC. «listening to music» (3 percent) and «playing a musical instrument» (1 percent). Among free time activities of a physical character there are «going for walks» (24 percent), «doing sport» (15 percent), «nature activities» (5 percent) and «travelling» (3 percent). These activities have a physically and psychologically regenerative component, and of active rest. Other activities mentioned have a greater practical character – because their end is utilitarian – and, in some cases, it is not really appropriate to catalogue them under the category of free time. In fact, «doing manual tasks», which 8 percent of those surveyed do in their free time, is certainly susceptible to being understood either as for enjoyment or as work. In addition, «family and domestic tasks», which 10 percent do during free time, can be understood as private activities, dedicated to the support of one’s personal life and family, or as an additional responsibility, particularly when one is responsible for dependent family members. However, other activities, such as «studying», that 3 percent do in their free time, or «work» that 1 percent do, are far from any interpretation that does not see these activities as having little to do with leisure. Perhaps here should be added those persons who stated that they «have no free time», representing 2 percent of the total. Overall, the persons that do these activities that are of doubtful «leisurely» character make up one fifth of the Spanish population. Despite the previous observations, it is clear that these activities highlight the broad, diffuse and personal character of leisure, as what represents obligation or work for one, constitutes an enjoyable activity for another. Evidently, choices in leisure and free time practices are conditioned by factors of widely varied character. In this chapter, for issues of opportunity and space, it is not possible to go deeply into these factors so we will simply highlight SPORT AND PHYSICAL EXERCISE IN THE SHAPING OF LIFESTYLES 25 this general finding. However we do analyze the data that has to do with the practice of «sport» and «going for walks» as leisure and free time activities as they are directly related to the objectives of this study. It should be noted that the data obtained through this survey departs from the stereotypes frequently accepted in the study of free time. Contrary to expectations, Spanish society gives almost the same importance to leisure of a physical character as to that of a social character, as can be seen in tables 1.1 and 1.2. The data confirms that «going for walks» and «doing sport» are two of the five principal leisure and free time activities among the Spanish, occupying the first and fifth positions respectively, which is a clear indicator of the changes which have taken place in recent decades in the use of free time in Spanish society, as Cagigal (1981) had anticipated years ago. But some aspects about the relevance of these findings must be qualified so that they can be accurately evaluated. Although the activities of a physical character occupy a preferential place among leisure activities in Spanish society, their importance is influenced by sociodemographic and socioeconomic factors. Consequently, if this data is broken down using a series of independent variables, such as age, sex or family income, it can be seen that there are considerable variations (see table 1.3). Thus, it can be confirmed, for example, TABLE 1.3 Type of leisure activities of the Spanish population, by sex, age and income By percentage of mentions SEX AGE CATEGORIES INCOME MEN WOMEN YOUNG PEOPLE SENIORS LESS THAN 1,000 € MORE THAN 1,000 € Leisure activities of a social character 52.9 50.6 64.6 29.6 50.3 56.2 Leisure activities of a physical character 54.2 41.2 46.3 49.2 44.3 52.1 Leisure activities of a cultural character 30.3 45.3 30.3 41.9 36.4 37.7 Leisure activities of a practical character 15.3 32.0 13.0 45.1 27.9 13.4 Source: Study E0727 IESA-CSIC. 26 SPORT, HEALTH AND QUALITY OF LIFE in a first approach, that the existing difference in participation in leisure activities of a physical character among young people and seniors is not significant, probably due to the fact that although the practice of sport is much more important among young people than seniors (24 percent in comparison to 7 percent),(2) going for walks occupies the greatest part of free time and leisure for seniors (38 percent in comparison to 13 percent). Therefore, this suggests that «going for a walk», in the sense of «walking for distraction or exercise» (RAE, 2001) has become a leisure and free time activity of great importance today. Perhaps this is explained by the fact that the physical effort necessary to «go for a walk» is much less than that necessary to do sport, or because it implies no economic expense. In addition, there has also been a change among medical professionals on this matter, as they are much more supportive today than years ago about older persons walking with frequency. However, a different approach on the influence of age on these leisure activities of physical character reveals that they are much more important among seniors than among young people, insofar as activities of a social character have a greater weight among young people in their use of free time. Concerning the relationship to leisure and free time broken down by sex, it can be observed that leisure activities of a physical character are a clear differentiator of roles if their importance is compared between men and women. While 54 percent of men say they do leisure activities of a physical character (the most frequently mentioned category of leisure activities among men), only 41 percent of women say they do (constituting the third most mentioned category of leisure activities behind those of a social character and a cultural character). It can also be confirmed that the income level of those surveyed constitutes a discriminating factor in the practice of leisure activities of a physical character. The data obtained show a difference of eight points between those who do these types of activities and possess monthly incomes of 1,000 euros and those whose monthly incomes are below that level (52 percent and 44 percent respectively). (2) This data matches data obtained in different surveys (García Ferrando, 2001; IMSERSO, 2000), where it is confirmed that only 7 percent of seniors do sport and physical exercise. SPORT AND PHYSICAL EXERCISE IN THE SHAPING OF LIFESTYLES 27 Sport in the social imaginary and cultural practices of the Spanish In the previous section sport and physical activity were considered within the context of how the Spanish population spends their free time. This is a fundamental indicator for determining the place of these activities in society. In what follows we will go into greater detail on this issue, undertaking a detailed analysis on sport and physical exercise, looking at the specific weight they have in the social imaginary and cultural practices of the Spanish. To do this, the interest in sport will be analyzed, as well as the habits and behaviours of sporting practice in the time that is exclusively used for this activity. In the survey done within the framework of this study some questions were introduced which provide us with information about the interest of the population for sport. The most explicit of them employed a closed set of answers that follow the habitual recommendations of these types of surveys: «Regarding interest in sport and level of participation we can consider six population groups. With which do you most identify?» (graph 1.1). The distribution of answers highlights that the majority of those surveyed have an interest in sport (eight of every ten persons), although there is a difference among them as some of them, despite GRAPH 1.1 Regarding interest in sport and your level of practice, with which statement do you most identify? In percentages ������������������������������������ ������������������������������� ��������������������������� ����������������������������� ��������� ����������������������� ������������������������ ��������������������������� ����������������������� ���������������������������� ���������������� ��������������������������� ���������������� � Source: Study E0727 IESA-CSIC. 28 SPORT, HEALTH AND QUALITY OF LIFE � �� �� �� �� �� their interest, don’t practice it as often as they would like (25 percent), others, in contrast, practiced sport but no longer do so (21 percent), while there are those that have never practiced sport (14 percent). Finally, only 21 percent of those who have this interest state that they practice it enough, which invites one to think of the existing asymmetry between interest in and practice of sport. What stands out the most from this data is that, of the eight out of ten persons that express an interest in sport, only a bit more than half place themselves among those that practice it on some level. The self-positioning of the surveyed in relation to sport is complemented by another question which refers to the desirability of practicing sport: «Independent of whether you do not practice sport, would you like to do some form of regular sporting activity, not including going for walks?». With this question almost six of every ten persons responded positively, a result which in principle seems to contradict with the eight of every ten persons surveyed who state they have an interest in sport. What this means is that to have an interest in sport does not necessarily imply having an interest in practicing it. To extend our knowledge we turn to the results of a more direct question on the practice of sport: «Without including going for walks, do you currently practice a sport?». In the answers it can be seen that only four of every ten persons state that they practice sport. Thus we see that there is an important asymmetry between interest in sport and the practice of sport, and the question emerges regarding what this is due to. To provide a possible answer it is necessary to investigate, on the one hand, the terrain of personal motivations that individuals habitually employ to justify the practice or lack of practice of sport; and, on the other hand, elements of a sociological character, that imply going deeper into less tangible factors, such as the cultural and economic capital of those surveyed, their occupation or the transmission of physical and sportive habits from their parents. Motivations for the practice of sports With regard to the initial analytical perspective, the answers obtained from the questions about motivation for the practice or not of sport were placed into different groups (table 1.4). The answers were numerous given the open character with which they were formulated (multi-answer questions). This task SPORT AND PHYSICAL EXERCISE IN THE SHAPING OF LIFESTYLES 29 TABLE 1.4 Motives for practicing and not practicing sport In percentages (multiple answers) MOTIVES FOR PRACTICING SPORT CATEGORIES Motives of a practical character MOTIVES FOR NOT PRACTICING SPORT TOTAL 8.9 CATEGORIES TOTAL Motives of a practical character 51.5 For enjoyment and to pass the time 4.9 Lack of time To be with friends 3.7 Because of work Because I like to compete 0.3 Structural motives 6.2 Because it fits ones conditions and circumstances 3.3 Because of obligation/work/job training 2.5 For the nearness of facilities Because of family responsibilities 38.1 8.9 4.5 Structural motives 7.1 Lack of money 4.7 Lack of nearby facilities 2.4 0.4 Motives of socialization 58.0 Because I like sport 52.1 Motives of socialization 30.1 I don’t like sport or have no interest 11.1 Because of habit, I’ve always done it Can’t be bothered 9.5 4.4 Because of age 3.7 Because of doctor’s advise 1.9 Lack of habit 3.5 Because of family 1.6 I don’t like to leave the house 1.8 Lack of support or stimulus 0.5 Motives connected to health 18.5 Motives connected to health 46.8 To maintain and/or improve health 20.3 For physical and psychological wellbeing 11.7 Because of health problems 9.7 To stay in shape 5.1 Personal motives To get physical exercise For health motives Because I feel healthy 18.1 0.4 1.6 Personal motives 4.6 1.6 Because I walk 2.4 Because I do other activities 2.2 Source: Study E0727 IESA-CSIC. permitted us to focus on understanding the social meanings which underlie the distinct categories used to explain the practice or lack of practice of sport. 30 SPORT, HEALTH AND QUALITY OF LIFE Regarding the motives that explain the practice of sport, in general terms what stands out, is that in comparison to the reduced number of reasons that were traditionally employed by persons to explain why they practice sport, today it is much more difficult to interpret motive because of the increased number of reasons given. Despite this, only some of the motives cited by the surveyed have a high frequency of response. Thus, we can see in the grouping of categories elaborated for this analysis that the motives connected to socialization («because I like sport», «because of habit», «because of doctor’s advice» and «for the family») and to health («to maintain and/or improve health», «for physical and psychological well-being», «because of health problems» and «to stay in shape») are the most important, representing 58 percent and 47 percent of the answers respectively. The other motives do not have the same weight. In these two groupings of categories, the individual answers that have the most importance in explaining the motives of those that practice sport are «because I like sport» (52 percent) and «to maintain and/or improve health» (20 percent). The place that both these answers occupy differs from that observed in other surveys on sporting behaviour of the Spanish population (García Ferrando, 1991, 1997, 2001 and 2006), where the principal motives referred to for this practice on the part of those surveyed were «to get physical exercise» and «for fun and to spend time».(3) Regarding the motives that explain not practicing sport, the presence of numerous causes is also seen, but in this case the category which has most influence has changed (see table 1.4 again). Among the groupings of categories made, health has the least importance in the explanation of motives for those who do not do sport («for health motives», «because I feel healthy»), at 19 percent. In contrast, the motives that have the greatest weight are those of a practical character («because of lack of time», «because of work» and «for family responsibilities»), at 52 percent, and, although following at a distance, reasons tied to socialization continue being important («I don’t like it/it doesn’t interest me», «laziness», «because of age», «lack of habit», «I don’t like to leave the house» and «lack of support or encouragement»), at 30 percent. However, looking at the categories individually, «health motives» do seem to have influence, behind «lack of time» (at 18 percent and 38 percent respectively). Obviously, the weight of these factors is altered by the unequal circumstances that characterize distinct age groups. Focusing specifically on the two generational groups that (3) Nevertheless, it should be mentioned that in these other surveys the question cited was close-ended (in other words, a question in which one had to choose from a series of previously determined options), which can influence the results. SPORT AND PHYSICAL EXERCISE IN THE SHAPING OF LIFESTYLES 31 frame the objectives of this study, young people and seniors, it can be observed that the differences are quite significant (tables 1.5 and 1.6). In what follows, this data will be analyzed independently by age group. Young people Regarding the motives for practicing sport, it can be seen that young people (in this study defined as persons between 16 and 34 years of age) almost exclusively refer to «liking sport» as the principal motive for their participation (56 percent). TABLE 1.5 Motives for practicing sport, by age groups and sex In percentages (multiple answers) MOTIVES AGE GROUPS YOUNG PEOPLE CATEGORIES SENIORS TOTAL MEN WOMEN TOTAL MEN WOMEN Because you like sport 56.3 62.6 44.5 31.5 32.0 33.3 To maintain and/or improve health 15.0 13.0 18.8 28.8 32.0 25.0 Because of health problems 5.0 3.8 7.0 22.4 24.0 21.9 To stay in shape 5.9 4.2 9.4 1.8 0.0 3.0 To get physical exercise 1.5 0.8 3.1 1.5 4.0 0.0 11.0 10.5 12.5 10.4 4.0 15.2 For enjoyment and to pass the time 5.7 6.3 4.7 6.5 4.0 6.3 To be with friends 3.5 3.8 2.4 1.2 0.0 3.0 For obligation/work/job training 4.0 3.4 4.7 0.2 0.0 0.0 Because you like to compete 0.3 0.4 0.8 0.0 0.0 0.0 Because of medical advise 0.9 1.3 0 9.6 4.0 12.5 Because of habit, you have always done it 5.1 5.5 4.7 7.2 12.0 3.1 Because of where you practice it 0.9 0.4 1.6 0.8 0.0 0.0 Because of family 2.6 2.1 3.1 0.0 0.0 0.0 Because it fits your conditions and circumstances 3.3 2.5 4.7 2.3 4.0 3.0 For the nearness of the facilities 0.0 0.0 0 0.0 0.0 0.0 Others 4.2 2.5 7.1 5.7 4.0 6.3 For physical and psychological wellbeing Source: Study E0727 IESA-CSIC. 32 SPORT, HEALTH AND QUALITY OF LIFE TABLE 1.6 Motives for not practicing sport, by age groups and sex In percentages (multiple answers) MOTIVES FOR NOT PRACTICING SPORT AGE GROUPS YOUNG PEOPLE CATEGORIES SENIORS TOTAL MEN WOMEN TOTAL MEN WOMEN Lack of time 59.0 60.6 58.1 10.1 8.7 10.9 You don’t like it or not interested 12.6 8.7 14.9 11.3 12.0 9.5 Because of work 9.0 16.5 4.7 5.2 7.8 2.9 Lack of money 0.8 0.0 0.9 0.8 0.9 0.7 Laziness 9.6 11.0 8.8 5.9 6.1 5.8 For health reasons 8.0 7.9 7.9 34.0 24.3 42.0 Doing other activities 2.3 1.6 2.8 3.5 5.2 2.2 Because of family responsibilities 6.1 1.6 8.9 4.6 4.3 5.1 Lack of habit 1.2 0.8 1.4 9.0 8.7 9.4 Because of age 0.0 0.0 0.0 14.2 20.0 8.8 Lack of support and stimulus 0.3 0.0 0.5 0.8 0.9 0.7 Lack of nearby facilities 1.2 0.0 1.9 6.7 3.5 9.5 Because you walk or take walks 0.5 0.0 0.9 3.7 5.2 2.2 Because you feel healthy 0.3 0.0 0.5 1.5 2.6 0.7 You don’t like to go out 0.2 0.0 0.5 0.7 0.0 1.4 Other reasons 4.2 3.1 4.7 2.9 1.7 3.6 Source: Study E0727 IESA-CSIC. This response behaviour could be determined by reasons of a sociological character, related to the fact that, among this age group, the transmission of sporting habits are much more established than among seniors, thanks to obligatory physical education which has been imparted since the 1970s in primary and secondary education and to municipal sport policies aimed at the promotion of this activity. However, it can be seen that the influence of this motive is greater among men than among women (63 percent in comparison to 45 percent), something, in any case, which is consistent with the closed character that sport still has today, as there continues to be discrimination against female participation as various studies have shown (Blanchard and Cheska, 1986; Dunning, 2003; Pavón et al., 2004; Puig and Soler, 2004; Moscoso, 2008). In regards to other motives, the influence of the motive «to SPORT AND PHYSICAL EXERCISE IN THE SHAPING OF LIFESTYLES 33 maintain and/or improve health» does not have excessive importance in this group (15 percent), probably because health conditions at this stage of life are good enough. The only exception is provided by sex, as it seems that among women there exists a greater tendency than among men to cite this motive for the practice of sport (19 percent and 13 percent respectively). Regarding the motives for not practicing sport, even more relevant data is detected. Among young people, «lack of time» is the fundamental reason for not practicing sport (59 percent) – though this data must be taken with care, as this is the population group which most practices sport. Other motives are expressed with more or less importance according to the sex of the young people. Thus, apart from «lack of time», among men «work» is a motive for not practicing sport (17 percent), and among women «not liking it or not being interested» (15 percent) and «family responsibilities» (9 percent). This data reveals a clear division of roles (work versus home) according to the sex of the person, which has an influence on the practice of sport among men and women, providing indisputable evidence that, effectively, sport continues to be subject to social determinants of a sexist character. It is precisely in this respect that García Ferrando et al. (1998) wrote: «Traditionally, it has been the role of the father to be the socializing agent of the sporting habitus… Sporting jargon is overloaded with allusions to masculine attributes as signs of strength and virility. While on the contrary, the incorporated schemas that have prevailed in processes of pre-socialization of women have had the mother as the primary referent. Ways of speaking, of dressing, of playing, etc., have shaped patterns of behaviour that have emphasized subtlety, tenderness, harmony or the aesthetic in detriment to vigour, strength or courage. It isn’t strange then, than women are more resistant to formalize their physical exercise». Seniors Regarding the motives for practicing sport, seniors (in this study persons older than 65) reveal diffuse answers: «because I like sport» (32 percent), «to maintain and/or improve health» (29 percent) and «because of health problems» (22 percent). As also among young people, the answers can be determined by sociological reasons but also by conditions of personal health and well-being typical of this age group. Hence, while young people have a greater enjoyment in the practice of sport – based on the reasons mentioned – , seniors principally 34 SPORT, HEALTH AND QUALITY OF LIFE employ arguments related to health and physical and psychological wellbeing. However, among seniors some differences on this question based on sex can also be observed: men more often cite the motives «to maintain and/or improve health» (32 percent versus 25 percent) and «because of habit, because I have always done it» (12 percent versus 3 percent). Women, on the other hand, more frequently employ reasons such as «for physical and psychological well-being» (15 percent in comparison to 4 percent) and «because of doctor’s advice» (13 percent in comparison to 4 percent) – we should not forget that it is older women who tend to go to the doctor most often. Regarding motives for not practicing sport, the data reveals the following as the most important: the two principal motives for those that don’t practice sport are «health» (34 percent) and «age» (14 percent). In other words, in the case of seniors, the subjective conception they have of their health problems is the principal barrier to the practice of sport, something which directly conflicts with what health experts recommend. Actually, the relationship between the practice of sport and tangible levels of health has been empirically demonstrated (Paffenbarger and Hide, 1988; Shephard, 1996; Alonso, 1997; Jiménez and Montil, 2006). What’s more, the lack of physical exercise can even be the cause for a worsening of health, which makes this an issue that sport and health policies must continue to address. The data also reveals that there is a substantial difference between older men and women and the frequency that they refer to these motives for not practicing sport. What stands out is that among women the health motive is more frequently mentioned than among men (42 percent versus 24 percent),(4) as is also the lack of nearby facilities (10 percent in comparison to 4 percent). For their part, men more often cite the motives of «age» (20 percent in comparison to 9 percent) and «work» (8 percent versus 3 percent). Sociological factors that influence the practice of sport The evidence examined so far leads us to the second analytical perspective indicated to explain the existing asymmetry between the elevated interest in sport and the lack of practice of sport. This second perspective focuses on the (4) An analysis of greater depth of this data permits us to discover that among older women that refer to this reason to explain their not practicing sport, almost half admit to having pain in some part of their bodies, 15 points more than among older men who refer to this same motive. Hence, the differences found in this relationship between men and women. SPORT AND PHYSICAL EXERCISE IN THE SHAPING OF LIFESTYLES 35 transmission of values related to sporting culture (the process of socialization) and living conditions as factors determinant in the practice of sport. With this analysis the intention is to set out the need of government and public institutions to put an end to obstacles that inhibit access to the practice of sport among specific sectors of the population. Numerous authors have shown the influence of socialization on the realization of sportive physical exercise (García Ferrando, 1986 and 2001), both in early ages (Patriksson, 1996), as well as in subsequent life cycles (Martínez del Castillo et al., 2006). The principal discoveries have shown that the practice of sport on the part of parents is a determinant in doing sport (García Ferrando, 2001), as is also having enjoyed an active past (Martínez del Castillo et al., 2006). In addition, social conditions are also decisive. As Rhodes et al. (1999), Collins (2003) and Donnelly (2003) have demonstrated, elements such as social class, educational level or occupation decidedly influence the practice of sport. In this study we have wanted to follow the path of these antecedents, trying to establish relationships, on the one hand, between socialization and the practice of sport and, on the other, between this activity and living conditions. To analyze both of these relationships we have looked at the data obtained in the survey. Regarding the first of these relationships, socialization and the practice of sport, the correlation between doing sport among the surveyed and the sporting practice of their parents has been confirmed («Can you tell me if one of your parents practices or has practiced a sport?»). As sociology has traditionally argued, the family is the principal agent of socialization for individuals’ patterns of behaviour, more so than the educational system, work and friendships. Therefore, the transmission of cultural values related to sport begins from early moments within this institution. The effect of this process will impact on subsequent stages in the practice or lack of practice of sport, as is confirmed in the results obtained from the survey. Among the individuals that state that they do sport, almost half share the circumstance that their parents also have practiced sport in the past or continue doing so. While among those that don’t do sport, the situation is the exact opposite: at least eight of every ten persons answered that their parents never did any 36 SPORT, HEALTH AND QUALITY OF LIFE sport. Therefore, it is clear that there is a positive correlation between parents practicing sport and their children doing so (graph 1.2). In addition, some authors agree that a relationship exists between an active past and the later practice of sport (Rhodes et al., 1999), something in which other institutions would tend to have an impact, such as the educational system. Martínez del Castillo et al. (2006), for example, argue that «the processes of human life (past experiences and lifestyles, among others) condition future behaviour regarding physical activity». Based on this idea, a question in the questionnaire was introduced that would permit us to test this hypothesis («We are going to think about the past. Did you do some physical activity or sport when you were a child, an adolescent or an adult?»). And as can be seen our survey results show that, in effect, the percentage of those who currently practice sport is much greater among those that did so in the past than among those who never did. The ratio being almost seven to three (see table 1.7). This clarity with which the relationship between the practice of sport and socialization is expressed does not reach a sufficient level of explanation until GRAPH 1.2 Participants in sport, according to whether their parents practiced or did not practice sport In percentages Source: Study E0727 IESA-CSIC. SPORT AND PHYSICAL EXERCISE IN THE SHAPING OF LIFESTYLES 37 TABLE 1.7 Participants in sport, according to whether or not they practiced sport in the past In percentages PRACTICED SPORT IN A PAST STAGE OF LIFE As a child As a young person As an adult PRACTICE SPORT IN THE PRESENT YES NO Yes 79.0 58.5 No 20.7 40.9 Yes 73.5 41.7 No 26.2 58.3 Yes 72.4 22.1 No 27.6 77.5 Source: Study E0727 IESA-CSIC. the influence of independent variables such as age is assessed. In this sense, it can be said that, in relation to the aspects of socialization that have been dealt with, among young people almost six of every ten persons that stated they practice sport share the fact that their parents also have practiced sport at some time in their lives. In addition, around nine of every ten young persons who practice sport remember having done so during their childhood and adolescence. On the other hand, among seniors, only one of every ten surveyed that do sport remember that their parents also did so, and in relation to the past, only four of every ten senior participants in sport remember having done so during their childhood and adolescence. However, among seniors, seven of every ten say they did sports when they were adults. This leads one to raise the first of the sociological differences that distinguish young people from old people in relation to the socialization of values and habits related to sport: namely that while young people were instructed in sport through the educational system – thanks to the establishment of physical education as a subject in the curriculum since the 1970s –, older people received this instruction later in life, as a result of «resocialization tied to perceived social support». This evidence leads one to the following two conclusions. The first confirms the hypothesis of Mosquera and Puig (2002), who argued that the differences in participation in sporting practice observed in the past between young and old were not due to reasons of a «biological» nature but were strictly of a generational character. Proof of this is the fact that in the symbolic imaginary 38 SPORT, HEALTH AND QUALITY OF LIFE of Spanish society, some older persons continue believing stereotypes related to sport that contain negative connotations about this activity, and this despite being a population group with insufficient experience in the practice of sport to take such a critical position over it. The data obtained shows us that 10 percent of older persons believe that sport «is bad for the heart», «worsens the general state of the body» and «is bad for the bones», and for almost 30 percent of these persons sport «makes you more nervous» (see table 1.8). This data provides support for the hypothesis of a «generational effect» on the limited practice of sport among seniors. Therefore, this is one of the battlefronts for government if it wants to encourage more seniors to practice sport to benefit their health and personal well-being. The second conclusion partially corroborates the results of other studies in which it has been confirmed that, among older persons, social support directed to the promotion of sport can contribute to modifying acquired cultural patterns (Chogahara, Cousins and Wankel, 1998; Graupera et al., 2003), in other words, by introducing among this population group values and habits related to the practice of physical exercise and sport. Proof of this is that in analyzing how medical advice influences the practice of sport and physical exercise among this group, the importance of this support is detected. This influence is not perceived in the area of «sporting practice» but rather is seen in relation with «walking». Data permits the confirmation that medical recommendation does not have any effect on doing sport, as only 20 percent of individuals that said they received this medical TABLE 1.8 Stereotypes about sport In percentages AGE GROUPS TOTAL CATEGORIES YOUNG PEOPLE ADULTS 2.3 9.7 7.2 96.9 93.5 95.8 3.7 8.3 6.2 95.8 90.5 95.7 5.8 9.5 6.1 It makes you feel more anxious 15.7 26.1 18.3 It’s good for your health 98.5 95.4 97.6 It’s bad for the heart Helps you meet people Worsens the general state of the body Makes you feel better about yourself It’s bad for your bones Source: Study E0727 IESA-CSIC. SPORT AND PHYSICAL EXERCISE IN THE SHAPING OF LIFESTYLES 39 recommendation followed it. However, among those that received this advice from their doctors, at least 60 percent take walks. This figure increases in the case of women, as around 70 percent of women that have received the recommendation from their doctors to do physical exercise or sport state that they take walks. To deal with the second relationship raised, the practice of sport and living conditions, this study followed the procedures employed in previous studies on this issue (Martínez de Castillo et al., 2006). In these studies, the structuralist current had an important weight, throwing light on the influence that social structures have on individual’s opportunities for action. The dimensions employed from this perspective in this part of the study are «educational level attained», «occupation» and «income». In all cases the clear influence of these variables on the practice of sport can be seen. Concerning the first of these variables, «educational level», it can be seen that, among those who practice sport, eight of every ten persons have completed secondary school or vocational training (57 percent) and university studies (21 percent), while among those that do not practice sport, seven of every ten have completed secondary school (42 percent) or primary school (28 percent). From this we can deduce that the probability of doing sport increases as does the level of education (table 1.9). A possible explanation of this fact is that those that have studied during a greater part of their lives could be more influenced by the channels of transmission of values and habits related to sport typical in the educational field (obligatory teaching of physical education in primary and secondary school, availability of installations and sporting activities in universities and other centres of post- TABLE 1.9 Participants in sport, according to educational level In percentages PRACTICE SPORT TOTAL EDUCATIONAL LEVEL YES NO Illiterate 0.1 2.3 1.5 No formal education 6.1 18.9 14.2 Primary school education 14.7 27.7 22.9 Secondary school education 57.4 41.5 47.3 University studies 21.3 9.5 13.9 Source: Study E0727 IESA-CSIC. 40 SPORT, HEALTH AND QUALITY OF LIFE secondary education, etc.). In this sense, García Ferrando et al. (1998) point out that «school not only sets and reinforces determined patterns of behaviour, but also, through a complex network of symbolic relations, consolidates and engenders positive attitudes toward the practice of sport». Regarding «occupation», we can say that it also has a decisive influence. The largest proportion of those who practice sport comes from mid-level management and executives (four of every ten). On the opposite side are found industrial workers, making up more than four of every ten who do not practice sport. In addition, among those who are not in the labour market, it can be seen that being a student positively affects practicing sport (60 percent of students practice sport), and being a homemaker negatively affects practicing sport, as in this group, composed almost completely of women, only two of every ten practices sport, results which are close to those obtained in other studies on the practice of sport in this specific sector of the population (Martínez del Castillo et al., 2005) (table 1.10). In this sense, we can say that this group also raises a specific challenge to government, faced with facilitating their access to the practice of sport and physical exercise. The evidence reveals that there exists some type of relationship between employment situation and occupation and the practice or not of sport. However, TABLE 1.10 Participants in sport, according to occupation or other employment situation In percentages PRACTICE SPORT EMPLOYMENT SITUATION Employed YES NO Middle level management 44.3 28.3 Services 13.8 15.5 0.3 3.4 Manual labor 28.9 42.0 Other 11.2 8.7 Not in labor market, homemaker 22.6 77.4 Unemployed, looking for first job 86.7 13.3 Student 60.0 40.0 Agriculture and Fishing Not employed Source: Study E0727 IESA-CSIC. SPORT AND PHYSICAL EXERCISE IN THE SHAPING OF LIFESTYLES 41 the reasons that would explain this relationship are not within the reach of these pages, as the objectives of our study are different. However, we can suggest a hypothetical explanation that has to do with the explanation that structuralists such as Pierre Bourdieu (1998) have employed at times. Bourdieu postulates that the practice of sport responds to a choice in which individual cultural capital and economic capital have influence, and on the basis of which individuals not only opt to practice or not practice sport, but also opt for the type of practice that contributes to socially distinguishing themselves from others, or identifying themselves with a specific group. «To understand the class distribution of the various sports, one would have to take account of the representation which, in terms of their specific schemes of perception and appreciation, the different classes have of the costs (economic, cultural and “physical”) and benefits attached to the different sports – immediate or deferred “physical” benefits (health, beauty, strength, whether visible, through “body-building” or invisible through “keep-fit” exercises), economic and social benefits linked to the distributional or positional value of each of the sports considered (i.e., all that each of them receives from its greater or lesser rarity, and its more or less clear association with a class, with boxing, football, rugby or body-building evoking the working classes, tennis and skiing the bourgeoisie and golf the upper bourgeoisie), gains in distinctions accruing from the effects on the body itself (e.g., slimness, sun-tan, muscles obviously or discreetly visible, etc.) or from the access to highly selective groups which some of these sports give (golf, polo, etc.)» (Ibid.:17-18). As with the previous variable, «income» also seems to influence the practice of sport. Looking at the data obtained it can be seen that among those with incomes above 1,000 euros per month, 51.6 percent do sport, while among those with incomes below 1,000 euros per month only 32.4 percent do sport TABLE 1.11 Participants in sport, according to income level In percentages PRACTICE SPORT TOTAL INCOME LEVEL YES NO Less than 1,000 euros 32.4 67.6 100.0 More than 1,000 euros 51.6 48.4 100.0 Source: Study E0727 IESA-CSIC. 42 SPORT, HEALTH AND QUALITY OF LIFE (table 1.11). Income level is a variable that is related to educational level, employment and occupation. As with the analysis made of the relationship between socialization and the practice of sport, here we also see some differences between young people and seniors. Among young people it can be seen that the process of the democratization of sport which took place in Spain between the 1970s and mid-1990s had its impact; as the obligatory teaching of physical education transmitted to new generations of Spanish the culture of physical activity and sport – this explanation is shared by other sociologists that analyze sporting phenomena (García Ferrando, Lagardera and Puig, 1998; Mosquera and Puig, 2003; Martínez del Castillo et al., 2006). Hence, among young people there are not great differences among those that do sport and those that don’t in function of their living conditions. Among seniors we also do not see great differences in the practice or lack of practice of sport based on analysis of living conditions. This is probably due to living conditions among the majority of this population group being very similar, thus we do not distinguish differences between those that practice sport and those that don’t based on different levels of education or income or related to occupation. Not in vain, the survey confirms that eight of every ten seniors have no formal education or only have a primary school education; the same proportion had occupations which would define them as workers or homemakers and have incomes below 1,000 euros per month. As a consequence, the group that forms the social class in which the most appropriate conditions exist for the practice of sport is only around 20 percent of this age group (and among those are located the 7 percent who practice sport in this age group). All these reflections will be examined further in the segmentation analysis done in section 1.3, although in that analysis the weight of sport will not be exclusively considered, as other activities that imply physical effort such as taking walks and the physical effort involved in work will also be examined. In addition, segmentation analysis will permit us to know if the lifestyles of the Spanish are more or less sedentary or active. The practice of physical exercise during work Before entering into the segmentation analysis on lifestyles of the Spanish population, we will take a brief look at the way in which labour activity has SPORT AND PHYSICAL EXERCISE IN THE SHAPING OF LIFESTYLES 43 developed among the population. This research provides additional elements for the analysis of the lifestyles of the Spanish population. As has been mentioned, one of the characteristic traits of the occupational changes produced in post-industrial societies has been the progressive substitution of blue collar workers for white collar workers, in other words, the decrease in occupations which require the use of physical force and the increase in the number of occupations that have a sedentary character. Therefore, what stands out the most in this change is the loss in importance of physical strength and effort in the majority of jobs today. To measure this change, in the questionnaire we introduced a question that would provide us with information in this regard: «Regarding whatever is your principal activity (work, taking care of the home, studies or other), which of the following situations best describes the physical activity you do?». As can be seen from the question, the criteria followed in the formulation of the question has been to include all those persons who do unpaid work and who are therefore not included among the employed, such as homemakers and students. In this way, we include a greater number of persons, increasing the sample’s representativeness of the population. The results obtained from this question show that nine out of ten Spanish are almost equally distributed among «sitting the majority of the time» (31 percent), «walking with frequent trips» (31 percent) and «standing the majority of the time, without making great effort» (27 percent). Only one of ten does «heavy work requiring great physical effort» (graph 1.3). As a consequence, it can be seen that two thirds of the Spanish population have sedentary occupations, spending the majority of their working day seated or standing but without great effort (studying, driving a vehicle, in front of a computer screen, behind a window, behind a counter in a shop, etc.). This frequency, if it is evaluated together with the low proportion of persons that practice sport or the growing practice of passive leisure, confirms the predominance of a sedentary lifestyle in Spanish society. In any case, these results will be discussed in the following section of this chapter. The responses reveal distinct behaviours if we cross them with a series of independent variables. To show the weight of these variables, in what follows «polar» reference categories are employed (see table 1.12). For example, types 44 SPORT, HEALTH AND QUALITY OF LIFE GRAPH 1.3 Whatever your principal activity, which of the following situations best describes the physical activity you do? In percentages ��� ��� ��� ��� ��� ��� �� �� ������ �������� ������� ���������� Source: Study E0727 IESA-CSIC. of work tend to be related to the population size of the town. In rural zones jobs that demand physical effort tend to be more common than in large cities, while in large cities sedentary jobs predominate more than in rural zones. The results of this research don’t show sharp differences, although it is clear that a greater number of those that reside in towns of less than 5,000 inhabitants state they do heavy work (11 percent) in comparison to those that reside in cities of more than a million persons (8 percent). Regarding sedentary work, the differences are somewhat greater, 34 percent living in large cities say they spend the majority of the work day seated while 26 percent who live in small towns say they do. These results correlate with the larger tertiary sectors which exist in cities and with greater economic activity in the primary sector in small towns. An additional variable related to type of physical activity done at work is educational level. In general, educational level tends to affect the type of job a person can do. Our research shows that only 3 percent of those that have university education do heavy work, while among those that have primary school education 13 percent have jobs which involve heavy work. On the opposite side, 52 percent of persons with higher education spend the majority of the working day seated, while among those with primary school educations SPORT AND PHYSICAL EXERCISE IN THE SHAPING OF LIFESTYLES 45 TABLE 1.12 Type of physical activity done at work In percentages SEATED STANDING WALKING HEAVY WORK Size of Municipality Less than 5,000 26.4 27.0 33.9 10.7 More than 1 million 34.2 26.3 30.0 7.7 Educational Level Primary 25.6 25.6 34.3 12.7 University 52.0 21.0 22.8 3.2 Age Young people 30.7 22.8 27.2 17.7 Seniors 30.0 36.5 30.0 0.6 Men 31.2 20.5 30.8 16.2 Women 28.4 33.4 31.5 5.0 Sex Source: Study E0727 IESA-CSIC. only 26 percent spend the majority of their working day seated. This means that the probability of leading a sedentary life, determined by the physical activity done on the job is much greater as educational level increases. The type of physical activity done during the working day is also related to age and sex. In general, those who do heavy work are young and men. In addition, it is notable that those who spend the majority of the working day standing are often seniors and women. In relation to the previous data, the explanation might be found in the great number of young men employed in the construction sector, a sector completely dominated by men and of great importance in recent years in Spain, where the level of physical effort is quite high. Regarding the second piece of data, this is explained by the large number of older persons, generally women, who, in retirement, carry out more intense domestic labours and undertake the care of persons in their family (spouse, grandchildren, etc.). The implications of this physical activity on personal health and well-being will not be dealt with at this point, given that this relationship will be analyzed in subsequent chapters of this study. In any case, we do want to make the following observation here: it is evident that the type of physical activity carried out at work is the cause for the appearance of illnesses and injuries among workers, many of which lead to extended sick leave. The importance today of jobs in which the majority of the work is carried out seated – considering that work involves a significant amount of time in our daily lives – will gradually 46 SPORT, HEALTH AND QUALITY OF LIFE lead to an increase in physical and psychological health problems associated with sedentarism. As a result, this lack of physical activity raises a challenge without precedent for public institutions and businesses, because if they do not find solutions to this problem in the future through adequate policies and actions, the material and organizational costs to the healthcare system and to insurance companies will become greater and greater. 1.3. Active persons and sedentary persons In this section we intend to look at the level of activity and sedentarism that defines the lifestyles of Spanish society. Until now we have analyzed this issue through partial data related to attitudes and behaviour with respect to leisure and free time, sport and physical activity. In what follows, based on the data extracted from the survey more detail will be provided on this point. To do this we have developed a system of operationalizations, which provide a consistent series of values to a set of variables, permitting us to establish an index through them (the Lifestyle Index [LI]) (see tables 1.13, 1.14 and 1.15). This index is calculated using the following formula: LI = Σ[Active dimension] + Σ[Sedentary dimension]; limits: + 3; – 3 Σ[Ad] is the sum of the weights of the indicators of the active dimension; Σ[Sd] is the sum of the weights of the indicators of the sedentary dimension. TABLE 1.13 Empirical variables of the active dimension DIMENSION OF ACTIVITY SUBDIMENSION OF ACTIVITY Walking or taking walks Independently of whether you practice sport or not, do you tend to walk fast? Yes. Every or almost every day; two or three times per week. Sport Without including walking, do you currently practice any sport? Practice one; practice several. Every or almost every day; two or three times per week. Principal activity work Whatever your principal activity (work, household tasks, studying), which of the following situations best describes the physical activity you do? Walking, with frequent trips; doing heavy with great physical effort. Source: Study E0727 IESA-CSIC. SPORT AND PHYSICAL EXERCISE IN THE SHAPING OF LIFESTYLES 47 TABLE 1.14 Empirical variables of the sedentary dimension Walking or taking walks DIMENSION OF ACTIVITY SUBDIMENSION OF ACTIVITY Independently of whether you practice sport or not, do you tend to walk fast? Yes. Only on weekends, only on vacations; sometimes, when you have time or when you remember. No. Sport Not including walking, do you currently practice any sport? Yes. Only on weekends, only on vacation; sometimes when you have time or remember. No, not any. Principal activity Whatever your principal activity, which of the following situations best describes the physical activity you do? Seated the majority of the time; standing without great effort the majority of the time. Source: Study E0727 IESA-CSIC. TABLE 1.15 Weighting coefficient of the Lifestyle Index WALKING CATEGORY SPORT COEFFICIENT CATEGORY DAILY ACTIVITY COEFFICIENT CATEGORY COEFFICIENT «Every day or almost every day; two or three days per week» +1 «Every day or almost every day; two or three days per week» +1 «Walking with frequent trips; doing heavy work with great physical effort» +1 «No»; «only on the weekends; only on vacation; once in a while» –1 «No»; «Yes; only on the weekends; only on vacations; once in a while» –1 «Seated the majority of the day; standing without great effort the majority of the day» –1 Source: Study E0727 IESA-CSIC. The reading of the index constructed to analyze the lifestyle that predominates among the Spanish must be done from the following guidelines. The frequency distribution of the Lifestyle Index (LI) (table 1.16 and graph 1.4) distinguishes 48 SPORT, HEALTH AND QUALITY OF LIFE those who are characterized for having a sedentary lifestyle from those that could be considered to have an active lifestyle. Among the sedentary are found those that present values between –1 and –3 and, among the actives, we find those that are situated between the values 1 and 3. As would be expected, based on the data analyzed up to now, the majority of Spanish share a sedentary lifestyle. In other words, six of every ten persons are sedentary, meaning, «they don’t walk with much frequency (or simply not at all), they don’t practice sport or only do so in a sporadic manner, and they spend the TABLE 1.16 Frequencies from the Lifestyle Index FREQUENCY PERCENTAGE ACCUMULATED PERCENTAGE –3 –1 343 835 17.6 43.0 17.6 60.6 1 3 611 154 31.5 7.9 92.1 100.0 Total 2,018 100.0 VALUE Source: Study E0727 IESA-CSIC. GRAPH 1.4 Classification of the Spanish population in the Lifestyle Index (LSI) ����� ��� ��� ��� ��� � �� �� ��������� � � ������ Source: Study E0727 IESA-CSIC. SPORT AND PHYSICAL EXERCISE IN THE SHAPING OF LIFESTYLES 49 majority of the working day seated or standing, without having to put forth great effort». On the opposite side are the active persons (39 percent), who «tend to walk regularly, do sport at least three times a week and spend their time at work walking with frequent trips or doing heavy work». The correlation of values from the index with the independent variables used to detect possible variations (age, sex, civil state, educational level, employment situation and sporting practice of parents), in function of the relative weight of each one of them, in all cases gives as a result the consolidation of sedentarism in our lives. However, the importance of this lifestyle is less among certain sectors of the population. Considering age, seniors participate much more than young people in a sedentary lifestyle (70 percent in comparison to 50 percent), something that was confirmed previously. Even so, the percentage of young people with sedentary lifestyles is sufficiently high to create concern in the Spanish government, as it foresees the problems this will lead to in the future. The introduction of the sex variable shows that women participate more than men in sedentary habits and behaviour (64 percent versus 57 percent). This finding is not surprising, given that there is a wide segment of the female population, particularly among older women, whose responsibility for the care of the home combined with their standing much of the day leaves little free time available to do sportive physical exercise. Civil state appears to also have influence in this respect, given that those that are single or live with their partners have less sedentary lives than those who are married, divorced, separated or widowed. Probably, this situation is due to the greater availability of free time among this group, as they have fewer family responsibilities. In this sense, it is very likely that it is in this group that the majority of young people are found, many of them still students. Employment situation influences lifestyle in the same way: those who work or study are less sedentary than homemakers or the unemployed. Regarding studies, those with higher levels of education have more active lifestyles than those with less education. Previously analyzed data revealed the importance of education in the transmission of sporting habits and values. Finally, those that have seen their parents practice sport are much more active than those that haven’t (64 percent and 51 percent respectively) – this is predictable given the weight of the family in individual socialization. 50 SPORT, HEALTH AND QUALITY OF LIFE Beginning with this first incursion into the data, and making use of the software program ANSWER TREE, a multivariate segmentation analysis of the Lifestyle Index has been carried out. This analysis permits us to, on the one hand, associate lifestyles with different sectors of the population and, on the other, determine which variables best explain the concurrence with one or the other lifestyle. The results show that only three of the six variables introduced in the analysis predict changes in lifestyle: educational level, employment situation and having active or inactive parents. The analysis does not reveal great differences among the distinct terminal groups (graph 1.5 and table 1.17), but rather confirms the establishment of a sedentary lifestyle in the Spanish population. But the segmentation in function of different variables permits us to elucidate the different degrees of participation by the Spanish within this predominant tendency. In concrete, what is seen is that as the educational level increases the difference in numbers between those that have a sedentary lifestyle and those that have an active lifestyle is smaller (55 percent and 45 percent respectively in the group with the highest educational level), and as educational level decreases, greater is the number of sedentary persons (82 percent of persons with no formal education are sedentary). These two groups, the highest educated and the least educated, make up an eighth of the Spanish population. Therefore, it can be seen that educational level – one of the principal mechanisms of socialization of values and habits – is the variable which best explains differences in the lifestyle of the population. This corresponds to the results obtained previously. But it is the intermediate position which permits a more detailed interpretation of this segmentation to be made. Graph 1.5 and table 1.17 show that the persons grouped in this segment with a low educational level (primary school) form three terminal groups, in which the predictor with most weight, which acts as a filter, is employment situation. This variable differentiates into one group which includes those that don’t work, the unemployed and homemakers, among whom there is almost absolute predominance of sedentarism; and to two other groups composed of those who study, work or are retired, but are differentiated based on whether they have parents with active or inactive pasts. Those with parents with inactive pasts are more sedentary (the first of these two groups, 66 percent sedentary) and those with parents with active pasts are more active (the second of these two groups, 82 percent active). Thus, SPORT AND PHYSICAL EXERCISE IN THE SHAPING OF LIFESTYLES 51 GRAPH 1.5 Segmented analysis of lifestyles of the Spanish population LIFESTYLE INDEX NODE 0 CATEGORY % ฀Sedentary ฀Active Total N 61.3 1,173 38.7 739 100.0 1,912 — EDUCATIONAL LEVEL SECONDARY AND UNIVERSITY EDUCATION/ PRIMARY SCHOOL NODE 1 NODE 2 CATEGORY % ฀Sedentary ฀Active Total N CATEGORY ฀Sedentary ฀Active Total 55.0 651 45.0 533 61.9 1,184 NO EDUCATION NODE 3 % N 64.7 35.3 22.5 278 152 430 CATEGORY ฀Sedentary ฀Active Total % N 81.9 18.1 15.6 244 54 298 — EMPLOYMENT SITUATION EMPLOYED/RETIRED/PENSIONER/ STUDENT HAS NOT WORKED/HOMEMAKER/ UNEMPLOYED NODE 4 CATEGORY ฀Sedentary ฀Active Total NODE 5 % N 85.2 14.8 7.4 121 21 142 CATEGORY ฀Sedentary ฀Active Total % N 54.5 45.5 15.1 157 131 288 — ACTIVE/INACTIVE PARENTS FATHERS/MOTHERS INACTIVES/ FATHERS/MOTHERS ACTIVE NODE 6 CATEGORY ฀Sedentary ฀Active Total NODE 7 % N 65.6 34.4 11.6 145 76 221 CATEGORY ฀Sedentary ฀Active Total % N 17.9 82.1 3.5 12 55 67 Note: Only the variables that generate statistically significant differences have been included in this graph, in agreement with the chi-squared test and using a significance level of p < 0.001. Source: Study E0727 IESA-CSIC. 52 SPORT, HEALTH AND QUALITY OF LIFE TABLE 1.17 Groups resulting from the segmentation of the Lifestyle Index GROUPS N % TOTAL % SEDENTARY % ACTIVE Individuals with no formal education 298 15.6 81.9 18.1 Individuals that have a medium-high level of education 1,184 61.9 55.0 45.0 Individuals with a medium-low level of education, that do not work, are unemployed or are dedicated to work in the home 142 7.4 85.2 14.8 Individuals with a medium-low level of education, that are students, work or are retired and whose parents were inactive 221 11.6 65.6 34.4 Individuals with a medium-low level of education, that are students, work or are retired and whose parents were active 67 3.5 17.9 82.1 1,912 100 61.3 38.7 Total Source: Study E0727 IESA-CSIC. together with educational level, the second variable with the most influence on lifestyles is employment situation. In effect, employment situation, which is related to educational level, economic resources and available free time, conditions lifestyles. It is for this reason a determinant variable of lifestyles. We are not going to go into greater detail on the fact that having had active parents is decisive in our also being active (or the inverse). Something which captures our attention is that the age variable does not appear as a differentiating element of lifestyles. In this chapter it has been shown that age is fundamental to understand the unequal behaviour of the population in the practice of sport. Young people do sporting activities with greater frequency than older persons. Therefore, it was to be expected that this variable would have a great weight in the prediction of distinct groupings of lifestyles in the Spanish population. It should be taken into account that the high number of seniors that walk daily and the increase in the number of young persons that spend a good part of their time seated and increasingly do less sport could ultimately have influence in the loss of weight that age has in comparison to other independent variables such as educational level. This SPORT AND PHYSICAL EXERCISE IN THE SHAPING OF LIFESTYLES 53 is the only way to explain how in the segmentation analysis on active and sedentary lifestyles the influence of age has been discarded. At this point nor will we enter into an analysis of the relationship between lifestyle and health and personal well-being, because this is precisely the task that is undertaken in subsequent chapters of this first part of the study. 1.4. The paradoxes of modernity and their impact on living conditions The changes lived through in Spain in the last decades of the 20th century were decisive in the spread of sport among the population. From being considered a classist and minority activity, it has today, along with other leisure practices, become one of the principal elements of our daily lives. The educational system and public initiatives adopted after the arrival of democracy contributed to its spread. These circumstances don’t by themselves explain the importance acquired by sport in the close of the 20th century. Clearly its relevance has a lot to do with the role played by sport as spectacle, thanks to the broadcasting of sporting competitions and the publication of sporting news in the media. Despite this, probably few people two decades ago would have imagined how much passion the practice of physical activities and sports like aqua-aerobics, hydra-gym, yoga, pilates, power dumbell and spinning would provoke today in Spanish society in the sports centres of towns and cities. Nor would they have imagined finding municipal sporting facilities full of men and women over 70 years old, or the appearance of new «fashions» like «taking walks» around town to improve our health. There are dual circumstances which probably best summarize and explain the tendency currently lived in the practice of sport. One circumstance is the social, cultural, political and economic changes that the country has lived through in recent years which have been determinants of the spread of sport, understood as another achievement in the process of democratization. However, and this is the second circumstance, these changes present a certain paradox as they have also brought about a lifestyle which is increasingly more sedentary, which has led in the long run to our becoming more conscious of the need to do sport to compensate for the lack of physical exercise in everyday life. In any case, both 54 SPORT, HEALTH AND QUALITY OF LIFE circumstances correspond in time with the predominance of two very distinct conceptions of sport: •฀ The first is the so-called «elitist conception of sport», in which sport is promoted in terms of competition and in which not everyone sees in it a reference for their own lives («sport is for young people», «sport is for those who have ability»). •฀The second, the conception of sport oriented toward the improvement of health and staying in shape, emerging during this phase of an increase in sedentarism, responds to these new circumstances and, therefore, we see a great number of people identifying with it. The problem that we find today is that, whether for the predominance of values in which the elitist conception of sport is still very present, as well as other traditional values (the differences in roles between men and women, negative stereotypes about the practice of sport among older persons, etc.), or because of the fast pace of our lives and the sedentary activities that have us trapped, we find numerous barriers that impede our practice of sport and physical activity (lack of free time, work, care of other persons, etc.); although we are conscious of its importance and the need to practice it. This leads to internal conflict, the more we lack the physical, psychological and social benefits of sport, the more this generates frustration as we feel a greater need for them. This conflict between what is and what could be illustrates many of the feelings that individuals must today be feeling in relation to the practice of physical exercise, sport and other related activities, and, as a consequence, it is also illustrative of the states of mind that accompany the tension generated by the consciousness of our material limitations (in the form of time and resources) and the necessity to be healthy and have quality of life. This being such a transcendental matter in our lives, this is precisely the place where the government has to intervene. The analysis made in this chapter clearly illustrates these circumstances. The treatment of the quantitative data obtained through the survey reveals that, despite the great interest that the public shows toward sport and physical exercise, in practice few persons do these activities during their free time, in a time strictly set aside for sporting activity – understood as a habit in daily life – or during the work day. SPORT AND PHYSICAL EXERCISE IN THE SHAPING OF LIFESTYLES 55 Concerning the practice of sport and physical exercise during free time, as has been seen, this has been subject to a series of changes which have taken place in the form of relationships, the organization of work, family structure and in the conception and use of this time itself. Thus, we confirmed that some leisure practices of a physical character (such as taking walks and doing sport) today have as much weight as others of a social character (being with family, friends or one’s partner). This tendency is happening among all age groups, although it is becoming particularly important among seniors. Essentially among this age group, in contrast with young people, leisure activities of a physical character, being the most mentioned, are more important than other leisure practices. This can be explained by the fact that seniors «take walks» more often than young people, especially in a period in which young people are spending more time seated. At the same time, seniors appear to have more independence from family responsibilities, as leisure activities of a social character occupy a smaller part of their free time in comparison to young people (30 percent to 65 percent, respectively), who still live with their families and relate more with friends and partners. Sex and income level are also two important factors that influence the same noted tendency: women and those with lower incomes do less leisure activities of a physical character. Concerning the practice of sport as a daily habit in our lives, the existing asymmetry between the interest expressed by the population for this activity (at least eight of every ten persons state an interest in this activity) and the percentage of persons that do it (less than four of every ten) stands out. To understand this asymmetry, the reasons most often given by individuals for both the practice of sport and inactivity were analyzed. Regarding «reasons for practicing sport», the population mostly coincides on those connected to the role of socialization and health, especially stressing the answers «because I like sport» (52 percent) and «to maintain or improve health» (20 percent). Regarding the «reasons for not practicing sport», it seems that reasons of a practical character have greater influence («lack of time», «work» and «family responsibilities») and those connected to the role of socialization («I don’t like it, it doesn’t interest me», «I can’t be bothered», «lack of habit», etc.). Among these, «lack of time» (38 percent) stands out, although «for health reasons» (18 percent) is also important. 56 SPORT, HEALTH AND QUALITY OF LIFE Both young and old share to a certain degree these answers, although some observed differences ought to be highlighted. Regarding «reasons for practicing sport», although «enjoyment of sport» is the principal answer in both population groups, among young people this has greater weight (56 percent and 32 percent respectively). In addition, among seniors the answers «to maintain and/or improve health» (29 percent) and «because of health problems» (22 percent) are also important in contrast to the answers given by young people. The answer «enjoyment of sport» has less weight among women than men, above all among older women. Regarding «reasons for not practicing sport», «lack of time» is the principal reason mentioned among young people (59 percent), but not among seniors, among whom the principal reasons mentioned are «health» (34 percent) and «age» (14 percent). Again, the sex variable reveals differences between men and women among those who don’t practice sport, as among men, in addition to «lack of time», the reason «because of work» also has influence, while among women the reasons «I don’t like sport» and «family responsibilities» have greater weight. The «health» reason is used much more specifically among older women than among older men. All these reasons referring to the practice or non-practice of sport have some sociological explanation if factors related to the socialization process and living conditions are looked at. Thus, on the one hand, our analysis has revealed a positive relationship between doing sport on the part of the parents of those surveyed and their doing sport. There is also a positive relationship between having practiced sport in previous stages of life and practicing sport now. Both relationships have greater importance among young people than among seniors, as surely, as was already mentioned, the extension of physical education among the generations of young people has had its effect. On the other hand, analyzing social conditions through variables like educational level, occupation and income has confirmed that as educational level, income and occupational qualifications increase, the proportion of persons who practice sport also increases. Therefore, socialization and living conditions are also determinants in the practice or lack of practice of sport. Finally, regarding the physical activity that we do during the work day, the data reveals that the majority of the population does activities which do not involve great physical effort. The majority are in the following situations: «spending the majority of the time seated», «walking, with frequent trips» or SPORT AND PHYSICAL EXERCISE IN THE SHAPING OF LIFESTYLES 57 «standing the majority of the time but without great physical effort». In other words, there is a high percentage of persons that do sedentary tasks. Although this is the general tendency, the introduction into the analysis of independent variables such as municipal setting, age, sex and educational level reveal some differences on this issue among distinct groups of the population, as we have already made explicit reference to. The analysis of the practice of physical activity and sport in the three areas analyzed has allowed us to obtain a general idea about the lifestyle that predominates in the Spanish population. In addition, in the last section the principal indicators referring to each one of these areas were grouped with the aim of elaborating an index with which we could determine with greater precision which is the lifestyle most characteristic of the population. The results of this analysis reveal that the majority of the Spanish have a sedentary lifestyle (six of every ten), insofar as they don’t walk or don’t do so often, they don’t practice sport or don’t do so often enough and spend the majority of the work day seated or standing but without making great effort. Although this is the general tendency, the use of segmentation analysis based on this index shows that sedentarism is more consolidated among those with lower educational levels, the unemployed or those that work in the home and whose parents never practiced any sporting activity. These results coincide with conclusions drawn from contrasting the practice of physical activity and sport in different areas of our lives. 58 SPORT, HEALTH AND QUALITY OF LIFE II. Lifestyles and self-perceived health Concern for health and the analysis of health are as old as humanity. However, the form these take have been different throughout history. From the magical or supernatural conception of our ancestors to the scientific-epidemiological and psychological perspectives of today, we have tried to understand what affects physical and psychological wellbeing, with the ultimate goal being to increase life expectancy: increasing the length of life. Currently, in the most developed western societies life expectancy has reached a level never known before,(1) which has generated a multitude of new realities and social phenomena. There are many voices that reflect on the problems that are associated with such phenomena and which, in the health field, begin to point out a new objective as priority. This could be concretized as increasing well-being and quality of life more than years of life: improve the life lived. From this perspective we analyze social, cultural and individual behaviour connected to life styles that are related to health; health is here understood not only as a result but as a process. Situated in this conceptual framework, the promotion of health does not only correspond to health authorities, nor belong exclusively to the area of health assistance or services. It is necessary to aim for a more comprehensive vision of health in which diverse disciplines, authorities and sectors participate, each one of them contributing resources, ways of working, processes, etc., with the aim of reaching the common goal of improving the health of the population. With the objective of contributing empirical knowledge to a fundamental part of this discussion, in this chapter we address the relationship between health and (1) Life expectancy at birth in Spain is 76.5 years old for men and 83.8 years old for women (2007), above the average of the European Union (EU15), which is 75.8 years old for men and 81.6 years old for women, or that of the United States (75.2 and 80.6 respectively). LIFESTYLES AND SELF-PERCEIVED HEALTH 59 physical activity in Spain. To do this the following section will begin with a brief theoretical explanation of the principal concepts analyzed: health, perceived health and active lifestyle, indicating in turn how they are concretized in our study. In a second section the relationship between lifestyle and perceived health will be analyzed, both in the overall population and for each one of the age groups analyzed (young people, adults and seniors). To conclude, in the third section the principal conclusions extracted from the results will be presented. 2.1. Defining concepts Comprehensive conception of health Having gone beyond the traditional vision of health based exclusively on the biomedical model, which defines it in negative terms as «the absence of illness», currently the concept of «health» refers to a much wider phenomenon. The World Health Organization (WHO) considers health to be «globally, as a state of physical, mental and social well-being in relation to multiple areas that embrace the purely physical (for example, the environment, housing or the environment), the social (for example, safety and hygiene in the workplace, education and healthcare and equity in the distribution of available resources), lifestyle (for example, adequate food, physical exercise, consumption of tobacco and alcohol), the state of health itself (morbidity, mortality, life expectancy), the healthcare system (for example, physical and human resources, hospital care, medical insurance and research) and perceived health or the self-assessment of health». Understanding health from this point of view, it then doesn’t seem adequate to approach the measurement of individuals’ states of health in a determined society only from a biological and/or epidemiological perspective, focusing on classic indicators such as mortality or morbidity, instead, it seems necessary to introduce other indicators that directly or indirectly take into account other elements such as life habits or mental health. In this sense, a subjective indicator like self-perceived health becomes one of the most important and powerful indicators for the analysis of state of health, given that, because of its nature it takes into account the health of a specific person in a global manner, including purely physical aspects as well as mental, psychological, social, cultural and others. Essentially, the state of self-perceived health can be defined as the 60 SPORT, HEALTH AND QUALITY OF LIFE perception that individuals have of their own health, a more global dimension that constitutes a more comprehensive state of well-being (Esteve and Roca, 1997; Guyatt, 1993; Ware, 1987; Testa, 1996). Ruiz Román et al. (2003), among others, state something similar, considering that «health, the somatic sensations like pain or satisfaction, functional capacity, emotional, psychological and social well-being are dimensions of the quality of life related to health». Thus, factors other than the purely physiological determine the perception that an individual has about his/her own health (Azpiazu and others, 2002), therefore the state of perceived health takes into account the multidimensionality and complexity that the current concept of health has, but with no greater complexity than that which the individual makes of it. In addition, it has been verified that self-perception of health is an indicator which is very sensitive to social factors that give rise to an unequal distribution of health (Gonzalo and Pasarín, 2004), which enriches this indicator and makes it even more interesting for analysis. All this explains why this indicator has been one of the most used and important in health surveys in recent years. Its use is also justified by the empirical fact that diverse studies (among others, Idler and Benyamini, 1997) have demonstrated that the state of perceived health is a general indicator of health related to well-being, which has shown itself to be a good predictor of mortality; in fact, even more complete and effective in many cases than clinical diagnosis because of biases which have been documented based on sex, age, race, social class and physical appearance. In a similar way, the subjective state of health appears to have influence on the use of health services (Aday and Anderson, 1981; DeSalvo, 2005, and others). In short, a useful alternative for measuring health, comprehensively considered, is the use of surveys in which those surveyed assess their own state of health. This strategy has been shown to be reliable and consistent, and can provide quantitative information representative of different subgroups in society. An additional advantage of this measure is that it takes health into account in a broad sense, as a state of comprehensive well-being that goes beyond alterations of a physiological or clinical type. The limitations of the use of a subjective concept have been revealed in different studies; nevertheless, we insist that despite these problems it continues being an adequate indicator in sociological and multidimensional studies about health, as diverse authors LIFESTYLES AND SELF-PERCEIVED HEALTH 61 have demonstrated (Esteve and Roca, 1997; Schwartzmann, 2003). Even more so, when there does not exist any valid, agreed upon and generic «objective» instrument for measuring health (Rajmil et al., 2001), and even less so through a questionnaire for the general population. As a result, in this study state of health is recorded through two variables from two questions about perceived health, in which the person interviewed has to assess his/her own state of health. The reasons that justify the inclusion of these two similar questions in two different places in the questionnaire are principally methodological. It is, on the one hand, a mechanism of control of the questionnaire and of the consistency of the responses of the individuals and, on the other hand, an element of verification of possible biases from the placement of the question, given that the first question is given at the beginning of the interview, while the second is placed toward the end, after a relatively extensive block about sport in general and individual sporting practice in particular. As was to be expected, a high correlation between both indicators of selfperceived health was observed, therefore only one of them could have been used as they measure the same thing. However, with the objective of having the most potent dependent variable possible, the aggregation of both within a global indicator was opted for. The principal reason for this decision was that the resulting indicator be highly consistent, containing more information than each indicator by itself.(2) Regarding the answers obtained, as can be observed in table 2.1, between 70 and 72 percent of those surveyed assessed their health as good or very good, 20 to 22 percent as fair, and only between 5 and 8 percent as poor or very poor. However, this self-assessment of state of health seems to be conditioned by age. In graph 2.1 the scoring by age for the aggregate indicator of subjective health (which includes the two questions) can be observed. It can be seen that seniors are the ones that show the worst health despite all the age groups, including them, obtaining high values (above 70). The confidence interval for each subpopulation can also be observed in the graph, it being wider as (2) To accomplish this, a categorical principal components analysis was carried out, which meant the aggregation of both variables in one indicator. 62 SPORT, HEALTH AND QUALITY OF LIFE TABLE 2.1 Responses obtained for the two items about perceived health CATEGORIES OF RESPONSE % RESPONSE (TOTAL SAMPLE) DIMENSION QUESTIONS Perceived health And regarding your state of health, you feel…? 1. Very bad 2. Bad 3. Neither good nor bad 4. Good 5. Very good 6. No answer 2.5% 6.2% 20.5% 44.8% 25.9% 0.1% How would you describe your current state of health? Would you say that it is…? 1. 2. 3. 4. 5. 1.4% 3.8% 22.5% 55.3% 16.9% Very bad Bad Okay Good Very good Source: Study E0727 IESA-CSIC. Base: percentage of cases. age increases, in other words, young people have better perceived health and in addition, this perceived health is very similar for all the members of this group. The senior population is found on the opposite end, as they reveal a GRAPH 2.1 Average perceived health by age group, with confidence intervals (95%) LEVEL OF PERCEIVED HEALTH 90 85 80 75 70 YOUNG PEOPLE ADULTS SENIORS AGE GROUPS Source: Study E0727 IESA-CSIC. LIFESTYLES AND SELF-PERCEIVED HEALTH 63 somewhat more negative vision of their health, as well as greater dispersion or variability among the members that compose this group. The high assessment that individuals tend to make of their own state of health, even at advanced ages, has been confirmed in diverse studies, as an accommodation is produced in the assessment individuals make based on their particular situation, hence seniors assess their health based on what they perceive as «normal» or «optimum» for their age. As a result, in the national health survey (INE, 2006), 68.8 percent of the population assessed their health as good or very good, and in the health barometer in Andalusia in 2007 by the IESA-CSIC this number was 76.5 percent. Those interviewed think, in general, that they have similar health to their «peers» (in age and sex), being the modal category in all the age groups in general, and among young people in particular. The number of older persons that indicate that their health is equal to their peers is considerably less, not because they have a negative vision of themselves, but rather because of an increase in the answer «I don’t know». It is interesting to note that the persons that consider themselves to have poor health are, in all cases, less than 10 percent, while those that believe they have better health than others is around 20 percent, being somewhat higher among those above 64 years of age than among young people. This is coherent with the greater variability in perceived health with respect to the average that, as mentioned above, we see among older persons. Regarding the perception of health over time, those that have a negative selfperception are the seniors, 26 percent believing that their health is worse than it was a year ago, in comparison to only 7.9 percent among young persons. Exercise and active life The second element of analysis to which this chapter is dedicated is the active lifestyle. Defining lifestyles means establishing typologies of individuals based on specific variables. This has been a constant objective of the work of sociology throughout its history, and has led to more or less complex definitions of the meaning of this concept. Thus, for Lagardeta (1992) lifestyles represent «a complete program of behaviour, but in contrast to cultural patterns, there is no conscious thread on the part of individuals». Therefore, they are made up 64 SPORT, HEALTH AND QUALITY OF LIFE GRAPH 2.2 Perceived health in relation to others and over time by age group IT IS WORSE THAN PEERS IT IS EQUAL TO PEERS 16-24 years of age IT IS BETTER THAN PEERS 25-34 years of age IT IS WORSE THAN IT IS EQUAL TO IT IS BETTER ONE YEAR AGO ONE YEAR AGO THAN 35-64 years of age 65-79 years of age Source: Study E0727 IESA-CSIC. of customs, attitudes and behaviours that individuals maintain, without there necessarily existing a feeling of group belonging. They are patterns of learned conduct (Generelo, 1998), which, on occasion are defined in comparison with opposite patterns (this is the case with the idea of an active lifestyle in contrast to a sedentary lifestyle). It is difficult to find conceptual references to an active lifestyle without the concept «healthy» also appearing. Nevertheless, for now attention will be centred on the word «active», which is fundamentally associated with the field of sport and/or physical activity, where a person is considered to do physical activity if he/she carries out certain actions or bodily movements, with a determined frequency, duration and intensity, leading to the consumption of energy. From this perspective one proceeds to a division between those that are active and those that are not (sedentary), and among those that are active a continuum is established that proceeds from less to greater activity. Following this dual pattern, a differentiation is made, at first, among those that do sport and those that do not (sport as an unequalled element of physical activity, and that, in addition, follows certain more or less strict norms) and, LIFESTYLES AND SELF-PERCEIVED HEALTH 65 secondly, a distinction is made among persons that do other types of activities such as walking, which constitute elements connected to physical exercise, and those that do not do this type of activity. In this sense, walking can be considered as a «natural» activity, at the reach of all at all ages. These two concepts, sport and physical activity connected with regular walking are today, in the majority of cases, tied to periods of leisure and free time. However, it is also important to take into account physical activity developed during the days’ non-ludic period (whether it be in the workplace, housework, etc.), and that can entail or not physical or bodily activities. For these reasons in the study detailed in these pages we understand physical activity in this broad sense, as covering both sporting practices as well as other types of actions (walking and the tasks of daily life), which although they don’t require a priori such intense and/or regulated effort as sport, do require physical work, which, according to the evidence of scientific studies in this field, is related in one form or another with health. The American College of Sports Medicine proposes in diverse guides the optimal frequency and intensity of exercise that individuals should follow to produce an improvement in their physical capacities. It is considered to be necessary to do physical activities and sports three to five days a week, at a low to moderate intensity, with a duration of between 20 and 60 minutes. These parameters, however, depend on the type of activity and other factors. Following these considerations three indicators have been taken into account in this study by those that drew up the questions and possible responses which were defined in the previous chapter (see tables 1.13 and 1.14). With this classification, we can identify, on the one hand, what could be called a «purely sedentary lifestyle», characterized by not taking walks in a regular manner, not doing sport and spending the majority of the day sitting (essentially the polar opposite of an active lifestyle advocated by health authorities as an element beneficial for health). As was mentioned in the previous chapter, as age increases the lifestyle becomes more sedentary, fundamentally because of the absence of the practice of sport, as the percentage of persons that spend the majority of their day seated among the different age cohorts is very similar. On the other hand, are found persons characterized as having an «active lifestyle», in other words, they practice sport, they walk or take walks and 66 SPORT, HEALTH AND QUALITY OF LIFE they do non-sedentary work during their working day. In this case it is young people who are the most active, principally referring to the practice of sport, as taking walks is common among all age groups. In short, the variables «walking or taking walks», «doing sport» and «activities of daily life» are considered as the elements constituting the activity of those interviewed and, therefore, the indicators of a more or less active or sedentary lifestyle among the Spanish population. These three variables will be analyzed based on whether they influence or not the perceptions that individuals have of their own health. Health and active lifestyle Within the definition that the WHO has of the concept «health» physical exercise appears as a constituting element, connected to the concept of life habits (like dietary habits and the consumption of alcohol and tobacco). Health and physical exercise and/or sport are clearly connected by researchers in the disciplines of medicine and sport and there exist a large number of studies that confirm this connection theoretically and empirically, although generally the concept of health that is used is derived from the biomedical paradigm, in other words, health defined only as the absence of illness. According to different studies, doing physical and sporting activities constitutes a beneficial element for one’s health (Carbin, Pangrati and Welk, 1994), while infrequent exercise is not beneficial. The continuity and intensity of physical and sportive activity is also a cause for concern for the American College of Sports Medicine, which says that it is necessary to do at least 30 minutes of low to moderate physical activity most days of the week to obtain healthful benefits. Thus, they indicate that «persons that regularly do activities of greater duration will obtain greater health benefits» (USDHHS, 1996). Other authors, perhaps not as precise, simply consider a lifestyle as healthy if «it generates or maintains health» (Sagrera and Bautista, 1994). However, whether from the restrictive vision of some, or the more lax vision of others, there is unanimity in the literature in recognizing that physical activity is an element that stimulates health (Generelo, 1998). In this sense, exercise is considered to improve both physical functions as well as mental or psychological functions related with «body image», sense of well-being, etc., and to reduce risk factors to health such as obesity, diabetes or cholesterol, among others. LIFESTYLES AND SELF-PERCEIVED HEALTH 67 There are many epidemiological studies that demonstrate the undeniable relationship between physical exercise and health, although carrying out longitudinal studies that provide causal relations is difficult. These studies are based on the biological concept of «health», as they use physical indicators (heart rate, blood pressure, muscular pain, etc.) to measure the health of the object population. With a base in these indicators, it is estimated that between 9 and 16 percent of deaths in developed countries can be attributed to a sedentary lifestyle, taking into account that sedentary habits are, in many cases, associated with other risk factors such as unhealthy dietary habits or the consumption of tobacco and/or alcohol (Entrala et al., 2003). Thus, the WHO has warned that sedentarism can be an element that provokes mortality, morbidity and disability, situating it as one of the ten principal risk factors for death and disability in the world, due to illnesses closely associated with this lifestyle (cardiovascular diseases, diabetes, obesity, hypertension, osteoporosis, depression, anxiety, etc.). Nevertheless, the configuration of the concept of health in its most comprehensive version, as was indicated previously, means accepting more complete indicators that cover not only the physical dimensions of the term. In this sense, there are few studies that tie health with doing physical activities and sport, an absence that stands out even more in the Spanish case. Current Spanish society is characterized in this area by two conflicting traits. On the one hand, Spain is found at the head of Europe regarding the rate of physical inactivity among its inhabitants, revealing a notable sedentarism characteristic of modern western societies (Ministry of Health and Consumer Affairs, 2004). On the other hand, a growing interest in sport and sporting activities can be observed, both in their practical aspect and as spectacle. 2.2. The relationship between active lifestyle and perceived health The association between health and active lifestyle can be shown from various perspectives, either from a physical perspective (epidemiological), psychosociological (state of perceived health) or motivational. 68 SPORT, HEALTH AND QUALITY OF LIFE As we saw in the previous chapter, from this last approach, the population that practices some sport (36.7 percent) claims as motivational principals(3) for the practice of this activity themes related to health, such as «to maintain and/or improve health» (20.3 percent), «to maintain physical and psychological wellbeing» (11.7 percent), because of «health problems» (9.7 percent), or because of «doctor’s advise» (1.9 percent). These percentages reveal important variations by age group, as can be seen in tables 1.5 and 1.6 in chapter I. However, lack of health is also used among a relatively high percentage (18.1 percent) for the opposite argument, in other words, for not doing sporting activities. In general terms, the Spanish population thinks that sport and physical activity are «good for the health» (97.6 percent indicate this), and that «they permit you to feel better about one self» (95.7 percent), in other words, they affect the overall well-being of the individual (table 1.8 in chapter I). The percentage of persons that think that sport is «bad for your heart», «will worsen the general state of your body» or that it is «bad for the bones» is, in all cases, below 8 percent. The percentage of individuals that believe that physical activity or sport «makes you feel more anxious» is significant, 18.3 percent of those studied accepting this statement (this percentage increasing to 23.9 percent among seniors). On the other hand, the relationship between health and an active life from a more physiological perspective means that for 43.1 percent of the Spanish population, a doctor or therapist has recommended they do some sporting or physical activity, such as walking. This percentage climbs to 63.5 percent among persons above 64 years of age (graph 2.3). It is interesting to note that the population, among all age groups, that says it suffers from aches or pains in some part of the body follows a similar tendency, although somewhat more pronounced. Finally, from a psychosocial perspective, the connection between health and active life in the study is reflected through the possible association between the indicator of «perceived health» and the physical activities the individual undertakes. Thus, the influence that the variables that measure lifestyle could have on the assessment that individuals make regarding their own state of health was analyzed. To do this an analysis was carried out which permits us to see if the estimation the individual makes of his/her health changes in function of the (3) The percentages correspond to the total of answers, as they are from a question with multiple answers, in other words, the interviewed could claim more than one motive. Therefore, the total is greater than 100 percent. LIFESTYLES AND SELF-PERCEIVED HEALTH 69 GRAPH 2.3 Recommendation to do physical activity by doctor or therapist and aches and pains in some part of the body, by age of interviewed Source: Study E0727 IESA-CSIC. individuals level of activity (for example, does it change if the individual walks more or less, if he/she practices more or less sport or depending on the level of activity in daily life). The results can be seen in table 2.2. As was observed in the previous table, walking or taking walks positively affects the subjective perception of the state of health of individuals in general, although if analyzed independently for each one of the population samples we can see that it is only among older persons that a statistically significant relationship is produced. The same does not happen with sporting practice, which significantly affects all the age groups. Among youth and adults this relationship is practically linear, in other words, the higher the frequency of the practice of sport the higher the positive assessment of the state of health. It is not like that among seniors, where differences can be seen between those that practice sport and those that do not, with those that do sport, even if it is irregularly, revealing better self-perceived health in comparison to the rest. Finally, a clear relationship between doing physical activity during the non-ludic day (workday, household tasks, studying, etc.) and the subjective 70 SPORT, HEALTH AND QUALITY OF LIFE perception of health is observed in all age groups except young people. Doing hard physical work is associated with higher levels of health (it must be taken into account that it is young people and adults that, fundamentally, do this type of work), while those whose daily activity includes walking daily with frequent trips assess their health positively, and lastly, are those that are principally standing or sitting the majority of the day and who assess their health less positively. In short, as has been shown, health and physical activity are related from different perspectives, including in the discourse of Spanish citizens of all ages. The medical-physiological argument seems to be consolidated in the TABLE 2.2 Averages of perceived health by physical activity and age groups AVERAGE INDICATOR OF PERCIEVED HEALTH Walking or taking walks No walking Walking but sporadically Walking 2 or 3 times per week Walking everyday Total Sport No sport Doing sport sporadically Doing sport 2 or 3 times per week Doing sport everyday Total Activity Sitting Standing Heavy work Walking Total TOTAL SAMPLE (**) YOUNG PEOPLE ADULTS SENIORS (**) 77.3 82.9 84.6 83.9 82.3 87.5 87.4 91.5 88.8 88.6 76.7 81.2 81.5 82.2 80.6 65.8 77.0 76.4 77.1 73.0 TOTAL SAMPLE (**) YOUNG PEOPLE (**) ADULTS (**) SENIORS (*) 79.2 86.0 86.1 90.6 82.2 86.7 90.7 88.7 93.1 88.7 78.4 82.1 85.0 89.9 80.5 71.5 82.6 78.1 78.7 72.8 TOTAL SAMPLE (**) YOUNG PEOPLE ADULTS (**) SENIORS (**) 79.4 82.8 88.5 81.8 82.1 89.3 88.7 89.1 87.4 88.6 77.3 82.7 87.9 79.5 80.4 62.8 75.0 82.2 78.9 72.5 Note: (*) Indicates that in this sample, the differences in subjective health reach statistically significant levels with a p < 0.05. (**) indicates that in this sample, the differences in subjective health reach statistically significant levels with a p < 0.01. Source: Study E0727 IESA-CSIC. LIFESTYLES AND SELF-PERCEIVED HEALTH 71 population, which assumes that health and physical activity are necessarily united and explicitly expresses this, and that is how it appears when analyzing both dimensions empirically. In fact, this connection can be observed between the indicator «perceived health» and the three variables that measure the «active lifestyle» of the population. Nevertheless, we consider it necessary to carry out a more exhaustive analysis which takes into account the social and individual characteristics of those interviewed given that, as has been indicated, both the concept of health and that of lifestyle are conditioned by the social, cultural and individual context. To do this, a dependency analysis was carried out that included all the variables together, so that the effect of each one of them on health could be analyzed, independent of the effect of all the others. The type of statistical analysis carried out to clarify this effect is regression analysis. This analysis permits us to confirm the influence that a series of variables (called «independent variables» or «predictors») has on others (the «dependent variable»). In our case, two of these analyses were carried out: in the first the dependent variable was the indicator of perceived health, and the predictor or independent variables were those we have considered as variables that define lifestyle (walking, sporting activity and daily occupation). In the second analysis, in addition to the just mentioned predictor variables, the following sociodemographic variables were also included: sex, civil state, educational level, employment situation, size of household, living situation, nationality, income and size of municipality.(4) In addition to presenting the results obtained for the entire sample, the analysis of three subsamples studied independently (young people, adults, seniors) is also presented, which permits us to go deeper into the different realities that are identified with each age group. General population The first results that are presented are those related to the total sample, made up of the Spanish population from 16 to 79 years of age. The results of the (4) Given that the independent variables are not metric, but ordinal or nominal, it was not advisable to do classic regressions, so categorical regression with optimal scaling was done, the operation of which is, in general, the same as that of a classic linear regression, in which the variables are transformed using optimal scaling. 72 SPORT, HEALTH AND QUALITY OF LIFE regression analysis appear in column a of tables 2.3 and 2.4. In this last table the complete regression model is included, containing both the physical activity variables and the sociodemographic variables. In the first regression (see table 2.3a) we can see that the three variables together can explain 9 percent of the variability in the indicator, perceived health among the Spanish population, sport being the one that contributes most to this variation, with an importance of 62.5 percent, followed by walking or taking walks (33.7 percent), and last, with much less importance, the activity taking place in daily life, which has little influence (less than 4 percent) in the self-perception of health. When other variables of a sociodemographic type are included in the model (see table 2.4) such as sex, age, civil state, educational level, employment situation, etc., the variable with the strongest relationship to perceived health is the age of those interviewed, which, as would be expected, produces a negative relationship, in other words, the older the individual, the worse is the selfTABLE 2.3 Regression analysis.(5) Dependent variable: perceived health. Independent variables: lifestyle a) TOTAL SAMPLE b) YOUNG PEOPLE c) ADULTS d) SENIORS B (SE) IMP (6) B (SE) IMP B (SE) IMP B (SE) IMP Walking/ taking walks 0.172 (0.022)** 33.7% 0.074 (0.035)* 15.1% 0.135 (0.049)** 37.2% 0.180 (0.034)** 31.9% Sport 0.241 (0.022)** 62.5% 0.178 (0.035)** 83.7% 0.165 (0.049)** 54.1% 0.122 (0.034)** 13.2% Activity 0.052 (0.022)** 3.8% –0.023 (0.035) –0.072 (0.049) 0.240 (0.034)** 54.8% 3.3% 3.2% 11.5% Corrected R2 9.2% Source: Study E0727 IESA-CSIC. (5) For each variable the following values appear: beta coefficients (B), the standard error (SE) between parentheses and statistical significance. Regarding statistical significance, it is indicated in the following form: **significance to 99% (p < 0.01), *significance to 95% (p < 0.05). Lastly, the R2 of the model is presented, in other words, the percentage of variation explained (the variability due to the variables introduced in the regression). (6) As with linear regression, in categorical regression, the principal results are the regression coefficients (B), although in this type of analysis they are not easy to interpret. For this reason the values of the Pratt Index are included (Pratt’s importance measure). The sum of the importance measures of all the independent variables is 100, so these values can be interpreted as percentages of their importance on the dependent variable. LIFESTYLES AND SELF-PERCEIVED HEALTH 73 TABLE 2.4 Regression analysis. Dependent variable: perceived health. Independent variables: lifestyle and sociodemographic variables a) TOTAL SAMPLE b) YOUNG PEOPLE IMP c) ADULTS B (SE) IMP B (SE) B (SE) IMP Walking/ taking walks 0.137 (0.020)** 12.0% 0.070 (0.034)* 4.0% 0.144 (0.046)** 6.8% 0.153 (0.033)** 14.3% Sport 0.126 (0.021)** 14.9% 0.129 (0.036)** 16.4% 0.156 (0.047)** 9.0% 0.110 (0.033)** 6.3% Activity 0.088 (0.021)** 2.6% –0.024 (0.034) –0.120 (0.046)* 3.4% 0.259 (0.033)** 32.6% Sex –0.097 (0.022)** 7.4% –0.055 (0.039) –0.032 (0.050) –0.245 (0.038)** 28.4% Age –0.155 (0.033)** 25.3% –0.046 (0.044) –0.110 (0.055)* 6.9% 0.041 (0.034) Marital status –0.037 (0.021)** 1.2% –0.155 (0.034)** –0.308 (0.054)** 11.5% 0.098 (0.035)** 2.1% Educational level 0.145 (0.023)** 18.1% 0.027 (0.038) 0.130 (0.034)** 10.5% Employment situation 0.101 (0.032)** 15.1% 0.127 (0.036)** No. of persons in home 0.053 (0.024)* 4.2% –0.043 (0.037) Living situation –0.053 (0.022)** 0.2% 0.225 (0.038)** 17.3% B (SE) 0.072 (0.051) 8.4% –0.283 (0.054)** 30.8% 0.037 (0.035) –0.169 (0.050)** 6.3% 0.084 (0.035)* 2.4% 39.3% 0.237 (0.051)** 3.6% –0.085 (0.033)** 1.5% 1.1% 0.124 (0.046)** 5.5% 0.071 (0.032)** 2.5% Nationality 0.021 (0.020) 0.052 (0.034)* Income 0.026 (0.023) 0.054 (0.043) 0.098 (0.053) Residential Setting –0.043 (0.021)* –0.060 (0.034) –0.086 (0.046)* Corrected R2 18.5% 10.2% 17.1% 0.3% IMP d) SENIORS 0.015 (0.037) 1.3% –0.023 (0.033) 18.3% Source: Study E0727 IESA-CSIC. assessment of health. Educational level (which is a positive relationship, in other words, the higher the level of education the better is the self-perception of health) and employment situation also have influence. In this regard, diverse studies have confirmed differences in health based on socioeconomic criteria, which can explain the direction of the association of health with educational 74 SPORT, HEALTH AND QUALITY OF LIFE level and employment situation, as variables closely related to individual socioeconomic situation. Finally, this second regression analysis indicates that doing sport and walking maintain the relationship previously explained, while the other variables have little importance. Young people For young people from 16 to 34 years of age, health is conditioned to a minor degree by lifestyle and by sociodemographic variables, the first explaining 3.3 percent of variability, and the second, 10.2 percent (column b of tables 2.3 and 2.4). This minor explanation from the regression models could be due to young people perceiving their health positively (the average of the indicator is situated at a value of 95.8), without great differences among them, thus the standard of health would be high and homogeneous within this collective, which explains why there is little variability among the members of this cohort. In this age group, the only variable related to an active lifestyle that has importance in the variability of perceived health is the practice of sport (it explains 16 percent of variability over perceived health), walking being a subsidiary activity of the first and of considerable less importance, and the activity done during the working day resulting as completely irrelevant and of no significance. It must be remembered that in this group there is a higher percentage of persons that do heavy work (17.65 percent). In addition this is the cohort with the smallest percentage of persons that don’t do any type of sport (48.3 percent, in contrast to 63.4 percent for the total sample). This is, as was mentioned, the group that does the most sport, but it is also the group that does the most walking. Regarding the sociodemographic characteristics (column b of table 2.4), the variable of greatest influence is living situation. Despite all young people having a positive self-perception of health, with indicators that go from 90 to 98 percent, those that assess their health most positively are those that share apartments with friends, live alone, live at home with parents or share an apartment with siblings. On the opposite side we find young people with children or partners, or those that live in a home with only one parent. The first cases, which correspond with the situation of young people at home with LIFESTYLES AND SELF-PERCEIVED HEALTH 75 parents, or students that share an apartment or that live independently, reveal an extremely positive perspective in respect to self-perceptions of health. The second cases could correspond to young couples, separated parents and young destructured families. These have a somewhat worse self-perception of health, though they are found within the boundaries of the high standard of health of the group, always above the value of 90 out of 100. In second place in importance we find civil state, with a relationship very similar to that of living situation. Thus, singles claim a better state of health than married people or those that live with their partners. The case of divorced or separated individuals shows a large dispersion, which makes them difficult to classify. Adults The group of adults, persons between the ages of 34 and 64, also has a very positive self-perception of health, although somewhat lower than the previous group. Thus, this group attains an average measure of 90.6 on this health indicator, with an interval between 75 and 100 points. As in the previous cases, the influence that different sociodemographic and lifestyle variables have on perceived health has been calculated (column c of tables 2.3 and 2.4). Among the adult population, sport is also the variable with the greatest influence with respect to indicators of an active lifestyle, although together these explain only 3.2 percent of the variability of perceived health. When sociodemographic characteristics are included, the explanatory capacity of the model increases to 17 percent, employment situation (30.8 percent) and civil state (11.5 percent) being the principal variables in the analysis, sporting activity relegated to 9 percent Pratt’s importance. The fundamental differences in perceived health in adults, according to their sporting practice, is produced between those that do and those that do not do sport, not being particularly significant the differences according to the frequency of said practice, as can be seen in graph 2.4, where the confidence intervals of the close categories overlap, something which does not happen among those that «don’t do sport» and those that «do sport every day». In addition, doing sport sporadically is not easily classifiable, given that the persons that indicate this sporting frequency present a large spread in their perceived health. 76 SPORT, HEALTH AND QUALITY OF LIFE GRAPH 2.4 Average perceived health according to sporting practice of the adult population, with confidence intervals (95%) Source: Study E0727 IESA-CSIC. Walking or taking walks also influences the subjective perception of health; individuals that walk are more satisfied with their state of health (responsible for 6.8 percent of the variability in this indicator). Adults looking for their first job and students are the most satisfied with their health, the opposite of retired persons, pensioners or homemakers. However, it is necessary to qualify this, as students and the unemployed in search of their first jobs make up 23 percent of the adult population, while those that work are 62 percent. Homemakers also make up an important percentage, 18 percent. Due to the age interval that defines this group – adults – being larger than the rest, the influence of age on self-perception of health within this group can be analyzed. Doing this the results are that the age variable is significant and negative, in other words, older means worse subjective perception of health. Seniors Finally, among the older population (from 65 to 79 years of age), although the health indicator presents very positive values, with an average of 72.3 over LIFESTYLES AND SELF-PERCEIVED HEALTH 77 100, it must be emphasized that, as was predictable, said value is 18 points below the average in the adult population, and more than 23 points below that of the population of young people. Regarding the analyses of dependency done, perhaps the first element to highlight is the percentage of variability that the three questions on lifestyle explain about the health indicator (11.5 percent), the activities of daily life standing out as the variable of most importance, followed by walking (column d of table 2.3). Sport is less important in this age group, acquiring greater importance the non-ludic activities of daily life and walking or taking walks. It must be taken into account that more than 80 percent of the seniors interviewed say that they do not do any type of sporting activity, compared to 50 percent that walk or take walks every day. This group is the least active of those analyzed, but despite this, members of this group maintain a fairly high assessment of their state of health. Regarding the activity of daily life, they are the ones that give greatest importance to not staying seated during the whole day, as it is also probably the group with the most free time. GRAPH 2.5 Average perceived health according to lifestyle among seniors Source: Study E0727 IESA-CSIC. 78 SPORT, HEALTH AND QUALITY OF LIFE When the rest of the sociodemographic characteristics are included, the percentage of variability explained increases to 18.3 percent, and sex acquires fundamental importance, women indicating that they have worse health than men, with an importance of 28.4 percent over the indicator of perceived health. Educational level also is significant as persons with higher levels of education show themselves to have better health. 2.3. The health benefits of physical activity It has been scientifically demonstrated that the practice of physical exercise and sport provides benefits for the human organism, benefits which are not only physical, but also psychological and social, and which can lead to a better perception of individual health, understood in its broadest sense, as the World Health Organization has expressed it. Although sporting activity has gradually become generalized, only 36.7 percent of the population studied (the Spanish between 16 and 79 years of age), indicate that they do some sporting activity, whether frequently or sporadically. Watching television in general, and among adults and seniors in particular, or sitting in front of the computer or videogame console among the younger population, have become the principal leisure activities of the population, which is adopting an increasingly sedentary lifestyle, typical of current modern societies, where, in addition, physical work associated with employment has declined. In this situation, public authorities, through public policies at both the micro social and macro social levels, are trying to promote «healthy habits and lifestyles». But it is undeniable that without raising the consciousness of the population about the real benefits of physical activity and sport on the «quality of life», little or nothing can be done to reverse the accentuated tendency toward inactivity in Spanish society. Based on the results of the present study, it can be stated that sporting activity influences the perceived health of the Spanish population. Thus, practicing sport in a continuing manner influences the perceived state of health in all the age groups in a statistically significant way, although with qualifications in each one. Among young people and adults, the relationship between sporting LIFESTYLES AND SELF-PERCEIVED HEALTH 79 practice and perceived health is practically linear, in other words, the greater the frequency of doing sport, the higher is the self-assessment of health. This confirms the thesis of institutions like the American College of Sports Medicine, which sustain that «more is better», at least in these age groups. In contrast, in the seniors’ group the differences observed are principally between those that practice sport and those that do not, with the frequency of practice being unimportant. Among seniors, more than a linear relationship, results seem to lead to a polarity between those who do sport and those who do not. Walking or taking walks, as another element of physical activity, also significantly influences the perceived state of health of the population, though with less importance than sport among young people and adults, but not among seniors. For them, walking or taking walks has even more influence on the positive perception of health than does sporting activity. Perhaps for this age group the message of health authorities on the benefits of moderate physical activity, such as walking, has been more effective. It is not unusual to find older people walking for their health in small groups, across both urban and rural landscapes, what is now popularly known as the «cholesterol route». The activities of daily life undertaken by individuals (doing heavy work, walking, standing without major trips or sitting the majority of the day) are also an element of change in perceived health in all the age groups, except among the youngest. Paradoxically, the group of seniors, now retired and for this we might think they have a more sedentary lifestyle, are those that grant the greatest value to this variable over the perception of health. This fact can be related to the need to perceive themselves as active persons, valuing more than other collectives the fact of «not getting lazy» as an element of health. In addition to the variables related to the physical activity of individuals, sociodemographic characteristics (sex, civil state, educational level, etc.) have also been analyzed to see up to what point they influence or condition the state of perceived health. These characteristics explain to a certain degree the social part of the concept of «health», their reach being distinct according to the age group being analyzed. Among young people, for example, «living situation» has a lot of weight; among adults «employment situation» is the most significant, and among seniors «gender» and «educational level», as was seen in the analysis by age group. 80 SPORT, HEALTH AND QUALITY OF LIFE In this sense, for example, being a man or woman is only shown to have a statistically significant relationship with state of perceived health in the case of persons of older age, senior women perceiving their health more negatively than their generational partners. There are many studies of gender and health that document this inverse relation between being a woman and having a poorer perception of health. On the other hand, the lesser participation of women in the field of sports is also known, particularly in competitive sports, gender differences existing both in doing sport as well as in the type of sport practiced (Martínez del Castillo, 2005). In this sense a doubly negative situation is produced given that, as has been indicated, less sport activity also leads to a worse state of health. As discussed in earlier chapters, one of the objectives of this study is to analyze with particular detail the results related to young people and seniors. Regarding young people, it is important to remember that the prevalence of sporting and physical activity at adult age and older is clearly related to the development of this type of activity in childhood and adolescence. It is recommended that young people do moderate physical activity 3 to 5 times per week. This study has confirmed the progressive relationship between sport and health in this group, which in general reveals feeling good about or very good about its state of health. It is also the group that practices sport the most, despite there still being a high percentage of young people that do not do any type of physical activity. Regarding seniors, as is well know, it is a group whose demographic weight is increasingly important, due to the increase in life expectancy and the low birth rate in Spain. Older persons are also undergoing biological, psychological and sociological changes associated with age that make them a collective toward which numerous policies aimed at improving their situation are directed. As one ages sedentarism increases, and this seems to affect physical aging. All the studies done from a biomedical perspective see physical exercise as the motor for the improvement of physical and mental health that alleviates this vicious circle, and even show how moderate activities like walking, swimming or riding a bicycle provide benefits to seniors’ sense of well-being of. The results of this study confirms these statements form another perspective, qualifying that the well-being of seniors, measured through self-reported health, is to a great degree conditioned by the activities that are carried out during daily life. In this age group, the thesis «more is better» doesn’t seem LIFESTYLES AND SELF-PERCEIVED HEALTH 81 to work, and what is important to their perception of health is to feel active in a period of forced inactivity or a reduction of activity. In this sense, the WHO supports the development of active aging as beneficial for health, and among its recommendations it emphasizes the importance of including physical activities in the day to day life of seniors, at home, at work if they have it, or in free time. They recommend activities such as walking, going up or down stairs, gardening, dancing, swimming, etc. To sum up, in this study the relationship between the physical activity and sport that the Spanish do and how they perceive their own health has been empirically verified, although with some qualifications for each age group. Different public institutions try to raise the consciousness of the population about the benefits of exercise for our health. The message seems to have taken roots in the population, as people have internalized positive messages about sport as a vehicle for good health, but even so, a high percentage of the population continues with taking action. The connection between sport and quality of life, as a broader element than health, may be another way of motivating individuals to do sport that should be explored. Sport and health professionals, through scientific evidence contributed by many studies, insist on the practice of physical exercise as an element of health under specific parameters of duration, frequency and intensity, in what have been called theories of «dose-response relationship». From this perspective, only activity developed under these parameters has effect on health. There are now voices against this thesis (Blair, 2006), that say that «doing some physical activity is better than doing nothing», indicating that moderate exercise, such as walking, done by a very high percentage of the population, also is beneficial for the health of the population. More is better than less, but something is better than nothing according to these interpretations, and in the case of the senior population, this is what our analysis of the Spanish population shows. Perhaps the public will find this message more reasonable and, therefore, less likely to be rejected, and in this way the final objective will be achieved: improving the health of the population through the practice of sport and physical exercise, in other words, through active lifestyles. 82 SPORT, HEALTH AND QUALITY OF LIFE III. Lifestyles and well-being «Quality of life» is a relatively new concept (the first publications which mention it appeared in the 1970s) which emerged with the intention of extending the understanding of two concepts commonly considered in the objectives of social policies: a concept of strongly economistic implications, «welfare», and another of psychosocial implications, «well-being». Beginning in the 1980s, the concept of «quality of life» gained particular importance in the design of all types of policies, programs and social projects – in healthcare, the social environment, etc. – as they specifically raised the «improvement of quality of life» as an objective. Policies and programs to promote sport or physical activity were also expressed in this way, in Spain (see the special number of the Revista Española de Geriatría y Gerontología [REGG], 2005, 3), in Europe (see, for example, The European - Enhancing Physical Activity; UNISPORT, 1993) or in other international forums (see, for example, the proposal of the World Health Organization called Heidelberg Guidelines for Promoting Physical Activity). Given the importance of health and quality of life in sports policies (and in the wider context of physical exercise), the approach of this study is that, in addition to having a relationship to health (as we have seen in the previous chapter), physical activity and sport can also contribute to the well-being and quality of life of the population. It is precisely this relationship that we want to look at in this chapter. However, before explaining the results obtained from our survey, existing problems with the operational definition and measurement of quality of life (QOL) and well-being ought to be discussed. LIFESTYLES AND WELL-BEING 83 3.1. What do we mean by quality of life? As was said in the previous section, quality of life appears as a concept that refers to certain social «results» and is an attempt to move beyond other concepts that are to a certain extent, reductionist («welfare» – economistic, «well-being» – psychosocial). It is also a multidimensional attribute which, like life, takes account of the diversity of phenomena with the positive mention of quality. In other words, improving «quality of life» in an individual, group of individuals or population refers to an improvement in a series of conditions of these individuals or population. Thus, for example, from a demographic perspective, the wellknown publication, The Economist has proposed a quality of life index which includes indicators related to the economy, health, political stability, social participation, family stability, gender equality, etc. In a similar manner, from a contextual perspective, Moos and Lemke (1996; see Fernández-Ballesteros, Zamarrón and Maciá, 1996) developed a multidimensional instrument that evaluates a series of physical and architectonic variables and others related to political organization, residential and social climate, personal, etc., to evaluate the quality of residential settings (and of other types). Lawton (1985), for his part, defined a concept of individual «quality of life» focused on seniors in which aspects such as satisfaction with life and with well-being, health and physical competence, the physical environment and perception of the environment are included. In short, the measurement of quality of life has two essential characteristics: it is multidimensional and includes both objective and subjective aspects of life. However, while these may be the characteristics different authors highlight, quality of life is increasingly being reduced to a subjective concept. In other words, although it is true that quality of life is considered to be multidimensional – in the sense that it makes reference to different aspects of the object studied, whether an individual, a group of individuals, a context or a population –, the examination of the multiple dimensions in the majority of cases is made through the opinion, judgment or evaluation of the persons themselves whose quality of life is being evaluated. Thus, if quality of life is considered to reflect economics, health, family and social aspects, the individuals (or group, etc.) are asked if they considers that their lives, in these specific areas, are going well, or if they are satisfied with these aspects of their lives, or if they consider these dimensions to be important. In short, when it comes to studying quality of life, 84 SPORT, HEALTH AND QUALITY OF LIFE the tendency is to reduce it to a subjective condition that requires the judgment, assessment and evaluation of the individual, and where the «objective» reality primarily does not count (such as individual income level, if the individual suffers from chronic pain, is divorced or lives in a high-crime neighbourhood, etc.). However, the comparison of the subjective appreciation of a specific situation does not necessarily correspond with its objective determination (or as we might say, it is «intersubjective»). In what follows we will take a look at the results of some research related to this theme to help place the findings of this study in context. For example, the judgment and evaluation of physical comfort in a determined context may hardly correspond with an objective judgment of conditions of comfort; subjective judgment about physical competence is minimally associated with competence evaluated by objective procedures, and subjective health is not closely associated with medical, radiological or analytical examinations (see, for example, Fernández-Ballesteros, 1997), although it has been empirically demonstrated that this last indicator is a good predictor of mortality and the use of health services (see, for example, DeSalvo, 2005; Fan et al., 2002; Bierman et al., 1999; Tatsuro et al., 2006, or Ferraro and Farmer, 1999), which probably refers to the great capacity of this one indicator to capture the multiple aspects that compose the health of a person. However, the measures gathered on subjective concepts such as satisfaction, well-being or happiness are strongly associated. Despite psychologists’ investigation of these different concepts and attempts to attribute different connotations to them (for example, satisfaction with life refers essentially to the past, while well-being and happiness are situational concepts), all of them point toward a very similar meaning. This analysis of the lack of consistency between objective and subjective dimensions and of the high correlation between subjective dimensions is not intended as a criticism of subjective measures, but to justify the fact that the subjective does not always lead to the objective and that subjective indicators do not only have similar meanings, but rather, their lack of differentiation happens because all of them result from the same «bias» attributable to method: self-reporting. Nevertheless, it must be also be pointed out that said methodological «bias» is also its greatest strength, given that the assessment that individuals have of their happiness, the satisfaction they have with one or another part of their lives or with life in general or the assessment they make LIFESTYLES AND WELL-BEING 85 about their quality of life is the only indicator possible of how individuals perceive and interpret these concepts. Although this is not the place to discuss the different reasons (epistemological, methodological or even ideological) that explain this tendency toward «reductionism and subjectivisation» of the quality of life (easily verifiable in any review of the scientific literature), it does seem important to make this phenomenon explicit, as it is what justifies the use given in this study to the concept of «quality of life» and the reason why it is studied by asking the participants how they evaluate a series of aspects of their lives (see FernándezBallesteros, forthcoming). In other words, the concept «subjective quality of life» was used based on questions related to satisfaction with life and wellbeing. In addition, a criterion question (mono-dimensional) about quality of life was included. 3.2. Measuring the subjective quality of life and related concepts The questions related to the three dimensions evaluated (quality of life, QOL; satisfaction with life, SL; and well-being, W) are presented in table 3.1, as we consider them to belong to the same network of subjective meanings. Hence, it is assumed that QOL and SL are two broad concepts, confused in the scientific literature, that imply distinct temporal dimensions; QOL refers to the present, while SL refers to the past. Finally, we evaluate well-being both in general and in eight specific areas; money, housing, free time, work, health and relations with one’s partner, with family and with friends. These three dimensions will help us to operationalise the concept. The results or scores obtained from these assessments, as can be observed in graph 3.1, are, in all cases superior to the middle value (point 5 on a scale of 0 to 10). Money is the indicator worst valued (with an average score of around 5), together with free time (with an average slightly above 6), satisfaction with life and job satisfaction. The scores for general well-being and satisfaction with life coincide with the choice of answer «fairly satisfied». Similarly, quality of life in general obtained a score equivalent to «good». Of the scores for concrete aspects of life, the highest refer to well-being related to social relations, with scores above 8 points. The relationship with one’s partner, with friends and with family are the aspects most highly valued by the 86 SPORT, HEALTH AND QUALITY OF LIFE TABLE 3.1 Average and Standard Deviation for variables of well-being, quality of life and satisfaction by age groups(1) TOTAL SAMPLE YOUNG PEOPLE ADULTS SENIORS AVG. STAN. DEV AVG. STAN. DEV AVG. STAN. DEV AVG. STAN. DEV 7.4 1.8 7.8 1.4 7.4 1.6 7.0 1.9 6.6 2.9 7.4 2.4 6.6 2.8 6.3 2.7 Well-being in your life in general 7.1 2.5 7.8 2.0 7.2 2.4 6.7 2.7 Well-being regarding money 5.5 2.6 5.9 2.5 5.7 2.5 5.3 2.8 Well-being regarding your home 7.3 2.5 7.4 2.5 7.5 2.3 7.8 2.0 Well-being regarding your free time 6.5 2.9 6.4 2.9 6.4 2.8 7.7 2.4 Well-being regarding your work 6.9 2.4 7.2 2.2 6.9 2.3 7.6 2.2 Well-being regarding your health 7.1 2.4 8.1 2.0 7.1 2.3 6.3 2.6 Satisfaction with your relationship 8.4 with your partner 2.0 8.8 1.8 8.4 2.0 8.4 2.0 Satisfaction with your family 8.5 1.9 8.8 1.7 8.5 1.9 8.8 1.6 Satisfaction with your friends 8.5 1.6 8.8 1.5 8.3 1.7 8.7 1.6 Quality of life Valuation of your quality of life Satisfaction with life Satisfaction with your life Well-being Source: Study E0727 IESA-CSIC. participants, with assessments clearly above those for general satisfaction or quality of life. These scores are affected by age group (table 3.1), producing an inverse relationship between the scoring of the most general concepts – life in general, quality of life and satisfaction with life, including health – and the age group to which the person interviewed belongs. Only the scores for housing, work and free time act in the opposite sense (higher scores as age increases). Hence, at first, young people seem to be «happier» and more satisfied with their lives in (1) For the calculation of averages for each indicator the values 8 and 9 (do not know/no response) are considered missing so that only the answers of persons that have made an effective valuation are analysed. Due to not all the questions being measured on the same scale (the questions were composed of a scale of responses of five points [1 to 5], with the exception of the question regarding satisfaction with life, compose of four values [1 to 4], and with the objective of facilitating comparison between them, the values were transformed, so that the minimum value is 0 and the maximum 10, maintaining the original composition of the data. LIFESTYLES AND WELL-BEING 87 GRAPH 3.1 Average of the indicators for well-being, quality of life and satisfaction (total sample) MONEY FREE TIME SATISFACTION WITH LIFE WORK HEALTH LIFE IN GENERAL HOME QUALITY OF LIFE PARTNER FRIENDS FAMILY AVERAGE SCORES Source: Study E0727 IESA-CSIC. general, though not with concrete aspects, such as access to housing or with work, problems known to be common in this generational group. As pointed out in the introduction to this chapter, a series of closely related concepts are being evaluated. To do this and to simplify things, the close relationship between these concepts will be taken advantage of to elaborate a single global indicator. Factor analysis is the statistical procedure indicated to obtain a single variable that groups all those questions that are shown to have scores that are closely related to each other. After doing this analysis we obtained a factor or dimension in which a high association among the questions «How do you assess the quality of your life?», «To what extent do you feel satisfied with your life?», «How do you feel in respect to your life in general?» and «Regarding your state of health, do you feel…?» appeared. This factor, which contains both the 88 SPORT, HEALTH AND QUALITY OF LIFE variables mentioned (satisfaction with general aspects of life) and those related to concrete aspects of life (satisfaction with money, housing, work, free time, family relations, relationship with partner and with friends), although with less factor loading, as they have greater factor saturation in other dimensions, is what will be used in the rest of this analysis. This new indicator will be referred to as «well-being». As has been shown, and based on the data observed in table 3.1, it is confirmed that at higher ages individuals show a worse score on their subjective wellbeing. The principal differences can be seen in the group composed of young people, with an average score on this indicator 1.5 points above the rest of the groups. Young people, as has been mentioned, reveal themselves to be highly positive about their lives in general, and therefore, with the indicator of general well-being. 3.3. The influence of lifestyle on the degree of well-being One of the research questions is whether an active lifestyle – identified, as already specified in chapter I, through three aspects: doing sporting activity, walking or taking walks, or doing physical activity during the activities of daily life – has influence in some way on well-being and on the satisfaction and subjective quality of life. To analyze this, two different approaches were used. In the first place, an analysis of mean differences was done between the well-being indicator and each one of the active lifestyle variables taken separately. Secondly, a regression analysis was done, in which the influence of the lifestyle variables (and others of a sociodemographic character) were considered simultaneously. Regarding the first approach, it can be observed that walking or taking walks influences the mean well-being of individuals in the total sample and among young people, but not adults or seniors, for whom the influence of this variable does not reach statistically significant levels (table 3.2). Seniors are those that walk the least of the three groups analyzed, although it is one of their habitual physical activities, as 60 percent of seniors indicate that they walk every day. Nevertheless, this activity does not seem to be related with their well-being, at least not if we analyze more variables together. LIFESTYLES AND WELL-BEING 89 The same occurs with the practice of sport. As can be seen in graph 3.2, sporting activity produces greater well-being only for the overall sample and the group of young people. Young people are, in addition, the group that most practices sport (almost 17 points more than the senior group), although in no group does the percentage of persons that do sporting activity reach 35 percent. Something worth highlighting is that, as is revealed in graph 3.2a, for the total sample, the differences in well-being manifested by those interviewed is produced between those that do sport, whether in a sporadic, habitual or daily manner, and those that do no sport of any type. However, the frequency of sporting practice does not seem to influence well-being, at least not according to our results. TABLE 3.2 Averages for well-being in function of physical activity Walking or taking walks No walking Walking sporadically Walking 2 or 3 times a week Walking everyday Total Sport No sport Doing sport sporadically Doing sport 2 or 3 times a week Doing sport everyday Total Activity Sitting Standing Heavy work Walking Total TOTAL SAMPLE (**) YOUNG PEOPLE (**) ADULTS SENIORS 6.63 7.10 7.25 7.00 6.95 7.78 7.88 8.52 8.03 8.01 6.72 7.08 6.94 6.80 6.84 6.36 7.04 6.80 6.98 6.75 TOTAL SAMPLE (**) YOUNG PEOPLE (**) ADULTS SENIORS 6.66 7.39 7.42 7.55 6.94 7.71 8.00 8.47 8.32 8.02 6.68 7.17 7.17 7.30 6.84 6.62 7.60 7.17 7.31 6.74 TOTAL SAMPLE (**) YOUNG PEOPLE (**) ADULTS SENIORS (**) 6.77 7.02 7.19 6.96 6.94 8.13 8.23 7.71 7.92 8.02 6.52 6.97 7.31 6.89 6.84 6.18 6.94 7.15 6.97 6.71 Notes: (*) Indicates that, in this sample, the differences in well-being reached statistically significant levels with a p < 0.05. (**) Indicates that, in this sample, the differences in well-being reached statistically significant levels with a p < 0.01. Source: Study E0727 IESA-CSIC. 90 SPORT, HEALTH AND QUALITY OF LIFE GRAPH 3.2 Representation of well-being in function of sporting activity a) and age groups b) Source: Study E0727 IESA-CSIC. LIFESTYLES AND WELL-BEING 91 Finally, in relation to the activities of daily life, significant differences can be observed in well-being in all the groups except in that formed by individuals from 35 to 64 years of age.(2) In general terms, individuals that spend the majority of their day sitting are the least satisfied with their personal wellbeing. Among young people, doing heavy work is a factor which is associated with less well-being, although this is not the case in the other age groups. In short, beginning with the results of this first analysis it can be stated that physical activity, in its distinct forms, seems to lead to greater well-being in all the groups, although fundamentally among young people. However, it is evident that not only age, but also other sociodemographic characteristics have affect or influence on well-being. Because of this, a second approach was used to analyze the influence that lifestyle can have on well-being, doing an analysis not of separate variables, as was explained in the previous paragraphs, but one which included all the possible influencing factors at the same time. As was commented on in chapter II, the analysis indicated in this case is regression analysis, which permits us to test if a certain group of variables (in our case, lifestyle and other sociodemographic variables) influence or predict the results obtained on our variable measuring well-being. Our regression analysis was done taking into account all the variables together and we could, therefore, discriminate among those which have the greatest influence on the well-being of individuals (the dependent variable) independent of the rest of the variables. In other words, we are talking about testing if active lifestyle has influence on the self-reported well-being of the participants in our study independently of their sociodemographic characteristics (tables 3.3 and 3.4). It must be emphasized that given that this is a transversal study we can not say if this influence is causal, or rather a covariation that results from the associated statistical relationships between the independent variables and well-being. The results of this analysis are first presented for the total sample, and after, for each one of the three age groups separately. (2) It could be considered significant in this age group if the criteria of significance were relaxed and a margin of error greater than 5 percent were accepted. 92 SPORT, HEALTH AND QUALITY OF LIFE General population In the previously commented on analysis, it was observed that walking as well as practicing sport and physical activity are related to well-being in the total sample. In the regression analysis, when all the variables together are taken into account, we see that physical activity is not statistically significant, sport being the factor of greatest importance among the three variables which measure the active lifestyle of the population. Despite this, the percentage of variance explained is relatively small, 7.2 percent (table 3.3, column a). When sociodemographic characteristics are also included, the percentage of variance explained by the model increases to 22.6 percent (table 3.4, column a), being age (the higher the age the less satisfaction with well-being or quality of life), employment situation, living situation and practice of sport the variables which contribute most to this explanation. In graph 3.3 the average and confidence interval can be observed for the values of the dependent variable (factor 1 of well-being), according to the sporting TABLE 3.3 Regression analysis.(3) Dependent variable: wellbeing. Independent variables: lifestyle a) TOTAL SAMPLE B (ET) b) YOUNG PEOPLE c) ADULTS B (ET) IMP B (ET) Walking/taking walks 0.112 (0.022)** 17.9% 0.102 (0.034)** 12.4% 0.033 (0.050) Sport 0.244 (0.022)** 80.6% 0.232 (0.034)** 68.3% 0.141 (0.050)** 0.032 (0.022) –0.123 (0.034)** 19.3% 7.2% 7.3% Activity Corrected R2 IMP (4) IMP d) SENIORS B (ET) IMP 0.141 (0.035)** 26.0% 0.163 (0.035)** 31.5% 0.041 (0.050) 0.179 (0.035)** 42.5% 0.8% 8.4% 87.4% Source: Study E0727 IESA-CSIC. (3) A categorical regression analysis was done with optimal scaling – CATREG, the dependent variable being the wellbeing indicator, and as predicting or independent variables, active lifestyle (walking or taking walks, doing sport and activities of daily life), as well as the sociodemographic variables that characterize those interviewed. This analysis has been done for each one of the sample populations (young people, adults and seniors), as it is important to point out that they are not comparable, given that they do not share the same dependent variable, and the analysis has been done in a completely independent manner. (4) In the table the value of the beta coefficients (B), the standard error (SE), and the statistical significance (** if the significance is to 99%, * if the significance is to 95% and without a star if it is not significant to 95%) appear. The «Pratt importance» is also included in one column. LIFESTYLES AND WELL-BEING 93 TABLE 3.4 Regression analysis. Dependent variable: well-being. Independent variables: lifestyle and sociodemographic variables a) TOTAL SAMPLE B (ET) IMP b) YOUNG PEOPLE B (ET) IMP c) ADULTS B (ET) IMP d) SENIORS B (ET) IMP Walking/taking walks 0.071 (0.020)** 3.4% 0.080 (0.032)** 3.1% 0.018 (0.046) Sport 0.124 (0.021)** 12.0% 0.201 (0.034)** 18.4% 0.177 (0.046)** Activity 0.047 (0.020)* 0.7% –0.061 (0.033) Sex –0.058 (0.021)** 3.2% 0.010 (0.036) Age –0.180 (0.032)** 23.8% –0.167 (0.043)** 6.8% –0.159 (0.053)** 9.2% 0.022 (0.034) Marital status –0.136 (0.024)** 1.1% 0.094 (0.037)** 0.0% –0.256 (0.049)** 16.7% –0.175 (0.036)** 21.0% Educational level 0.069 (0.023)** 7.4% 0.116 (0.036)** 8.8% –0.163 (0.050)** 3.0% 0.172 (0.035)** 19.5% Employment situation 0.206 (0.028)** 26.6% 0.203 (0.038)** 10.1% –0.222 (0.054)** 22.7% 0.088 (0.037)** 4.0% No. of persons in home –0.081 (0.022)** 0.1% –0.237 (0.036)** 15.4% –0.093 (0.050) 3.0% 0.084 (0.039)* 3.5% Living situation –0.142 (0.021)** 12.2% –0.262 (0.034)** 22.4% –0.214 (0.048)** 12.6% –0.102 (0.037)** 2.5% Nationality –0.070 (0.020)** 1.8% –0.093 (0.032)** 5.9% 0.050 (0.047) 0.056 (0.032)* 1.2% Income 0.116 (0.023)** 10.3% 0.160 (0.042)** 0.252 (0.053)** 26.5% 0.075 (0.037)* 6.4% 1.3% –0.033 (0.033) 0.101 (0.033)** 6.7% 0.138 (0.033)** 10.1% 0.046 (0.047) 0.184 (0.033)** 17.6% 0.053 (0.050) –0.158 (0.040)** 15.9% Residential Setting –0.022 (0.020) –0.041 (0.032) –0.090 (0.046)* Corrected R2 22.6% 20.9% 17.8% 5.0% 19.0% Source: Study E0727 IESA-CSIC. activity the individuals do. Two groups can be clearly seen: that of individuals that do not practice sport, with a significantly different level of well-being, and those individuals that practice some type of sporting activity, whether sporadically, two or three days a week or everyday (as among them there are no clear differences, the confidence intervals overlapping). 94 SPORT, HEALTH AND QUALITY OF LIFE GRAPH 3.3 Average well-being by sporting practice, with confidence interval (95%) ����������������� ��� ��� ��� ��� � ��� ��� ��� ��������������� �������� ������������ ��������������� ������������ �������� ��������� ����� Source: Study E0727 IESA-CSIC. As was mentioned at the beginning of this chapter, age reveals clear differences in the well-being of individuals. In graph 3.4 we can see the differences in the values of the dependent variables according to the age group to which the interviewed belong. The older the interviewed the lower is subjective well-being, with significant differences in all the groups. Another variable that is of interest in studying well-being is employment situation. The highest values are obtained by students (a category visibly related to age, which, as just mentioned, correlates with well-being), and persons that are working. Clearly, the unemployed (among the unemployed can be seen a wide dispersion, with a confidence interval that covers maximum and minimum scores), the retired and pensioners are situated below (here also the influence of age is present). Homemakers also show lower values, although somewhat higher than these lasts groups. Young people Young people report higher well-being and quality of life than the rest of the population groups. In addition, living situation, household size and sporting LIFESTYLES AND WELL-BEING 95 GRAPH 3.4 Average well-being and age, with confidence intervals (95%) ����������������� ��� � ��� � ������������ ������ ������� ���������� Source: Study E0727 IESA-CSIC. practice are significantly important for them. The model in totality explains 20.9 percent of the variability in well-being shown by young people (table 3.4, column a). Sporting practice positively influences the well-being shown by young people, with an importance in the model of 18.4 percent, above that of employment situation, educational level, income, civil state, etc. Doing sport influences the well-being of young people, but the frequency of it is not significant, as can be observed in graph 3.5, as the differences produced are between those that do no sporting activity (with a level of well-being clearly inferior to others), and those that do sport two or three days per week or everyday (whose well-being is clearly superior). Young people that do sport sporadically show a great dispersion, for which they are difficult to classify in one or another group, their well-being probably depending on other characteristics distinct from the practice of sport. Adults In the adult population lifestyle does not seem to influence well-being, the three variables explaining only 0.8 percent of this (table 3.3, column c). Of the three, 96 SPORT, HEALTH AND QUALITY OF LIFE GRAPH 3.5 Average well-being and practice of sport among young people, with confidence intervals (95%) ����������������� ��� ��� ��� ��� � ��� ��� ��� ��������������� �������� ������������ ��������������� ������������ �������� ��������� ����� Source: Study E0727 IESA-CSIC. only the practice of sport results significant at 95 percent confidence with a positive sign; in other words, the greater the practice of sport the higher the subjective well-being, despite the confirmed lack of weight sport has. Wellbeing, however, is influenced by other variables, such as employment situation, income or civil state (table 3.4, column c). Regarding sport, as the only significant physical activity for the adult group, there do exist significant differences among those that do not do any type of sport (with lower declared well-being), and those that do sport everyday (with greater well-being), the two intermediate groups being difficult to classify. As can be seen in graph 3.6, the confidence intervals of the different groups are greater than those produced for the same variable in the group formed by young people. For the adult population employment situation constitutes, together with income, the principal source of well-being. The employed are those that show the highest level of well-being, with low dispersion. On the opposite side are found retirees, although these are not so clearly classifiable, as they maintain LIFESTYLES AND WELL-BEING 97 GRAPH 3.6 Average well-being and practice of sport among adults, with confidence intervals (95%) ����������������� ���� ��� ���� � ���� ��� ��������������� �������� ������������ ��������������� ������������ �������� ��������� ����� Source: Study E0727 IESA-CSIC. very diverse positions, and homemakers, who declare a level of well-being manifestly inferior to that of the employed. Seniors Lastly, we analyze the population group constituted by those from 65 to 79 years of age (tables 3.3, column d and 3.4, column d). This group gives greater importance in the variability of their quality of life and well-being to variables related to an active lifestyle (8.4 percent), the three elements of an active lifestyle contemplated here being significant and activities of daily life standing out, responsible for 42 percent of this variability. When the rest of the variables are included, sport accounts for 10 percent of the variability in well-being and activity in daily life, 17.6 percent. Also of greater importance in this group than in the other groups are gender (women feel less happy than men), civil state (single and married persons are more satisfied with their lives than the divorced and widowed) and educational level. The conclusions about sport are similar to those presented for the other age groups. Thus, seniors that do not practice any type of sport are clearly differentiated 98 SPORT, HEALTH AND QUALITY OF LIFE (with a level of well-being below 7 points) from those that do sporting activities everyday or two or three times a week (who have a level of well-being above 7 points). Again, the group that does sporting activity sporadically reveals no clear tendency. Nevertheless, this sub-group’s valuation of their well-being is more positive in this age group than in the other age groups, thus, though there exists a high level of dispersion in this sub-group (that which does sporadic sporting activity) and though this does not permit us to generalize about the results obtained, we can appreciate a tendency toward higher levels of satisfaction with life. This seems to indicate that at these ages, doing some sport, though little, positively influences reported well-being. Also standing out are the differences revealed between men and women at this age, as in the other age groups differences were not produced or were of little importance. Thus, in this group men have values of well-being one point above women. This data points in the same direction as that presented in the previous chapter on physical activity and health, which indicated that women have a worse perception of their health than men, particularly in this age group. GRAPH 3.7 Average well-being and physical activity among seniors, with confidence intervals (95%) ����������������� � ��� � ��� ��������������� �������� ������������ ��������������� ������������ �������� ��������� ����� Source: Study E0727 IESA-CSIC. LIFESTYLES AND WELL-BEING 99 3.4. The benefits of physical activity on quality of life The results of this chapter are in line with theoretical expectations and with other findings of the same type. Those interviewed report being fairly satisfied with life, having high levels of well-being and a good quality of life. Regarding specific aspects of quality of life, interpersonal relationships are reported to be highly satisfactory; this is consistent with other studies about quality of life and well-being. In Spain (as well as in other Mediterranean countries), interpersonal relationships have a primary importance (see, for example, Antonucci et al., 1996; FernándezBallesteros, Zamarrón, Rudinger et al., 2005; Fernández-Ballesteros, Zamarrón and Macía, 1996). The relationship between all the subjective valuations related to one’s life is verified in the results obtained from the factorial analysis. The high correlation between well-being, satisfaction and quality of life are confirmed in the results, which indicates that the participants in this study see them as closely related aspects. This not only bears out the initial approach, but also permits us to use a weighted score for the concept that was evaluated, merging the distinct verbal labels present in the literature, reducing them to only one, called «wellbeing». In short, to evaluate the quality of subjective life, as much as we introduce quality controls, the results embrace other subjective concepts, such as satisfaction or well-being. Regarding the relationship between well-being and the different contexts for physical activity it was found that, as expected, the participants that did more physical activity and did sport reported feeling greater well-being. However, there do exist differences due to age, given that this only occurred among young people and when taking the total sample into account (surely because of the affect of the young people). When we ask about activities of low physical effort (walking or taking walks and activities of daily life) the relationship between more activity and more well-being is produced in all the age groups (the adult group presents the same tendency, although its average does not reach a statistically significant level). After the regression analysis the conclusion is that the three aspects of an active lifestyle explain 7.2 percent of the variability in the well-being of individuals; 100 SPORT, HEALTH AND QUALITY OF LIFE however, when sociodemographic variables are introduced the variance explained increases sharply, with age (being older means less satisfaction with well-being or with quality of life), employment situation and living situation the most important sociodemographic variables. It is interesting to note that it is possible to establish two groups: individuals that do not practice sport and those that do. Both groups differ significantly in the well-being expressed; in other words, individuals that practice some type of sporting activity report greater well-being. This reinforces the importance of sport in the perceived well-being of the individual. In addition, it is also worth highlighting that the results establish that older means less well-being. This is contrary to what was established in other studies in which age has little weight on level of satisfaction. This lack of a relationship is even explained through distinct theories related to the adaptation to the process of aging (Carstensen et al., 2000), to processes of self-regulation (Fernández-Ballesteros, 2008) and to processes of resiliency and coping skills (Diener and Diener, 1999; Baltes and Baltes, 1990). It requires much broader longitudinal research if we intend to compare past studies with current ones and, surely, it also requires establishing if the differences between young people and seniors are due to an increase in the well-being of young people or a decrease in the well-being of seniors or, as a post hoc compatible hypothesis, if social values are not influencing the perception of well-being in younger «hedonistic» generations in comparison with «industrious» older generations. A second source of sociodemographic differentiation comes from sex. Women, both adults and seniors, express less satisfaction than men, manifest less well-being than men. This coincides with the research in this field which, in general, tends to show that women express lower levels of quality of life, satisfaction, well-being and health than men. Despite this fact being known, its explanation is not clear. It is suggested that women have worse health (objectively: they suffer a greater number of illnesses, go more often to the doctor, take more medications and suffer a greater number of chronic diseases related to the osteoarticular system), and this is the reason why they score more negatively than men on subjective conditions. Other authors postulate that women self-evaluate more negatively than men, given that culturally they are prepared to report on themselves more negatively (for a LIFESTYLES AND WELL-BEING 101 review, see Roysamb et al., 2002). In any case, what is important is that this study reveals this phenomenon, as well as that women also differ from men in that they do less physical activity. Other important demographic factors are civil state (single and married persons are happier than the divorced and widowed) and educational level (those with the highest educational level feel the happiest); employment situation and income level are the variables with the greatest explanatory power of wellbeing for the adult population. In short, it has been confirmed that persons that do physical activities tend to report greater well-being, satisfaction and quality of life, although only the young people that do more sporting activities are the ones that express greater well-being. Differences regarding well-being exist based on age and sex. As was expected, a close relationship between the subjective concepts of wellbeing, satisfaction and quality of life was found. 102 SPORT, HEALTH AND QUALITY OF LIFE IV. Quality of life, health and physical activity in the discourses of young people and seniors 4.1. Defining the problem In this chapter some of the results from the qualitative phase of the research are presented. Specifically, the data examined is that obtained in the discussion groups from different samples of the population of young people and seniors in urban and rural areas, and taking into account socioeconomic conditions and gender. Our analysis also looks at the discourse which emerged from a group represented by a small sample of persons belonging to school parent’s associations. Before beginning this task, some considerations about the approach used in the analysis will be made with the aim of better understanding the reach of the evidence gathered and the structure established for its interpretation. First, it should be indicated that this part of the study is based on a study of exploratory character. This means that the results obtained have to be understood more as an advance toward the object of study than as a categorical demonstration. Secondly, it is advisable to be aware of the limitations of sample design (see the Methodological appendix). With the sample used we have tried to cover relevant aspects of the relationship between physical activity and sport and health and quality of life in the social imaginary of young people and seniors. To achieve this objective a purposive sample was designed, with the aim of delineating the different opinions, beliefs and assessments these groups share in regarding this relationship. Therefore, this sample does not represent the broad heterogeneity of social positions and lifestyles that can exist within each of these populations; rather it is centred on detecting similar positions in the social spectrum in function of a series of independent variables (economic QUALITY OF LIFE, HEALTH AND PHYSICAL ACTIVITY IN THE DISCOURSES OF YOUNG PEOPLE AND SENIORS 103 and educational level, sex and size of municipality). This factor has also led us to focus on the topics that both seniors and young people share in their discourses. The opinions drawn from young people and seniors are complemented by those shared by a small sample of parents of students. The reason for considering the opinions of this sector has to do with a special interest in knowing the attitudes and behaviour related to our theme of a sector of the population, minors, that it is difficult to have direct access to for legal reasons. Given that, as some authors have raised (Ayuso and López, 2007), many of the tendencies noted in current sedentary lifestyles among the Spanish population are manifested at higher levels among children and adolescents, the decision to research on this terrain among parents seemed opportune. In third place, there is no intention to hide an additional limitation, which is that the three axial elements of the study (sport, health and personal wellbeing) make reference to a much wider group of sociological issues. Hence, the analysis done in this chapter aspires, in particular, to determine the specific weight of each one of them within the different populations studied. The analysis developed in the following pages is structured in three sections. The first is focused on the concept of «quality of life». It deals with what each of the distinct populations studied understands by this notion, which will later help us find connections with sport. In the second section we will talk about the concept of «health». Here we will have the opportunity to confirm the close relationship that people make between health and quality of life. This relationship will provide some keys to understanding the place sport is granted as an essential element of health and well-being, something which will be dealt with more extensively in the third and final section of this chapter. The results reveal that sport is very present in discourses within the Spanish population related to health and personal well-being. However, in the relationship that is established there is no unanimous agreement about the pre-eminence of any one of these elements over the others, nor about the direction in which they turn – in other words, although sport and physical activity impact positively on our well-being thanks to their effects on our health, having a good state of health and well-being also favourably impacts on doing physical exercise and sport. 104 SPORT, HEALTH AND QUALITY OF LIFE 4.2. Quality of life in the social imaginary As Fernández-Ballesteros argues (1997), and as has been pointed out in another part of this book, to define, delimit and measure what is understand by quality of life represents an arduous task; so much so that not even social scientists are in agreement. The difficulty lies in the fact that around this notion a wide number of dimensions enter into play and that they appear as dualities (material and immaterial, objective and subjective), difficult to define as different meanings and values emerge among and between social groups, and even at the level of the individual. In what follows the intention is not to enter into conceptual debates about this issue. Our interest is in knowing the way in which people conceive the idea of quality of life. In this sense, it must be said that the persons studied in the sample also did not spend time on its definition, as the elements that they considered to provide quality of life were many and heterogeneous. Despite this, in the analysis of the discourses recorded some points of agreement about a series of characteristics were detected, which helped us to reconstruct social representations of this concept. The first point of agreement is the relationship of quality of life to elements of both a material and/or tangible character (among others, money, work or access to housing) and immaterial or intangible (enjoying free time, personal satisfaction, company, self-perception of health, etc.). Therefore, these elements themselves provide quality of life. –I think it is a set of things… And according to if you have a good job, if it’s near, good friends, a… everything. (Woman, 24-32 years old, Madrid) The elements that the participants in the study talked about to refer to quality of life can be summed up in four central dimensions which, in general, are interrelated: 1) Health: groups elements connected to the absence of illness and to physical and psychological well-being within one’s close social circles (family, partner or friends); 2) Work: includes aspects concerning employment conditions (access to the labour market, obtaining a decent salary), the ability to consume specific objects and services and the possibility to be self-sufficient; 3) Time: the relationship between time dedicated to necessary activities (work, QUALITY OF LIFE, HEALTH AND PHYSICAL ACTIVITY IN THE DISCOURSES OF YOUNG PEOPLE AND SENIORS 105 care and attention of children, etc.) and free time and leisure – in other words, the possibility of having and managing free time within the obligations of each person; 4) Social environment: this covers both physical space as well as the social, in other words, the fabric of social relations in interaction within a given physical space. –Quality of life for me is connected to the theme of mental health, or in other words, to be fine with oneself and, good, later there are other aspects referring to your house, to work… (Woman, 24-32 years old, Madrid) –(…) It’s more what you have around, help from family, health, the closest circle in general. (Woman, 60-75 years old, Barcelona) Corresponding with the above, the second point of agreement derives from the informants understanding that the presence or not of these elements in our lives provides a greater or lesser degree of quality of life, an observation to which some qualifications will have to be added. The first is that the perspective from which each person looks at these elements corresponds with the social and economic conditions which surround him or her. Therefore, each individual or group, in function of their economic situation, their values (acquired in socialization), age and the social environment in which they live, will give greater or lesser importance to each one of these elements. First man: I don’t have personal problems. My retirement is the maximum, my children are all out of the house, it’s only my wife and I, and the quality of our married life is good, but I think that there are people for whom it is bad, according to the pay they have. Second man: Of course, there are a lot of thing, a lot of factors, it’s not only money, careful… there’s also health… (Seniors, 60 to 75 years old, Barcelona) –Possibly your personal situation isn’t mine, perhaps not all of us here earn 1,000 euros, perhaps not all of us are working, perhaps not all of us want to have a family. (Woman, 24-32 years old, Madrid) 106 SPORT, HEALTH AND QUALITY OF LIFE Following from this, the second qualification is that the starting conditions for all individuals demarcate specific personal and/or group needs and expectations. Based on the degree of satisfaction of these, the individual or group will have a greater or lesser sensation of quality of life. This means that it is a concept that contains a certain relativism, and therefore, what is important for some is not necessarily important for others. First woman: (…) It not only depends on what you have outside or the exterior, or what you obtain. Often you can get a lot of things and not feel content with yourself, or not be happy. Not having a good quality of life depends on your expectations, mine… Second woman: If you look at the quality of life of each person, we’d see that it can be very different. It has something to do with the expectations that the person has. (Young people, 24-32 years old, Madrid) –So the quality of life depends on the glasses you look through. (Man, 60-75 years old, Barcelona) These qualifications lead us to the third point of consensus reached about quality of life among the population: quality of life is the achievement of a balance between the possibility of satisfying our material and immaterial needs and aspirations and the capacity to accept the circumstances that limit our living conditions. This point of equilibrium to which the participants allude to leads us to a subjective idea of greater reach, namely: «happiness». –In other words, that your personal life and your work life are in harmony, this also means that your mental health will be good. (Woman, 24-32 years old, Madrid) –I was also a teacher and I am also retired and I’m happy, I don’t need much more. I’m not rich, we aren’t rich but we are satisfied with what we have. (Woman, 60-75 years old, Barcelona) Given that the elements contemplated here are attributed different values according to social and economic conditions and, by extension, possible personal needs and expectations, the notion of quality of life is beset by numerous nuances in different stages of life, as we will see in what follows. QUALITY OF LIFE, HEALTH AND PHYSICAL ACTIVITY IN THE DISCOURSES OF YOUNG PEOPLE AND SENIORS 107 In addition, the influence of socialization or the social and historical context lived by young and old exercises an important role. Quality of life and the senior population Among the senior population, one of the central pillars of quality of life is health. Health at that age means the potential condition to continue being active and, above all, to maintain independence and autonomy. The importance of health, as a condition for continuing to be active is connected to the wear on our bodies and the appearance of illnesses and conditions common to this age. This situation leads as a consequence to the appearance of a major preoccupation with the body and its limitations. –First thing is health! You don’t realize it until someone at home has problems. While everything is okay you don’t realize it, but when someone at home has bad health then you realize it comes first and everything else is extra. (Man, 60-75 years old, Barcelona) What’s more, in this stage the quality of life depends on the way in which changes undergone in the reorganization of daily life are lived, which are influenced by the arrival of retirement and the abandonment of the home by children (what is known as the «empty nest»). Both events mean a transformation of daily life, dedicating a greater part of available time to activities that are disconnected from work and domestic obligations, such as leisure and free time activities. First woman: I think that you have to have your life organized after you retire, just as we had when we worked. Second woman: You have to prepare yourself before you retire, if not you won’t do it. Third woman: Once the time comes you say: «and now, what do I do?». First woman: It’s an age where things are always happening. Second woman: Things to do, activities that make you better… First woman: Yes, that’s it, participate in activities, go out, don’t stay at home… Third woman: And in the morning that the alarm doesn’t go off is also important. Second woman: Yes, live a little bit at your own pace. First woman: Do things that you couldn’t do before. 108 SPORT, HEALTH AND QUALITY OF LIFE Third woman: A little bit of reading, taking walks, a trip… (Seniors, 60-75 years old, Barcelona) Leisure and free time activities are important because, on the one hand, they are a way of filling available time with new interests once daily life connected to work and family has lost its centrality and, on the other, a way of broadening and strengthening social ties, as well as overcoming loneliness and reclusion in the private space of the home, with all that this implies for the emotional stability of seniors. –It’s fundamental to fill life with activities because there is nothing worse for the mind that not having anything that excites you and doing nothing. (Woman, 60-75 years old, Barcelona) In obtaining quality of life, economic resources also have a fundamental role, now received in the form of a pension. In effect, in a society in which access to goods, experiences and services depends to a great measure on the spending capacity of individuals, the pension has the same centrality that the salary has in other stages of life. The pension therefore conditions the possibility of enjoying quality of life. Beyond a means to satisfy basic necessities, the pension is the key to access to and/or exclusion from free time and leisure activities, such as travelling or going to a gym. In this relationship, the caretaker role that the social environment and public actors exercise is unquestionable. First man: Quality of life begins when you are retired. If the retirement you have is enough to live on, in other words, that is the fundamental point… Second man: Money is fundamental because without money you can’t live. You have quality of life if you have money, if you don’t have money you don’t have quality of life. Third man: The person that gets to retirement and hasn’t saved anything is condemned to failure. Second man: Look, hold on, let me explain it. Fifty two years old and they give you 300 something euros a month and, as you don’t have any place to stay, you die. (Seniors, 60-79 years old, Barcelona) In any case there is no doubt that aging, its changes and the way they are confronted, are closely related to individuals’ social and economic conditions. QUALITY OF LIFE, HEALTH AND PHYSICAL ACTIVITY IN THE DISCOURSES OF YOUNG PEOPLE AND SENIORS 109 As a consequence, this process provides heterogeneous situations on the basis of which also emerge very different ways of understanding quality of life. Quality of life and young people Youth can be defined as a transitory stage between adolescence and adulthood, as «a provisional situation in which one stays until acquiring social competencies» (Fernández Esquinas et al., 2003). The pace of this process varies in function of the social, economic and cultural differences that young people live. These differences are reinforced by the range of «ages» (cultural) that have been included in this stage in recent decades. This expansion has been motivated by the delay in the acquisition of competencies, in other words, in the arrival of adult life and the elements that define it, such as access to work and a salary that facilitates independence, emancipation and the formation of a new nuclear family. It is worth highlighting, therefore, that youth is not a homogeneous collective. As Alonso and Conde (1994) point out, «there does not exist one sole state of youth, but various states that consist in distinct social situations». The road to adult life from youth means a gradual transition that implies a passage through distinct stages, in which the pace is not regular. As a consequence, differences in this stage result not only from social and economic conditions, but depend in addition, on differences derived from the pace and rites of passage through which youth live the passage to adult life. These differences will have notable influence on the aspirations and expectations of young people, which will impact on their conception of quality of life, on the importance that is granted to different aspects related to it in the distinct stages of youth. In general, work and housing mark the centrality of their discourses, although we can see different themes that preoccupy young people according to whether we are taking about those of 18 to 23 years of age, or those from 24 to 32 years of age. First man: There is no place for young people either, we all go someplace and they already fenced it off. Second man: They stop you having the botellón [informal outdoor gatherings with alcohol] in the park, they send you somewhere else, they tell you that in Arenal you can’t drink and now they take your place away. Then, the local government, what do they do? They take away the «botellón». 110 SPORT, HEALTH AND QUALITY OF LIFE First woman: There is no entertainment, they open up a discotheque and two days later they close it. There is no entertainment for us. (Young people, 18-22 years old, Puente Genil (Córdoba)) First woman: Quality of life for me is… making sure your life is taken care of in terms of your housing, in terms of work and little more. Second woman: (…) It’s having more time for my family and for myself. First woman: For me, as much time as you have, and as much as you dedicate to your family, and however well it’s going, if the work situation goes wrong no… First woman: In Spain we work too much in comparison with other countries… In hours, but not made good use of… One thing is long working days, but if you look at work in public administration and others, well, the quality of life is better because the hours are less, of course. There is more compatibility between family life and work, there are a lot more things that, well, when you want to form a family and when you work in this area, of course, it makes things easier. (Young people: 24-32 years old, Madrid) The instability and uncertainty with which young people live the changes related with the transition to adult life and its world lead to, in regards to quality of life, access to work and housing becoming much more important than other aspects such as health – in contrast to what occurs among older persons. For young people work means independence from family and hence, the entranceway into adult life, even more so the younger one is. First man: Housing is very expensive, work is bad. First woman: Things aren’t too good for becoming independent. First man: And then the contracts, that once you’ve worked, and after six months, they have to give you a better contract or one for more time and they put it off. (Young people, 18-22 years old, Puente Genil (Córdoba)) First man: You have to differentiate between people that have mortgages and people that don’t. Quality of life for me, for example, I’m accustomed to sharing an apartment with people and I’m not thinking of buying a place because it’s too difficult. Second man: Here in Spain… there’s a lot of frustration, the people are very frustrated when it comes to finding housing, work… It seems to me that the frustration in the end works against the quality of life, your expectations. (Young people, 24-32 years old, Madrid) QUALITY OF LIFE, HEALTH AND PHYSICAL ACTIVITY IN THE DISCOURSES OF YOUNG PEOPLE AND SENIORS 111 Work among young people also means the possibility of having a certain autonomy to manage in a model of society based on consumption. The salary means having the capacity of consume, to access goods and services. It is the key to living independently in a consumer society. First man: I think that the principal problem is work. Second man: And, if there is no work, how do they think we’ll buy a house and become independent. (Young people, 18-22 years old, Puente Genil (Córdoba)) If you’re on unemployment, or you’re paying for an apartment, or you have to feed your family, or you have to feed yourself and you don’t have any money or means or anyone that can help you, then I think that mentally you can’t be very happy, I think that you can’t have quality of life… however healthy you are, whatever good friends you have, if you can’t pay for these things… It is impossible to live without spending. (Woman, 24-32 years old, Madrid) This fact is particularly important in the area of leisure and social relations, both closely connected. Certainly, leisure and free time activities, where young people habitually interact with groups of peers, are increasingly tied to consuming. A good part of their relationships, activities and ways of spending this time are subordinated to acts of consumption that demand the capacity to consume. As Bauman (2005) says, the unknown in these new generations is no longer if they «live to work or work to live»; but rather «if they consume to live or live to consume». First man: Although you have three thousand euros, if you can’t go and have a beer with your friends, this isn’t quality of life, although you earn ten thousand euros. First woman: Could be that quality of life for one person is having the latest model of car and being able to spend 100 euros on the weekend. Second woman: Of course, because in the end… we all consume and, although we don’t want to, you’re caught in a vicious circle… First woman: Our parents always instilled in us all the things they couldn’t have, well, you can have and it seem that we always have to have something better and something more. «If my father has this car, when I’m older I have to have a better one because you want to say that things have gotten better and evolved». Maybe that’s what we all think indirectly… (Young people, 24-32 years old, Madrid) 112 SPORT, HEALTH AND QUALITY OF LIFE The importance of work for young people appears connected to two other fundamental dimensions in the conception of the enjoyment of quality of life: time and health. Regarding the first, work raises concerns as far as the management of leisure time is concerned. Flexibility in the new models of the organization of labour (in the stage of post-Fordist production) has led to the deregulation of the structure of daily life through the flexibilisation of the schedules for work and for leisure. The consequences of this disarticulation are manifested on two levels: in the possibility of managing free time and leisure, and in social relations in this area of life; something which does not take place, as before, only in urban spaces, but rather increasingly represents a regularity in a global and homogeneous world. –What happens is that leisure… I, when I put in 12 hours a day working, for me leisure is getting home and lying down. (Man, 18-22 years old, Puente Genil (Córdoba)) First woman: A job that leaves you time, that you don’t live to work, but work to live… Second woman: The metro, the car, traffic jams and then you get there, and often you can’t even imagine having parking at a job, but, of course, you can spend half an hour looking for a place to park… And I think that this is also quality of life, having a job either nearby or where it’s easy… (Women, 24-32 years old, Madrid) With regard to the second dimension, as a consequence of working conditions of the post-Fordist production model, new health problems have appeared, such as stress and anxiety, pathologies that even affect children.(1) Woman: I also agree, but I think that everything is related to mental health… but it’s like you say «we live to work», in other words, lack of time. Man: I agree with her, in other words, with respect to mental health. Well, if you don’t have a good job, well you can’t have it… and if you are working all day, well you aren’t going to have mental health… Man: This is another problem; you have to have time for leisure. (Young people: 18-22 years old, Puente Genil (Córdoba)) (1) Which is related to the issue that was raised in chapter I, whereby the preeminence of material values, among which work is a substantial axis in our lives in a context of great competition for access to the labour market, has led parents in recent decades to introduce their children into circuits to acquire merits that reach similar depth to that of labor circuits. Evidently, this tendency has led to the same health problems that white-collar workers suffer (stress, depression, anxiety, etc.). QUALITY OF LIFE, HEALTH AND PHYSICAL ACTIVITY IN THE DISCOURSES OF YOUNG PEOPLE AND SENIORS 113 Another issue not dealt with in this point for its minor importance, but which, in any case, appears in the discourse of young people, is the social environment in which they live (large or small cities, towns). The social environment in which they live will influence their enjoyment of free time and their leisure and consumption options in an unequal manner. Quality of life of children seen from the perspective of their parents The social, political and economic changes lived through in recent years have had consequences for the relations between parents and children. These transformations mean that the world in which parents were socialized is very different from the world in which their children now live. This can be seen through situations such as the gradual reduction in the dependence of children and the increase in the importance of their broader living environment, in which other actors reduce the socializing role of the family. These facts, and the sensation of losing control over the life of their children, increase the uncertainty of parents about the decisions they make regarding their education. Hence, the central element in the quality of life of minors, according to parents and/or guardians, is associated with the role of education. This is understood in a broad sense, as a global process which includes the totality of activities in the daily life of the child, the environment in which he/ she develops and the different social actors with whom he/she relates. The education of children and their success depends, according to the parents of school parents’ associations, on good communication between the agents involved (the school, teachers, monitors and parents). –I think that what is fundamental is communication, of course. The function that it has is so important, what you can have with your child, what you have to have with the teacher, with the school. (Mother, school parents’ association, Barcelona) But concerns connected to education go beyond the school. Thus, for example, parents think that the time their children spend outside of school has an important impact on their quality of life. In this area, they highlight aspects such as the relationship between free time and the time connected to school and homework done at home. Parents think that this is often excessive and puts a limitation on leisure, which at this age provides very positive elements 114 SPORT, HEALTH AND QUALITY OF LIFE for the development of the child and/or adolescent. Playing, and in particular, playing with other children is an essential activity in the eyes of parents. –(…) He’s in school all day. Then he gets home; he has a lot of homework, it has to be at least an hour, an hour and a half every day, no? Then he has to copy his notes…or whatever, if you understand me. I say; «Damn, he also needs some time to have fun». (Father, school parents’ association) The references parents make regarding the free time of their children and the importance it has in their quality of life, reveals various concerns parents have, among which stand out the immediate environment in which they live, the emergence of new forms of leisure and social pressure to consume. Regarding the immediate environment (the city or town and neighbourhood), this is a central element which affects leisure because of the impact it has on the possibility for children to be autonomous. This possibility depends on the spaces that are available, the opportunity to use them and the dangers that can await them either from traffic or lack of safety. –With the immigration there is. I live near a park, and if you were to see it at seven in the evening you can’t imagine what goes on there. I don’t know: stuff of kids, but I’m telling you, it scares me. If it scares me, imagine my kid. (Father, school parents’ association, Barcelona) Regarding the emerging forms of leisure tied to new technologies, digital entertainment (audiovisual media and its use in entertainment) is at the head of the concerns of parents regarding the use of free time by their children. In concrete, what concerns them about this type of leisure is its possible pernicious effects and the lack of self-control among children and adolescents, as well as the violence associated with some digital entertainment. –Because my 7 year old son also goes crazy with the PlayStation… Children, if they play more than a certain time, later they don’t know how to play with other children, I don’t like that. (Mother, school parents’ association, Barcelona) Regarding consuming, the concern of parents specifically stems from the social pressure that their kids can face through specific consumer behaviour reproduced as a process of integration in peer groups. It is an issue that is QUALITY OF LIFE, HEALTH AND PHYSICAL ACTIVITY IN THE DISCOURSES OF YOUNG PEOPLE AND SENIORS 115 expressed with a lot of tension among parents when speaking about quality of life: the opposition between having and being as a fundamental pillar of the values and attitudes that they provide their children to have access to a good quality of life. –Having everything is not quality of life. (Father, school parents’ association, Barcelona) In brief, as parents see it, the quality of life of their children has to do with achieving balance between those elements related to their education, development and growth and assuring their well-being and capacity to confront the future. 4.3. Health in the subjectivity of the population studied As has been pointed out by specialists in another part of this study, health encompasses a multitude of aspects related to daily life. In this section we will discuss this issue briefly, using the discourses obtained in the discussion groups. Our objective is to analyze the perceptions, values and beliefs shared about health in relation to quality of life with the aim of understanding the associations that can be established between health and quality of life and sport and physical activity. As has been seen in the previous section, health is recognized to be a central pillar in the quality of our lives. From this starting point, in the social imaginary shared by the participants in our study, health is represented in two distinct forms. On the one hand, by its effects on quality of life, on the other hand as a means for achieving quality of life through personal care. In relation to the first way of understanding it, health is conceived in a global form, as the result of a broad series of aspects tied to well-being, including among them the strictly physical, but also others of a psychological character. –Man! The healthier a person is the better the quality of life he has, that’s for sure. It’s not the same for a person that has back problems, asthma or any of those things as for someone who doesn’t have them. You feel better doing your work, you are more content, happier. (Man, 18-22 years old, Puente Genil (Córdoba)) 116 SPORT, HEALTH AND QUALITY OF LIFE This perception implies that our conception of health is increasingly distant from one restricted to health as the absence of illness, as was commented on in chapter II. Corresponding with this first aspect, health is also understood as the result of the attitude with which each person pursues it, and not exclusively as a totality of biological circumstances which one can’t change. First woman: It’s that, when you realize this, when you are older, you begin to organize yourself with food, because before you didn’t pay attention, at least I didn’t pay attention, I ate anything and I was always thin, but then I did, salt… Second woman: Sometimes our health isn’t completely okay, but we can do things to improve it. (Seniors, 60-75 years old, Barcelona) Health, seen as something that must be taken care of, is constructed on two parallel planes. A first plane, in which taking care of health is understood in a therapeutic manner, in other words, aimed at reducing health problems suffered, and a second plane in which care acquires a preventative character in relation to possible illnesses. Health and the importance of its care, independent of whether it is understood in a therapeutic or preventative sense, imply an investment in time, effort and money. In other words, taking care of oneself involves a series of closely related environmental and sociological circumstances – self-perception of health, personal experiences, socialization processes (through which each person has acquired habits, behaviours and attitudes toward health) and the social conditions that surround individuals – as will be seen in what follows. In other words, health, our perceptions of it and the consciousness of the need to take care of our health, are constructed through the daily experience of individuals. These experiences come to us determined by age, processes of socialization and the distinct actors that take part in those processes (the school, the family, the media, the figure of the doctor and other actors in the healthcare field). Due to these issues, despite the different groups that are the objects of this study sharing the idea of health as one of the basic pillars of the quality of life, its importance will be different, depending on the stage in life one is in and the elements that characterize that stage. In effect, age, being so closely related to the gradual lose of health, has a fundamental weight in the self-perception of health and, above all, in the strategies that persons follow to take care of their health. QUALITY OF LIFE, HEALTH AND PHYSICAL ACTIVITY IN THE DISCOURSES OF YOUNG PEOPLE AND SENIORS 117 Health in the senior population As we stated earlier, health has great importance in the senior population, as it is understood to be the necessary condition for enjoying a good quality of life. Enjoying health in this population is related to individuals continuing to lead their lives in an autonomous and independent manner, enjoying new activities to fill free time and mix with others outside of the home. This leads to health, its care and the practice of the habits of a healthy life having central weight in this age group. –I think that the most important is health. You can have all the money you want, if you don’t have health you won’t enjoy anything. (Man, 60-75 years old, Barcelona) For the older population, the gradual lessening of health during aging is a clearly tangible physical and psychological process, which, therefore, provokes enormous sensitivity. On the psychological level, the problems that arise from aging appear on two different levels. On the one hand, older persons experience illnesses tied to the deterioration of the nervous system (Parkinson’s, Alzheimer’s, senility…). On the other hand, problems such as loneliness, depression and anxiety appear, which those interviewed associate with the absence of social relations in their lives. First woman: The lower back yes. I have hernias everywhere. I’ve been taking care of my husband with Alzheimer’s for 14 years now… Second woman: I have terrible health. I have cholesterol, I have sugar… Third woman: I have a corset, one of those made from whale bones, because of my back. Fourth woman: Me, my bones… I, when I bend down a bit, I don’t know how I’m going to get up, because I can’t. When I bend over, my lower back now… I always have sciatica. Fifth woman: I live with my nerves on end and my body can’t do anything. Sixth woman: Your problem isn’t mine. I’m alone. Because the only company I have is my husband, but he doesn’t talk to me, doesn’t say anything… What can I say to him? So, my problem is being very lonely. (Seniors, 60-75 years old, Antequera (Málaga)) Care at this age has great importance in both its dimensions, preventative and therapeutic, although it is the therapeutic benefits that are most present 118 SPORT, HEALTH AND QUALITY OF LIFE and most valued, due to the ailments seniors suffer. Despite, in many cases it meaning an extra sacrifice, taking care of one’s health in this population is an obligation and a basic necessity, constituting a way of maintaining life and fighting against death, something that is increasingly present in daily life at this age. But care of health among older persons is an objective that exceeds the possibility of individuals. At this age, preservation of health becomes a collective issue, requiring the support of people close by (friends, family, partner), and an essential requisite for enjoying a certain quality of life. In this sense, the lack of a healthy environment can limit the attainment of personal health, something in which social, economic and cultural differences also have an impact. First woman: Family responsibility, as old as we are, it’s hard. What happens is that when you have support, well then, you manage, half limping. But when you don’t have support, well, then it’s true that… Second woman: It also depends on the family that’s there and also the help that you receive from the government. (Seniors, 60-75 years old, Antequera (Málaga)) An illustrative situation in this respect is that of senior women that have to take care of someone ill at home. These women normally have a middle to low income level. Among them, the relationship between the self-perception of health and the necessity to take care of themselves (to invest time and effort) is conditioned by their socioeconomic situation, by the type of social relations available to them, by the roles they carry out and by processes of socialization and the values acquired through them. Thus, these women live with a great tension related to their health, which they perceive as not good and in need of care, and to the structural difficulties that impede them from taking care of their health. Among the difficulties, the most frequently pointed to for this group of the population is the lack of time for personal care, a result of the numerous roles they carry out daily as homemakers, mothers, grandmothers or «social workers». Obviously, this situation has numerous effects on the health of the person carrying out so many roles and, of course, represents an enormous social burden, sharpened by not being able to retire due, among other reasons, to economic limitations which do not permit someone to be hired who can take on these tasks. QUALITY OF LIFE, HEALTH AND PHYSICAL ACTIVITY IN THE DISCOURSES OF YOUNG PEOPLE AND SENIORS 119 First woman: I am eight… nine years younger than my husband, and I can see that I am getting older than him because… You get depressed, because you see yourself as powerless. You see you are obligated. You say: «I have to take care of this person because I can’t abandon him». And they did an MRI and the doctor told me «you can’t do what you are doing!» and what do I do? Second woman: In other words, if you have the resources, that person has possibilities, because I know people that do, there’s someone sick and he has three women. One comes in the morning until mid-day, the other comes from mid-day until the evening and the other at night until the morning. Well this family, they have this sick person, but… And they go and see him when they want. (Seniors, 60-75 years old, Antequera (Málaga)) In this situation, taking care of one’s health, dedicating time to one self and making the effort to include healthy habits and routines in one’s life becomes, in the majority of cases, an almost impossible aspiration. But the processes of socialization lived through also have an influence on this. To a great degree, this population has been socialized with traditional values, among which the role of the woman is almost exclusively seen as in the home. In relation to the difficulties that these women have in taking care of themselves, the values associated with personal sacrifice and altruism stand out, prioritizing the care of others above care of one self. First woman: It’s that we are bad to ourselves. We are great with everyone else. Second woman: The education that we received has not been… In other words… First woman: For us. Second woman: For us, no. It’s been for everyone else. Third woman: We are the caretakers of everyone else, but we don’t take care of ourselves. (Woman, 60-75 years old, Antequera (Málaga)) As a consequence, among seniors health is at the centre of their concerns, and is understood as a state that is not determined only by their age, but also by social conditions and the socialization processes specific to their environment. 120 SPORT, HEALTH AND QUALITY OF LIFE Health among young people Among young people, concern over health is not a part of their daily lives. Health is something that is taken for granted and, therefore, with exceptions, doesn’t generate worries. Hence, young people pay more attention to other aspects of their lives, such as work and free time. –I’m fine… We are also young, when we’re old… (Woman, 18-22 years old, Puente Genil (Córdoba)) Despite the fact that the subjective self-perception of health at this age is positive, at more advanced ages of this stage a point of reflection occurs, which is determined by the entrance into the labour market, the imminence of adult life and the formation of a family. These events lead to the beginning of the disappearance of that sense of invulnerability typical of adolescence and to the appearance of a certain consciousness of physical limitations and of psychological problems. –People are going to be screwed up when they are fifty, and that’s going to generate a lot more problems, more dissatisfaction… we are going to be increasingly stressed out, every day we are more unhappy, more down, with more anxiety and more depressed over every little thing. (Woman, 24-32 years old, Madrid) The loss of well-being perceived among young people is related, in general, to access to work and working conditions, which are in the majority of cases the source of the psychological imbalances which affect them. In this sense, there are two principal types of health problems that the young people interviewed talked about; on the one hand, those associated with stress, anxiety and depression and, on the other hand, those associated with sedentarism. Regarding the first, young people tend to tie them fundamentally to the new forms of flexible organization at work and the consequences this has on the availability of free time, to the general instability of their employment and to other situations generated by the post-Fordist model of production (IOE, 2007). –If you don’t have a good job, or good working conditions you can’t have good mental health… and if you don’t have mental health, you don’t have anything. (Man, 24-32 years old, Madrid) QUALITY OF LIFE, HEALTH AND PHYSICAL ACTIVITY IN THE DISCOURSES OF YOUNG PEOPLE AND SENIORS 121 Regarding sedentarism, it tends to be tied to new types of jobs, the ways they are organized and the consequences this has on the relationship between work and free time. The emergence of an economy oriented toward services and the production of knowledge favours the growth in professions based on intellectual activity. –For example, you are sitting in an office all day, and better if it’s only 8 hours, because there are also people who are there 12 hours… Really, I’ve been a little more than a year sitting in an office and it’s true, you want to, when you are sitting all day, to go, look for something to do. (Man, 18-22 years old, Puente Genil (Córdoba)) At the same time, the emergence of passive forms of leisure and, in concrete, night-time leisure, in many cases related to sedentary and not very healthy practices – practices that have a central role above all in the first years of youth –, affect the self-perception of health and the necessity to take care of one’s health. –The «botellón» [informal outdoor gatherings where alcohol is drunk] every weekend, in the long run… it’s not good for your health. (Man, 18-22 years old, Puente Genil (Córdoba)) In short, what the evidence in this study shows is that young people in general grant less importance to health than older people. However, as they grow older, health, and in particular, mental health acquire greater weight. Mental health is related to working conditions, access to housing and the possibility to balance work life with private life (family, free time, etc.). Children’s health from parents’ perspective The principal concern of parents in relation to the health of their children is that they acquire healthy habits that will help them to maintain health in the future. –Friends of my children, when they came to eat one day at home, my wife said: «Here, have some fruit!...», and they said: «No, at home we don’t eat fruit!» My children: apples, fruit… My wife has them used to it. (Father, school parents’ association, Barcelona) Among the central concerns of parents about the health of their children are two interrelated problems which are increasingly present among minors: obesity and sedentarism. Regarding the first problem, parents think that 122 SPORT, HEALTH AND QUALITY OF LIFE one of the principal causes is poor diet, motivated by the loss in current societies of healthy eating habits based on eating fruits and vegetables and a balanced diet. Mother: You are talking about a problem that you hear about that Spain is a country, that it is the third most obese country of Europe, I don’t know… I don’t know the details, we’ve gone from the Mediterranean diet to the Anglo-Saxon thing, no? Father: In other words, food, to begin, that’s the fear that I have, that the youth of today are being poorly fed. (Fathers and mothers, school parents’ association, Barcelona) Regarding the second problem, the concern related to sedentarism is related to the current lack of physical activity among minors. Among the causes enumerated by parents to explain this fact, their children’s choice of passive leisure activities, many of these activities using digital and electronic media, stands out. –(…) That is to say, they ought to do it in another way or well, I think, that we’ve gotten comfortable with it and now we don’t play like we played football before, and we are more with these little machines and the PlayStation and other things. (Father, school parents’ association, Barcelona) Sedentarism and the lack of physical activity are facts alluded to repeatedly by parents when referring to the problem of childhood obesity, something which is also influenced by poor diet. This fact explains the concern of parents for their children acquiring a series of healthy habits connected to matters such as diet or sport. –No, and sport is fundamental for children, because sport is like eating well, it’s healthy for them. (Father, school parents’ association, Barcelona) Thus, in relation to health, parents express a particular concern for a series of unhealthy habits that begin to appear among children and are related to diet, lack of physical exercise and sedentarism in general, and which provoke problems such as obesity and must be confronted through education. QUALITY OF LIFE, HEALTH AND PHYSICAL ACTIVITY IN THE DISCOURSES OF YOUNG PEOPLE AND SENIORS 123 4.4. Sport and physical activity in discourses on health and quality of life The word «sport» has, in our days, acquired such a proliferation of meanings that it is difficult to know what someone is referring to when using the word. This means that we are talking about a phenomenon of enormous complexity. As José María Cagigal (1981) expressed it, «when you speak about sport, or when you use an adjective like “sporting”, you are referring to a style, a habit, a world of defined behaviour, or perhaps an institutional area of specific character (federations, competition, etc.), or a dominant mode in certain periods, almost stifling in ours. The label “sporting” applies to both a champion as to the generous gesture of accepting defeat, to a tremendous spectacle, to a feat of solidarity, to a way of accepting life, or to an article of clothing». In this study we will not go beyond the meaning of sport that is inferred from our study: an activity that permits us to stay in physical shape – a definition that coincides with that obtained in the five-year barometers about sporting habits of the Spanish population, to which we have referred to in previous chapters. As a consequence, in what follows we will focus on exploring the aspects of the daily life of the Spanish related to sport and, more concretely, the possible connections that can be found between this activity and the health and well-being of persons. Sport and physical activity in daily life The discussion of sport and its role in daily life has led to the participants in this study making numerous references to other closely related activities, such as physical exercise and play. This could be due to the lack of formal criteria that the participants have to define the scope of this activity. Only the parents interviewed, belonging to school parents’ associations – something that perhaps leads them to being better informed – establish more or less clear limits between these terms. For them, sport generally refers to a type of regulated activity, with a certain obligatory character and which their children do in official contexts (at school, in gyms, sports clubs, etc.). Be that as it may, what is certain is that the term that the participants in our study normally apply to refer to activities of a physical character, related to the motor skills of the individual, is that of sport. In effect, in analyzing the discourses of 124 SPORT, HEALTH AND QUALITY OF LIFE the population studied we find that when the participants refer to physical activities that have more or less a relationship with sport then they do not speak about physical exercise but rather strictly about sport, or the specific activity, such as playing basketball or cycling. This confusion in defining sport does not, however, impede the participants in this study in agreeing in placing it in the daily free time and leisure of individuals. –If you don’t do sport I understand that in leisure time maybe you meet with friends, or read, watch television… (Woman, 24-32 years old, Madrid) This characterization means that this activity necessarily requires availability of free time as a basic condition for its realization. In addition to free time, sport also demands physical effort, will and in certain circumstances, money. This means that, beyond the predisposition of individuals to do sport, which results from the processes of socialization through which they have passed (which includes specific likes and lifestyles), there exist a set of structural conditions that make it possible to do it. First woman: Man, because although you want to, after…! For example, this guy works and doesn’t have time. The time he has is for him, his girlfriend, or to be at home, and if you have time you don’t have money because you don’t have work. Second woman: I think it’s good we do sport, but myself, for example, I want to do sport, I want to do aerobics, but I don’t have any money. My mother says: «I’m not going to pay for it!»… If they had free classes or something, I would be happy to go. (Young people, 18-22 years old, Puente Genil (Córdoba)) Regarding the relationship between sport and quality of life, the populations studied say the same thing: sport is seen as a valuable means toward obtaining a good quality of life. However, some prior minimal levels of quality of life also favour the practice of sport. Therefore, among both elements a reciprocal relationship is established. Later we will have the opportunity to examine this relationship more deeply. QUALITY OF LIFE, HEALTH AND PHYSICAL ACTIVITY IN THE DISCOURSES OF YOUNG PEOPLE AND SENIORS 125 First man: The person that does sport will always be better than the one that doesn’t. Second man: I don’t feel the same as when I was doing sport, in the gym, right now that it’s been at least a year without doing anything, really. It’s even good for your work, but you have to have time and desire to do it. Because a guy in good shape is not going to work the same as someone who’s gone his whole life without doing any sport. To move, to lift, whatever things… but it’s that, having time and a place to do it. (Young people, 18-22 years old, Puente Genil (Córdoba)) This consensus among the participants in the discussion groups related to sport and quality of life needs some clarification to understand the sense in which it is raised. When they agree that sport is an activity that positively impacts on our quality of life, what is really being establishing is that through the positive effects of physical exercise on health, sport helps us to enjoy a good quality of life. In other words, the improvement in physical and mental health obtained as a consequence of doing sport provides quality of life. –You feel better, you are livelier, more agile, you lose weight, you lower your cholesterol, circulation, blood, for your breathing… (Woman, 60-75 years old, Barcelona) In other respects, sporting activity is considered ideal for establishing and reinforcing connections and, in many aspects, also for acquiring values and social skills. First woman: If you do a sport in a group, you can share things with other people… Second woman: Relating. First woman: You relate, you get support from other people, because if you do a team sport, I have for a long time, then you have to trust in other people, because in the end it all depends on not only you doing well, but that the whole group does well, which means that you are gaining a lot of relationships. First man: You develop your capacities, in team sport. You develop leadership capacity; you develop the capacity to work in a group, a lot of things. (Young people, 24-32 years old, Madrid) However, the quantity and variety of benefits that the participants connect to sport redounds in the importance it has on health. The association between 126 SPORT, HEALTH AND QUALITY OF LIFE sport and health is not invariable. As age increase so does this association (in detriment to the ludic character that dominates at younger ages), increasingly related to personal care and, ultimately, quality of life. –I say that it’s in my hands to improve my health and extend my life, of course, that’s not enough. You have to go to the gym… the day that they do pilates early in the morning at eight, at eight I get up. (Woman, 60-75 years old, Barcelona) This association means that practicing sport is understood as a personal investment in our daily life, in our leisure and free time space, an investment in health in which we employ physical effort, time and also, as we said, money. It is precisely this which leads to categorizing it as a form of healthy leisure («Leisure sport, leisure in general, healthy leisure I believe», woman, 24-32 years old, Madrid). This way of adopting healthy customs, through leisure and, in concrete, through sporting activity, is often accompanied by the acquisition of other healthy habits, such as watching one’s diet or the abandonment of harmful habits such as smoking. First man: Whoever does sport is taking better care of himself because he is watching his diet, and maybe whoever works and doesn’t do sport or anything, is always eating junk food. First woman: And the food is also having a lot of influence on the quality of life of people because everything now is precooked. First man: Hamburgers, pizzas… Second woman: Things as they are, when you are doing sport you don’t smoke as much. First woman: You don’t think of it. (Young people, 18-22 years old, Puente Genil (Córdoba)) Despite sharing this perspective on the connection between sport, health and quality of life, there are some slight differences among the different populations that participated in this study. These are motivated by, as was previously mentioned, the unequal economic and social conditions in which each age group is found, the processes of socialization through which they have passed and, finally, other aspects related to the physical and psychological conditions specific to the life stage in which they are found. QUALITY OF LIFE, HEALTH AND PHYSICAL ACTIVITY IN THE DISCOURSES OF YOUNG PEOPLE AND SENIORS 127 Sport and physical activity when older: meaning, benefits and motivations The practice of physical activity and sport has a fundamental importance among seniors. This is due to their seeing both activities as healthy habits that aid them in facing the physical and psychological problems associated with aging. –I could tell you that there are days when I say: «How terrible, what pain!». I go to the gym for two hours and I forget that I have pain, and I do everything moderately, because I have three herniated discs in my lower back, but then you go and you feel like a different person. (Woman, 60-75 years old, Barcelona) Among the benefits of sporting practice connected to health, stand out those related to the development of motor skills, balance and equilibrium, as well as relief from muscular and skeletal pains. Nevertheless, this activity is also associated with health benefits for other problems such as the accumulation of sugar and fats. First woman: What do I know, because there are a lot of things that… For example, you can… that, just walking, it’s something that burns sugar. Second woman: Man, influence no, but you’ll see, if… Yes, because you’ll see, if you see someone that’s exhausted, that has that pressure, at least, if they do a little sport… (Seniors, 60-75 years old, Antequera (Málaga)) First woman: The solution is walking, taking walks. First man: I do twenty minutes everyday on the bicycle to keep in shape, to not get fatter, but nothing more. Second woman: But of course, maybe you burn a tenth of the excess that you ate. (Seniors, 60-75 years old, Barcelona) However, the benefits derived from sport are understood as going beyond just the scope of prevention and the reestablishment of physical health. For the older population, doing sport also permits them to continue enjoying an active and independent life, contributing to the improvement of their personal wellbeing, thanks to its positive impact on psychological health. –It’s helping you, exercise, physically it’s good for you, and psychologically also, because you spend an hour relaxed, you talk about all the issues… 128 SPORT, HEALTH AND QUALITY OF LIFE Perhaps, you say «Look, that politician, or this politician. I don’t think that… I think this». (Woman, 60-75 years old, Antequera (Málaga)) The psychological benefits of sport at this age translate, therefore, in the acquisition and the reestablishment of personal capacities and improvement in mood. This is because doing sport and physical exercise among this group improves the self-perception they have of their capacities («feeling capable») and their life expectations by boosting self-esteem and relativising the limitations and fears derived from the aging process. –And the first days I said: «Okay, I can’t do anything, I’m rusty, with what I did before and now…». And little by little I’ve found… (Woman, 60-75 years old, Barcelona) The personal well-being perceived by the senior population as a consequence of doing physical activity and/or sport, is also due to their being a means for reconstructing social ties. This is explained by the fact that sport, being done outside of the home, permits them to disconnect from the routines that occupy the majority of time, leave the home, relate to other persons that are not part of the family and do different activities. This is especially relevant for older women who find themselves busy with domestic tasks, as for them more than for others, doing sport constitutes a way of getting out of the home and confronting the risks associated with being alone and enclosed in the home, such as depression and despondency. In this way, sport can be also understood as a mechanism for social integration at these ages, permitting seniors to establish social ties and connect with a wider circle. Sport permits them to share aspects of their lives, communicate with other persons and get involved in the surrounding world. –Anyway we have to, apart from it being good for our health physically, it is also psychologically, because we need to relate with other persons that are not in our circle… (Woman, 60-75 years old, Antequera (Málaga)) Sport also helps older persons with other daily problems of this life stage: the reconstruction of routine through the daily organization of leisure and free time activities. Whether it’s going to the gym, a sports club or the simple fact of going out to walk with friends, doing sport means keeping busy. The practice QUALITY OF LIFE, HEALTH AND PHYSICAL ACTIVITY IN THE DISCOURSES OF YOUNG PEOPLE AND SENIORS 129 of sport as a habit at these ages becomes an activity done at a particular time of the day, one which is gratifying and around which a routine can be established which aids in reconstructing daily life. –If you organize yourself and say: «I’m going to go to the gym this many days a week, I’m going to go to talks, I’m going to go out with my friends, I’m going to…». This helps a lot, I’ve seen it. (Woman, 60-75 years old, Barcelona) These physical, psychological and social benefits make the practice of sport an activity that helps to compensate for some of the principal sources of the imbalances that affect people at this age and provides elements for improving the quality of life. The perception of these benefits is the best motivation for practicing sport for seniors and, at the same time, it reduces and makes the associated costs (physical effort, time and, sometimes, economic costs) worth it. However, this is not to say that the practice of sport does not require a certain predisposition to do it. Sport, like any activity related with personal care, requires the existence of a set of circumstances; one of which is a willingness to do it, which means that the person has to have been influenced at some point by a mechanism of socialization (the family, school, the media and institutions of public health…) which transmits this interest to the person. In this sense, as has been pointed out in other parts of this study, different authors have demonstrated in prior research that, among older persons, having had an active lifestyle or, in concrete, having previously done sport, increases the probability of doing sport during this stage in life (Levinson, 1978; Voulle, 1985; Lehr, 1999). Others have pointed out that the intervention of socialization mechanisms in advanced stages of our life, which is understood as «resocialization tied to social support received», can also be decisive (Chogahara and Yamguchi, 1998; Chogahara, Cousins and Wankel, 1998; Graupera et al., 2003; Martínez del Castillo et al., 2006). In the first chapter the existing relationship between having practiced sport in childhood and/or adulthood, and one’s parents having done this activity, and practicing sport in the present was demonstrated. In the qualitative phase of this study we have also found connections in this sense. Thus, the strong perceived association between sport and health in this population group is explained, in part, by the medical discourse about the virtues of sport for improving health 130 SPORT, HEALTH AND QUALITY OF LIFE being strongly internalized. Thus, in this stage the role of the doctor is central in the acquisition of sporting habits. –Me, a couple of days a week… The fibromyalgia doctor sends me to do Pilates, it would be good for me, they’re slow exercises, with breathing… (Woman, 60-75 years old, Barcelona) When the «social support» of the doctor to do physical exercise and/or sport does not correspond with the real opportunities of seniors, as occurs among vulnerable collectives (such as older women and homemakers responsible for dependent persons), the feeling produced is one of powerlessness and frustration; more so among those that are conscious of the benefits produced by this activity, either because of having experienced it or because of being convinced by their reference group. First woman: And then the doctor says: «I’m giving you all these solutions and you don’t accept them…». And I say: «It’s not that I don’t accept them, it’s that I can’t… I don’t have the time nor the means…». Second woman: I have high blood pressure. And the doctor says: «They complain about everything», but I can walk for an hour or less. I can’t walk so much. (Seniors, 60-75 years old, Antequera (Málaga)) This fact, as with other aspects related to the social and economic conditions of seniors, affects the practice of sport. These will be dealt with later, in the section on barriers that limit the practice of physical and/or sporting activity and the effects of this activity on the quality of life. Young people, sport and physical activity in the transition to adult life The population of young people, in contrast with seniors, has lived through an historical period (from the 1970s to today) in which sport has become institutionalized within Spanish society (Moscoso, 2006). In this period with the approval of the Ley del Deporte y la Cultura Física [Law of Sport and Physical Culture] in 1980, a wide number of public policies were promoted with the objective of inculcating sporting habits and facilitating access to its practice throughout the population. As a consequence, this population grew up in a period in which physical education was obligatory in schools, sporting installations for doing sport multiplied and sporting QUALITY OF LIFE, HEALTH AND PHYSICAL ACTIVITY IN THE DISCOURSES OF YOUNG PEOPLE AND SENIORS 131 activities were perceived positively thanks to the spread of information about its physical, psychological and social benefits. Young people today are, therefore, socialized in sporting habits. Despite this, sporting practice is done in a varied manner in this life stage. This is due to there being numerous tensions related to the entrance into adulthood in this stage which also impact on the practice of sport, as has been demonstrated in different studies done in Spain (García Ferrando, 1993; Puig, 1996; Mosquera and Puig, 1998). Sport, its meaning, the motivations and barriers to doing it, reflect the diversity of situations that exist among young people during this period of transition between adolescence and adulthood. The heterogeneity of situations that exist in this stage has effects on the role that sport plays among young people, the meaning that it has in their lives, the motivations that give rise to its practice and its effects on quality of life. Probably the principal rupture is found in the predominance of a ludic conception of this activity during the first phase of youth (18-23 years old), in contrast to the emergence later (24-32 years old) of a perception more concerned with the benefits to health that are derived from sport. Differences due to age, incorporation into the labour market, emancipation, changes in social relations among peers or in the environment in which they live, lead to different speeds in this process, as do differences in the conception of the practice of sport and the barriers they find to do it. To understand this diversity of situations more accurately, in what follows, the form of sport as conceived in the two phases that differentiate young people have been analyzed. Abandonment of sport and physical activity in post-adolescence The first stage of youth is characterized by the ambiguity in the attitudes, behaviours and values that define individuals. This circumstance is marked by the transition toward adult life, determined by entry into the labour market and the acquisition of personal autonomy, while at the same time residues of adolescence persist, such as the importance of peer groups, continuing educational processes and economic and emotional dependence on parents. 132 SPORT, HEALTH AND QUALITY OF LIFE Discourses about sport in this stage are very influenced, therefore, by two essential components in the shaping of daily life: the beginning of working life and changes in the leisure and free time sphere.(2) Both these aspects intervene, above all, in the organization of time and the tasks that constitute the routine of daily life, which also affects the practice of sport. The new demands of work mean that the organization of free time takes on greater importance. This is because young people go from enjoying abundant free time to having it become a somewhat scarce resource. First man: [Sport] is more for minors, because now at our age, you are working until 6 or 7 in the afternoon… Second man: While you are studying, okay. Me, when I was studying, I was in sports competitions, I was in the sports school here, in football, in basketball. My younger brothers that are studying, the same, but I think that once you end your studies and begin to work, no more… The summer indoor soccer league, in winter, and not much else. (Young people, 18-22 years old, Puente Genil (Córdoba)) This perception of free time as a scarce resource, acquired by young people in this first phase, together with having begun to have a salary and greater independence, leads them to show more interest in «passive leisure» – closely related in turn with night time leisure –, tied to new forms of social relations and consumer practices in private places (bars, amusement arcades, shopping centres, etc.). Man: After a hard week of work, if you have it, well, when the weekend comes you like to go out and enjoy it. Woman: You can go out for a coffee with friends… Man: There are discotheques open. (Young people: 18-22 years old, Puente Genil (Córdoba)) This type of leisure and the implications that its practices entail are contrary to the demands of sport and the investment of will, effort and time that this requires. This situation leads to, given the limits of free time, sport and physical activity being in competition with these other leisure activities. In this situation, a fundamental element is the peer group. The peer group will continue having (2) Probably these changes will vary a lot with regards to those young people that are still studying and not working, and those that do competitive sports. However, due to limitations of the sample, here we will be referring to only those that are economically active. QUALITY OF LIFE, HEALTH AND PHYSICAL ACTIVITY IN THE DISCOURSES OF YOUNG PEOPLE AND SENIORS 133 great importance in the life of young people, which means that choices with respect to leisure practices are, to a great degree, established based on the choices that predominate in this group. The importance of the peer group has influence in two senses on the practice of sport. On the one hand, the practice of this activity can mean making an individual decision against the group or partner, thus the cost of deciding on the occupation of free time will be greater. Therefore, doing sport at this age, in many cases, means deciding between doing this activity or being with friends in the free time available after work. On the other hand, doing sport will be influenced by the type of sporting disciplines that are practiced in the peer group (individual or team), this being a possible motivation or excuse in the choice to do this activity instead of others during free time. Accordingly, if sport is practiced in the peer group, it is probable that even those not very interested will do it, and the reverse, if the peer group doesn’t share this interest, it can mean the abandonment of its practice even for those who are most interested. First man: I started with the idea of going running and the third day I stopped, because I was bored going alone. First woman: Man! Me, when I get together with my friends, it’s rare for us to do sport, if it’s not because it’s a holiday or something like that and you say: «Let’s play a little game of soccer», and we also play, the girls, even though we don’t know how, but it’s rare that we get together to do sport. (Young people, 18-22 years old, Puente Genil (Córdoba)) Among the youngest of this age group we see, therefore, a loss of importance in the meaning that sport has in their lives due to other elements, such as night time leisure and other forms of passive leisure, taking on greater importance in their lives, these being the basis upon which social relations in the peer group are articulated. This loss in the importance that sport has in the daily life of young people is explained equally by the lack of free time available upon entry into the working world and the dedication to studies, as by the predominance of a very positive self-perception of their state of health – which means they reveal no health concerns to attend to. However, despite this, it is certain that during this stage sport does not completely disappear from the life of young people, but rather it is located in an indeterminate space, without a concrete routine and done only occasionally. 134 SPORT, HEALTH AND QUALITY OF LIFE Recuperation of physical activity and/or sport at the end of youth The end of youth or young adulthood is characterized by the nearness of adult life and the elements that define it, such as full incorporation into the work world, emancipation as a reality and not an aspiration and the formation of a nuclear family, independent of its characteristics. In this stage of young adulthood, although all these milestones have not always been completed, in the majority of cases there has been entry into the working world and this constitutes a central aspect in their lives. For young people that are at this stage, work is the backbone of daily life. Through work the relationship between obligatory time and free time is structured, and work converts into the fundamental cornerstone of daily life. –Or you have to turn something important in at work the next day and you can’t go work out… You don’t have time; you have a job to do… (Man, 24-32 years old, Madrid) In daily life, sport reappears occupying a new place related to personal care and the need to adopt healthy habits. As previously indicated, the self-perception of health is constructed through daily experiences and the socialization process. Health and concern for health at these ages are related to aspects connected to work and lifestyle, the new forms that they take and the consequences they have. Therefore, sport in this stage of young adulthood, comes to be conceived as a means to obtain well-being, a way of dealing with problems that derive from work and its psychological consequences (stress, anxiety, depression…). Sport permits us to disconnect; it helps us to break with routine and liberates accumulated tensions. But in addition, sport makes it easier to confront a problem of specific concern, that of sedentarism. First man: I was wiped out and hadn’t played in two years and I couldn’t even run, I began to think about what bad shape I’m in. Second man: Before I did sport for fun and now I do it a more for necessity. First woman: (…) To maintain your body and not get fat … Second woman: (…) Now that summer’s coming everyone joins the gym or those that are members but don’t go now begin to go. First woman: You also can’t forget, we do sport not only to be in good shape but for back problems. I go swimming because of back problems, that’s also taking care of yourself… care of your health. QUALITY OF LIFE, HEALTH AND PHYSICAL ACTIVITY IN THE DISCOURSES OF YOUNG PEOPLE AND SENIORS 135 Second woman: If it reduces your stress that’s good. If it’s a way to be with others, good. If it’s a way to spend your time and not be at home on the sofa, which you don’t want to do because you are an active person, well better than. First woman: Of course, because maybe they had a more physical work, but in general we don’t have physical work. The majority of people have work… So you want to go out and move a little because you feel bad. (Young people, 24-32 years old, Madrid) Hence, the daily experience of deteriorating health, a result of contemporary forms of work, means that the need to take care of oneself emerges. In this context, the investment in time and effort that doing physical exercise and/ or sport requires seems relative. Given that doing sport, as a healthy habit, provides well-being and improvement in the quality of life, this investment becomes less costly. In this way, sport in this final stage of young adulthood begins to be taken on as a necessity and an obligation connected to personal care. First woman: Before we didn’t go to the gym, instead we went down to the square to play soccer or whatever, no? But now we go to the gym, in other words, it’s how to take care of yourself… Second woman: Before it was more for fun. First woman: It was just a game, it was to play, it wasn’t doing sport, because «I’m going to do sport» was playing basketball with my friends or whatever or running in the park. But now it’s not a game, now its: «I’m going to join the gym and I have to go, it’s like I have to make myself go…». (Young people, 24-32 years old, Madrid) Indeed, in this stage the peer group is losing importance in daily life, due to the difficulties of sharing the same pace of life because of work, one’s partner or family. These changes mean that, in comparison with the earlier phase, it is easier to make individual decisions regarding free time, which facilitates the decision to do sport. The practice of sports of an individual character, such as swimming, running or working out, begin to have greater relevance at these ages, something which has been confirmed in the quantitative analysis of the survey done as part of this study. These sports represent a great solution to the problem of often not having the company of the peer group and the need to do sport as a way of taking care of oneself. 136 SPORT, HEALTH AND QUALITY OF LIFE Despite the centrality of health in the practice of sport, other elements such as the enjoyment of playing and, increasingly, concern for physical image, also have influence at this stage. Third woman: No, I do sport because I like it and, since I like it, I’m free and I forget about other things. First woman: I think so, I think that underneath this it’s that we want to be in shape… maintain our bodies at a certain weight… Second woman: Health and having a good body, which psychologically makes you feel good, go and say: «I wear a size M», because of course if you use a L it seems you are obese, you are bigger, you say: «But what’s happening here?». (Young people, 24-32 years old, Madrid) Parents and children and sport: inculcating habits and their difficulties The meaning of sport at these ages, according to parents, is found in the tension between entertainment, tied to playing, the learning that comes from sport and the benefits it has on health. Parents relate sport with the development and growth of their children. Sport helps their children to grow and develop mentally and physically in a healthy manner. Regarding the physical aspects, sport, through the bodily activity that is involved, favours the development of motor skills and helps one enjoy physical health. –My son uses sport, what for him is sport, because my son was a very sedentary child, we make him do tennis. (Father, school parents’ association, Barcelona) Psychologically, sport aids through the things that are learned in its practice and the relationships between those that do it. At the same time, being connected in the majority of cases with winning and losing, sport is considered by parents like a small school of life, in which one learns how the world works and its values. First man: And the relationships they have, participating in collective play. First woman: Of course, the relationship between them. Second man: And winning, losing. QUALITY OF LIFE, HEALTH AND PHYSICAL ACTIVITY IN THE DISCOURSES OF YOUNG PEOPLE AND SENIORS 137 First man: It also serves to mature, because they find what they will also find in life. First woman: Sport gives you values that maybe you can’t find in other spaces… Second woman: Discipline, responsibility. (Parents, school parents’ association, Barcelona) Although children today are growing up in a society in which sport is fully institutionalized, in which there are many more sporting installations than just a few years ago, in which sport is imparted as a subject in school curriculums and is associated with a large number of positive benefits for health, its practice in this stage seems to face new difficulties derived from social changes produced in the last decade and their effects on the daily life of minors. According to their parents, sport and play among minors has changed in many aspects with respect to when they were at that same age. To understand sport, the meanings attributed by parents to the role it plays at these ages and its importance, these changes and how they affect the practice of sport must be taken into account. Sport, in their imaginary, is associated with the tensions that exist around the sporting practice of their children, its benefits, the barriers to doing it and their consequences. The relationship between these three elements and their perception are part of the changes that have been produced in contemporary societies. The principal change that parents point to is that sporting practice, or better said, doing physical activity as play, was the central element of free time during their childhood. In contrast, today their children have many more ways to entertain themselves, to fill their free time, among which physical activity is not necessarily the most important. The diversification of forms of leisure and, in concrete, passive leisure, has adverse effects on the choice of practicing sport in free time and, in contrast, increasingly favours minors having a sedentary lifestyle. –It’s the issue is that we talked about the PlayStation and things, now they get together and don’t even do… We played board games, we played games in the street with bottle caps, chalk, rubber bands. (Father, school parents’ association, Barcelona) In urban space, this change that parents identify is placed in relationship with the lack of safety perceived in public spaces (increase in traffic, lack of adequate 138 SPORT, HEALTH AND QUALITY OF LIFE spaces, the deterioration of strong social ties that existed in neighbourhoods, the appearance of new and unknown population groups), impeding children from occupying it and playing in it. This has a decisive effect on the free time of minors, the role of physical activity and sport and the forms under which this takes place. In the first place, because the practice of sport as play requires a physical environment where it can take place, and secondly, because, it also requires the possibility that a group of children meet to do it. Due to the difficulties in meeting these conditions, the practice of sport is displaced in the daily life of minors, becoming a controlled and regulated activity and increasingly connected to school as an obligatory subject or extracurricular activity. –The sun’s gone down, where’s the kid going to go? Because vacation still hasn’t begun. I go to school «x» or high school «a», and I go there and play in the facilities they have, in other words, I play basketball, football or I run, and there are two or three monitors that keep an eye on things… (Mother, school parents’ association, Barcelona) These changes lead parents to think that although sport and physical activity are good for their children’s health (their physical and mental well-being) and for their education, they see it as increasingly distant from playing and requiring greater effort to do it and for it to become part of the daily habits of their children. –That’s why I’m telling you. Sport has to be something that helps them and motivates them, something that makes them relate together, that makes them learn other values, not an obligation. (Mother, school parents’ association, Barcelona) The displacement of the physical activity of playing onto sport, understood as regulated physical activity which is done at concrete times, leads as a consequence to its distancing from the daily life of children and has to compete with other leisure and free time activities. In this sense, parents underline the need for this activity to be transmitted as an additional habit in life, not as an obligation. 4.5. Barriers to the practice of sport and physical exercise Among the senior population, the principal barrier for the practice of physical exercise and/or sport is state of health, resulting from the aging process. This QUALITY OF LIFE, HEALTH AND PHYSICAL ACTIVITY IN THE DISCOURSES OF YOUNG PEOPLE AND SENIORS 139 becomes a real barrier when it affects the specific capacities that a specific sporting activity demands, leaving the person physically incapable of doing it. When this doesn’t occur, but rather aging only gives rise to limitations specific to age, and the sporting activity that is done can be adapted to the possibilities of the older person, the barriers to practicing sport then become other issues of a psychological character, such as seeing oneself as incapable of doing it. –Paco, the monitor, is always saying that who can’t do it don’t do it. That you sit down and do what you can. (Woman, 60-75 years old, Antequera, (Málaga)) Another of the barriers that conditions the practice of sports among the population has to do with the social environment. In this area, the network of relationships and the roles that seniors carry out has a fundamental role, both because of the availability of free time that they enjoy, as for the symbolic support with which they are encouraged to practice sport. In this sense, as we have seen, older women that carry out the role of homemaker find themselves with more obstacles for doing sport as they enjoy less free time and receive less support from family members. First woman: It’s that this, this is what we lack, at our age. But, for example, in our home, they don’t believe it’s necessary… Second woman: Yes, because the first thing they say is: «With the problems you say you have, and now what do you want, get involved in something else? Are you going to make more problems for yourself?». Well then you continue with what you do. First woman: Listen! You say you are tired and now you are going to the gym. (Women, 60-75 years old, Antequera (Málaga)) Money has less weight than other elements in this relationship. This is for different reasons. On the one hand, in many cases the physical activity of seniors is limited to walking, for which money is not needed. On the other hand, at this age there are a great number of sporting activities that are subsidized, if not free. In examining the barriers connected to the practice of sport among the population of young people, it can be seen that in the majority of cases they have to do with their incorporation into the labour market and the emergence of new forms of passive leisure connected to consumption and night time leisure, 140 SPORT, HEALTH AND QUALITY OF LIFE and around which the sociability of young adults turns. In effect, independent of the stage of young adulthood, the principal obstacle to practicing sport is the lack of free time and in some cases, the limited ability to manage it. This lack of time is caused as much by one element as the other. –I still say what I said before: I think that it’s because of time and being tired that we have less and less free time. (Man, 18-22 years old, Puente Genil, (Córdoba)) Regarding other barriers, low salaries or the lack of economic resources typical for persons at these ages, as well as the weight of the peer group, are decisive elements in the practice of sport in young adulthood. In speaking about their children, parents that live in urban areas point to three fundamental barriers connected to sporting practice: the social environment, the habits of passive leisure and free time. Regarding the first of these barriers, parents believe that the lack of public spaces in the neighbourhood where children can move with autonomy and in a safe manner, where they can stay without worries, affects the practice of sport. –A moment arrives when we are cutting off the resources to our child: «You, there you can’t go. Not there either. Here there are those. Here you can’t»… Well, no! (Mother, school parents’ association, Barcelona) In addition, the lack of accessible and nearby public installations, or the fact that schools are closed outside of school hours, has a fundamental weight according to parents as it reduces the possibilities that minors have for practicing sport. –You know what happens? That the centres, hey! they close the grounds for the use and enjoyment of those of the centre. (Father, school parents’ association, Barcelona) The second barrier has to do with the forms of passive leisure that minors enjoy through audiovisual media and computers, such as videogame consoles, television or Internet, which, in many cases, shifts the practice of sport to the background in the free time and likes of minors. –There is another serious problem, I’ll go back again to what we were talking about before: we have a lot, a lot of the blame for the quality of life of our QUALITY OF LIFE, HEALTH AND PHYSICAL ACTIVITY IN THE DISCOURSES OF YOUNG PEOPLE AND SENIORS 141 children. And why do we have it? Because we scare them, more than you… than we think: «Listen, don’t go out, listen I don’t know what, listen. Instead of going out why don’t you stay and play here a bit? Turn on the PlayStation»… (Father, school parents’ association, Barcelona) The last barrier pointed out is given less importance: the lack of free time available given the hours spent in school, homework and extracurricular activities. However, this barrier diminishes when doing sport is among the extracurricular activities. 4.6. Sport and quality of life, a reciprocal relationship At the beginning of this chapter we indicated that the relationship between sport, health and quality of life has a circular character; it is reciprocal. As has been seen in the fragments of the interviews, sporting practice seems to contribute to obtaining a good quality of life, to improving our state of physical and psychological health, but at the same time, having a good quality of life is a basic condition for doing sport. In the discourses obtained through the qualitative research, quality of life is understood as a sort of balance obtained through a series of elements of both material and immaterial character (health, management of time, work and social environment). The practice of sport, as we have had the opportunity to see, requires the availability of free time, some basic conditions of health, the existence of installations or spaces for doing sport, and sometimes all of this is related to enjoying a sufficiently comfortable economic situation. As a consequence, the personal investment that practicing sport demands is determined by the presence of these elements of quality of life, converting them into a means or a barrier for the practice of sport based on how they manifest themselves in our lives. The free time that is available in daily life has a fundamental effect on sporting practice. The less time that is available, the more expensive is the decision to invest it in practicing sport. –You, if you want, you can use it [time], what happens is that later you don’t have time for yourself, to do anything, you don’t have any time left. If you use if for sport, then you can’t do everything else… (Woman, 18-22 years old, Puente Genil (Córdoba)) 142 SPORT, HEALTH AND QUALITY OF LIFE Health is another of the conditions necessary for doing sport, as a lack of health impedes its practice. Health affects the effort that sport requires, both on the physical level – linked to our bodies – and the mental – linked to our desire and mood. Work influences the practice of sport in diverse manners. One of them is of a structural character, as the practice of sport often requires an economic investment, whether for adequate clothing, equipment or, in some cases, the rental of spaces made for its practice or the contracting of services for learning and training. Another way in which work influences the practice of sport is in determining the availability of free time and, in addition, of a specific state of mind, which can stimulate and/or condition to a greater or lesser degree the practice of sport. The social environment is another element which affects the quality of life and, therefore, the practice of sport. Social environment is here understood as both the network of social relations in which the life of the individual develops – which condition access to different resources (Bourdieu, 1997) – as well as the physical space in which daily life takes place and, therefore, the practice of sport. –If I don’t have someone in my family, I have to look for a family member or a friend. Listen, do me a favour, stay for an hour and a half, it’s that I’m going for a walk. And it costs me money, because, you know, no one’s going to come for free and take care of my house… (Woman, 60-75 years old, Antequera, (Málaga)) The social environment in which one lives conditions the investments required for doing sport, having an impact on its cost. For example, the existence of free and accessible spaces and sporting installations can have a direct effect on this practice, reducing the investment of time and money necessary; especially among specific populations, such as seniors and young people who have fewer resources to defray the costs of access to these types of installations. –The gym up to a certain age, because, of course, now we don’t pay, but until now we had to pay. (Woman, 60-75 years old, Antequera, (Málaga)) Although the barriers that affect the practice of sport respond to these elements, they manifest themselves differently among the different populations under study. As can be observed, among the senior population the principal barrier QUALITY OF LIFE, HEALTH AND PHYSICAL ACTIVITY IN THE DISCOURSES OF YOUNG PEOPLE AND SENIORS 143 is the state of health that tends to accompany the aging process. Regarding young adults, the barriers are associated more with working conditions, in concrete, with the long working day, and also with the emergence of new leisure practices (night time leisure and passive leisure), which compete with the practice of sport. Among the parents of the school parents’ associations interviewed, another barrier to the practice of physical exercise and sport that they mention when referring to their children, is the safety of public spaces in cities and the lack of sporting installations open outside of school hours. 144 SPORT, HEALTH AND QUALITY OF LIFE V. Critical sense versus common sense. The discourse of the experts This chapter gathers together the principal contributions made by a group of experts on the relationships between sport, health and quality of life. These experts were chosen for their links to the world of sport, but with multidisciplinary criteria, in this way integrating different perspectives (see the Methodological appendix). Among those interviewed we have counted on four experts in physical education, sports medicine, medicine and nutrition, and physiotherapy, plus a family doctor and the manager of an association dedicated to the promotion of sport. Two of the interviewed are university professors, and in addition to teaching they are dedicated to research in sport. Two other professionals are engaged in providing direct care to the population and, in maintaining daily contact with the pathologies of this population, understand very well the properties of sport as a preventative or therapeutic tool. Another of the interviewed has direct contact with amateur athletes, who in many cases follow a very intense sporting practice. Finally, one of the interviewed works promoting team sports among children and adolescents. As can be seen, among all of them we have combined perspectives of professionals that specialize in sporting practice and in research on sport. The perspectives of professionals from the healthcare system are also integrated, so we can see how the population lives the doing of physical activity and sport. Finally, regarding the practice of sport among children and adolescents and its impact on their habits of personal care, we look at this activity as a factor in the prevention of the consumption of substances harmful to health. The results reached from these interviews are very timely because the accumulated experience of these experts in empirical research, the healthcare system and the management of sports organizations complements some of CRITICAL SENSE VERSUS COMMON SENSE. THE DISCOURSE OF THE EXPERTS 145 what was observed in the quantitative study. What’s more, these results permit us to advance to a level of greater rigor in regards to the impact that sport and physical activity have on health and well-being, which is very useful in countering the common sense opinions that generally prevail in social discourses. To achieve this objective, the specialists interviewed were consulted on the concepts of «sport», «health» and «quality of life», the interrelationship and influence of these elements – placing the accent on their impact on young people and seniors – , the situation of the practice of sport in Spain, and the strategies and resources that are used to promote sport among the population. In the interviews it was possible to confirm that their connection to the population serves to consolidate and frame their opinions. 5.1. Sport, health and quality of life: the scientific point of view The concept of «sport» In the interviews with experts, sport is the concept which raised the least discrepancies of the three concepts discussed. The level of abstraction with which it is defined is greater the more the interviewed are connected to scientific activity. Although the interviewed establish a clear difference between sport and physical activity, in the course of the interview the use of one term or the other became indifferent. This can be due to the word «sport» currently having acquired a polysemous character, conceiving it as having a wide range of meanings. Precisely, in article 2 of the European Sports Charter from 1992 a definition is used which expresses this character: «“Sport” refers to all forms of physical activity which, through casual or organized participation, aim at expressing or improving physical fitness and mental well-being, forming social relationships or obtaining results in competition at all levels». Hence, frequently the interviewed refused to use the term «sport», substituting it for the term «activity» or «physical exercise». –Man, the interactions, we want to have them very clear. It’s more, although sport has been the word that has been used, we are much more in favour of physical activity. When we were debating the name of the research group we even ended up using both. (Doctor of sports sciences, Granada) 146 SPORT, HEALTH AND QUALITY OF LIFE Some of the interviewed have tried to objectify it as far as possible in the amount and intensity of physical activity necessary to generate benefits to health and the quality of life. This is important because, as has been pointed out, sometimes a false sensation can be generated from sporting activity, as practicing a sport can give the appearance that a significant expenditure of energy is taking place when that is not the case. In a more or less conscious manner, for the experts interviewed, the key to considering a physical activity as healthy is in the expenditure of energy. Based on this, various more or less precise indicators have been formulated. Thus, it must be an activity that implies a use of energy superior to basal energy expenditure, that varies, is not monotonous and, if possible, that is done in a group. We have an indicator of the amount of physical activity necessary with the level of energetic expenditure that scientific research sets: a weekly average of energy expenditure superior to basal expenditure by between 800 and 2,000 kilocalories. –No, physical activity would be that which is above basal level and which, for example, beginning from 10,000 steps per day we have some metabolic benefits… (Medical doctor, Barcelona) As can be seen from the extract, the doctor interviewed uses a measure of the intensity of physical activity set at 10,000 steps per day, which for older persons would mean a physical activity of 30 minutes of aerobic exercise and which implies the use of large muscle groups and entails stretching and minor strength exercises. The concept of «health» This concept was barely defined by those interviewed, who saw in it both a vague and little structured objective. Those interviewed most connected to research work have been the ones that have expressed a more structured vision of health. For them, the concept groups different dimensions or factors of the person, among which there is agreement in pointing to health as incorporating purely biological aspects, although that is not the term always used, as there are those that do not explicitly refer to health, it being incorporated in an implicit manner in the biochemical aspects of the person. CRITICAL SENSE VERSUS COMMON SENSE. THE DISCOURSE OF THE EXPERTS 147 –(…) We begin from the dynamic of the research we have, trying to always do it from a multi-factorial focus. There are always biological variables, psychological variables, there are social variables and environmental variables. We believe that something which doesn’t combine these four elements ends up relatively weak… (Doctor of sports sciences, Granada) The dimensions of health mentioned are biological, social, environmental, mental, biochemical, structural and psychological. What these dimensions are for each expert interviewed is implicit in their discourses on the concept of «health», as none of them managed to provide a definition that covered all of them. Health is described, among professionals of physical activity, sport and health as a situation related to the capacity to realize acts linked to physical work and functional capacity. This capacity is connected to physical, mental and social well-being, and can only be measured in relation to its loss or its optimal state. This interpretation of health integrates the antonymous concepts of health and illness in a continuum in which optimal health permits a functional development sufficient to establish well-being in the three basic dimensions of health (physical, mental and social). Below this optimum we would talk about «illness». By incorporating illness into the health continuum, the perspective of the experts interviewed approaches the international attempt to define health as something of value in itself, distancing it from the definition of health as the absence of illness. –The extreme pole is the loss of health, death, or you are very ill, let’s say, with an important disability. And the optimal pole, what is it? Well, the best you’ve felt. And we are always at these poles. Therefore, we call them, and they are understood as degrees of health, the possibilities that I have to raise issues linked to the quality of life and, therefore, to the capacity for physical work, to the functional capacity… (Medical doctor, León) However, this last comment is the definition of health from the perspective of an interviewee who provides medical care, who defines it as «absence of illness in which the subject is in a state of physical, psychological and emotional wellbeing». Together with this, which is close to the international definition of health, 148 SPORT, HEALTH AND QUALITY OF LIFE other definitions have been even more reductive, as health is simply reduced to «physical and psychological well-being», and even more, «to the state in which the body feels good with itself». The rest of the definitions merely touch on the dimensions or factors implicated without even establishing an interrelationship between them that would illuminate a concept of health at a higher level for us. But, if the explicit definition of health is not very clarifying for laypersons, the use of the concept is, even more so in its interrelationship with the concept of quality of life. The concept of «quality of life» All those interviewed related the concept of «quality of life» with the conservation of health, in this sense in agreement with the evidence obtained in the quantitative part of this study and in the part based on group interviews among young persons and seniors. «Quality of life» is for everyone a broader concept than that of «health», as it includes the possibility of personal realization in all the dimensions of life, health being a basic condition among these. In effect, the absence of health, in other words, illness, either denies one the possibility of enjoying quality of life, or it diminishes the level of quality of life. –(…) I think having quality of life is having good health, it’s also having a… it’s an agreeable situation that surrounds us. (Manager of Sporting Association, Madrid) Quality of life is a vital aspiration that does not only depend on health. In this part of the study we will refer to all of the dimensions of health, on what all are based on in some form: it is assumed that health must exist for there to be quality of life, because quality of life is the full functional capacity of the human being in all his/her dimensions, without impairment of his/ her possibilities for realization; it means the capacity to do what one wants, because the body is capable of responding to the desires of the mind and this is adapted to the normal possibilities of the body; quality of life permits the enjoyment of the physical environment and a network of social relations; it is having the independence that comes from good health.(1) (1) The perspective of the majority of those interviewed on quality of life starts outside of the subject, as if one could measure its level, calibrate it and assess it from outside. The level of quality of life, although it is not quantitatively measurable, is interpretable taking into account, in addition to health, other vital dimensions. CRITICAL SENSE VERSUS COMMON SENSE. THE DISCOURSE OF THE EXPERTS 149 –(…) If we take as the starting point that we live in technologically advanced developed societies, where basic needs are covered (…) in other words, our concept of quality of life is accompanied by the concept of health, what we call quality of life is related to or oriented toward health, because we take as a given that base… (Doctor in sports sciences, Granada) From the perspective of outside experts, there is a certain general agreement about the fact that a harmonious circle of social relations is very important to establish the level of quality of life. A standard of living sufficient to satisfy primary human needs is necessary, as quality of life is situated at higher levels of personal development within the hierarchy of human needs. The socioeconomic situation must favour a sufficient standard of living for personal realization. But quality of life is also linked with the standard of living in its relationship to all the dimensions of being human: physical, psychological and social. It is also linked with the standard of living because, in addition to health, it depends on the network of social relations and family, because quality of life is the enjoyment of the environment around you, and this requires harmony in the network of relations. In this way the experts interviewed incorporate socioeconomic conditions into the concept of quality of life. –Yes, because we can say that the quality of life of a person has a relationship to one’s independence in the activity of daily life. And if you have a restriction, because of illness, your quality of life is diminished, that’s clear. If sport helps you to improve it, it is helping to improve your quality of life. Not only yours, but yours and that of the persons around you. (Doctor in physiotherapy, Córdoba) Nevertheless, this largely shared perspective by the external observer, the expert, though not negating the capacity to evaluate the quality of life of a subject from outside, alludes to the fact that, ultimately, quality of life is still the subjective perception of each individual, so that the same living conditions can mean a satisfactory quality of life for some and an unsatisfactory quality of life for others. –No, I think that quality of life is an individual perception, therefore for me it is individual, in other words, one person in the same situation can be content and the other could be miserable. (Manager, sporting association, Madrid) 150 SPORT, HEALTH AND QUALITY OF LIFE As has been observed, the dilemma between objective and subjective indicators of quality of life, already mentioned in previous sections of this chapter, also appears in the answers of the experts interviewed. The interrelationship between the concepts «sport», «health» and «quality of life» As the choice of experts interviewed was made giving priority to a profile of individuals socially and professionally dedicated to sport, it seems logical that in their analyzing the interrelationship of the concepts «sport», «health» and «quality of life», sport would be the cornerstone of the interrelationship. The interrelationship that the experts describe has a predominantly linear character, according to which physical activity and sport affect the other dimensions. The experts described three types of linear relationships. The experts whose work is dedicated to research and that have a specialized medical training oriented toward sport (whether in its amateur or therapeutic facet), have described a linear relationship according to which the practice of sport will improve health and better health will result in a better quality of life. As a consequence, this discourse emphasizes the physical and biological dimensions of physical activity and sport much more so than the psychological or social benefits. –(…) For me these three concepts are interconnected. Thus, it is precisely the reason why they encourage, for example, physical activity among seniors. Why? To improve their functional capacity for movement and, therefore, permit them to execute more types of activities. This leads to more social relations, better mood, therefore better quality of life. (Medical doctor, León) For their part, the experts connected to social intervention programs for the promotion of sporting habits among the population have described a direct linear relationship, but with a dual perspective. On the one hand, the medical vision, which centres its discourse on the medical-therapeutic benefits that physical activity and sport have, and, on the other hand, the social vision, that directly ties sport to the social benefits it produces for those who do these activities. –(…) In other words, quality of life I think is like they say in that song, «health, money and love». In other words, to have quality of life I think is to have good health, to also have a pleasant situation around us… (Manager of sporting association, Madrid) CRITICAL SENSE VERSUS COMMON SENSE. THE DISCOURSE OF THE EXPERTS 151 In what follows we will see what influence sport has, based on the accumulated experience of these experts, on the physical, psychological and social dimensions of the population. The influence of sport on the human body The benefits of sport on the physical and biological dimension of the human being has been extensively described by experts. Some studies deal with the positive aspects (what improvements do physical activity and sport produce) and others deal with negative aspects (what harm comes from inactivity). In general, it is confirmed that sport prevents illness and disease, and that it contributes to treatment when one is ill. And this is so because, according to the experts interviewed, physical activity improves the functioning of the human body and organ systems, especially the musculoskeletal and immune systems, balancing the blood and lymph, positively activating the hormonal system, improving motor function and, in short, contributing to the homeostatic balance of the body. –Sport aids not only in mobilizing body segments, but aids in rebalancing the homeostasis of the body, mobilizing blood, lymph. This makes the immune system stronger, our defence system is stimulated and strengthened, and this prevents illnesses… (Doctor in physiotherapy, Córdoba) On the physical dimension, two closed cycles are described by one of the experts interviewed. According to the first, the lack of physical activity provokes musculoskeletal diseases and a deficit in movement that impedes and makes physical activity difficult. According to the second cycle, physical activity, by generating endorphins that create well-being, boosts doing more physical activity. –Today there exist many studies that demonstrate the direct relationship between sedentarism, hypokinetic diseases, cardiovascular conditions and obesity (…) with what that entails for deficit of movement (…). Physical exercise, even at early ages, increases what is called exercise adherence, no? And regardless of what physical exercise you do, in function of the amount and the intensity of what you do, you are able to release endorphins that, in turn, are a continual inducement for doing physical exercise… (Medical doctor, León) 152 SPORT, HEALTH AND QUALITY OF LIFE These two cycles (see graph 5.1) exemplify the importance that habits of physical activity have. If, as it seems, the practice of physical activity feeds on itself, as does the lack of activity, then both behaviours have important social implications, namely: the rigid division of the population into two blocks: those that practice sport and those that do not. And between them there do not exist sufficiently strong connections to incite the passage from inactive lifestyles to active lifestyles. The predominance of the cycle of inactivity is what is spreading sedentarism in society. For the experts interviewed, it is clear that sedentarism is causing serious pathologies, the increase in the percentages of obesity in the population standing out. The social trends regarding obesity are sufficiently negative that they cannot be ignored, but this does not take away from the importance of hypokinetic illnesses (coronary diseases, hyperlipidemia, musculoskeletal disorders) that reduce muscular and bone mass and diminish functional capacity. –We are in a country where sedentarism is, despite the favourable climate that we have, very prevalent, childhood obesity is now the highest in Europe. (Medical doctor, Barcelona) Of course the benefits of sport are not limited to physical aspects; the psychological area also appears in the responses gathered. GRAPH 5.1 Cycles of inactivity and activity, accordind to one of the experts CYCLE OF INACTIVITY CYCLE OF ACTIVITY Inactivity Physical activity Deficit of movement Osteo-muscular feeling of illnesses Well-being Generation of endorphins Source: Elaboration by authors from interviews. CRITICAL SENSE VERSUS COMMON SENSE. THE DISCOURSE OF THE EXPERTS 153 The influence of sport on psychological well-being The influence of sport on psychological well-being is evident for all those interviewed, which they present as a consequence of the physical well-being that sport generates. The positive influence is produced because physical activity stimulates the production of hormones that improve psychological well-being, so that sport also has a positive influence on psychological illnesses, improves the psychomotor capacity of the individual and, as a consequence, increases the personal autonomy that the subject perceives, which positively influences his/ her mood. –(…) Exercise is a good anxiolytic and in some way reduces the consumption of hypnotics and medication (…), improves depression by the continued synthesis of endorphins. Therefore it is a good antidepressant. (Medical doctor, Barcelona) –I think so, I think that all the psychological is also connected with social aspects. I think that sport from a psychological perspective permits one to be more relaxed, tranquil, to burn adrenaline, etc. (…) and this has an impact on the social aspect and vice versa. When one finds oneself doing things with others, you find connections with others, you have better social relations, this is undoubtedly a psychological benefit to people. (Manager of sporting association, Madrid) The experts on this theme that have a linear perspective on the interrelationship of these concepts emphasize more the medical aspects of psychological well-being, particularly those that have a medicalized vision. From this perspective, they emphasize the improvements that physical activity produces in the well-being of persons that suffer depressive disorders, as it reduces the gravity of the illness and also the necessity for drugs. –(…) Because from a psychological point of view, I am increasingly convinced of the importance that doing physical activity has, no? The whole theme of self-esteem, that above all you feel better about yourself, a better self-image, there’s no depression, for the synthesis of endorphins, this analgesic effect and euphoric effect, social relations… (Doctor in medicine and nutrition, Granada) 154 SPORT, HEALTH AND QUALITY OF LIFE The experts interviewed that intervene in this field from a more practical perspective on sport or that are involved in sport research, also see a linear relationship between sport and psychological well-being, but they centre more on broader psychological than psychiatric aspects of psychological well-being. Thus, they say that physical activity improves well-being, reduces stress, increases self-esteem, strengthens emotional control, reduces the propensity for mental disorders and improves psychic well-being, as a consequence of the better social relationships that it facilitates. –(…) There is a study published which has demonstrated that doing a sporting activity improves depression. In other words, that regular sporting activity, not momentary, improves one’s state of mind, state of happiness. (Doctor of physiotherapy, Córdoba) Finally, among those who place greater emphasis on the social vision of sport, they highlight the psychological benefits that are produced by changes in the behaviour of the person. A more relaxed, tranquil and less aggressive behaviour is what athletes achieve, as a consequence of the improvements made in the social dimension of their lives: more and better social relations which avoid isolation and provide greater security. And it is like this because inactive persons are psychologically dependent as a consequence of this social deficit. –Social skills are very important for one to be able to manage in life, and I believe that sport is a good tool for working on individual skills that then have a social aspect, such as assertiveness, decision-making, emotional control, problem-solving… (Manager of sporting association, Madrid) Thus, the psychological benefits join with the physical benefits as aspects derived from the practice of sport and that, at the same time, reinforce it. The panorama, however, would be incomplete in the eyes of those interviewed if we did not take into account the social benefits that the practice of sport involves. The influence of sport on social well-being The improvements in social well-being that physical activity provokes are accepted by all of the experts interviewed, but in different ways depending CRITICAL SENSE VERSUS COMMON SENSE. THE DISCOURSE OF THE EXPERTS 155 on their perspectives. The perspective that is less specific regarding these improvements is that of the medical vision of the interrelationship, which in general terms sees physical activity as positive because it improves sociability – in particular among those persons that are socially isolated, such as seniors. Those interviewed connected to services for seniors highlight that sociability is strengthened because social relations within the family environment also improve. All this happens because with physical activity, the self-esteem and physical capacity of seniors improves and, as a consequence, social relations also evidently improve. –(…) An example that I always use when I am giving a talk or classes is the issue of seniors. Seniors have a class at 12 o’clock and it ends up that at 11 you see them there in the installation, at 11 they are walking around talking to each other (…) and they leave at one, and at one they leave talking with each other again… (Doctor in medicine and nutrition, Granada) From the perspective of palliative intervention the fact that sport prevents illness and injuries which disrupt family relations stands out, as both physical ailments as well as psychological ones have relational and socioeconomic consequences for the family. By preventing this, sport improves personal independence and betters the general quality of life of those who practice it. –(…) I often find in my practice that when someone is injured, really injured (…). It produces a disruption in the middle of the family because of the person’s state of mind, because he or she can’t go to work, because if he or she is selfemployed income decreases, etc., etc. And this is a socioeconomic problem, we can say it then: sport, evidently to a certain degree, prevents these types of problems. (Doctor of physiotherapy, Córdoba) From the perspective of sport research what stands out is the social wellbeing that physical activity produces as a consequence of a third closed cycle (see graph 5.2). Sport, in producing psychological well-being and euphoria, provides better social and collective relations, which reinforce adherence to programs of physical activity. Physical activity is not only boosted by the endorphins that it generates but also by the improvements in social life that practitioners of sport get from its collective activities. 156 SPORT, HEALTH AND QUALITY OF LIFE –(…) Exercise doesn’t stop having an aesthetic component. I want to do exercise sometimes, not as a source of health, but rather to improve my body image. To the extent that I am able to achieve those benefits, it reinforces the stimulus to continue… (Medical doctor, León) The expert interviewed that has a social vision of the interrelationship emphasizes the social benefits that the collective practice of sport provides. Given his involvement with social intervention among young people it seems logical that he would focus on the social benefits more than the less evident in the short term, physical benefits on health and quality of life among this population group. Team sport educates in group consumer behaviour and group lifestyles that prevent the appearance of socially deviant behaviour. Physical activity does not only prevent these risks, it also improves individual social skills: it produces greater assertiveness, improves decision-making abilities, produces greater emotional control and it increases problem-solving skills. –(…) Our programs, what they work on above all is the issue of social skills. (…) The importance of sport also with everything related to community and with relations with others. (…) Sport is a good tool for working on individual skills, that later have a social aspect, such as assertiveness, decision-making, emotional control, problem-solving… (Manager of sporting association, Madrid) Another less emphasized social benefit, but no less important, is related to the impact of the practice of sport on the workplace. Based on knowledge from a series of studies on the impact of sport on the carrying out of work and professional responsibilities, some of the experts take into account the conclusions of studies that are developing around the ergonomics of work and the prevention of illnesses and accidents at work, through the promotion of physical activity outside and during the work day. In this sense, it seems that physical activity produces obvious improvements in work performance, which increases the productivity at work among those employees that do physical activity and also, as a result, their employability. –(…) Physical activity during the work day or outside of the work day, if it improves performance, it’s being looked at (…) There are studies that confirm CRITICAL SENSE VERSUS COMMON SENSE. THE DISCOURSE OF THE EXPERTS 157 GRAPH 5.2 The cycle of activity: inclusion of the social dimension CYCLE OF ACTIVITY Physical activity Improvement in social relations Feeling of well-being Generation of endorphins Source: Elaboration by authors from interviews. it, there are studies that show no effect at all, but almost no study has shown that there are negative effects. So, to start with, we can say it’s recommendable… (Doctor in sport sciences, Granada) In what follows we set out the qualifications that are added to this general vision of the influence of sport on the different spheres of the individual’s life when the experts interviewed focus on young people and seniors as differentiated groups. The distinct influence of physical activity on young people and seniors The most widespread opinion among the experts is that the practice of sport not only has immediate physical benefits, but an important social component among young people. In addition, those benefits are found to be related to the development of the personality and with education in hygienic and healthy habits which are less perceptible in the short term, but lasting in time. –(…) Prevention is education, and what you learn when you are young, what you learn as a child is part of the character of a person and later you will have it during your whole life. (Manager of sporting association, Madrid) To obtain these benefits it is necessary that sport in children and young people have certain determined characteristics. The opinion shared by the experts is that young people must practice a sport oriented toward having fun and in 158 SPORT, HEALTH AND QUALITY OF LIFE social relations with their peers, relegating competitive sport to the background, because it has a higher risk of provoking abandonment when the participant perceives that he/she is not having success in competition. –This has been one of the biggest mistakes. For example, internationally there is a lot of analysis of why there is so much abandonment of physical activity and sporting practice in adolescence, and one of the many theories is that a lot of it is due to the emphasis on competition. The competitive thing in the end, the only person who stays in the competitive thing is the good one. (Doctor in sport sciences, Granada) Children and adolescents should do varied physical activity and in a group to feel motivated, as the principal source of enjoyment is the participation and integration in the group. In this way, it was foreseeable that one of the experts interviewed would state that the school is the place of reference (and strategically) for promoting sport among children and adolescents, because only the school can provide a wide sporting offer capable of including all children and adolescents, who have different tastes and capacities. –Therefore, not only is it necessary that the school, to call it that, offers the possibility of practicing all types of sports, but that later when going to sign up to one or the other they are going to do it in groups, it’s going to be a group of friends that are going to sign up to that sport. (Medical doctor, León) The physical benefits of sport are immediate and tangible for young people, and they materialize in improvements in general physical ability and in health. But, for the experts, more important than these are the behavioural benefits and the acquisition of habits. Thus, sport betters the diet, improves sleep, makes young people more respectful, more self-disciplined and responsible, increases their motivation and distances them from deviant behaviour. –These young people that do exercise will have good eating habits, won’t have toxic habits, probably good sleeping habits, consumption of substances, what we commented on, the socialization, the respect, training, they will improve their complete physical condition. (Medical doctor, Barcelona) CRITICAL SENSE VERSUS COMMON SENSE. THE DISCOURSE OF THE EXPERTS 159 It is with the behavioural benefits where the experts indicate that the social benefits begin. With sport, the young person acquires a lasting benefit in his/ her life, which manifests in the behaviours and also in the acceptance of social values that improve personal development and relational skills. Through sport, the young person becomes accustomed to social relations, sets collective goals and as a result, fully develops his/her social skills, which will later be so important in family and work life, and in relations among peers. –(…) What young people look for in sport are things, often, like relating with others, like setting goals together, as can be in competition, and also to look good. (Manager of sporting association, Madrid) These benefits justify the investment in sporting activities for youth, but their importance grows if we take into account the current situation of this group. Indications are that, although in the history of humanity children have seen their parents die, the situation is currently reversing, and in the coming decades parents will become accustomed to seeing their children die. This is explained by the spread among young people of sedentary lifestyles at epidemic levels. The experts point out that young people have lost the Mediterranean diet of their parents and have an unbalanced diet; their work and study environments do not favour physical work; their leisure habits are passive and encourage even more sedentarism, and the risk of ingesting toxic substances is increasingly high. The consequences are manifesting in a wide range of biochemical imbalances in their bodies which will provoke, in the medium term, a health catastrophe. –The great majority of the elderly living now have good health (…) And this is really, really surprising. Among these young people, their diet is no longer the habitual Mediterranean diet (…) the majority spend the working day sitting, they get about in cars, their hobbies, interests, well, Internet, all these things are practically also very sedentary and their cholesterol levels, for example, are now much higher (…) and when Doctor X in the Advisory Council recommended, okay, we said, didn’t we?, that parents will be burying their children… The truth is that a generation is here that is frightening at the level of the cardiovascular risk they have… (Medical doctor, Barcelona) 160 SPORT, HEALTH AND QUALITY OF LIFE From this same perspective, the health situation of seniors has been described as the polar opposite of that of young people. Seniors today generally have good health, enjoy a Mediterranean diet and lead and have led to a good degree a physically active life, which improves the other aspects of health and well-being. –The great majority of the elderly living now have good health. They are individuals that have followed a Mediterranean diet throughout their lives (…) The majority come from rural areas where there was no deprivation when it came to food. Many of them did relatively physical exercise or worked in agriculture, [when] it wasn’t as mechanized as it is now. These people are healthier than many of their grandchildren. And the truth is, this is really surprising. (Medical doctor, Barcelona) Does this mean that seniors do not need to do programmed or regular sport or physical activity? That is not the opinion of the experts. Sport is beneficial at all ages, and improvements in health and in the quality of life is evident in all of them, especially among seniors. The differences that our experts point out between seniors that are active and those that are inactive are that active seniors live longer, have more autonomy and greater quality of life, while inactive seniors are headed toward suffering obesity and concomitant pathologies, in addition to having less body flexibility and a worse perception of themselves, which redounds in a worse quality of life in general. –Among the elderly what we see is that people that have the same age are sitting next to each other in the waiting room and their physical condition can be very different. We have eighty year olds, eighty five year olds, eighty eight year olds that have a fantastic quality of life, people that are completely autonomous, that go out every day for a walk, that do their shopping, that go and play petanque or go to the pool to do some type of activity and these are people with an enviable quality of life, and others quite a bit younger who, for the pathologies they suffer (…) don’t move. This makes your perception of health much worse, your quality of life, your flexibility, your mobility, your social life and all that… (Medical doctor, Barcelona) CRITICAL SENSE VERSUS COMMON SENSE. THE DISCOURSE OF THE EXPERTS 161 For those interviewed, physical activity impacts on the situation of seniors in three different and not exclusive ways: physical activity is therapeutic, because it improves health, aids in the prevention of illness and improves the social life of seniors who are at risk of loneliness and lack of relationships. The experts are in agreement on the benefits of physical activity on the physical and psychological health of seniors. Among these benefits they point to the following: improvement in self-esteem and self-image, a reduction in the risk of depression and relief of existing depression, decrease in pain and increase in quality of life, reinforcement of healthy diets and of good health in general, the modification of musculoskeletal composition, the link of sport with greater intellectual capacity and the prevention of the deterioration associated with age and hypokinetic pathologies. –But when we analyze body composition, weight hasn’t changed but fats have decreased because muscle has increased. (Medical doctor, León) –(…) From a psychological perspective, I am more and more convinced of the importance that doing physical exercise has, right? The whole theme of selfesteem, that above all they feel much better about themselves, a self-image… (Doctor of medicine and nutrition, Granada) Regarding the social benefits, for seniors the focus is on that physical activity provides a meeting place for seniors, and this increases their network of social relations. Thanks to physical activity they form groups, and these groups stimulate interpersonal relationships which increase the opportunities to improve social skills and family relations. –(…) When they continue walking the excuse is not cholesterol. And I have often even seen, that when these people that have become hooked on a physical activity, once they have resolved the pathology, continue hooked on sport, because they have seen that it is a means of escape, a way of relating. (Doctor in physiotherapy, Córdoba) But how can physical activity and sport be promoted among seniors? While all the experts interviewed are in agreement that social benefits are the principal motivating factor for the practice of physical activity among seniors, on the motivation that the therapeutic and preventative benefits generate there is no unanimous opinion among them. 162 SPORT, HEALTH AND QUALITY OF LIFE –Sport among seniors is used as a meeting point. It is an excuse to get out of the house, get together with friends, talk, etc. (Doctor in physiotherapy, Córdoba) Among the experts interviewed there are those that believe that seniors are only looking to sport to preserve their health so they do not become ill and do not have aches and pains, and there are those of the opinion that they are looking to lose weight. Either way, to the extent that seniors are successful it reinforces sporting activity, but if they are not they abandon sport, as it seems that among seniors the benefits of sport are not as evident as among young people. In contrast, there are those interviewed that, from a perspective of providing care to seniors, think that those physical benefits are enough to promote sport among this group, though they do not ignore the motivating capacity that social relations have. Hence, we can say that, although therapeutic and preventative benefits have an important influence in promoting physical activity among seniors, in agreement with the experts interviewed, to motivate physical activity the social benefits obtained from this activity are of even greater importance. The following comments present examples of this range of objectives (related to health and social life) that seniors pursue through physical activity: –In old age you sign up to those programs to achieve a series of objectives, (…) when they talk about improving their health almost always this is connected to issues of obesity, reduction of weight. (Medical doctor, León) –[Seniors] look to have this good appearance, they are not looking for competition, what they are often looking for, is not having aches and pains, not having problems. (Manager of sporting association, Madrid) Faced with this conclusion, the strategy mentioned by one of the experts interviewed to promote physical activity in all age groups acquires great importance. This consists in knowing the expectations and interests of the concrete groups so that it is possible to motivate them. In the case of seniors, two reasons for rejecting physical activity have been identified: one, that of seniors that have never done physical activity during their lives, alleging lack of habit and time for not beginning to do it; and, the other, the rejection of activity CRITICAL SENSE VERSUS COMMON SENSE. THE DISCOURSE OF THE EXPERTS 163 by those seniors that, having been habituated to competitive sport during their lives, do not feel sufficiently stimulated by sport now that it no longer has that competitive character. This implies that different sporting alternatives have to be designed and, probably multiple offers, such as in the case of young people of school age. –(…) There are older people that (…) are afraid to begin, right?, because they’ll look bad in front of others, for example, right?, or because they have a lot of social, work or family commitments, and they constantly tell us they don’t have time, that they can’t… (Doctor in sport sciences, Granada) In any case, some argue that at any time a sport program can be planned as long as it is not very demanding. It is only necessary to respect the dynamic of «the virtuous circle of physical activity», which could be formulated in the following form: with physical activity one improves physically and psychologically, which in turn raises self-esteem and this facilitates social relations, which reinforce, in turn, the frequency of physical activity. –And almost all recent studies, all the works published, each one in its field, that are dedicated to analyzing these issues, a lot of Americans, from Northern Europe don’t only say this, but also that it doesn’t matter the period of life in which one begins to an immersion in this type of program. In other words, (…) it is beneficial for your body. (Medical doctor, León) As we can see, this logic corresponds to the cycle of activity that we had expressed graphically earlier, in concrete in graph 5.2. 5.2. The practice of sport and physical activity among the population Now that we have commented on how the experts interviewed elaborate the concepts of health, quality of life and physical activity, and what type of relationships exist between them, we can look at how they assess the practice of sport and physical activity in the population; what motivating elements do they perceive, what obstacles make it difficult for this practice to be more widespread and what are their recommendations to promote it. 164 SPORT, HEALTH AND QUALITY OF LIFE The internalization of sport within the population Generally there is a high degree of agreement among the experts interviewed that sport has been positively internalized by the population. Some experts highlight the transformation that has been produced in the majority conception of sport, which has gone from a prevailing elitist conception of a few decades ago (according to which, physical activity and sport were practices of cultural and economic elites who were in condition to follow intense programs for high level performance) to a popular conception (in which sport is considered as positive for health and can be practiced by the great majority of the population). Regarding this issue, one of the experts interviewed thinks that among a good part of the population the elitist conception of sport still predominates. –For many the referent is this: a sportsman or sportswoman is equal to a great athlete that appears in the media and makes a lot of money, and some of them go to the Olympics. (Medical doctor, Barcelona) –I think that there are no doubts, it is very internalized. (…) In addition in a massive way by the vast majority of the population, the benefits that practicing sport can have. And they see it as very valuable. In fact, that’s where the boom in practicing sport at all ages comes from; school sports, sport among young people and perhaps, especially among seniors. (Manager of sporting association, Madrid) One of the experts interviewed expressed a polarized vision, speaking of the radical division that exists in the population between those that practice sport and those that do not. The first, according to this expert, are strongly influenced by the presence of sport in primary socialization, in the family and in school, and the second group lack the presence of sport in this socialization – similar evidence was obtained through the quantitative analysis from the applied survey in this study. The active population group, in addition to doing sport, has healthy habits and a higher socioeconomic profile. The inactive group in the population has unhealthy eating habits, inadequate posture, bad sleep rhythms, and consumes toxic substances. This expert explains this inactivity by the uselessness that this population attributes to sport, something that impedes them from internalizing it as something positive. CRITICAL SENSE VERSUS COMMON SENSE. THE DISCOURSE OF THE EXPERTS 165 –Okay, those that don’t do sport, really don’t do sport for two motives, I think, because in their stage of growth there was no incentive to do sport, or because their mode of life is far from the area of sport. As a general rule, a person that is in contact with people that do sport, healthy people (…) And curiously the people that don’t do sport tend to have bad health habits… (Doctor of physiotherapy, Córdoba) Despite this dual situation, those interviewed believe that a sporting boom is being produced which is filling sports centres with people of all ages, but especially young people and seniors. Contributing to this, in good measure, is the increasing widespread consciousness of the benefits of sport, and also the greater involvement of medical professionals, who are stimulating this interest in their patients. –Let’s see, I think there are no doubts, it is very internalized (…) I think that the population has it very internalized, also in a massive way, the benefits that practicing sport can have. It is highly valued. In fact, that is where the boom in the practice of sports at all ages comes from (…) in addition, the sports centres of the majority of towns in Spain are full throughout the week, above all in the mornings, of sports for older persons; in the afternoons, no, in the afternoons the young people go, the children… (Manager of sporting association, Madrid) In this sense, there are experts interviewed that draw attention to the fact that among the active population there are more and more social sectors that approach the practice of sport with the intention of obtaining physical benefits. According to this opinion, the population is recognizing the benefits of physical activity, but we see it checked by the lack of time, due to sport not having its own status in daily life and its practice being limited to the personal level. As individuals are not submitted to effective group pressure to do sport, and nor do there exist sufficient programs to stimulate physical activity, people use other manners for recreation. –In other words, everyone knows that they have to get physical exercise every day and that would be ideal, but they know that from Monday to Friday they can’t, and that on Saturday they have to do the shopping and then they don’t have time to do exercise. (Medical doctor, León) 166 SPORT, HEALTH AND QUALITY OF LIFE Following this reasoning, we conclude that the population has internalized the benefits of the practice of sport, but has still not internalized the habit of practicing sport, because this is conditioned differently in each group of the population. Among seniors physical activity has spread because of the abundance of programs financed by public institutions. Among adults, work impedes them from having the time necessary, if the business does not facilitate this practice. Children are influenced by new living conditions in which physical activities in the street are disappearing, and in which their physical activity depends to a great degree on the availability of their parents. For young people in the university there is a lack of sporting competitions that provide incentive and alternatives to bars and discotheques. Motives for physical activity All the experts are in agreement in pointing out that the principal motive that the population has for doing physical activity is health, although each one has focused on some particularity in this regard. Some point out that women are motivated more by aesthetic concerns and care of their physical appearance. Others add that, in general, when the adult population inclines toward doing sport it is because they feel that their health and physical ability has declined. This is something that occurs more frequently among older persons, because they have more free time to do physical activity. This perception is produced, as some of the interviewed point out, when young people who are passive begin to feel bad about their own bodies and physical form, but also when they have health problems or begin to see obesity as a problem. The medical prescription of doing sport for some pathologies is another motive according to some experts, who grant a great deal of importance to the recommendations of family doctors. –(…) Two things are primary: one, the internalization that this is good, the society continually transmits messages that sport is good, health (…) And two, the need of the body, we have a need to move, and we know that when we move this helps us. (Medical doctor, León) Finally, among the motivations of a physical type, the need for body movement that human beings have has been pointed out, and the relief and pleasure that this produces, which is the expression of a positive closed cycle: the effects CRITICAL SENSE VERSUS COMMON SENSE. THE DISCOURSE OF THE EXPERTS 167 of physical activity promote physical activity; in other words, once the subject perceives its benefits, he/she feels more motivated to continue with the activity. Pleasure and enjoyment are reasons that are situated on the border between physical motives tied to health and psychological motives. Pleasure and enjoyment are the principal psychological motives pointed to, and from some of the experts interviewed they are necessary conditions for individuals to do physical activity. Enjoyment is more important the younger the person is, and especially for children and adolescents, so it becomes a fundamental motive that can introduce and reinforce sporting habits. –(…) Children do sport because they like it: «I like to play basketball», «I like to do volleyball», «I like swimming», and they begin simply for the enjoyment of doing a sporting practice. When people are older, (…) if they don’t have the habit of doing sport, when they see that physical deterioration is when they are encouraged to do something in many cases; or because they have a health problem, or because they have become very fat… (Manager of sporting association, Madrid) Habit is another of the psychological motives pointed to (the population that does not have this habit does not practice sport). Habits acquired in childhood and in adolescence have a high probability of being maintained throughout life. Another psychological motivation is the desire that people feel to compete, to test their ability and to measure themselves in relation to others. Although measuring oneself in comparison to other athletes can have negative effects on motivation, the comparison with others that do not do physical activity is strongly motivating. One of the experts interviewed pointed to the catharsis that physical activity produces as another motivation. It is a motive at the border between the psychological and the social, and is very widespread among older women with important responsibilities and routine obligations. Sport liberates them from these obligations and makes them feel good about themselves, producing a psychological benefit and social benefits which come from the contact with other women with whom they communicate and interchange information about common problems. 168 SPORT, HEALTH AND QUALITY OF LIFE –(…) Among women, concretely in this type of population, they describe it first as a time for themselves, that satisfies them personally, and as a time for social relationships among a peer group. (Doctor in sport sciences, Granada) Among the social motives for sport, the benefits derived from the social relations that sport entails have been pointed to as the most important. Those interviewed believe that these social relations reinforce the practice of sport and counteract the general lack of motivation. They even point out the special case of social relations that motivate the practice of sport even beyond the perception of its benefits (the gym and its social relationships). The same occurs with the daily contact with friends for those who practice a collective sport, which induces physical activity more effectively than personal perceptions; something frequently seen among young men. –As a general rule, a person that is in contact with people that do sport, healthy people, are people that for inertia end up doing sport: «My friends go and run, I go with them», my friends do aerobics, I go with them»… (Doctor in physiotherapy, Córdoba) Once the principal motives for practicing sport are explained, it is also interesting to set out the vision of the experts interviewed with respect to the criteria and logic that people use when doing this activity, as these criteria could have influence on the type and magnitude of the benefits that are obtained. The criteria that the population uses in doing physical activity It can be stated, as one of our experts does, that the criteria with which the population practices sport flow from their beliefs, which they apply intuitively. According to this expert, the majority of these beliefs are positive because they are practiced with moderately conservative criteria. In this way, although the frequency, duration and intensity of the activity may tend to be low the beliefs behind it are correct because the majority of the population thinks that it is necessary to do physical activity several times a week with an average duration of one half to one hour. Another expert thinks that the physical activity of the population is not adequately planned to obtain full benefits. This expert says that there is a lack of professional protocols to guide the population in their physical activity, CRITICAL SENSE VERSUS COMMON SENSE. THE DISCOURSE OF THE EXPERTS 169 which makes progress more difficult. This issue has also been raised as a conflict between healthcare professionals and professionals in the field of sport and physical activity, as the first do not provide their patients with appropriate information, often only recommending generic physical activity which the patient then must concretize according to his/her beliefs. This is a conflict that must be resolved, and in which this expert advocates for doctors in their consultations with patients providing information about the adequate sport or physical activity for each person and with attainable objectives. –(…) I don’t want my patients to be Olympic athletes, I only want them to improve their health and the quality of their lives. Then, to teach them or send them to places where they can do activities adequate for themselves and, above all, look for objectives that are accessible because, if not it will confuse the patient and he or she won’t come back to us. (Medical doctor, Barcelona) But despite this need which elevates the demands on a healthcare system with limited resources, faced with this dilemma between the population doing physical activity controlled and planned by an expert or freely adopted physical activity, a conservative attitude has been adopted: it is better that one does some freely adopted exercise, although it may be deficient, than run the risk of not doing any exercise at all because one cannot follow professional protocols. In general, experts agree on the fact that, although the population has increased its practice of sport and there are incentives for its continued expansion, the physical activity that they do suffers important deficiencies. Among them, errors in choosing the sporting practice when a specific benefit is looked for. Thus, at times, when it is recommendable to walk, individuals run, or, if it is necessary to do an activity on a hard surface, they do an aquatic one. –(…) The population lightly follows the recommendations of weekly frequency, duration and intensity, possibly slightly below what they should be, but sometimes they commit the error that the real type of practice that they do is not the best for them, and this is because of a lack of knowledge, culture. (Doctor in sport sciences, Granada) 170 SPORT, HEALTH AND QUALITY OF LIFE The poor practice of sport is also criticized, because individuals often do not do the stretching and warming up prior to and after physical exercise that improve the benefits and help prevent problems. The practice of sport among different population groups Regarding concrete sports activities, the experts interviewed pointed out different styles for different population groups. Thus, they say that there exists a minority of the population that does a lot of physical exercise, but that in general individuals are not persistent in their activity and always expect to achieve immediate benefits. They mention that a good part of the population do daily activities that involve physical activity, and that the practice of sport in sports centres and taking walks are activities that are on the increase, despite the monotonous routines which are often followed. Regarding women, the experts say that taking walks is one of their principal physical activities until they can get involved in a more structured physical activity. Among young women dance stands out as a very motivating and adequate activity, because the search for the aesthetic in this group can, on occasion lead to negative practices, converting them into temporary athletes who mix sport with drastic diets, only to abandon it once they have achieved their aesthetic objectives. Children and young people have been the focus of attention of all the experts. Regarding them they point out that their sport practice is well below their needs, due to sedentarism having settled among school-age children and the culture of playing in the street at the end of the school day having disappeared. Because of this, the probability of doing physical activity is closely associated with the availability of parents to accompany children to the places where sport is done, a serious problem due to adults’ time limitations. As a consequence, the deficient socialization in schools toward sport has been sharply criticized by the experts. –And the child? The child only has the physical activity in school. And we are seeing that this two, three hours is clearly not enough. And the rest, now they don’t move, because we always assume as fact that children don’t move, but the reality is that they no longer move (…) nor do we let them stay in the street continually playing… (Medical doctor, León) CRITICAL SENSE VERSUS COMMON SENSE. THE DISCOURSE OF THE EXPERTS 171 Regarding university students the experts say that they do not have sports programs that stimulate them and that serve as an alternative to passive and night time leisure, although young men often have the possibility of participating in collective sports with their friends. Among adults, the experts have not provided a lot of information, perhaps due to this group escaping in great measure from their professional scope. Despite this, they do say that this group counts on little free time to practice sport and that this makes it difficult for them to practice a physical activity. Ways of practicing sport and physical activity Regarding the way in which physical activity is done, three different groups are described by our experts: on the one hand, there are those that practice sport daily and that, therefore, do an activity very methodically, there is also a very broad group that does sport on the weekends, and, finally, there is a group that does sport irregularly and which can do very demanding activities without any preparation and with serious danger for their health. –There is a bit of everything, a bit of everything, from the people that take it a bit more seriously and do sport daily, and there are other people that don’t take it seriously because they don’t have time, that do sport mostly on the weekends; (…) up to people that do it in a less methodical way (…) Look, there are people that go out to run a marathon without practically having done sport. (Manager, sporting association, Madrid) Therefore, it seem that, with the exception of a minority of persons that practice sport in a methodical and regular manner, and that obtain all the benefits and the prevention that sport provides, the majority of the sporting population does the activity irregularly based on their availability and perceived needs. Obstacles to doing physical activity The experts unanimously say that the greatest obstacle that people face in doing sport is the little time they have available, although they also say that that is a subjective impression that is not completely accurate. The problem of time increasingly appears at earlier ages, up to the point where adolescents refer to 172 SPORT, HEALTH AND QUALITY OF LIFE time as a primary motive for not doing any physical activity. However, some of the experts interviewed think that in reality young people suffer from poor time management, because when one analyzes the distribution of their activities during the day, it can be seen that they have a lot of dead time available and they spend long hours on the computer or watching television. –(…) Curiously to us, in the research that we are doing of a more sociological character, time appears at increasingly earlier ages (…) And it’s not a lack of real time, it is the poor management of time, but individuals indicate having a lack of time. Time systematically appears at almost all ages, it is, we can say, possibly the primary obstacle. (Doctor in sport sciences, Granada) The lack of time is explained by the structure of social habits, with jobs that take up long hours of the day and with poor schedules. This affects, above all, young people and working people. Communication technologies are the second obstacle most mentioned by the experts interviewed, especially among children and adolescents who spend a lot of time on video game consoles and video games, taking time away from sporting activities and playing with friends. Access to sporting installations has been pointed to as an obstacle for seniors. The difficulties come from lack of resources, from the requisites for admission and, above all, from the economic cost. Access is considered to be expensive which affects seniors, for whom this is an important obstacle, and young people, for whom it represents the greatest obstacle. –You can say that the obstacles that young athletes find are set by the infrastructure of the city (…) it is expensive and they have to settle for those sports in which they don’t need an infrastructure (…) Among young people, the greatest obstacle is the economic, without a doubt. And then we have another group of persons for whom the obstacle is their physical condition, their physical limitations… (Doctor in physiotherapy, Córdoba) Other obstacles mentioned have a psychological dimension. Among these stand out the lack of motivation, which, when it is not recognized by the subject in question, is justified through rationalizations, particularly among CRITICAL SENSE VERSUS COMMON SENSE. THE DISCOURSE OF THE EXPERTS 173 seniors: difficulty in taking the first step to initiate sporting activity, doubts about whether they will be consistent in their practice and the rejection of involvement with those who run the sporting installations. Another obstacle which affects parents with young children is the institutional deficit of support for parents, as gyms and sporting installations do not have day-care that would permit parents to go to the centres with their children to get physical exercise. The existence of day-care would permit the section of the population with the least available time, parents, to benefit, while children would also benefit as they would be socialized in lasting sporting habits. This lack of service combines with another obstacle: it is not sufficiently understood that mothers need to get physical exercise, so that mothers reject asking other family members or friends to take care of their children while they do sport. –Perhaps they lack support. One of the initiatives that they are doing in Sabadell, for example (which other centres have copied) is a day-care centre in the sports centre. Then the parents, typically mothers of small children, leave their children in the installation (…) It is complicated by the issue of your mentality, of what you say to your mother or your mother-in-law about taking care of your child because you are going to the gym. If you are going to work, they understand it, but, if you are going to the gym, they see it as a whim, right?... (Medical doctor, Barcelona) In this way, when it is the mother (and particularly in this case, because our experts mention the mothers and not the fathers when they talk about this theme) it is particularly difficult to find the adequate conditions for them to follow or initiate a sporting practice. A brief comparison of physical activity in the population In general, the experts think that there is a sporting backwardness in Spain with respect to Europe, because the proportion of persons that practice sport in Spain is low. This situation is particularly grave among young people because educational institutions do not sufficiently promote sport and because the quality of sport practiced is poor, due to the lack of a sufficient sporting culture for doing adequate exercises in optimum conditions. Consequently, the quality and quantity of physical activity can and must improve to equal that of 174 SPORT, HEALTH AND QUALITY OF LIFE Europe, which has higher rates of physical activity and an important tradition of sporting health, without the excesses that are committed here. –(…) Things can improve a lot. If you travel to some countries in Europe you will see that we still have a ways to go. (…) Above all, because we do not have the tradition of sporting health that those countries have. (Manager, sporting association, Madrid) In addition, the experts mention that as a result of the lack of sporting practice we are seeing the appearance among young people between the ages of 30 and 40 of degenerative illnesses, which before did not appear until 60 years of age. 5.3. Recommendations for promoting sport All the experts agree that it is necessary to promote sport. In this sense they point out that, although sporting activity is promoted, they do not believe it is promoted enough, especially given their knowledge of its contribution to solving many health problems and in preventing illness. Because of this, they think that investment in sport will provide important returns derived from those important benefits to health. This reflection is an important example of the practical, social and budgetary importance that sport has (or should have) for individuals and for society as a whole. –(…) I think that the money that we invest in sporting practice will be repaid when we have to treat certain diseases. (Manager of sporting association, Madrid) The experts go into great detail over this idea when they concretize the future health risks that result from physical inactivity. They think that the spending allocated to the promotion of sport will be much less than the cost of treatments resulting from the consequences of obesity. Given that obesity will carry an immense future cost, promoting physical activity would mean an enormous savings and be a very profitable investment. The objectives that the experts suggest for the promotion of sport are similar but have been formulated in different ways. Thus, numerous objectives emerge some of which are very specific. CRITICAL SENSE VERSUS COMMON SENSE. THE DISCOURSE OF THE EXPERTS 175 Raising awareness and consciousness in the population in all areas of life and throughout the lifecycle (in the schools, businesses, health institutions and services for the elderly) is a general objective that includes other more specific objectives, such as reducing morbidity. –First we have to go sensitizing the population, raising their awareness, but at all levels of the population, and after reaching all the areas, in other words, the educational area (…) we have a subject that lets us work in this area, which is the subject of physical education. We have to get to businesses, to occupational health. We have to get to institutions, that have to do with health or with quality of life, (…) IMSERSO [Institute for Seniors and Social Services], through hospitals, through primary care, (…) and then the final step would specifically be that of training, right? (Doctor in sport sciences, Granada) To get the population to do physical activity and maintain them doing it to overcome the dominant sedentary discourse and the youthful leisure practices of the «botellón» (informal outdoor gatherings with alcohol) and the discotheque, focus should be on two specific objectives oriented toward two areas of life: facilitating the practice of physical activity through businesses or places where people work, and through guaranteeing a minimum of physical activity among children and adolescents in the educational system. Lastly, among seniors measures to encourage maintenance exercise must be strengthened. Promoting physical activity as a habit that must be incorporated into the daily life of everyone in the society. In contrast to competitive sport which is intended to produce champions, another objective is to make sport part of the daily habits of the majority of the population, a basic pillar of which is promoting lasting practice of physical activity among young people. –That life expectancy and morbidity improves, yes. If the habit was generated in childhood, it won’t be lost in adolescence and it will be maintained in adulthood. Of course, I am interested in generating it as soon as possible… (Doctor in sport sciences, Granada) The most general way in which sport has been promoted has been through its spread to the general population, as is clear from the objectives described. However, there is a discussion about the role that high-level competitive sport can play in the promotion of sporting activity in the general population. 176 SPORT, HEALTH AND QUALITY OF LIFE Some argue that high-level competitive sport must not be ignored, because it constitutes a model that promotes the spread of more popular sport. While others argue that efforts to promote sport should exclude high-level competition, because what is of real interest is generalizing the practice of sport in the majority of the population, pointing to the example of countries that do not have great competitive athletes, but do have a widespread practice of sport. While the promotion of competitive sport is based on the consideration that the therapeutic objective of sport is secondary to the objectives related to quality of life, promoting the generalized practice of sport is associated with what one expert interviewed calls sporting health. –(…) To me I’m interested more in physical activity reaching almost one hundred percent of the population because it would be better as a way of promoting health and the public health of the population. What happens is that, sometimes, we also know that the sports model acts as reinforcement of the behaviour of people. It should in this case, right?, a ten with a ten, a balance between one model and the other… (Doctor in sport sciences, Granada) Regarding what messages have to be transmitted, it seems that all the experts interviewed have formulated, in a more or less conscious manner, positive messages that highlight the benefits of sport: «sport is well-being», «consume physical activity» and «physical activity and a balanced diet» are the slogans extracted from the discourses of the various experts. «Sport will make you free and well-balanced» is a slogan expressly formulated by one of the experts. Beyond the marketing suitability of the messages, we want to highlight that the experts interviewed believe that sport offers sufficient positive values so that these can be the core of hypothetical campaigns that can be launched. But the promotion of sport is not, for the experts, in any way just a series of more or less effective messages, but rather must involve a wide range of institutions and public and private bodies that promote it within the specific fields in which they act. Thus, the principal government institutions that are in direct contact with broad social groups, across all the territorial levels, plus businesses, sporting associations and clubs and social institutions as basic as the family and workplace, must be involved in the promotion of sport. CRITICAL SENSE VERSUS COMMON SENSE. THE DISCOURSE OF THE EXPERTS 177 Bodies and institutions that must be involved in the promotion of sport In identifying the authorities and social institutions that should have an important role in the promotion of physical activity, the experts interviewed mention, among others, the family, the educational system, the health system, businesses and clubs and associations. We will examine in what sense each one of these institutions, according to them, must help. The family Together with the educational system, the family is considered to be the basic institution for the promotion of lasting sporting habits. Nevertheless, only three of the experts interviewed mentioned involving the family in the promotion of sport. Nor did they say much in this regard, but they did leave it clear that the family has great importance for the success of the promotion of sport, as, if the family fails, other actions and measures that can be taken from other institutions will not have any success. This is so because they believe that habits are generated from as early as two years of age, and that individuals’ primary mode of learning them is at home until 16 years of age. In this stage values are inculcated and reinforced, and parents represent an example for their children to follow. Thus, if the parents practice sport, the probability that the children will also do so throughout their lives increases. In addition, the durability of the sporting habit is reinforced along with other healthy habits, such as, for example, the Mediterranean diet. For these reasons, it is very important that parents are conscious of the benefits of sport and that they value it as highly as other school subjects, in that way facilitating the work of the teachers of physical education. –The family is basic. So, the family has to intervene in many ways. (…) How do they intervene? Well, from the organization of family schedules, also improving the diet, the food… All these patterns are fundamental. Probably, if a parent does not exercise, it will be very difficult that the child will and some, when they do it, the parents even reproach them, right? (Medical doctor, Barcelona) In this way, the family is not only an agent of promotion but also becomes an object of this promotion, as sporting habits must be encouraged in those families that have not acquired them. 178 SPORT, HEALTH AND QUALITY OF LIFE The educational system The educational system is also considered a key piece in the promotion of sport, given that, together with the family, it is considered to be a fundamental generator of habits and values in children. As one expert commented, it is the perfect institution for promoting this activity, as the whole population of the country passes through it. Thus, from three until 16 year of age (if we only consider compulsory education), the school gives us the opportunity to practice sport in a regular manner during a set number of hours each week. In general, the experts believe that the educational system functions well. The majority of those interviewed see the system positively because, with regulated and planned activities, and under the direction of competent teachers, it generates habits and, with these, forges a society in which physical activity has a role. –(…) I see the books on physical education, and they explain the importance that doing physical exercise has. As it isn’t only practical classes, as there are also theory classes. I see that the physical education teachers are doing something, right?… (Doctor in medicine and nutrition, Granada) However, among the experts interviewed there is a discordant voice, which belongs precisely to the person that has most deeply analyzed this issue in his work. According to this expert, important deficiencies exist in the quantity and quality of physical activity that takes place in schools. He points out that the three hours per week of physical education under compulsory education has been reduced in practice to two hours, with one of those hours even dedicated to the teaching of theory. And, even more seriously, finds that physical education has disappeared from the final cycle of secondary education or «bachillerato», as has happened in the university, which, together with the spread among students of a hypercaloric diet, is laying the groundwork for the appearance in the near future of degenerative diseases at increasingly younger ages (beginning at 30 or 40 years old). The issue is that by reducing physical activity among students to one hour per week, under no perspective will they be expending the weekly number of kilocalories that the World Health Organization recommends.(2) This negative vision also extends to extracurricular activities, which not only (2) Students would be burning 600 kilocalories weekly, which is approximately one third what is recommended by the WHO: between 1,800 and 2,000 calories burned per week in physical activity at school. CRITICAL SENSE VERSUS COMMON SENSE. THE DISCOURSE OF THE EXPERTS 179 reach just 40 percent of students but may not necessarily include physical activity as an important component. –(…) Parents believe that their children are doing sport and they aren’t. Parents think that their child does sport because now they do sporting activity or physical education in school. But they don’t, (…) therefore; many children that don’t do any type of extracurricular activity (…) only do what they do in school. What are we talking about then? That possibly the parents don’t let them do extracurricular activities, that they can’t take them, that they can’t pick them up. And if these children have acquired these positive habits in this period, which is where they acquire them, the society itself, the functioning of the system is really impeding them from doing sport. But if you ask everyone «do you do sport?», they say yes… (Medical doctor, León) Both the experts that evaluate the action of the educational system more positively on this issue, and those that show themselves to be more negative, are in agreement on the need to take action to promote sport in the educational system. Some of these measures will affect the objectives. They think that it must be obligatory to do a minimum of physical activity in school, which one of the experts interviewed situated at one hour per day, not necessarily during classroom hours, together with an improvement in the offering in sport, with more teachers, installations and availability of hours. It is also thought that the sports that most appeal to students should be encouraged, and that sport should complement studies so there is no breakdown in the habit. To achieve these objectives a series of concrete measures are indicated. One of them consists in externalizing physical education by financing free gyms for students in order to strengthen their inadequate sporting habits. As a variant of this measure it is proposed that physical activity in the university count as free elective credits, and that «courses» can be taken through agreements between universities and private gyms. In the compulsory stage of education, it is thought that schools should be open in the mornings an hour earlier so that, taking advantage of the need of many parents to bring their children to school earlier due to work schedules, they can take advantage of this daily hour with physical activities. It has also been thought that sport should be stimulated in the educational system transversally, the same as other transversal subjects, so that all the areas and subjects take it into account in the curriculum. Finally, it 180 SPORT, HEALTH AND QUALITY OF LIFE has also been proposed that schools and their sporting facilities be open to all of the community so that, daily and during weekends, both the students as well as the rest of the population can benefit from them for the practice of sport. –When they get to the university perhaps they might have to do it, I don’t care if it means getting elective credits. (Medical doctor, León) –(…) That hour a day will have to be found and I don’t think it would be bad, for example, if children entered school at eight in the morning. In some way it would help to balance the schedules of a lot of families, it is a social reality. Therefore, it could be organized so that at eight in the morning there would be groups in the school that would be doing physical education. (Medical doctor, Barcelona) –Yes, I think that in all these subjects that there are in the educational system they have to encourage sport. Not just limiting it to the two hours of physical education that is established… (Doctor in physiotherapy, Córdoba) In short, the majority of the proposals try to strengthen the system because the experts interviewed believe in it. But, when you do not believe in the system you support the outsourcing of the activity. –(…) If 60 percent of the children at school age don’t do extracurricular activities, only do the activities of school, could we revert the tendency to do sport if we said that children up to 18 years old, or it occurs to me, 16, had free access to gyms? (Medical doctor, León) The solutions do not seem easy and although the proposals are not incompatible with each other, they must be studied closely because they represent a considerable increase in resources and greater pressure on the educational system, already overloaded with social demands. The health system It is surprising given that the majority of experts interviewed are professionals in the healthcare field, that they did not put much emphasis on how the healthcare system might contribute to the promotion of physical activity. We CRITICAL SENSE VERSUS COMMON SENSE. THE DISCOURSE OF THE EXPERTS 181 already mentioned that healthcare professionals are overwhelmed in their practices and only recommend in a generic manner that their patients do sport, because they do not have either the time or sufficient knowledge to give patients adequate advice about the initiation of physical activity. Despite this, those interviewed recognize that currently, although with little financing, it is the public healthcare system which is carrying out a strategy, sponsored by the United Nations, to fight against childhood and adolescent obesity, in which the educational system is also involved at a secondary level. –(…) We made a proposal to have at least one week at the national level dedicated to promoting exercise, to the benefits of exercise, in which the media would also be involved. Anyway, political stuff, the issue has been left standing. We associated it a lot with obesity… (Medical doctor, Barcelona) It is these concrete campaigns that the health system should be promoting so that the population perceives more clearly the benefits of sport. The health system has been criticized up to now for only being concerned with therapy and is not involved in prevention, when it is much cheaper to promote physical activity than to invest in high-tech healthcare therapy. We have seen that the experts unanimously recognize that this is the major benefit from sport in the healthcare field, with the added advantage that the population’s perception of improvements in health reinforce the physical activity they do. –(…) Everyone sees a very direct relationship between health and healthcare system; it could be better. What’s going on is that the healthcare system has been particularly concerned with treatment, but up to now has done very little in the area of prevention (…) They invest a lot in having the ultimate technology to have a magnetic resonance of the ultimate generation, but invest very little in a health centre in my town. Everyone can be doing physical activity at a much lower cost, okay? (Doctor in sport sciences, Granada) Because of this, and because they recognize the important work of the healthcare system, they have formulated few proposals, but of unquestionable social reach. One of them consists in including personnel specializing in sports medicine in health centres, to advise patients and design personal plans for physical activity. Such personnel would be very useful for integrating persons 182 SPORT, HEALTH AND QUALITY OF LIFE with pathologies into physical activity through specific programs, as one of the major obstacles found in the promotion of physical activity is avoiding health problems at the initiation of the sporting practice. –(…) An eternal demand, that there be a specialist in sports medicine in the health centres. (Doctor in medicine and nutrition, Granada) While this professional service at health centres is being established, our experts think that healthcare professionals connected with sport should collaborate with healthcare services and, in addition, with all those initiatives that develop to disseminate the benefits of sport. Businesses The experts interviewed are conscious that we find a high percentage of the adult population working in businesses where they spend the better part of their day. As a result it is a strategic place for promoting sport. In addition, many of the experts commented that it would be profitable for businesses to facilitate a time for their workers to do physical activity, as they obtain short term benefits with increases in performance and productivity, and long term benefits with decreases in sick leave. –No, I think there is still a lot to do. From an employer understanding that there can be an immediate benefit in the work day and a medium term benefit, as you will have fewer days of work missed, there is still a lot to do. It’s beginning now. (Doctor in sport sciences, Granada) The experts suggest that businesses ought to facilitate the physical activity of their workers, programming flexible schedules that permit incorporating physical activity into the work schedule. This is important for two reasons: first, workers are also very busy outside of work, particularly with family matters when they have small children and with other matters that require a more irregular attention; and secondly, because incorporating this activity into the work day also facilitates the compatibility of work life and family life. In addition to this flexibility, they also call for other measures which will facilitate physical activity at work, such as providing access to sporting facilities, installing small gyms in workplaces, following the same philosophy as with CRITICAL SENSE VERSUS COMMON SENSE. THE DISCOURSE OF THE EXPERTS 183 dining rooms and day-care facilities, or promoting exercise and stretching before work to benefit the locomotor system and reduce injuries at work. –In business activity itself the schedule can be more flexible, now there is talk about flexibility in the scheduling to leave time for an hour of exercising. (Medical doctor, León) –Some businesses here have also begun to have small rooms with wall bars, some material to do stretching during or after the work day. (Medical doctor, Barcelona) There is also awareness that the culture of physical education in businesses is undeveloped, despite there being businesses that have begun to elaborate programs for their workers and that have spaces available for doing physical exercise. These are activities that are more important for work places in which the work is sedentary, but workers that do work with a physical component should also not be excluded, as such work requires that they receive guidance in working in safe conditions and in the prevention of injuries. Clubs and associations According to the experts, the majority of clubs or sports associations do not develop activities geared to promoting sport for all, despite the importance that they have in this work. Specifically, regarding sporting clubs, the experts think they have a very commercial bias in their activity and that they are not the appropriate vehicle for the promotion of basic sport, as the professional clubs are not oriented toward the promotion of sport among the population, but rather only toward competitive and professional sport. For their part, the corporate sports clubs are oriented more toward popular competition and their own commercial promotion. In addition, regarding sports federations, they mention their passivity in promoting basic sport, as, instead of dedicating effort to the development of a pool of young athletes, they passively wait for the educational system, obsolete in terms of sport, to provide them with these young athletes. –Yes, yes, the federations should be drawing in children and doing activities but they leave it: «They’ll come to us». Where are they going to come from? From school sport, if school sport no longer exists… (Medical doctor, León) 184 SPORT, HEALTH AND QUALITY OF LIFE Regarding sporting associations, the experts say that neither the public nor the private associations adequately promote popular sport. The public associations have small budgets and barely qualified personnel, and while the private ones do have budgets, they also do not have adequate personnel. In addition, popular neighbourhood associations do not do an adequate job because they are often more interested in promoting sports teams with a lot of economic problems and have staff which lacks knowledge and qualifications, and whose dedication to the association is through a second job or as a hobby done without monetary remuneration. The experts do recognize that the role of sports managers is very important because they are the referents for parents and for their children; thus, they must transmit adequate sporting values: solidarity, the job well done and good hygiene. Given this, the associations tied to non-competitive sports have been given tasks of great importance related to the social reproduction of sporting habits. They must provide continuity to the sports they support, getting young people to continue the practices of the veterans. To do this, the ideal would be to create sports schools, counting on institutional aid and the services of professional experts. This would be the best way to promote popular sport among the population. –(…) Sports trainers or those that are going to be managers, they are, for me, a fundamental element, right? Sometimes even small children will pay more attention to them than to their own parents. Look at their importance. If they transmit values, (…) the children are going to remember them, right? (Doctor in medicine and nutrition, Granada) –(…) The public associations have a big problem, and it’s their budgets. And if they are lacking a budget, they have no personnel specialized in sport. And not having specialized personnel, well, they do what they can but they don’t do everything as they should… (Doctor in physiotherapy, Córdoba) Apart from the measures already mentioned, in their discourse the experts also referred to other measures or orientations which will be discussed in the following section. CRITICAL SENSE VERSUS COMMON SENSE. THE DISCOURSE OF THE EXPERTS 185 Other measures The media are an object of commentary on the part of many of our experts. According to them, the media should promote the reduction of obesity and combat sedentarism with the collaboration of famous athletes who could act as social referents. The media could broadcast advertisements on the effects and benefits of sport which can be very useful in educating individuals about those benefits; and also on pathologies, so that the effects and action of physical activity is clear. In addition they could reintroduce the old programs for promoting sport, instead of the exclusive broadcasting of elite sporting events which, in the long run, only stimulates sedentarism in the audience. –And for example, the media. I remember some years ago that school sport was very rewarding and programs like «Contamos Contigo» or «El torneo» that were successful (inaudible) have disappeared. Well then, now the most watched programs on the television are usually games for the national league (…) but the people that watch the game probably don’t have the habit of doing exercise in their day to day lives and school sport in this sense has been abandoned. (Medical doctor, Barcelona) Regarding the educational system and its resources, there are also various proposals. It has been proposed that sports installations in schools be used for physical activities for the whole community. In the educational system the subject of physical education must be as equally valued as the other educational subjects and sporting habits have to be promoted from early childhood. The so-called «paradox» of wanting to battle the «botellón» while leaving school sporting installations closed all weekend is also mentioned and should be avoided. If these installations were opened, as has been demanded for quite a while now, it could provide young people with an alternative to the «botellón». –It is a paradox, we complain that our young people consume alcohol and tobacco, above all on the weekends, (…) but if they had sporting activities available and who has the best installations, the schools, and in a lot of cases they aren’t the best installations, they are the only ones, and they are closed. (Manager of sporting association, Madrid) 186 SPORT, HEALTH AND QUALITY OF LIFE Regarding other sporting installations, the experts suggest that they also widen their hours and reduce the dissuasive prices which some have through the construction of new installations that are commensurate with the high demand that exists. In addition, the partial closures in many existing facilities must be avoided, favouring the influx of people with a reduction in price at times when there is less demand. In short, more facilities and improving the return on them, given that standardized «social schedules» concentrate the demand in a few hours per day. –(…) There are facilities that close on the weekends. There are pitches that are open four hours a day, and the rest of the time they’re empty. (…) More facilities, because above all in the facilities in large cities like Madrid or Barcelona it is very difficult to practice sport, because the demand is enormous, and make the ones that are already there more profitable by increasing their hours. (Manager of sporting association, Madrid) In regard to old age, the experts point to the need to promote maintenance exercise with evaluations that detect the possibility of seniors moving on to doing other activities. Recruiting professionals that will guide seniors in their activity and will evaluate them should help in achieving this. –(…) In the framework of old age, or when we are older, continue promoting those programs of maintenance exercise. And above all looking for some type of evaluation that will lead to greater motivation. (Medical doctor, León) And lastly, a proposal that we could call «the sportification of urbanism and the environment», which consists of taking advantage of the natural conditions in the environment, creating trails (in forests and on beaches) and, also creating urban circuits appropriate for skating, bicycling or running in which, in addition, public information is exhibited on the effects and benefits of physical activity. Resources As can be seen, many proposals have been made to promote sport within the society. But all of them require resources, about which the experts were also asked. Despite recognizing the enormous merits of the efforts of local town and city governments as owners and managers of sports facilities, and of CRITICAL SENSE VERSUS COMMON SENSE. THE DISCOURSE OF THE EXPERTS 187 the autonomous communities which finance these facilities, there is general agreement that the financial resources necessary for the promotion of sport are lacking. The experts do not see the financial resources needed as excessive, not from a macro-social perspective, because the costs will always be small in comparison with the costs for healthcare which awaits in the future if we do not reverse the tendency toward sedentarism, nor from a micro-social perspective, given that basic physical activity does not require the large investments needed for competitive sports. Apart from the financing of personnel and infrastructures, the experts would allocate financial resources in a somewhat contradictory manner. For some the financing should prioritize specific social collectives, such as those ill with fibromyalgia, adolescents, seniors and homemakers, and should promote sport in the general population. For others, the financing should promote the pool of high-level athletes, beginning with grants for promising young athletes that would permit them access to facilities, medical exams and stays in centres for high-performance sport. –And after that, the other measures are much more specific, because now they would be for concrete collectives. The examples we have mentioned before, right?, persons with fibromyalgia, adolescents, homemakers and seniors. (Doctor in sport sciences, Granada) –(…) Grants for the kids that stand out, that have qualities, that’s the first thing. Those kids that (…) can go somewhere in their sport, facilitate their access to the sport and provide support for them in their lives in regards to access to sporting facilities, medical exams, access to high-performance sport centres. (Doctor in physiotherapy, Córdoba) Personnel are also a valuable resource and must have the corresponding economic support. Thus, they consider necessary resources to defray the cost of personnel derived from the increase in classroom hours in physical education, and to contract personnel for the opening of schools and support staff for extra-curricular physical fitness activities. We have already seen that qualified personnel are considered indispensable both for direct physical activity as well as for programming activities in the healthcare system. Regarding infrastructure, the enormous development in recent years, responsibility of local governments and private gyms, is recognized, but even 188 SPORT, HEALTH AND QUALITY OF LIFE so, they demand more. The experts point to the importance of some very concrete infrastructure, such as swimming pools, which have multipurpose use for all ages and support less aggressive activities and activities appropriate for persons with pathologies. Resources for small towns and for adaptations to the rural and urban environment are also necessary. –Swimming is very good for everyone. We weigh ten times less in the water, and this helps us to move. And it is a way which is not at all aggressive to introduce ourselves into the world of sport. So I would invest a lot of money in the swimming pools… (Doctor in physiotherapy, Córdoba) Lastly, they point to the need to finance informational campaigns and campaigns to raise awareness in society. CRITICAL SENSE VERSUS COMMON SENSE. THE DISCOURSE OF THE EXPERTS 189 Conclusions The present study begins with the assumption that sport and physical exercise have a significant impact on improving health, well-being and quality of life. The relationship between these elements has been demonstrated on innumerable occasions in the health sciences, and in fact the United States Department of Health and Human Services report Physical activity and health: a report of the Surgeon General states: «The body responds to physical activity in ways that have important positive effects on musculoskeletal, cardiovascular, respiratory and endocrine systems. These changes are consistent with a number of health benefits, including a reduced risk of premature mortality and reduced risks of coronary heart disease, hypertension, colon cancer, and diabetes mellitus. Regular participation in physical activity also appears to reduce depression and anxiety, improve mood, and enhance ability to perform daily tasks throughout the life span» (USDHHS, 1996). However, in this study this issue has been examined from a different perspective: that offered by the social sciences. Incorporating this perspective, health is not only the result of the physiological and biological functioning of our organism, but also the result of cultural circumstances and our living conditions. Precisely for this reason studies of this type are increasingly needed, promoting the collaboration between academic disciplines. In this sense, Professor José María Cagigal (1979) pointed out in the 1970s that it was going to be time for the social sciences to concern itself with the study of sport in the same way as the medical and biological sciences had. But he also warned that this would not be possible if theory and empirical research were not adequately combined. However, analyzing these issues from the social sciences is very complex, as studying the perceptions, values or 190 SPORT, HEALTH AND QUALITY OF LIFE feelings of individuals presents a series of difficulties that are not found in studies about observable biological phenomena. Even if we address this issue, the medical perspective today faces a series of difficulties to bridge certain gaps: as Hernando and Martínez de Quel (2006) recognize: «despite the close relationship between health and quality of life, there are no studies which demonstrate that sporting physical activity improves or increases quality of life. In fact, nor have tests, questionnaires or instruments been found which permit us to measure how sporting physical activity improves the quality of life of healthy individuals».(1) According to these authors, regarding physical activity, «the most common and accepted scientific instruments for measuring quality of life are designed to assess it in individuals who are ill or with certain diseases. In the case of generic instruments, they suffer from a “ceiling effect” which impedes adequately evaluating the “physical functioning” component» (Ibid.: 660; see also Alonso et al., 1998). For them, the problem stems from the instruments of evaluation employed being inadequate for establishing the relationship between sporting physical activity and quality of life, which means that it is necessary to create tools that aid in undertaking this task. They share the same opinion on questionnaires regarding quality of life related to health, common in the medical field, which tend to suffer these same biases and reflect low sensitivity to changes and therefore lack test validity (Villagut et al., 2005; Badia and Lizán, 2003). For these reasons, this study is an advance in the difficult task of evaluating the impact that doing physical exercise and sport has on the subjective perception of health and quality of life of those who practice it. The study shows that individuals that do sport and physical exercise regularly, tend to evaluate their health and quality of life in more positive terms. In addition, the results of the research highlight that sport and physical activity constitute an important component of well-being in our lives. Together with money, housing, free time, (1) They came to this conclusion reviewing 338 different questionnaires employed to measure quality of life in different studies, taking as source of reference http://bibliopro.imim.es/BiblioPRO.asp (BiblioPRO). The data base of BiblioPRO is the most extensive on questionnaires on quality of life in Spain. Its browser has 23 therapeutic areas for choosing questionnaires on quality of life. In addition, they used http://www.fgcasal.org/rediryss/ which permitted a search for questionnaires using other data bases such as Medline. Pubmed, ISI Web of Science, PsycINFO, IBECS, TDR; LILACS and TESEO. CONCLUSIONS 191 work, health and social relations, doing sporting physical exercise contributes to shaping how we assess our quality of life. Based on this study, the two dimensions analyzed, «health» and «quality of life», are in part determined by a much broader concept, which could be called «healthy lifestyle». In this sense, the idea employed here is limited, as it only focuses on those aspects of lifestyle tied to the practice of sport and physical exercise in our leisure time, when there are other aspects of lifestyle that also have an important impact on health and quality of life, such as diet, hygiene, the use of free time, consumption of toxic substances and type of work. This study, however, only focuses on the effects of sport and physical exercise. Sport, physical exercise and lifestyles among the Spanish population Looking at the overall results of this study, the first result which merits highlighting is that the Spanish population is largely sedentary. Its level of sporting practice is low: less than half the population practices sport, and only two of every ten persons do so regularly. Regarding physical exercise, few individuals walk daily: only one third of the Spanish population states that they walk at least one hour a day. Despite this, walking is the principal physical activity that is practiced during free time, while the practice of sport is situated in fifth place among free time activities. In the time dedicated to daily tasks, fundamentally those that have to do with work, the Spanish hardly do any physical activity, as six of every ten say they spend the majority of the working day seated or standing without making great effort. In second place, and specifically related to the practice of sport, the research contributes some data of interest for understanding the tendencies previously pointed to. The motives which have the greatest influence on persons doing sport or physical activity are, first, «liking sport» (52%) – which is, according to specialists in sport sociology, a factor tied to the process of socialization, followed by «improvements in health» (20%) and «physical and psychological well-being» (12%) – two factors related directly to health and well-being, although they also have a cultural character. Regarding motives that have influence on persons not doing sport, the factors of a practical character are the most important: «Lack of time», «work» and «family responsibilities» are the reasons given by half of the Spaniards to justify their inactivity in this field. Also important is the fact that four of every ten persons give as reasons 192 SPORT, HEALTH AND QUALITY OF LIFE for not doing sport that «they don’t like doing it» (11%), «laziness» (10%) and «health problems» (18%). In third place, the study shows the importance that socialization through the family has in sporting habits; there is a high positive correlation between doing sporting activities and a history of practicing sports in the family. It also shows the importance of personal history, as the fact that an individual has practiced sport in the past is a decisive element in their willingness to continue practicing it, above all in the older age groups. In fourth place, the present study shows how living conditions are determinants in the practice of sport and physical exercise. Their practice increases as do educational levels (being highly correlated with the fact of being a student or working), job qualifications and income levels. Individuals with low educational levels, with low incomes and who are not working or who work doing domestic tasks practice sport less. Therefore, socialization and living conditions are found to be closely related with the habit of practicing sport, something which the specialists interviewed in the qualitative part of the study have corroborated. In fifth place, the study reveals the socio-demographic characteristics of those that have an active lifestyle and those that have a sedentary one. Although, as was mentioned above, the majority of the Spanish population does not practice sport or do physical exercise, and this is independent of age, sex or educational level, some differentiating characteristics between sedentary persons and physically active ones do stand out based on the data from the survey. Sedentary persons are more likely to be: women, homemakers, not young, divorced, separated or widowed, unemployed, with low or mid-level education and, finally, persons from families where sport was not practiced.This means that it is more probable to find sedentary persons in each one of these groups than physically active ones. Conversely, it is more probable to find individuals that practice sport or do physical exercise among men, young people, single people and couples, those that are studying or working, those that have higher educational levels and those whose parents or grandparents practiced or practice some sport. According to the results of the segmentation analysis done using the data from the survey, the variables that have the greatest weight in the choice of a sedentary or active lifestyle are educational level, employment situation and family history of practicing sport. CONCLUSIONS 193 Relationship between sport, physical exercise and perception of health The results obtained in this study confirm the initial hypothesis that doing physical activity and sport significantly influences our subjective perceptions of our health. Both the quantitative study as well as the qualitative study obtained the same results, which mean that the reliability and validity of the data are very high. The persons that practice sport assessed their state of health as being significantly better. The frequency and intensity of the practice of sport also seems to have an influence. Thus, the majority of experts share the opinion that sport only contributes to improving our health if we do at least a half hour each day. The study also confirmed that as the frequency of the practice of sport increases among individuals so does their subjective valuation of their health. Doing physical activities in our free time – such as going for a walk – or in our daily lives – principally at work and while doing domestic chores – also improves our perceived state of health. In this relationship, the frequency and intensity with which it is carried out (in the case of going for walks) or the type of physical activity done in our daily lives will have a decisive influence on our self-perception of our health. Going for a walk has a positive impact on our perception of our health when it is done for at least one hour a day, and the activity we do in our daily lives has the same effect if it implies «walking the majority of the time» or «physical effort». A more thorough analysis of these activities permits us to see they have an unequal impact on the perception of health in function of socio-demographic characteristics. Thus, for example, regarding sport, while its positive effect on young people’s perceptions of their health increases with the frequency and intensity of their sporting practice, among seniors this improvement in the perception of health is produced simply through sporting activity regardless of the type of sport or the intensity of its practice. With regard to going for walks and everyday activities, their impact on individuals’ valuation of their health is high among seniors but practically nil among young people. Being a man or women, as well as living situation, educational level and employment situation also impact to different degrees and manner on this relationship. Although the quantitative study has supplied proof that the relationship between sport and physical exercise on one side, and the subjective perception of health on the other, is significant, the qualitative study has served to corroborate the 194 SPORT, HEALTH AND QUALITY OF LIFE evidence and also to clarify the terms through which individuals establish this relationship. The different segments of the population interviewed share the opinion that the practice of physical activity and sport favourably impacts on the valuation of one’s state of health, an effect which is also recognized in the opposite sense. Those interviewed recognize the improvement in the valuation of health that doing physical activity and sport contributes on the physical level (their impact on general physical condition), the psychological level (above all, the benefits from reduction in stress and anxiety) and the social (improvements in social skills, the prevention of isolation and loneliness, the provision of social values tied to respect for others and their efforts, etc.). These effects from sport and physical activity on our physical, psychological and social health, pointed out in the group discussions, have been confirmed in the opinions of the experts, which are based on empirical evidence obtained in epidemiological and longitudinal studies. These studies indicate that health represents an opportunity as well as a barrier to the practice of sport and physical activity among the Spanish population. The experts indicate that having good health is a basic condition for practicing sport at certain ages (for example, among older persons), therefore health allows or hinders the development of certain physical and sporting activities; but they also point out the paradox that having good health in youth can be a barrier to the practice of sport, sport understood not in its dimension as play, but rather in its positive effects on our health and well-being. If a young person perceives (although incorrectly) that his/her health is good, he or she may not take care of it through physical exercise or the practice of sport. This issue, quite subtle, has been raised by experts and specialists in sport medicine as a problem which emerges in that stage of youth when the ludic dimension of sport is abandoned and is not substituted by physical exercise as a necessary practice to maintain and improve health. The relationship between sport, physical exercise and subjective quality of life The study also examined the influence of sport and physical exercise on the subjective quality of life. The study has provided evidence that as individuals’ practice of sport or physical exercise increase so does the valuation of their perceived well-being. CONCLUSIONS 195 The qualitative research has verified that physical exercise and sport have a significant impact on the general valuation of our quality of life. As individuals relate physical exercise and sport with health, and in turn, health with quality of life, the relationship between sport, physical exercise and quality of life is automatic. The analysis of the information obtained through the survey is oriented in this same way, as the dimension «subjective quality of life» is evaluated based on the factor «subjective well-being», which is formed by, among other variables, «perceived health». Regarding the practice of sport specifically, the survey revealed a significant difference between those who practice sport and those who do not. Among those that do some type of sport the perception of well-being is much greater than among those who do not practice sport. The same tendency is seen when looking at the influence that certain physical activities that we do in our work or leisure time (in particular, going for walks) have on our perceived well-being: the greater the level of activity the greater the perceived well-being. As occurs with the self-perception of health, among the population surveyed some differences in the tendencies can be observed according to sociodemographic profile. Thus, young people, men, single persons and married persons and, lastly, those with higher educational levels and higher incomes have a higher perceived well-being than seniors, women, the divorced, widowed and those with lower educational levels and income. The socio-demographic profiles that are obtained when we look at the degree of subjective well-being coincide with those obtained when establishing the profiles of those who practice sport and physical exercise (the first group) and those who do not (the second group). This means that the profile of who practices sport is very similar to that of who expresses feeling a higher subjective level of well-being and, therefore, a higher quality of life. Sport, health and quality of life among young people In this research it has been confirmed that young people in Spain are the population group that does the most sport and physical exercise. This has been explained by the fact that the majority of young people in Spain have had the opportunity to be instructed in the practice of sport and physical activity through the educational system. In addition, among these generations it is common to find parents that also have practiced sport, transmitting to their 196 SPORT, HEALTH AND QUALITY OF LIFE children their active pasts and, therefore, serving as a reference for sporting values. Despite this, the data shows that the number of young people that do sport is low: about half of those between the age of 18 and 34. The low percentage of young people that practice sport is attributable to, according to the evidence obtained through this study, the importance acquired by other leisure activities (digital and night time leisure), which take time and importance away from physical exercise and sport. In addition, young people state that they are subject to a strict meritocratic system which leads them to constant participation in the acquisition of qualifications, impeding them from dedicating more time to basic tasks of personal care and the cultivation of social relationships. Therefore, lack of time, together with entry into the labour market and the predominance of new leisure practices are the principal motives given by young people to justify their lack of sporting practice. If we look at the low percentage of young people that practice sport or walk daily (four of every ten and seven of every ten respectively) and, in addition, we take into account that more than half spend the day sitting or standing without great physical effort, we can see that young Spanish people are very sedentary. This sedentary lifestyle does not, however, have a negative influence on the perception of health among young people given that, in this age bracket they still enjoy good health. Therefore, doing physical exercise and sport has no significant impact on the subjective perception of health among young people. Nevertheless, in the qualitative research a slight difference can be observed among those between the ages of 18 and 24 and those between 25 and 34, as in this second group a greater awareness of the loss of health associated with worsening physical condition can be detected. In contrast to what occurs regarding perceived health, the practice of sport and physical exercise does have positive influence on the subjective well-being of young people. Practicing sport has greater impact on the subjective perception of well-being than other factors, such as employment situation, educational level, income level or marital status. Thus, it seems notable the difference between those who do not practice sport and have a low perception of their well-being, and those that do practice sport and perceive their well-being as much higher than that of others. According to the results of the qualitative phase of the study, the aspect that young people most associate with the contribution CONCLUSIONS 197 that sport and physical activity makes to subjective well-being is its utility for facing psychological health problems (stress, anxiety, depression, etc.), many of which derive from work. Sport, health and quality of life in old age The senior population is subject to health conditions which in themselves make the practice of sport and physical activity difficult. And to such an extent that health problems, together with age, constitute the motives most frequently mentioned by older persons to explain their lack of participation in the practice of sport (among, at least half of those that do not do sport). It is evident that the basic conditions are distinct from those of young people. In addition, seniors have the additional handicap that, a significant percentage of them did not have parents that did sport or physical exercise, nor did they earlier in their lives. Therefore, seniors find themselves having missed the process of socialization in sporting values, which has a negative impact on their propensity for physical activity. In addition, the lack of sporting facilities near to places where seniors live does not contribute to facilitating their access to the practice of sport. Despite seniors doing less sport than young people (only two of every ten persons over 65 years of age practice sport), they do go for walks with almost the same frequency. At least six of every ten seniors go for walks regularly, which represents a high figure considering that they suffer much less favourable health conditions than young people. This observed tendency of going for walks is a result of various factors, first, the increase in life expectancy and the better health conditions people have when they arrive at old age; secondly, the emergence of values that emphasize the need for personal care and the enjoyment of free time among seniors themselves and supported by family doctors that guide them in adopting healthy habits; and, finally, the fact that doing this physical activity (going for walks) does not demand as much as the practice of sport. All of this has favoured the emergence of the phenomenon known in many places as the «cholesterol route», meaning urban or suburban walking routes frequented by seniors and adults who walk daily in order to burn calories and improve their health and well-being. Regarding the daily activity of seniors, it should be noted that it is mostly sedentary. Seven of every ten seniors spend the majority of their time seated or standing, and only one third say they walk. These habits, together with the lack 198 SPORT, HEALTH AND QUALITY OF LIFE of sporting practice translate into a high percentage of seniors with sedentary lifestyles, in other words, unhealthy lifestyles. As a result, the practice of sport among seniors does not have a significant impact on their subjective perceptions of health. In contrast, daily activity, followed by the habit of taking walks, does have a positive impact. The challenge of healthy living Through the present study we have had the opportunity to reveal the trends that characterize the lifestyles of the Spanish population, determined in a specific way by their habits related to the practice of sport and physical activity, highlighting in particular the way this is expressed among young people and seniors. The results obtained lead one to see the future with a certain degree of concern regarding the health conditions and well-being of these age groups. Among seniors, it is worrying that the increase in life expectancy and improvements in medical and health services are not accompanied by the sense that seniors’ physical health conditions and well-being are also improving. Among young people, the strong tendency toward sedentarism is even more worrying, and the low level of participation and low frequency of the practice of sport and physical exercise is of concern as it will provoke in the not distant future a progressive decline in the health and well-being of this segment of the population. Proof of this is the data discussed in the introduction to this study about the high percentage of young Spanish people that suffer from obesity and overweight, and the consequences that this has on their health and well-being. These tendencies suggest that, in the future, seniors will live longer but they will do so in worse physical condition. At the same time, young people will prematurely suffer from illnesses associated with aging, to the point that, as some of the experts interviewed suggested, for the first time in modern history, older persons may see their children die for reasons not associated with war but rather with overabundance. In addition, greater public resources will have to be allocated for the treatment of illnesses produced by sedentarism which will put public spending in other areas at risk. Through the combination of quantitative and qualitative methodology, the study has shown that, ultimately, absence of health is the worst enemy of trying to improve health, as it limits the activities possible, such as physical exercise and sport which improve health, both in physiological terms as well CONCLUSIONS 199 as psychological and social. At the same time, the study has shown that the social environment is fundamental in the transmission of habits and incentives for doing physical activity and sport. We have also verified that economic conditions limit the practice of sport, as do working conditions, above all if sporting infrastructure of easy access and low cost is not available. Specialists in health sciences and sport medicine have proposed interesting strategies which could contribute to overcoming many of these barriers. To do this the key is in understanding the need to change our lifestyles if we really have an interest in having the health necessary to enjoy a higher quality of life, something which necessarily requires paying greater attention to our habits related to physical exercise and sport. In this sense, the experts interviewed in this study share the idea that the only way to guarantee a healthy lifestyle in our society is to employ the resources of the government in a coordinated manner toward the integration of physical exercise and sport in our daily lives. This use of public resources should involve the mobilization of those institutions and bodies (public and private) that can contribute from their distinct fields of action to this objective. The specialists consulted referred to, among other authorities and institutions to be mobilized, the family, the educational system, the healthcare system, businesses, sports clubs and associations and the media. Regarding the family, the specialists indicate that it is of strategic importance. This is because they believe that the development of sporting habits, as with other healthy habits, must be transmitted in the early years of life. This early development of the culture of sport guarantees its durability over time. The socialization of this habit within the family plays a crucial role. This perspective is corroborated by the data from the survey, in which the correlation between an individual’s practicing sport and the fact that his/her parents also did so is verified. Hence, the specialists consider it important to promote the practice of sport in the family. The institutions with responsibility for the promotion of sport must take this into account in designing their plans and programmes. This means adopting measures directed at promoting sport in the family and, in addition, adopting other measures that allow family members to balance family responsibilities with their own personal needs. Thus, for example, one of the specialists 200 SPORT, HEALTH AND QUALITY OF LIFE highlighted the wise decision of some sports facilities to offer childcare services for parents that want to use the facilities but that are kept from doing so because of their parental responsibilities. Regarding the educational system, the experts consider it, together with the family, as the institution sine qua non in the transmission of sporting habits. This is because everyone passes through the educational system and, in addition, does so during stages which are fundamental in the socialization of values and habits. Given that physical education is a compulsory subject, the specialists see the educational system as a privileged space for strengthening sporting habits. This, however, contrasts with the lack of importance this subject has in comparison with other school subjects. In effect, students and their parents do not value physical education in the same way that they do other subjects, probably because they are not aware of the benefits of sport. Perhaps for this reason the number of hours dedicated to physical education each week is so low (barely three hours per week, of which one hour is dedicated to theory) and, it has even disappeared from the baccalaureate and the university; a circumstance which, in addition to impeding children and adolescents from burning the minimum calories suggested by the WHO to have good health (between 1,800 and 2,000 kilocalories per week), will lead over time to young people suffering from degenerative illnesses. As a solution, the experts propose a series of measures. First, make sure that sport becomes a cross-curricular theme in the educational system in order to reinforce its importance for our lives. This objective could be achieved by increasing the number of hours per week of physical education (one hour per day is suggested by these experts, which does not necessarily have to be during the school day as extracurricular activities would serve), expanding the operating hours of the sporting installations in schools (something that could serve students looking to enjoy their leisure time outside of the school day – during the afternoon or weekends – as well as parents who could leave their children at school before going to work) and making sport a free choice credit in the university. Secondly, the experts propose improving what is offered in physical education in the schools, increasing teaching staff and improving quantitatively and qualitatively the sporting installations. To do this the experts propose establishing agreements between schools and private gyms in order to outsource certain physical education services to guarantee the practice of sport among students. CONCLUSIONS 201 Another important institution which must be mobilized to promote sport is the healthcare system. Until now, except in limited cases, this system has lacked specialists in sports medicine. The healthcare system has fundamentally seen sport as therapy and not prevention. Despite this, in recent years doctors have become more aware of the need to recommend the practice of physical exercise and sport for their patients, above all because of the worrying increase in obesity among children and young people. In line with this, the function of the healthcare system in the promotion of sport is justified by the fact that it will be much less costly to invest in promoting sport (as a preventative activity for determined illnesses associated with sedentarism) than the high technology of many healthcare therapies. Consistent with this idea, within the healthcare system there have for some time now, been campaigns to promote the practice of physical exercise as a way of improving health. Given that their reach is limited, and taking into account the need to redirect healthcare policies concerned with this issue toward the path of prevention, the specialists agree on the need to adopt measures of a greater scope, such as introducing the figure of the sports doctor into health centres, offering a specialized service for patients that require it and establishing collaboration between primary care doctors and professionals in sports science. Another area where it is necessary to promote sport is in the workplace. The population – specifically the adult population – spends a good part of their time at jobs which today hardly demand physical effort. This change in the productive tasks of workers has, in recent years, led to a new concern among businesses: the increase in sick leave as a consequence of health problems related to new organizational models in the knowledge and service sectors (physical aches and pains such as lumbago or other back problems, and psychological conditions related to stress and anxiety). Many of these problems could be resolved through sport and physical exercise; however, many companies have still not taken up this issue. The specialists think that it would be more profitable for many companies to provide time for their employees to practice sport than to face the costs of workers absent for health problems that are a consequence of sedentarism. In addition to these benefits, the fact that productivity and performance increase with a greater state of health must also be recognized. For these reasons, the specialists suggest that companies providing their own sporting facilities to their employees (as occurs with lunchrooms and day-care facilities in some 202 SPORT, HEALTH AND QUALITY OF LIFE companies) or access to facilities would be a positive step, and they advise companies to promote exercise and stretching before work, which helps to reduce injuries and strengthens the musculoskeletal system. Regarding the strictly sporting area (federations, clubs and sports associations), the experts agree in pointing out that, currently, these are not the most adequate organizations for promoting popular sporting practice. The majority of these federations, associations and clubs plan their activities more around competitive and professional sports than «Sports for All». As a result, the logic, objectives and plans are different when one is promoting competitive sport rather than the popular practice of sport. In addition, among the associations and clubs that are not focused on competitive sports, the resources they have available do not permit their activities to reach a large segment of the population. For these reasons, the specialists point out that the ideal would be that the municipal sports schools had more weight than the clubs and federations, and would have greater resources and would focus their policies on promoting sport for all. Finally, the media, generally concerned with competitive sports news, should assume part of the responsibility by providing a different image of sport. It is essential that the media, which has critical importance in the transmission of values and images related to sport, tries to raise awareness in society of the problems associated with lack of physical exercise and sport, and their impact on our health and personal well-being. All these proposals can contribute to the objective of making sport, health and well-being key elements in the life of population in the 21st century. These elements should not be taken lightly, as the evidence demonstrates that the practice of sport notably improves health and well-being and, as a consequence, contributes to reducing the costs to the healthcare system of the treatment of illnesses associated with inactivity. This study has sought to provide food for thought in support of measures aimed at promoting sporting habits in society, which are essential for maintaining health and improving quality of life. For the promotion of sport to be successful it is necessary to take into account expert opinion as well as laypersons’ beliefs and values related to physical activity and sport. It is precisely this combination, the points of view of the expert and the layperson, which this study has tried to provide. CONCLUSIONS 203 Bibliography ALONSO, L. E. and CONDE, F. 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BIBLIOGRAPHY 209 Index of graphs and tables Graphs 1.1 Regarding interest in sport and your level of practice, with which statement do you most identify? 28 1.2 Participants in sport, according to whether their parents practiced or did not practice sport 37 Whatever your principal activity, which of the following situations best describes the physical activity you do? 45 1.4 Classification of the Spanish population in the Lifestyle Index (LSI) 49 1.5 Segmented analysis of lifestyles of the Spanish population 52 2.1 Average perceived health by age group, with confidence intervals (95%) 63 2.2 Perceived health in relation to others and over time by age group 65 2.3 Recommendation to do physical activity by doctor or therapist and aches and pains in some part of the body, by age of interviewed 70 Average perceived health according to sporting practice of the adult population, with confidence intervals (95%) 77 2.5 Average perceived health according to lifestyle among seniors 78 3.1 Average of the indicators for well-being, quality of life and satisfaction (total sample) 88 Representation of well-being in function of sporting activity a) and age groups b) 91 3.3 Average well-being by sporting practice, with confidence interval (95%) 95 3.4 Average well-being and age, with confidence intervals (95%) 96 3.5 Average well-being and practice of sport among young people, with confidence intervals (95%) 97 Average well-being and practice of sport among adults, with confidence intervals (95%) 98 1.3 2.4 3.2 3.6 210 SPORT, HEALTH AND QUALITY OF LIFE 3.7 Average well-being and physical activity among seniors, with confidence intervals (95%) 99 5.1 Cycles of inactivity and activity, according to one of the experts 153 5.2 The cycle of activity: inclusion of the social dimension 158 Tables 1.1 Leisure activities of the Spanish population 24 1.2 Leisure activities of the Spanish population by type of activity 25 1.3 Type of leisure activities of the Spanish population, by sex, age and income 26 1.4 Motives for practicing and not practicing sport 30 1.5 Motives for practicing sport, by age groups and sex 32 1.6 Motives for not practicing sport, by age groups and sex 33 1.7 Participants in sport, according to whether or not they practiced sport in the past 38 1.8 Stereotypes about sport 39 1.9 Participants in sport, according to educational level 40 1.10 Participants in sport, according to occupation or other employment situation 41 1.11 Participants in sport, according to income level 42 1.12 Type of physical activity done at work 46 1.13 Empirical variables of the active dimension 47 1.14 Empirical variables of the sedentary dimension 48 1.15 Weighting coefficient of the Lifestyle Index 48 1.16 Frequencies from the Lifestyle Index 49 1.17 Groups resulting from the segmentation of the Lifestyle Index 53 2.1 Responses obtained for the two items about perceived health 63 2.2 Averages of perceived health by physical activity and age groups 71 2.3 Regression analysis. Dependent variable: perceived health. Independent variables: lifestyle 73 Regression analysis. Dependent variable: perceived health. Independent variables: lifestyle and sociodemographic variables 74 2.4 INDEX OF GRAPHS AND TABLES 211 3.1 Average and Standard Deviation for variables of well-being, quality of life and satisfaction by age groups 87 3.2 Averages for well-being in function of physical activity 90 3.3 Regression analysis. Dependent variable: wellbeing. Independent variables: lifestyle 93 Regression analysis. Dependent variable: well-being. Independent variables: lifestyle and sociodemographic variables 94 A. Sample obtained by age group and sex and type of administration 216 B. Sample design for the qualitative phase of the study 219 3.4 212 SPORT, HEALTH AND QUALITY OF LIFE Methodological appendix To achieve the objectives of this study a research protocol was undertaken which combined qualitative and quantitative techniques of gathering and analysis of data. The two phases were carried out in succession, beginning in October of 2007 with the quantitative field work and ending in September of 2008 with the analysis of the results obtained in both phases. The quantitative phase of the study consisted in a survey aimed at the resident population in Spain with ages between 16 and 79. In the qualitative phase five discussion groups were formed based on individual characteristics, such as age, sex or state of health, and socioeconomic characteristics, such as income level, family situation, educational level and occupation. The qualitative part of the study was also complemented by in-depth interviews with seven experts on the theme of this study. Below are the methodological characteristics of each of these phases. Quantitative phase The fundamental criteria that has guided decision making, both in regard to the choice of data gathering technique and in the definitive design, has been their adequacy to the principal objective of the study, as well as the need to offer specific results on the population segments of young people and seniors. The data gathering technique chosen was computer assisted telephone interviewing (CATI). Both the object theme of the study and the defined objectives allowed for the design of a brief, highly structured questionnaire. In addition, the study did not require the subjects to show documentation or any METHODOLOGICAL APPENDIX 213 material during the interview. This technique also permitted the optimization of the costs of the survey and speeded up the completion of the fieldwork and analysis of the results. The principal argument against this choice of technique is related to the problems of the coverage of fixed telephones, as a consequence of their substitution by cellular phones among a significant part of Spanish households or among specific populations, such as young people. Only very recently have surveys been carried out using cellular telephones in Spain. However, their use is increasingly more important to guarantee the representativeness of the samples obtained through telephone surveys, although this raises some difficulties in implementation. Among these are the fact that a part of the population, and particularly seniors, may lack cellular telephones, and that there do not exist lists of these types of phones that serve as a sampling frame. In order for the survey to offer an adequate level of representativeness, the decision to incorporate both fixed and cellular phones in the sampling frame was adopted. For this, the interviews were distributed into two subsamples: one for doing the survey through fixed telephones, and the other through cellular. To determine the number of interviews assigned to each form of administration a prior analysis was done of the possession of telephones in the Spanish population by the strata that would be used in the configuration of the sample (age group and sex), according to data from the INE [National Statistics Institute]. The decision to incorporate cellular phones in the sampling frame of the survey was a technological and methodological challenge, although it has meant a qualitative improvement in the representativeness of the simple and, therefore, a decrease in the associated sampling error. This decision also explains a good part of the specificities of the technical specifications of the survey, whose principal characteristics we will summarize in what follows. Scope: national. Universe: the theoretical universe of this study is the resident population in Spain from 16 to 79 years of age. The practical universe corresponds to that population that has a fixed or cellular phone. 214 SPORT, HEALTH AND QUALITY OF LIFE Survey procedure: computer assisted telephone interviewing (CATI) through a structured questionnaire. Interviews were done through both fixed and cellular phones. The interviews were made by qualified interviewers with specific training for this study. The questionnaire had an average duration of approximately twelve minutes. Sample design: the objective of the sample was to obtain a good representation of the Spanish population from 16 to 79 years of age. In addition, gathering specific information on young people (persons from 16 to 34 years of age) and from seniors (persons from 65 to 79 years of age) was specified. Additionally, in the group of young people a minimal representativeness of two subgroups was wanted: those of 16 to 24 years of age and those of 25 to 34 years of age. For this, as was mentioned, interviews via fixed and cellular phones were done. The distribution of the interviews in function of the application mode (fixed or cellular) was made taking into account the data from the Survey on the Equipment and Use of Information and Communication Technologies (ICT-H) in Households of the INE, and corresponding to the second semester of 2006. With this data the optimal distribution of surveys for each age group and sex group by type of administration was estimated so that the estimated variance would be minimal. Once the field work was initiated, the difficulty of doing the planned interviews of seniors through cellular telephones was verified. This could be due to the fact that although they have cellular phones, from what the survey of the INE reveals they do not really use them. For this reason it was decided to do a part of these interviews through fixed phones, which had been shown to provide a much better possibility of contact with this segment of the population. Therefore, the final distribution of the sample is what appears in table A. After obtaining the data matrix, it was necessary to adjust the distinct probabilities that each individual had of having entered into the sample, thus, while those that only had a fixed or cellular phone would have a probability dependent on the number of interviews that would be done in that age group to fixed or cellular phones, those that possessed both technologies would have a greater probability of entering the sample, as they could be called on their fixed or cellular telephone. For this reason, the proportions obtained from these two types of telephones had to be adjusted to correspond with the real proportions. METHODOLOGICAL APPENDIX 215 TABLE A Sample obtained by age group and sex and type of administration SEX Men Women AGE FIXED CELLULAR TOTAL 16-24 41 164 205 25-34 46 161 207 35-64 76 127 203 65-79 337 24 361 16-24 37 162 199 25-34 36 157 193 35-64 85 123 208 65-79 Total 420 22 442 1,078 940 2,018 Source: Study E0727 IESA-CSIC. In addition to the adjustment made to correct for the probability of selection of the segments in function of the mode of administration of the survey, a correction was made of the results in function of the variable educational level. One of the principal effects of surveying through telephone interviews is that they tend to over-represent the population with higher educational levels. Although the incorporation of cellular phones in the sample corrects a part of this deviation, post-stratification continues being necessary, with the object of restoring proportionality to the variable educational level. The data used for this came from the National Population and Housing Census of 2001. The computer assisted telephone interviews (CATI) were carried out in the time indicated with the participation of two groups of 18 interviewers each (18 in a morning schedule and 18 in an afternoon schedule). To obtain the 2,018 successful telephone interviews a total of 26,196 calls were made (17,208 to fixed telephones and 8,988 to cellular telephones). 92 percent of the calls were with incidents and 8 percent of the calls were successful. The calls made to cellular telephones were much more successful than those made to fixed telephones (10.45 percent and 6.26 percent respectively). Sample error: the level of maximum admissible margin of error was fixed at +/–3 percent for the general sample and at +/–3.5 percent for the samples of young people and seniors. Within the group of young people, the margin of error for each subgroup is +/–5 percent. 216 SPORT, HEALTH AND QUALITY OF LIFE Sample size: 2,018 interviews were done. Field work and statistical treatment of the results: This was done by the Telephone Survey Section and the Statistical Section of the Institute for Advanced Social Studies (IESA). The field work was carried out between the 30th of October and the 20th of November of 2007. Qualitative phase Along with the use of quantitative techniques of social research, qualitative techniques were also employed: discussion groups and individual in-depth interviews. The fundamental objectives of this phase were to explore the values, perceptions, attitudes and behaviour of the general population toward the object of study, the position that the central concepts of the study occupy in the hierarchy of values of the population and the differences that can be found regarding the positions that the experts interviewed assign to them based on their professional knowledge and scientific evidence. In addition, we have attempted to explore the differences between the perceptions of the experts and those of the general population, which has great importance when it comes to developing public policy for the promotion of sport. The coordinators of the study participated in the planning of the qualitative part of the research, establishing the guidelines on the objectives of the study and the limitations of time and resources. The field work was carried out by only one researcher, and in the final drafting of the chapters that form this part two other researchers also participated. While the objective of the discussion groups was focused on exploring the opinions and perceptions of the general population, the in-depth interviews were concerned with revealing the views and assessments among experts. The dynamic in the discussion groups was planned based on very open criteria. In his/her intervention, the moderator tried to direct the discussion from the most general to the most concrete. The duration of the sessions was between 70 and 100 minutes. At all times notes from the contributions of the participants were taken and a voice recording of the session was also made. METHODOLOGICAL APPENDIX 217 With this objective, five groups were recruited and organized – two with young people from 18 to 32 years of age, two with seniors over 60 years of age and an additional group of parents of school age children from the ages of 10 to 15 – to discuss the theme of the study using the following design: «citizens residing in Spanish municipalities that fulfil the specifications set for each concrete group» (table B). This sample design of the qualitative study had an intentional character, given that we were looking to select those groups of persons situated in strategic positions within the system of relations connected to the object of research. What was looked for was not extensive but rather intensive representativeness, to gather information from the widest part of the differing perspectives of the implicated social structure. Therefore, it was not necessary to have representativeness that could be extrapolated to the overall population, but rather to the scope of the study. For the correct interpretation of the information from the preceding table we will clarify some issues: Participants and sex: the groups were formed by seven or eight persons, composed of men and women in four cases, and in one case, exclusively of women. This exception is justified by the fact that in rural areas there is a greater differentiation of gender roles among seniors, which is also reflected in the functions assumed within the nuclear family. As a consequence, not taking this differentiation into account would have led to an important bias in a mixed group with these characteristics in a discussion about a theme that is closely related to the family obligations of individuals. Health: the requirements of this type were such that there was an attempt to assure that the groups were made up of persons with the full mental and physical capacities necessary to carry out an autonomous life, although they could have some health limitation. Therefore, the study did not admit participants with limitations of personal mobility, or that had sensorial or mental limitations, considering that such problems could add greater difficulties in understanding the specific objectives of the study. Membership: this requirement refers exclusively to group 5, composed of parents of children in public schools who belong to the school parents’ association of the school in which their children are educated. Parents who work as teachers 218 SPORT, HEALTH AND QUALITY OF LIFE TABLE B Sample design for the qualitative phase of the study GROUPS PERSONAL CHARACTERISTICS SOCIODEMOGRAPHIC CHARACTERISTICS GROUP 1: 60-75 years of age (8 persons) Sex: mixed (half men and half women). Health: healthy or chronic Illness not physically or mentally disabling. Social status: middle-high (income of the home between 1,200-3,000 euros/month). Family situation: married without family responsibilities (neither children or other dependents). Sex: women. Health: healthy or chronic illness not physically or mentally disabling. Social status: middle-low (income of the home between 400-1,200 euros/month). Family situation: widowed or married with family responsibilities (grandchildren below 12 years of age, other relations, family members with disabilities). Sex: mixed (half men and half women). Health: healthy or chronic illness not physically or mentally disabling. Educational status: low-middle (intermediate level vocational training certificate and/or baccalaureate). Employment status: not students. Employed or unemployed. Family situation: single without children nor living with partner. Sex: mixed (half men and half women). Health: healthy or chronic illness not physically or mentally disabling. Educational status: middle-high (from intermediate level vocational training and/or baccalaureate to university studies or graduate). Employment status: employed with Madrid mid-level or high-level qualifications. Family situation: single or living with partner, with or without children. Sex: mixed (half men and half women). Membership in school parents’ associations. Educational status: middle-high (intermediate level vocational training and/or baccalaureate to university studies or graduate). Family situation: single or living with partner, with children from 10 to 15 years of age in school. Place: Barcelona GROUP 2: 60-75 years of age (8 persons) Place: Antequera (Málaga) GROUP 3: 18-22 years of age (8 persons) Place: Puente Genil (Córdoba) GROUP 4: 24-32 years of age (8 persons) Place: Madrid GROUP 5: 35-50 years of age (8 persons) Place: Barcelona Source: Study E0727 IESA-CSIC. METHODOLOGICAL APPENDIX 219 in public schools and those that do not belong to the school parents’ association were excluded. Exclusion based on the first criterion is justified by the need to avoid the discussion in the group being dominated by the more formal and authoritative discourse of a teacher who might be a participant in the group. The second criterion for exclusion results from the interest in avoiding the presence of parents completely disconnected from the socialization of sport in the schools. Finally, the parents in the discussion group were all from different schools as one of the technical requisites of the discussion group was that the participants did not know each other, as that ensures the free expression of social discourse. As a consequence, no more than one person with this profile could be admitted to the group form each school. Social status: in groups 1 and 2, made up of older persons, an attempt was made to differentiate the two groups based on socioeconomic and sociocultural status. It is thought that household income is the best indicator of status, therefore two income intervals were established: between 400 and 1,200 euros per month for group 2, and between 1,200 and 3,000 euros per month for group 1, calculated as the total monthly income that the home of the individual referred to receives. In this way, on the one hand, a discourse from a group of individuals of middle to low status and from a rural environment was obtained, and on the other, a discourse from a group of middle to high status from an urban environment also. From a sociological perspective this is important as they cover a wide spectrum of the senior population. Family situation: with this condition the intention was to provide homogeneity to the group and focus on the family situation of the majority of the reference population. An attempt was made to also differentiate the situation of the participants in relation to their family responsibilities, as these are considered to be relevant in the elaboration of the discourses that give sense to their sporting practices, as they limit or facilitate their availability to do sport. These two conditions were taken into consideration in the two groups of older persons, groups 1 and 2, and thus, on the one hand, in group 1 a group of married persons without family responsibilities was obtained and, on the other hand, in group 2, a group of women, married or widowed with significant family responsibilities. In the 2 groups of young people, groups 3 and 4, the young people from 18 to 22 years of age were considered to be single and without family responsibilities, which is most common at that age, even in rural areas. Group 3 included individuals that 220 SPORT, HEALTH AND QUALITY OF LIFE were living with a partner or not, or who had family responsibilities or not, as it is in the age bracket of 24 to 30 years of age when many begin to form families. Finally, for group 5 the most important factor considered was having school-age children between 10 and 15 years of age, independently of whether the parents lived together or not. Occupational and educational status: although among adults income is a good indicator of social status, among young people income is not the best indicator of status as careers are still in the making and not consolidated. For this reason, group 3 was considered to represent the social sector of young people with low-level qualifications and academic education that are employed or looking for employment and, therefore, are as a group well-differentiated from those that are still studying. More specifically, these are persons with the following characteristics: a maximum level of studies of an intermediate level vocational training or the baccalaureate and that are not self-employed. Group 4 was considered to represent young people with high level qualifications, with higher level vocational training or education and not self-employed. In other words, excluded are students, persons of independent means, businessmen, professionals, homemakers, pensioners, etc. In this case it is irrelevant if the group includes the unemployed. Some suggested occupations of reference were: skilled worker, chief administrative officer, civil servants from groups A, B or C, executives of banks, insurance or financial firms, professional staff, technicians, etc. Regarding the individual interviews, they were done with a group of professionals who work in the sports field to have a more comprehensive perspective on the situation of sport and its practice in the population. The persons interviewed were a professional physiotherapist, a manager of an association for the promotion of sport, a sports medicine doctor for competitive sports, a professional of physical education and sports research, a sports doctor for the general population and a doctor in a health centre involved in the promotion of sport. Those interviewed that are university faculty in departments of Physical Activity and Sport, along with their teaching activity for future sports professionals also participate in scientific research. METHODOLOGICAL APPENDIX 221 The structure of the script that was used is the following: 1. General description of the role of the interviewer and his/her organization in relation to sport, health and qualify of life. 2. The relationship between sport, health and quality of life from a scientific perspective. 3. The reality of sport and physical activity in the population. 4. Recommendations for the promotion of sport. Interview script points for the discussion groups A) Points to be considered in the debate: 1) Relationship between lifestyles, practice of sport and/or physical activity and the subjective perception of health and personal quality of life. 2) Subjective perception of doing sport and/or physical activity. Habits related to sport and/or physical activity. 3) Subjective perception of health (physical and psychological) and personal quality of life. 4) Motives and reasons for doing or not doing sport and/or physical activity. 5) Sport socialization. B) Points to be considered among the groups of young people: 1) Perception of sporting installations: problems and/or facilities. 2) The competition from other leisure activities. 3) How much of their well-being and health is attributed to sport and/or physical activity. C) Points to be considered among the groups of seniors: 1) What obstacles are there to doing sport and/or physical activity (physical, cultural and specifically stereotypes). 222 SPORT, HEALTH AND QUALITY OF LIFE D) Points to be considered among the groups of parents: 1) The promotion of sport and/or physical activities (in schools, in the government, in civil society). E) Statements: 1) The practice of sport neither improves nor harms one’s health or personal well-being. 2) It doesn’t matter what I do during the day, I always make time to do sport. 3) Despite my interest, I never find the opportunity or the money to do sport. 4) If I didn’t do sport and/or physical activity I would feel lonely. 5) I do sport because I want to be like… 6) No one can influence a person to do or not do sport and/or physical activity. Script points for the in-depth individual interviews A) Presentation and description of the objectives of the interview: 1) Establish the relationship between individual’s lifestyles related with sport and physical activity and the subjective perception that they have of their state of health and personal well-being. 2) In the interviews try to contrast the information gathered through the discussion groups and clarify the state of scientific knowledge about the relationship between sport, health and quality of life. 3) Gather information about the situation of sport and physical activity in the overall population and the existing strategies for their spread. B) The relationship between sport, health and quality of life from the scientific perspective: 1) Could you briefly define the concepts of sport, health and quality of life? METHODOLOGICAL APPENDIX 223 2) In general terms, what affect does sport and physical activity have on the health and quality of life of the individual? 3) How does sport affect the physical health of individuals? 4) How does sport affect the psychological health of individuals? 5) How does sport affect social relations and skills? 6) What is the difference in the affect sport has on young people and seniors? C) The reality of sport and physical activity in the population: 1) In general, how well do you think the population has internalized the advantages and disadvantages of doing sport and physical activity? 2) What criteria do people have when doing sport or physical activity? 3) What do you think are the concrete circumstances which motivate individuals to do sport or physical activity? 4) What do you think are the obstacles that individuals face in doing sport or physical activity? 5) What benefits does sport or physical activity have for individuals in different age groups (children, adolescents, young adults, mature adults, seniors)? 6) What harm does sport or physical activity have for individuals in different age groups (children, adolescents, young adults, mature adults, seniors)? D) Recommendations for the promotion of sport: 1) What is your assessment of the quality and quantity of the sporting practice and physical activity of the population? 2) Do you think the practice of sport and physical activity should be promoted, or do you think it is not necessary? 224 SPORT, HEALTH AND QUALITY OF LIFE 3) What institutions do you think are the most important for promoting the practice of sport and physical activity: government (central, autonomous, local), the educational system, the institutional sporting structure, the family, social associations in general, groups of friends and peers, etc.? 4) What types of measures should be taken by public and private entities to promote sport and the practice of sport? 5) What resources do you think should be made available for this end? METHODOLOGICAL APPENDIX 225 Social Studies Collection Available on the Internet: www.laCaixa.es/ObraSocial Published titles ฀฀ ฀ •฀฀YEARBOOK฀OF฀SOCIAL฀ INDICATORS 1. FOREIGN IMMIGRATION IN SPAIN (Out of stock) Eliseo Aja, Francesc Carbonell, Colectivo Ioé (C. Pereda, W. Actis and M. A. de Prada), Jaume Funes and Ignasi Vila 2. VALUES IN SPANISH SOCIETY AND THEIR RELATION TO DRUG USE (Out of stock) Eusebio Megías (director), Domingo Comas, Javier Elzo, Ignacio Megías, José Navarro, Elena Rodríguez and Oriol Romaní 3. FAMILY POLICIES FROM A COMPARATIVE PERSPECTIVE (Out of stock) Lluís Flaquer 4. YOUNG WOMEN IN SPAIN (Out of stock) Inés Alberdi, Pilar Escario and Natalia Matas 5. THE SPANISH FAMILY AND ATTITUDES TOWARD EDUCATION (Out of stock) Víctor Pérez-Díaz, Juan Carlos Rodríguez and Leonardo Sánchez Ferrer 6. OLD AGE, DEPENDENCE AND LONG-TERM CARE (Out of stock) David Casado Marín and Guillem López i Casasnovas (*) English version available on the Internet 7. YOUNG PEOPLE AND THE EUROPEAN CHALLENGE Joaquim Prats Cuevas (director), Cristòfol-A. Trepat i Carbonell (coordinator), José Vicente Peña Calvo, Rafael Valls Montés and Ferran Urgell Plaza 8. SPAIN AND IMMIGRATION (*) Víctor Pérez-Díaz, Berta ÁlvarezMiranda and Carmen GonzálezEnríquez 9. HOUSING POLICY FROM A COMPARATIVE EUROPEAN PERSPECTIVE Carme Trilla 10. DOMESTIC VIOLENCE (Out of stock) Inés Alberdi and Natalia Matas 11. IMMIGRATION, SCHOOLING AND THE LABOUR MARKET (*) Colectivo Ioé (Walter Actis, Carlos Pereda and Miguel A. de Prada) 12. ACOUSTIC CONTAMINATION IN OUR CITIES Benjamín García Sanz and Francisco Javier Garrido 13. FOSTER FAMILIES Pere Amorós, Jesús Palacios, Núria Fuentes, Esperanza León and Alicia Mesas 14. PEOPLE WITH DISABILITIES AND THE LABOUR MARKET Colectivo Ioé (Carlos Pereda, Miguel A. de Prada and Walter Actis) 15. MOSLEM IMMIGRATION IN EUROPE Víctor Pérez-Díaz, Berta ÁlvarezMiranda and Elisa Chuliá 16. POVERTY AND SOCIAL EXCLUSION Joan Subirats (director), Clara Riba, Laura Giménez, Anna Obradors, Maria Giménez, Dídac Queralt, Patricio Bottos and Ana Rapoport 17. THE REGULATION OF IMMIGRATION IN EUROPE Eliseo Aja, Laura Díez (coordinators), Kay Hailbronner, Philippe de Bruycker, François Julien-Laferrière, Paolo Bonetti, Satvinder S. Juss, Giorgio Malinverni, Pablo Santolaya and Andreu Olesti 18. EUROPEAN EDUCATIONAL SYSTEMS: CRISIS OR TRANSFORMATION? Joaquim Prats and Francesc Raventós (directors), Edgar Gasòliba (coordinator), Robert Cowen, Bert P. M. Creemers, Pierre-Louis Gauthier, Bart Maes, Barbara Schulte and Roger Standaert 19. PARENTS AND CHILDREN IN TODAY’S SPAIN Gerardo Meil Landwerlin 20. SINGLE PARENTING AND CHILDHOOD Lluís Flaquer, Elisabet Almeda and Lara Navarro 21. THE IMMIGRANT BUSINESS COMMUNITY IN SPAIN Carlota Solé, Sònia Parella and Leonardo Cavalcanti 22. ADOLESCENTS AND ALCOHOL. THE PARENTAL VIEW Eusebio Megías Valenzuela (director), Juan Carlos Ballesteros Guerra, Fernando Conde Gutiérrez del Álamo, Javier Elzo Imaz, Teresa Laespada Martínez, Ignacio Megías Quirós and Elena Rodríguez San Julián 23. INTERGENERATIONAL PROGRAMMES. TOWARDS A SOCIETY FOR ALL AGES (*) Mariano Sánchez (director), Donna M. Butts, Alan Hatton-Yeo, Nancy A. Henkin, Shannon E. Jarrott, Matthew S. Kaplan, Antonio Martínez, Sally Newman, Sacramento Pinazo, Juan Sáez and Aaron P. C. Weintraub 24. FOOD, CONSUMPTION AND HEALTH (*) Cecilia Díaz Méndez y Cristóbal Gómez Benito (coordinators), Javier Aranceta Bartrina, Jesús Contreras Hernández, María González Álvarez, Mabel Gracia Arnaiz, Paloma Herrera Racionero, Alicia de León Arce, Emilio Luque and María Ángeles Menéndez Patterson 25. VOCATIONAL TRAINING IN SPAIN. TOWARD THE KNOWLEDGE SOCIETY (*) Oriol Homs 26. SPORT, HEALTH AND QUALITY OF LIFE (*) David Moscoso Sánchez and Eduardo Moyano Estrada (coordinators), Lourdes Biedma Velázquez, Rocío FernándezBallesteros García, María Martín Rodríguez, Carlos Ramos González, Luís Rodríguez-Morcillo Baena and Rafael Serrano del Rosal Design and desktop publishing: www.cege.es Ciutat d’Asunción, 42 08030 Barcelona The present study begins from an apparent contradiction: although the benefits of practicing sport on health and quality of life are widely known, the practice of sport does not form part of the daily habits of the majority of the Spanish population. Sedentary jobs, lack of free time and passive leisure activities explain this discrepancy between the importance attributed to sport and its lack of practice. This study examines these issues. Its objectives are to measure the frequency of sedentary lifestyles in the population, what benefits people perceive from the practice of sport and what the principal obstacles to its practice are. The study also examines how physical activity and sport contribute to improving individuals’ perceptions of their health and well-being. The analysis is from a social perspective and broadens the traditional biological or medical focus on these issues. It thus, includes dimensions which refer to mood and the enrichment of social networks. To do this, the study examines the beliefs that positively and negatively affect the practice of sport. With this study, ”la Caixa” Social Projects intends to stimulate discussion on the value of physical activity and sport in improving the quality of life of individuals, as well as providing keys to help in designing better programmes and measures for promoting more active lifestyles. Electronic edition available on the Internet: www.laCaixa.es/ObraSocial