Legal Guarantees of Physical Activity as Determinants of the Human Right to Health: The Ukrainian Experience in the European Integration Context

ABSTRACT

The fact that physical activity (PA) is considered an important tool for promoting human health and a determinant of the right to health has contributed to the promotion of a separate human right to PA at the global level. This article compares the government policies and legal mechanisms for ensuring the right of citizens to health through PA in various EU member states and Ukraine. It has been established that in the absence of a single standard or conditions for implementing this right, the experiences of different European states are different in significant ways. According to our findings, the obstacles to ensuring the right of citizens to PA in Ukraine are due to (1) an inconsistent national development strategy, and adoption of unsystematic regulations without effective mechanisms for their practical implementation; (2) a lack of effective sectoral programs on PA for different social groups; (3) a low level of interest of the majority of citizens in PA as a means of promoting human health. The problem of realizing the rights of Ukrainian citizens has become much more acute due to the full-scale invasion of Ukraine by the Russian Federation, starting in February 2022.

KEYWORDS:

• physical activity
• human right to health
• state management
• health care
• sports law

Notes

1 World Health Organization, Global Action Plan on Physical Activity 2018–2030: More Active People for a Healthier World (WHO, 2018) CC BY-NC-SA 3.0 IGO.

2 Adrian E Bauman and others, ‘Correlates of Physical Activity: Why Are Some People Physically Active and Others Not?’ (2012) 380 The Lancet 258; Ding Ding and others, ‘Physical Activity Guidelines 2020: Comprehensive and Inclusive Recommendations to Activate Populations’ (2020) 396 The Lancet 1780;

3 Human Rights Council, ‘Report of the Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health,’ (2016) UN Doc. A/HRC/32/33.

4 Jeffrey A Woods JA and others, ‘The COVID-19 Pandemic and Physical Activity’ (2020) 2 Sports Medicine and Health Science 55.

5 Ding Ding (n 2); Valeriy V Makashov, ‘Development of Health-Enhancing Motor Activity of the Population in Modern Megacities of Ukraine: Public-Administrative Aspect’ (Dnipropetrovsk Regional Institute for Public Administration National Academy for Public Administration under the President of Ukraine 2021); K Maximova and others, ‘Monitoring Progress toward United Nations Commitments: Characteristics of Canadian Legislation to Promote Tobacco Control, Physical Activity and Healthy Eating. A Descriptive Study’ (2019) 7 CMAJ Open E745.

6 Committee on Economic, Social and Cultural Rights, ‘The Right to the Highest Attainable Standard of Health’ (Human Rights in Patient Care, 2000).

7 Ibid.

8 General Conference of UNESCO, ‘International Charter of Physical Education, Physical Activity and Sport,’ 2015, SHS/2015/PI/H/14 REV; Human Rights Council (n 3)

9 Verkhovna Rada of Ukraine, ‘Constitution of Ukraine’ (kmu.gov.ua, 1996).

10 OM Obozna, ‘Rozvytok Fizychnoyi Kul’tury i Sportu Yak Vazhlyvyy Napryam Derzhavnoyi Polityky Ukrayiny Shchodo Zabezpechennya Zdorov’ya Hromadyan [The Development of Physical Culture and Sports as an Important Direction of the State Policy of Ukraine on Ensuring the Health of Citizens]’ (2014) 2 Derzhavne upravlinnya: teoriya ta praktyka 39; Romana Sirenko, ‘Normativno-Pravovoye Obespecheniye Gosudarstvennoy Politiki Ukrainy v Sfere Fizicheskoy Kul’turí Sredi Studencheskoy Molodezhi [Regulatory Support of State Policy of Ukraine in the Field of Physical Culture among Students]’ (2017) 1 East Journal of Security Studies 102; Olena R Dashkovska and others, ‘The Features of the Implementation of the Sports Law (Características de La Implementación Del Derecho Deportivo)’ [2020] Retos 500; Oleksandr V Poproshaiev and Olena A Poproshaievа, ‘Pytannya Rozvytku Systemy Osvity, Fizychnoyi Kul’tury ta Sport v Umovakh Detsentralizatsiyi Vlady [Development Issues of the System of Education, Physical Culture and Sports in the Context of Decentralization of Power]’ (2021) 5 Scientific Journal National Pedagogical Dragomanov University 83.

11 Ibid.

12 Verkhovna Rada of Ukraine, ‘On Physical Culture and Sport. Law of Ukraine 3808-XII’ (zakon.rada.gov.ua, 1993).

13 Haidong Wang and others, ‘Global Age-Sex-Specific Fertility, Mortality, Healthy Life Expectancy (HALE), and Population Estimates in 204 Countries and Territories, 1950–2019: A Comprehensive Demographic Analysis for the Global Burden of Disease Study 2019’ (2020) 396 The Lancet 1160; Romana Sirenko (n 10); Valeriy V Makashov, ‘Health-Enhancing Physical Activity as a Field of Public Management Function: Theoretical and Applied Contents’ [2020] Electronic scientific publication ‘Public Administration and National Security’ < https://doi.org/10.25313/2617-572X-2020-8-6743>.

14 State Statistics Service of Ukraine, ‘Population of Ukraine 2019’ (2020) <https://ukrstat.gov.ua/druk/publicat/kat_u/2020/zb/10/zb_nas_2019.pdf>; Government of Ukraine, ‘Strategy for the development of physical culture and sports for the period up to 2028: Resolution of the Cabinet of Ministers 2020’; Olha Solodukha, ‘Why Are We One of the Least Physically Active Nations and How Can We Change That?’ Ukrainska Pravda (Kyiv, 2022) https://life.pravda.com.ua/columns/2022/02/9/247397/ accessed 10 June 2022

15 George Marian Ştefan, ‘European Welfare State in a Historical Perspective. A Critical Review’ (2015) 7 European Journal of Interdisciplinary Studies 25.

16 Office of the United Nations High Commissioner for Human Rights, ‘International Standards on the Right to Physical and Mental Health’ (ohchr.org, n/d).

17 Yrii Shvets, ‘Peculiarities of Protection of the Right to Health in the European Court of Human Rights’ (2018) 1 Jurnalul juridic naţional: teorie şi practică 58.

18 Committee on Economic, Social and Cultural Rights (n 6).

19 Nicole Hassoun, ‘The Human Right to Health: A Defense’ (2020) 51 Journal of Social Philosophy 158; Carlos Lema Añón, ‘Right to Health and the Social Determinants of Health in the Face of COVID-19. The Spanish Experience after Austerity Policies’ [2021] The Age of Human Rights Journal 220.

20 Commission on social determinants of health, Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health. Final Report of the Commission on Social Determinants of Health (World Health Organization 2008).

21 Office of the United Nations High Commissioner for Human Rights, ‘Fact Sheet No. 31: The Right to Health’ (ohchr.org, 2008) 1.

22 Messing S and others, ‘Physical Activity as a Human Right?’ (2021) 23 Health and Human Rights Journal 201.

23 General Conference of General Conference of UNESCO, ‘International Charter of Physical Education, Physical Activity and Sport’ (UNESCO.ORG 2015); Office of the United Nations High Commissioner for Human Rights (n 21); Council of Europe, ‘European Sports Charter’ (coe.int, 2021).

24 Department of Economic and Social Affair Disability, ‘Convention on the Rights of Persons with Disabilities (CRPD)’ (UN.ORG, 2006)

25 Human Rights Council (n. 3)

26 Matthew M Kavanagh, ‘The Right to Health: Institutional Effects of Constitutional Provisions on Health Outcomes’ (2016) 51 Studies in Comparative International Development 328.

27 Commission on social determinants of health, Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health. Final Report of the Commission on Social Determinants of Health (World Health Organization 2008).

28 Paula Braveman, ‘Social Conditions, Health Equity, and Human Rights’ (2010) 12 Health and Human Rights 31.

29 Lema Añón (n 19); Office of the United Nations (n 21).

30 Benjamin M Meier and others, ‘The World Health Organization in Global Health Law’ (2020) 48 The Journal of Law, Medicine & Ethics 796.

31 World Health Organization (n 1); World Health Organization Regional Office for Europe, ‘Physical Activity Strategy for the WHO European Region 2016-2025’ (www.euro.who.int, 2015).

32 Physical Activity Strategy (n 31).

33 World Health Organization Regional Office for Europe, ‘Physical Activity Factsheets for the 28 European Union Member States of the WHO European Region. Overview’ (www.euro.who.int, 2018)

34 ‘Council Recommendation of 26 November 2013 on Promoting Health-Enhancing Physical Activity across Sectors’ (2013) C 354 Official Journal of the European Union 1.

35 Peter Gelius and others, ‘Status and Contents of Physical Activity Recommendations in European Union Countries: A Systematic Comparative Analysis’ (2020) 10 BMJ Open e034045.

36 World Health Organization Regional Office for Europe, ‘Review of Physical Activity Promotion Policy Development and Legislation in European Union Member States’ (euro.who.int, 2010); Gelius (n 35).

37 Signe B Daugbjerg and others, ‘Promotion of Physical Activity in the European Region: Content Analysis of 27 National Policy Documents’ (2009) 6 Journal of Physical Activity and Health 805.

38 Ministerio de Sanidad Servicios Sociales e Igualdad, ‘Actividad Física Para La Salud y Reducción Del Sedentarismo. Recomendaciones Para La Población. Estrategia de Promoción de La Salud y Prevención En El SNS [Physical Activity for Health and Reduction of Sedentary Lifestyle. Recommendations for the Populati’ (mscbs.gob.es, 2015).

39 World Health Organization Regional Office for Europe, ‘Promoting Sport and Enhancing Health in European Union Countries: A Policy Content Analysis to Support Action’ (euro.who.int, 2011).

40 Council of European Municipalities and Regions, ‘Local and Regional Government in Europe. Structures and Competences’ (ccre.org, 2011).

41 Peggy Edwards and Agis Tsouros, Promoting Physical Activity and Active Living in Urban Environments. The Role of Local Goverments (World Health Organization 2006).

42 Ministry of Education and Culture Finland, ‘Act on the Promotion of Sports and Physical Activity (390/2015)’ (2015); World Health Organization Regional Office for Europe, ‘Finland Physical Activity Factsheet’ (euro.who.int, 2018).

43 ‘Government Resolution on Development Guidelines for Increasing Physical Activity and Nutrition’ (circumpolarhealth.org, 2008).

44 Ministry of Education and Culture Finland (n 42).

45 European Commission, ‘Health Equity Pilot Project (HEPP) The Promotion of Physical Activity in Finland Case Study’ (ec.europa.eu, 2017).

46 Ministry of Education and Culture Finland (n 42).

47 World Health Organization Regional Office for Europe (n 42) 2.

48 European Commission (n 45).

49 World Health Organization, ‘WHO Guidelines on Physical Activity and Sedentary Behaviour’ (https://www.who.int/publications/i/item/9789240015128, 2020); Ding Ding and others (2); Gelius (n 35)

50 Verkhovna Rada of Ukraine (n 9).

51 Ibid.

52 Ibid.

53 Verkhovna Rada of Ukraine, ‘On State Social Standards and State Social Guarantees: Law of Ukraine’ (zakon.rada.gov.ua, 2000).

54 Verkhovna Rada of Ukraine (n 9).

55 Ibid.

56 Yrii Shvets, ‘Zmist Konstytutsiynoho Prava Osoby Na Okhoronu Zdorov’ya [The Content of the Constitutional Right of a Person to Health Care]’ (2017) 8 Entrepreneurship, Economy and Law 135.

57 Verkhovna Rada of Ukraine, ‘Fundamentals of Ukrainian Legislation on Health Care: Law of Ukraine. 2801-XII, 19.11.1992’ (zakon.rada.gov.ua, 1992).

58 Ibid.

59 Verkhovna Rada of Ukraine (n 10).

60 President of Ukraine, ‘Tsil’ova Kompleksna Prohrama ‘Fizychne Vykhovannya i Zdorov’ya Natsiyi’ [Target Comprehensive Program ’Physical Education and Health of the Nation’]’ (zakon.rada.gov.ua, 1998); President of Ukraine, ‘National Doctrine of Development of Physical Culture and Sports: Presidential Decree’ (zakon.rada.gov.ua, 2004).

61 President of Ukraine (n 60) 2; Elena V Cerkovnaya, Anna I Prikhodko and Aleksandr V Poproshaev, ‘Poblems of Search of Ways of Optimization of Process of Physical Education in Higher Educational Establishments’ (2008) 8 Pedagogics, Psychology, Medical-Biological Problems of Physical Training and Sports 154

62 President of Ukraine, ‘National Strategy for Physical Activity for the Period up to 2025 ‘Physical Activity - Healthy Lifestyle - Healthy Nation’: Presidential Decree 42/2016’ (zakon.rada.gov.ua, 2016).

63 Board of the Ministry of Youth and Sports of Ukraine, ‘On Reforming Physical Culture and Sports: Roadmap and Memorandum of Support’ (search.ligazakon.ua, 2015).

64 Valeriy V Makashov (n 13).

65 Government of Ukraine, ‘State Targeted Social Program for the Development of Physical Culture and Sports until 2024: Resolution of the Cabinet of Ministers’ (kmu.gov.ua, 2017).

66 Ibid.

67 Government of Ukraine, ‘State Standard for Ensuring Physical Activity of the Population: Order of the Ministry of Youth and Sports’ (drs.gov.ua, 2018).

68 Government of Ukraine (n 14).

69 Ibid.

70 Ibid.

71 Government of Ukraine (n 65).

72 Government of Ukraine (n 14).

73 Ibid.

74 Haidong Wang and others (n 13).

75 Government of Ukraine, ‘Concepts of the National Program ‘Health -2020: Ukrainian Dimension’: Order of the Cabinet of Ministers’ (kmu.gov.ua, 2011); Ministry of Health of Ukraine, ‘Strategic Plan for the Development of the Health Care System of Ukraine until 2030’ (ukrinform.ua, 2021).

76 Ministry of Health of Ukraine (n 75)

77 Verkhovna Rada of Ukraine (n 53).

78 Valeriy V Makashov (n 13).

79 Government of Ukraine (n 13); Ministry of Youth and Sports of Ukraine, ‘Action Plan for 2021-2022 for the Implementation of the First Stage of the Strategy for the Development of Physical Culture and Sports for the Period up to 2028’ (mms.gov.ua, 2021).

80 Ministry of Youth and Sports of Ukraine (n 79).

81 Verkhovna Rada of Ukraine, ‘On Local Self-Government in Ukraine: Law of Ukraine’ (zakon.rada.gov.ua, 1997).

82 Verkhovna Rada of Ukraine, ‘On Voluntary Association of Territorial Communities: Law of Ukraine’ (zakon.rada.gov.ua, 2015).

83 Ministry of Youth and Sports of Ukraine, ‘Zvit pro Rezul’taty Vykonannya Derzhavnoyi Tsil’ovoyi Sotsial’noyi Prohramy Rozvytku Fizychnoyi Kul’tury i Sportu na Period do 2024 Roku za 2020 Rik [Report on the Results of the Implementation of the State Target Social Program for the Development of Physical Culture and Sports for the Period up to 2024 for 2020’ (2021).

84 Board of the Ministry of Youth and Sports of Ukraine (n 63).

85 Oleksandr V Poproshaev and Olena A Poproshaeva (n 10) 85.

86 Elena V Cerkovnaya, Anna I Prikhodko and Aleksandr V Poproshaev (n 61).

87 Kabinet Ministriv Ukrayiny, ‘Pro Deyaki Pytannya Derzhavnykh Standartiv Povnoyi Zahal’noyi Seredn’oyi Osvity [About Some Issues of State Standards of Complete General Secondary Education]’ (kmu.gov.ua, 2020).

88 World Health Organization Regional Office for Europe, WHO Guidelines on Physical Activity and Sedentary Behaviour (World Health Organization; 2020) 104.

89 Verkhovna Rada of Ukraine, ‘On Higher Education: Law of Ukraine’ (zakon.rada.gov.ua, 2014).

90 Oleksandr V Poproshaiev and Olena A Poproshaievа (n 10).

91 Ministry of Education and Science, ‘Rekomendatsiyi Shchodo Stratehichnoho Rozvytku Fizychnoho Vykhovannya ta Sportu Sered Students’koyi Molodi na Period do 2025 Roku [Recommendations for the Strategic Development of Physical Education and Sports among Student Youth for the Period up to 2025]’ (zakon.rada.gov.ua, 2021); Ministry of Youth and Sports of Ukraine (n 83).

92 President of Ukraine, ‘Tsil’ova Kompleksna Prohrama … ’ (n 60).

93 Olha Kolomiitseva and others, ‘Efficiency of Physical Education of University Students Based on the Motivation Choice of the CrossFit Program’ (2020) 8 Physical Activity Review 26.

94 Ministry of Education and Science of Ukraine, ‘Shchodo Osoblyvostey Orhanizatsiyi Osvitn’oho Protsesu ta Formuvannya Navchal’nykh Planiv u 2015/2016 Navchal’nomu Rotsi [Regarding the Peculiarities of the Organization of the Educational Process and the Formation of Educational Plans in the 2015/2016],’ Pub. L. No. 1/9-126 (zakon.rada.gov.ua, 2015); Ministry of Education and Science (n 91).

95 Ministry of Education and Science (n 91).

96 Cabinet of Ministers of Ukraine, ‘Derzhavna Tsil’ova Sotsial’na Prohrama ‘Molod’ Ukrainy’ Na 2021-2025 Roky [State Targeted Social Program ‘Youth of Ukraine’ for 2021-2025],’ Pub. L. No. 579 (zakon.rada.gov.ua, 2021).

97 Valeriy V Makashov (n 13); Oleksandr V Poproshaiev and Olena A Poproshaievа (n 10).

98 OM Obozna (n 10); Romana Sirenko (n 10).

99 Olha Solodukha (n 14).

100 The National Council for the Recovery of Ukraine from the Consequences of the War, ‘Draft Ukraine. Recovery Plan Materials of the “Youth and Sports” Working Group’ (2022) <https://www.kmu.gov.ua/storage/app/sites/1/recoveryrada/eng/youth-and-sports-eng.pdf>

101 Ibid.