‘I’ve just heard that there are people who feel like they need to exercise’: a photo-elicitation study of values and priorities influencing physical activity in a socioeconomically disadvantaged neighbourhood in Uppsala, Sweden

Abstract

ObjectivePeople living in socioeconomically disadvantaged neighbourhoods in Sweden engage less in physical activity compared with the general population, contributing to an elevated risk of cardiometabolic diseases. To inform targeted and effective public health interventions, understanding residents’ lived experiences is essential. This study sought to understand the values and priorities associated with physical activity by people living in a socioeconomically disadvantaged neighbourhood in Region Uppsala, Sweden, informing a public health intervention to prevent cardiometabolic diseases and promote healthy and active living.DesignThe study employed a photo-elicitation methodology, combining participants’ photographs with semistructured interviews. Data were analysed using reflexive thematic analysis.SettingA socioeconomically disadvantaged neighbourhood in the city of Uppsala, Sweden, characterised by a large proportion of households with low income, a large percentage of individuals living on economic aid, high unemployment rates, low educational attainment and high levels of poor health.ParticipantsA total of 15 participants (8 women and 7 men) were purposively sampled between February and August 2023 and recruited via fieldwork, social media and local stakeholders.ResultsParticipants described challenging conditions for physical activity, including conflicting values and priorities between themselves and the local authorities. Four main areas emerged as sources of tension; difficulties influencing decision-making processes affecting the neighbourhood, unmet needs of gender-separated physical activity spaces, discrepancy between the perceived pressure and individual motivation to be active, and their perception of health being solely an individualised responsibility, but their need of support.ConclusionsThis study underscores the importance of understanding and navigating the values and priorities influencing physical activity among residents in a socioeconomically disadvantaged neighbourhood, when designing public health interventions. Findings reveal that residents’ needs for being physically active are not met by the authorities who are perceived to have different priorities, and that the lack of influence of citizen voices undermines trust in the local authorities.