Exercise, inequalities and social prescribing: An individual approach to population health.

Being active contributes to good physical and mental health, with physical activity and exercise considered to be one of the 'best buys' in public health. More than two-thirds of the adult population in Scotland meet the guidelines for physical activity yet inequalities exist, and some have magnified since COVID-19 lockdowns. People with the lowest levels of physical activity, with existing health conditions and who are from the most socioeconomically deprived communities are most likely to benefit from exercise but need personalised support to do so. Social prescribing offers a means for health professionals to refer people to non-clinical services, which can be tailored to an individual's goals and circumstances, reframing the concept of 'realistic medicine' to 'realistic health'. However, there are practical and conceptual barriers that can make implementation challenging from both a practitioner and user perspective. Holistic support is intensive and is not usually possible in routine care but whilst longer consultation times and continuity may seem like a luxury in today's pressurised NHS, this may be the most cost-effective way to prevent and manage ill health and the high costs of healthcare treatment. Working with communities to provide activities that best fit is an effective way to improve uptake and make services sustainable. Health professionals are crucial advocates for their patients and through an individualistic approach they can impact on health inequalities, which is at the core of population health.