Across Trinidad and To­ba­go, the Min­istry of Health’s pub­lic health cam­paigns ad­vise the pop­u­la­tion to move more. These cam­paigns seek to re­duce non-com­mu­ni­ca­ble dis­eases (NCDs) like di­a­betes and hy­per­ten­sion; com­mu­ni­ty fit­ness dri­ves pro­mote struc­tured ex­er­cise—walk­ing, cy­cling, gym work­outs, or week­end sports. Cillekens et. al. (2026) chal­lenges the one-size-fits-all ap­proach by ask­ing: Are our glob­al phys­i­cal ac­tiv­i­ty guide­lines built for every­body, or are they ex­er­cise guide­lines de­signed for the priv­i­leged?

<The “Phys­i­cal Ac­tiv­i­ty Para­dox” and the Choice-Ne­ces­si­ty Di­vide>

Cillekens et al. (2026) high­light the phys­i­cal ac­tiv­i­ty para­dox and the need to dis­tin­guish be­tween choice and ne­ces­si­ty. Stan­dard pub­lic health rec­om­men­da­tions gen­er­al­ly as­sume phys­i­cal ac­tiv­i­ty is a leisure-time choice. But for mil­lions of man­u­al work­ers world­wide, phys­i­cal ex­er­tion is not a vol­un­tary health pur­suit—it is an eco­nom­ic ne­ces­si­ty.

Some re­searchers ar­gue that a dis­tinc­tion must be made be­tween Leisure-Time Phys­i­cal Ac­tiv­i­ty (LT­PA)—recre­ation­al ex­er­cise done by choice—which ben­e­fits car­dio­vas­cu­lar health, psy­cho­log­i­cal health, and longevi­ty, and Oc­cu­pa­tion­al Phys­i­cal Ac­tiv­i­ty (OPA), which of­ten does the op­po­site. The em­bed­ded phys­i­cal ac­tiv­i­ty in some jobs, such as heavy lift­ing, pro­longed stand­ing, repet­i­tive strains, and in­ad­e­quate re­cov­ery time dur­ing man­u­al work, can lead to chron­ic fa­tigue, mus­cu­loskele­tal in­juries, and el­e­vat­ed car­dio­vas­cu­lar stress. Telling some­one who has spent eight hours per­form­ing tax­ing labour that they need to “move more” does not ac­count for bi­o­log­i­cal fa­tigue and struc­tur­al in­equity.

<The Re­al­i­ty on the Ground in Trinidad and To­ba­go>

In Trinidad and To­ba­go, pub­lic health mes­sag­ing rou­tine­ly urges cit­i­zens to achieve at least 150 min­utes of mod­er­ate ac­tiv­i­ty per week. How­ev­er, what does this mean for dif­fer­ent seg­ments of the work­force?

· Man­u­al Labour­ers vs. Desk Work­ers: A con­struc­tion work­er on a site in the Point Lisas In­dus­tri­al Es­tate, or a cook at a fast-food out­let, spends all day do­ing in­tense, repet­i­tive phys­i­cal labour in high tem­per­a­tures; ex­pect­ing them to hit the gym or the

recre­ation­al ground af­ter a shift ig­nores bi­o­log­i­cal ex­haus­tion. In con­trast, a desk work­er in Port of Spain spends long hours seden­tary and di­rect­ly ben­e­fits from recre­ation­al ex­er­cise.

· Built En­vi­ron­ment and In­fra­struc­ture Con­straints: Pub­lic mes­sag­ing of­ten sug­gests jog­ging along pub­lic roads or join­ing recre­ation grounds. Yet, many com­mu­ni­ties lack safe side­walks, ad­e­quate street light­ing, or green spaces free from traf­fic haz­ards. Fur­ther­more, shift work­ers and those com­mut­ing hours along the East-West Cor­ri­dor face se­vere time pover­ty, mak­ing struc­tured leisure ex­er­cise a lux­u­ry of time and safe­ty.

<In­clu­sive Pub­lic Health Poli­cies>

In any eq­ui­table health frame­work for Trinidad and To­ba­go, pol­i­cy­mak­ers must re­vis­it the stan­dard, one-size-fits-all strate­gies:

In terms of oc­cu­pa­tion­al health, tra­di­tion­al pub­lic health meth­ods fo­cus sole­ly on ba­sic in­jury pre­ven­tion and haz­ard con­trol. Ac­cord­ing to Cillekens et al. (2026), work­places must in­cor­po­rate struc­tured rest pe­ri­ods and ac­tive­ly man­age oc­cu­pa­tion­al phys­i­cal strain.

In com­mu­ni­ty de­sign, the as­sump­tion is that not every­one can safe­ly ac­cess out­door spaces. There­fore, a mod­ern frame­work must ac­tive­ly de­vel­op walk-friend­ly city cen­tres, safe board­walks (such as those in Ch­aguara­mas), and well-lit rur­al parks. The Glob­al South does not have the same priv­i­leges as “WEIRD (West­ern, Ed­u­cat­ed, In­dus­tri­al­ized, Rich, De­mo­c­ra­t­ic) pop­u­la­tion liv­ing in rel­a­tive­ly ac­tiv­i­ty -sup­port­ive, safe and healthy en­vi­ron­ments.”

Pub­lic health mes­sag­ing of­ten as­sumes ex­er­cise is an in­di­vid­ual act and there­fore does not ac­count for nu­mer­ous so­cio-eco­nom­ic, men­tal, and af­fec­tive bar­ri­ers such as time pover­ty, ac­cess to fa­cil­i­ties, and trav­el.

Ac­cord­ing to Cillekens et al. (2026), any phys­i­cal ac­tiv­i­ty pol­i­cy and ac­tion plan must fac­tor in the pop­u­la­tion’s oc­cu­pa­tion­al re­al­i­ty. For Trinidad and To­ba­go to ef­fec­tive­ly tack­le NCDs, health pro­mo­tion must go be­yond telling cit­i­zens to “ex­er­cise more.” In­stead, the fo­cus must be on cre­at­ing work­ing con­di­tions in both the pub­lic and pri­vate sec­tors that will al­low every work­er to rest, re­cov­er, and move safe­ly.

Ed­i­tor’s Note

Ed­i­tor’s note: The views ex­pressed in the pre­ced­ing ar­ti­cle are sole­ly those of the au­thor and do not re­flect the views of any or­gan­i­sa­tion in which he is a stake­hold­er.