Sport, Physical Exercise and Public Health in Georgia

The present study is focused on the sport, physical exercise, and their role in the public health of Georgia. In this paper, the situation created by the COVID-19 global pandemic and its negative consequences on the physical or mental health of individuals was not considered, as at this stage, as the pandemic is not yet about to recede, it is too early to draw any far-reaching conclusions. Life after the pandemic will be quite different, but the significance of sports and physical activity for human health will probably become more in the spotlight. The paper discusses the low participation in physical activity of the population in Georgia as the risk factor for non-contagious diseases, as well as explains and analysis many reasons for such low engagement. Finally, the paper provides some recommendations, which in the author's opinion, will be beneficial for achieving growth of participation of the Georgian population in mass sport and physical activities.


Introduction
To estimate the contribution of sport and physical exercise to the health of nations, first need to be distinguished sport and exercise and physical activity. Physical activity by Khan et al. (2012) is "any bodily movement produced by skeletal muscles that results in energy expenditure" and is positively linked with physical fitness. Extensive components of physical activity include work, transport, domestic, and leisure time, consisting of exercise, sports, and structured recreation. An exercise has the features of "planned, structured and repetitive bodily movement, the objective of which is to improve or maintain physical fitness". Sport is a subset of exercise that can be accomplished individually or as a part of a team. Participants follow common rules and expectations and there is a defined purpose. Donaldson (2000), stated that the benefits of physical activity for public health are great. Physical activity is closely associated with better health and reduced all-cause mortality, including reduced fatality from coronary heart disease, stroke, colon cancer, etc. Exercise helps to reduce blood pressure and hypertension, and can protect against the development of type II diabetes mellitus. According to Wanname & Shaper (1992), people who are physically inactive have twice the risk of coronary heart disease and three times the risk of stroke than active people.
The World Health Organization (2011) stated that physical inactivity is now identified as the fourth leading risk factor for global mortality. Physical inactivity levels are raising in many countries with major implications for the prevalence of non-contagious diseases (NCDs) and the general health of the population worldwide.
In this paper the situation created by the COVID-19 global pandemic and its negative consequences on the physical or mental health of individuals was not considered. Of course, at this early stage, while the pandemic is not yet about to recede, as evidenced by the current state of the world, it is too early to draw any far-reaching conclusions. A survey commissioned by Nuffield Health (2020) found that more than three-quarters of people in the United Kingdom chose a new form of exercise in addition to walking, jogging, or cycling -activities at home such as yoga, weight loss exercises, and home treadmills. Not surprisingly, walking exercise turned out to be the most popular activity. Herein, almost two-thirds of people reported that physical exercises were significant for their mental health and wellbeing.
Undoubtedly, life after the pandemic will be quite different, but the significance of sports and physical activity for human health will probably become more in the spotlight and prepara-

Trends in Georgia
The Constitution of Georgia (Article 5, Social State) states: "The state shall take care of the development of sports, establishing a healthy lifestyle, and engaging children and youth in physical education and sports" (Constitution of Georgia, 1995).
According to Georgian Sport (2021) in all sports of Georgia registered 171696 athletes, 7004 trainers and 2739 referees, including 39305 women, 132391 men and 954 para-athletes. The number of medals won at various international tournaments in various sports is growing every year. Despite the pandemic, for the last year Georgian athletes won 145 medals on the international arena, including 43 gold. In total at all international competitions Georgian athletes have won 3244 gold, 2505 silver and 3309 bronze medals. Not a bad result for the country with a population of 3,985,076 people.
But, in general, according to Georgian Strategic Analysis Center (2019), the state of sport in Georgia reflects the situation of countries in transition.
According to European Union, United Nations Development Programme and Parliament of Georgia survey (2017), the number of people involved in sports in the country for the last 35 years decreased significantly: 33 thousands in 2010, in contrast of 1 million in 1975.
Low physical activity of the population in Georgia as well as low level of participation in sports exercises is observed in various studies. Results of a public opinion poll Georgia social and marketing research (GEOSOMAR), conducted by the Ministry of Sport and Youth Affairs in 2013, have revealed that about 70% of the respondents are not engaged in a physical activity at all. Only 20% of schoolchildren aged from 6 to 18 year are registered in sport clubs (European Union, United Nations Development Programme and Parliament of Georgia, 2017). This is when, according to the World Health Organization (2011), insufficient physical activity is one of the major risk factors for death from non-contagious diseases worldwide.
In this context, according to European Union, United Nations Development Programme and Parliament of Georgia survey (2017), several major non-contagious diseases have the highest mortality rates in Georgia: 1) Cardiovascular diseases, hypertension -71%; 2) Cancer -12%; 3) Diseases of the respiratory system -1%; 4) Other diseases, malnutrition conditions and injuries -14%.
According to survey of Gamkrelidze, Mebonia, Sturua, Demetrashvili, & Kakutia (2016), conducted through the technical and financial support of World Health Organization and the National Center of Disease Control and Public Health of Georgia: level of physical activity in 17.4% of respondents (male 16.2%, female 18.4%) does not meet World Health Organization recommendations on physical activity.
Above research results clearly highlight immediate need to implement an effective system for non-contagious diseases prevention and control, as well as raise awareness, encourage healthy lifestyle and decrease non-contagious disease risk factors.
Regular physical activity is one of the most important ways of reducing non-contagious diseases and related costs. According to the study conducted by the Korepanov et al. (2019), insufficient physical activity (17.4%) determined by World Health Organization recommendations will cost Georgia an average of 20.25 million USD. From this, direct healthcare costs are 14.9 million, while the productivity loss expenses are 5.350 million Dollars.
Major barriers that hamper engagement of population including youth/adolescents in physical/athletic activities are: not supportive regulatory environment, lack of state funding for the developments of sport and physical activities, lack of clubs and other sport organizations, lack of professional personnel, not favorable infrastructure (there are only about 550 sports facilities across the country, of which 40% need to be renovated and rehabilitated), obsolete equipment, lack of tailored sport and physical activity programs for disadvantaged groups of population funded by state, limited partnerships with private sector, lack of effective inter-sectoral collaboration, etc.

Conclusion
Based on above, we can conclude that political measures for the increase of the physical activity of the population, accessibility of the sports infrastructure and the reduction of non-contagious diseases are insufficient. In this regard, we recommend Public authorities to achieving growth of participation of Georgian population in mass sport and physical activities through: • amending existing legislation to develop comprehensive Strategic Development and Action Plans with relevant assignations and ensure access of all population to desired sport facilities, public authorities to develop system of public sport facilities with the same quality of services as private ones, which are expensive and not accessible for most of population; • ensuring inclusion of children in early and pre-school education institutions in compulsory, regular physical activities, as well as arrange/develop sport infrastructure for sport and physical education lessons at institutions of general education; • ensuring parks and recreation zones with friendly environment for sport exercises and physical activities, including walking paths as main activity of elderly people is walking, as well as consider developing of pedestrian and cycling networks in a city planning and relevant urban plans.
Implementation of above recommendations requires significant financial resources, which for obvious reasons, is problematic. However, given to international research, the lack of physical activity for Georgia is worthy an average of 16.8 million Georgian Lari (GEL) annually, and out of this number, direct health care expenses are 12.4 million GEL, and the products loss equals 4.4 million GEL (Thematic Inquiry Report of the Sports and Youth Affairs Committee, 2020). Even if the State directs only this amount of funds to the development of mass sports and physical activities, it will be enough for gradually improving the situation in a few years.