The Role of Chiropractors as Public Health Advocates

by BCA Board Member, Faye Deane

Covid-19 shone a spotlight on national health inequalities, highlighting the importance of public health in supporting individuals, organisations and society, to reduce the incidence of ill health and disease through health promotion, prevention and protection. As a profession, there are numerous ways in which chiropractors can play an active role in supporting regional, national and international public health initiatives, such as supporting and advising patients on a range of lifestyle modifications including diet, alcohol intake and tobacco use.

Over the last year, a specific focus on physical activity, or more importantly, physical inactivity has been adopted by various national and international chiropractic organisations. The World Federation of Chiropractic’s (WFC) Public Health Committee launched a 2022/23 Physical Activity Campaign and the Royal College of Chiropractors (RCC) released a Physical Activity Toolkit this autumn.

In this article we delve into the role of chiropractors in promoting physical activity and optimal health and wellbeing, through patient education, shared decision making and person-centred care.

The Benefits of Physical Activity

The benefits of physical activity are extensive, contributing to the prevention and management of non-communicable diseases (NCD) such as, cardiovascular disease, diabetes, cancer and stroke.  Research has found it helps to significantly reduce depression, a leading cause of disability globally and neurodegenerative diseases such as dementia and cognitive decline.  Furthermore, physical activity directly contributes to increased quality of life through improved weight management, sleep quality, self-esteem, mood, bone, and musculoskeletal health.

The Burden of Physical Inactivity

Physical activity levels have been on a steady decline since the 1950’s, with 23% of adults and 81% of adolescents not currently meeting the global recommendations set by the WHO.  Resultantly, it is the 4th leading risk factor for mortality and its estimated to cost society approximately $54 billion in direct health costs and an additional $14 billion in lost productivity.  As such, physical inactivity is one of the most recognised and prevalent public health issues globally. In 2017, the WHO launched a Global Action Plan on Physical Activity 2018-2030 (GAPPA), an evidence-based policy recommendation which is intended to be implemented nationally, using a multisectoral, whole-systems approach to reduce barriers to physical activity and provide more opportunities within communities for people to access it. Interventions, such as prioritising pedestrianisation, increasing green spaces and wearable fitness devices and are all examples of GAPPA.

The World Health Organisation’s Recommended Guidelines

The WHO recommend 150-300 minutes of moderate intensity aerobic activity a week or at least 75 minutes of vigorous-intensity activity, or a combination, throughout the week.

The Role of the Chiropractor in Health Promotion

The General Chiropractic Council’s (GCC) Code (Code A) explicitly states that chiropractors are required to “put the health interests of the patient first, ensuring you promote their health and wellbeing at all times”. It is therefore a chiropractors duty to ensure they are actively engaging in health promotion through the course of a patients care.

A recent systematic review by Fernandez et al (2022) found that approximately 90% were in favour of actively promoting physical activity. The nature of chiropractic practice involving multiple patient-clinician interactions makes chiropractors perfectly placed to take baseline measurements, give advice and regularly check-in with patients. Directing ‘table talk’ or “Making Every Contact Count” towards positive health promotion and education can strengthen the therapeutic alliance by providing comprehensive, patient centred care.

Click here to read our top 10 tips for promoting and measuring physical activity in your clinic


  • Fernandez M, Young A, Milton K, Pinhiero M, de Luca K, Ferreira P, Hebert J. 2022. Physical activity promotion in chiropractic: a systematic review of clinician-based surveys. Chiropractic & Manual Therapies; 30:55
  • Iso-Markko, P., Kujala, U., Knittle, K., Polet, J., Vuoksimaa, E., Waller, K. (2023). Physical Activity as a protective factor for dementia and Alzheimer’s disease; systematic review, meta-analysis and quality assessment of cohort and case-control studies.  British Journal of Sports medicine 52 (12).