Research conducted in poorer areas of Cork and Dublin has shown that health promotion initiatives encouraging people to take more exercise can actually be counterproductive.
Researcher Dr Louise Burgoyne of University College Cork concluded that initiatives such as Slí na Sláinte walking routes could be compared to "a sticking plaster" method, "masking more fundamental issues".
Her findings come from three studies carried out in economically disadvantaged areas of Cork and Dublin. "There are fundamental issues to be addressed - there is social disadvantage and problems with the physical and social environment in these areas. People don't have access to facilities and feel other areas of the city have a lot more going for them," Dr Burgoyne said.
An initial study in the Knocknaheeny and Hollyhill neighbourhoods of Cork city found that people were more likely to be physically active if they were content with their social and physical environment. Residents felt walking areas were needed.
A second study conducted jointly in the same two districts of Cork and in the Darndale and Belcamp areas of Dublin assessed the effectiveness of Slí na Sláinte walking initiatives. A "before and after" study found that, while people initially wanted to take more exercise, in fact, there was no significant increase in levels of walking.
A third study in Cork then explored why the walking routes did not result in increased activity levels.
Dr Burgoyne concluded that while walking routes "appear an attractive tool with easily obtained benefits", health promoters must assess the individual suitability of their interventions and be particularly aware of the social context they are working in.
She warned that health promoters must be "cautious of their tendency to adopt a paternalistic approach".
She added: "Everything has to be tailored to the specific area - you can't just put the same thing in every area, you have to look at what's going on underneath."
She said that health promotion initiatives had to be "deeply embedded in a supportive and facilitative environment" if they were to have any chance of improving health.
Problems identified with the walking routes included uncollected rubbish and stray dogs or horses in the area. Some people were nervous of groups of youths gathering along the routes.
While there are some 3,500 households in the Knocknaheeny and Hollyhill districts of Cork, there is no leisure centre in the area so people have to go to the nearby area of Churchfield.
Prof Ivan Perry, also of the public health department of UCC, said this was not, however, an argument against public health initiatives in general but of "superficial initiatives".
Those initiatives "more deeply-embedded at the level of community development" had a greater chance of succeeding, he said.
A good example, he said, was an organisation involved with the research in Cork, the Northside Initiative for Community Health (NICHE), where the emphasis was on working with people to improve the quality of life for themselves and their children.