OP-ED: From schoolyard games to couches – Why play belongs at the heart of public health

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“RUN!” “HOME!” “OUT!” across the Caribbean, these were the sounds of childhood, calls that sent us sprinting across fields, dodging outs, and racing for safety. Before the term physical activity entered our vocabulary, these were the words that kept us moving. Whether it was a bat striking a ball, a rope turning in rhythm, or feet hopping between chalked lines, we ran, jumped, and exercised in the purest form: play.

Our childhood was defined by movement. In Barbados, children turned sidewalks into courts for road tennis, gripping wooden paddles and rallying across chalked lines. In Trinidad and Tobago, games of Scotch, Moral and Peesay had children hopping, balancing, and jumping in rhythm, while marble pitch kept us crouched low, aiming and competing with steady hands. Across the region, games like rounders and chase filled open spaces with energy. Or what about Jamaica? Where Dandy Shandy, and Stuck and Pull had children moving joyfully, filling the air with squeals of delight. Every island had its own calls, its own rhythms, its own rules, warnings shouted, victories claimed, and laughter shared.

Whether dodging a flying box, hopping through rope, or breaking free from a grip, these were the sounds and systems of play that kept us in constant motion. Yet, between screens, schedules, and silence, this movement has faded from our schoolyards and communities.

This loss is significant because today’s conversations about physical activity center on gyms, programs, and performance. But we must not forget: long before we had fitness terms, we moved naturally and freely, and this cultural foundation is at risk of being forgotten.

In the Caribbean, movement was natural in our daily lives, woven into the fabric of our childhood. From “Bluebird In and Out the Window” to “Bull in the Pen”, and we dare not let him come out, we were constantly in motion. In this way, play functioned as an informal yet undeniably powerful component of public health, building strength, coordination, resilience, and social connection.

However, this shift from spontaneous movement isn’t just cultural; research shows it’s measurable. Today, non-communicable diseases (NCDs) cause over 70% of deaths across the Caribbean, with conditions like hypertension, diabetes, and heart disease. In fact, the Caribbean has one of the highest rates of premature deaths from NCDs (age 30-70) in the world, primarily driven by unhealthy diets, tobacco use, alcohol consumption, and, of course, physical inactivity. The “stillness” that has settled into our childhood spaces doesn’t stop there; it follows us into adulthood and affects our health throughout life. Across the Caribbean, 30-40% of people don’t meet the World Health Organisation’s recommended weekly activity levels. What started as fewer games in the schoolyard has now become a health challenge for many Caribbean families.

When movement isn’t part of daily life, the effects go beyond playgrounds and enter clinics, workplaces, and even national budgets. This puts a heavy strain on healthcare systems across the region, which need long-term treatments, medications, and ongoing care. As our elders say, “prevention betta dan cure,” but today’s prevention efforts often focus only on changing adult behaviour rather than restoring the environments that made movement natural. When play disappears, we lose the laughter in our communities and face more chronic diseases. So, rediscovering the joys of childhood is a recognition that good health starts early and communally, not mere nostalgia.

This understanding is currently reflected in local law and policy, including various CARICOM countries’ commitments affirming the right to health. Regional frameworks such as the Caribbean Public

Health Agency (CARPHA) Six-Point Policy Package (6-PPP) which is designed to promote healthier food environments, combat non-communicable diseases and address childhood obesity throughout the Caribbean through targeted policy actions. Additionally, there are regionwide exercise campaigns under Caribbean Moves to promote active lifestyles as part of prevention; this fuels programmes such as Jamaica Moves, Dominica’s Fit for Life Campaign, St. Lucia’s National Physical Activity Day, and Barbados’ Creative Play Initiative. Notably, recent measures in countries like Jamaica, such as the proposed tax on sugar-sweetened beverages, signal growing recognition that policy must address the drivers of non-communicable diseases. In light of this, the task ahead is not to create new promises, but to fully keep the ones we have made. We must ensure that safe, accessible play is recognised as a public health priority and not overlooked.

As we mark World Day of Physical Activity and World Health Day, the message is clear: movement isn’t a privilege, it’s our birthright and a key part of our culture that we need to protect. If we truly want to prevent illness, we must create space in our policies, schools, and communities for some good old Dandy Shandy, just like we used to.

Kayla Wright and Offniel Lamont are Advocates with the Healthy Caribbean Youth Healthy Caribbean Coalition.

Kayla Wright is a Jamaican youth advocate working at the intersection of public health, youth rights, and policy development in Jamaica and the Caribbean.

Offniel Lamont is a specialist in Sports Medicine, Exercise, and Health, as well as a physiotherapist dedicated to promoting physical activity and enhancing public health policy and care in Jamaica and the Caribbean.