Running public health initiatives within a sport setting seems such a simple and effective solution to getting more people healthy and well, but, as we have seen in the introduction, organised sport is a powerful institution with very deep meaning and influence within society and therefore is not without its challenges [1]. Robertson [2] and Spandler and McKeon [3] have warned against seeing the use of sport as a vehicle for public health work as being unproblematic, as it is associated with negative as well as positive connotations. Sport is recognised as a contested setting for public health work. Impossibly fit and able athletes and sportsmen and women compete in front of a crowd being fed on alcohol, fast food and gambling. Sport itself can be violent; the support of the club can become tribalistic and create very negative factions; stakeholders have vested interests they want to maintain; and the media and the clubs’ PR machinery can stir up emotions, for good or harm.

Sport is also a very gendered setting, in that it can have different resonances for men and women. The opportunity of participating in initiatives run within a sporting setting has to be matched with a desire to participate, with the appeal for men and women being influenced by their past and current experiences of sport, both as a supporter and as a player.

The significance of sport as a site for male identities and ideological forms of masculinity can be used to account for the continued resistance to including women at the site of sport, and hence the re/production of women’s sport as an inferior product for a less discerning and sophisticated audience. [4, p. 187]

This chapter seeks to explore the meaning of sport and fandom for both men and women and in so doing it aims to identify the potential barriers and facilitators to using sport for public health work.

There has been a world-wide exponential growth in women’s sport and the numbers of women who are active supporters of clubs is at an all time high, such that initiatives that combine a strong public health/preventative agenda aimed at women in the sporting setting have great potential for success. Kay [5] has argued that young women can accrue an array of benefits from sport participation, beyond the physical benefits of increased activity, including empowerment, improved confidence and improved educational prospects, and relations with peers and teachers.

The potential of sport for women has also been recognised by the United Nations, which considers sport as a key vehicle to empower girls and women (see Box 4.1). Since the 1978 milestone of sport being recognised as a ‘fundamental right for all’¹ the move to enhance women and girls’ participation in sport has been actively supported and developed by the UN. In 2011, the Human Rights Council passed Resolution 18/23 : Promoting awareness, understanding and the application of the Universal Declaration of Human Rights through sport and the Olympic ideal [6, p. 31]. This Resolution was based on promoting the values of respect, diversity, tolerance and fairness and as a means of combating all forms of discrimination, and has particular resonance for women as globally there has been a history of their exclusion within sport. There is also an assumption, based on the ‘Girl Effect’, that girls can be the catalyst of social and economic change for their families, communities and countries and that their engagement in sport can be a way of bringing about a profound change in society [7].

The chapter on Slum Soccer within this book is one prime example of girls’ and women’s sports-based interventions challenging gender expectations, but others also exist, such as within the British–Asian community, where women are actively engaging in football as a means of overcoming stereotypes and challenging inequalities [8].

Women’s engagement in organised sport has not been straightforward. Even the opportunity for girls to engage in sport at school is not universally accepted and is only recent in some countries. In America, it was in 1972 that the Educational Amendments Bill was passed, including a section, Title IX, prohibiting discrimination against girls and women in federally funded education—girls having previously been routinely overlooked in school sport provision. Since the Bill was passed, there has been an increase in women engaging in sport,² but it is noticeable that this took time to take effect and the benefits are only now being fully seen. Nor was this problem restricted to America. In Scraton et al.’s interview study [10], top-level sportswomen from across Europe in the late 1990s reflected on the lack of interest in girls’ sports at school and the absence of local clubs for female-only sport. In Europe, the opportunity to play in competitive sport has only recently been allowed to develop away from hockey and netball into football and other more traditionally male sports.

Outside of the school, women’s participation in organised sport has also been a challenge [11]. In Britain, women’s football had its greatest boost during the First World War, when women replaced men’s football with their own teams and tournaments, but this was met with fierce opposition from the Football Association—a ban on women’s football in England using existing sporting arenas continuing until the 1960s [12]. Similar objections to women’s football were seen in Germany, where prohibitions on the support given to women’s clubs were enforced by the German Football Association (DFB) until the 1970s [13]. This situation has, indeed, existed world-wide; in Brazil, for instance, women were forbidden by law to play football until 1979 [14]. The useful book by Hartmann-Tews and Pfister [15], gives a further international perspective on the struggle that women’s sport has had to endure to be accepted. Thankfully, there is a greater acceptance in the sporting world now for women’s football [16] and this is creating a new environment for women to participate in sport generally. But, considering the relatively short time span since many of these restrictions were lifted, though progress is being made rapidly, there is still a lot of ground to make up. The growth of women’s sport has, however, been greatly supported by the Olympics, with the 2012 Games being the first at which every country had female representation, and with the Organizing Committee for the Games now insisting that any new sports introduced must include women’s events.³

It is not yet time to be complacent, however, for the aspiration of the Olympic legacy leading to higher levels of inclusion within sport can still be restricted by the way sport is defined and supported:

… the [UK] government’s very definition of sport appears to be the partial ‘competitive sport for sport’s sake’ which encapsulates the sporting practices of a relatively small demographic; [and if] defined this narrowly, the majority of the population, disproportionally women, will be further disenfranchised in relation to sport. This will work against the 2012 legacy aspiration of the right to sport for all. [17, p. 271]

Indeed, despite the developments listed above, there are still relatively few women belonging to a sports or athletics club, with higher participation levels tending to be seen in events such as charitable marathons and walks, and with various surveys suggesting that keep fit classes and swimming remain the preferred form of exercise for many women [18]. Even though the Olympics did create an increase in women’s desire to take part in sport, there have not been major increases in the numbers actually taking part, such that there is still a strong need to find ways of enabling women, especially those in more deprived areas, to become active and to remain engaged.⁴

In part, the problem is due to the way that women perceive sport and whether they see it as an activity they want to pursue. In a South African study of recreational preferences, gender was found to be the most important predictor of the importance of the sports field as a recreational environment (67.8 % of men saw it as ‘important’ or ‘very important’ compared to 70.2 % of women seeing it as ‘unimportant’) [19]. A recent survey by the Women’s Sport and Fitness Foundation in the United Kingdom found the proportion of women participating in sport had declined, although there was a latent desire to be more active and engaged.⁵

A Spanish study of university students’ motivation to engage in physical activity found a statistically significant difference between male and female respondents [20], with early negative experiences of sport limiting the possibility of revisiting sport as a leisure time activity in later life. Green’s [21] study of young ‘non-sporty’ girls highlights how even girls who are actively engaged in sport in their younger childhood quickly absent themselves from sports in their teenage years. A UK study on why girls aged 15–16 drop out of sport found that embarrassment, pressure to succeed, or a self-perceived lack of ability in PE lessons were key factors, but it was also noted that lack of support from teachers, existing stereotypes of sport being a ‘manly’ thing to do and competing obligations were also important factors in dropping out [22].

Craike et al. [18], found that Year 11 students made a shift from competitive sport being for fun towards physical activity as a way of avoiding putting on too much weight, managing anger and finding relief from schoolwork. But there was also a change in the way that both boys and girls became more conscious of how they were perceived by others. Few other early experiences put the boy’s and girl’s success or failure on such open display as does sport. For adolescents, trying to create a place for themselves in the world, sport shows their bodies and their performances in a way few other aspects of their lives achieve:

By Year 8 the boys were becoming more competitive and aggressive and less inclusive. This period coincides with the time when young women are becoming more self-conscious about their appearance, particularly in front of boys. It also coincides with the period when young women become more interested in socialising and in less competitive forms of physical activity. [18, p. 160]

Similar findings came from an Australian study, where girls were concerned about the way they were perceived by others in what they saw as a predominately male world of sport [23].

In an analysis of how women who were physically active on leaving school maintained their engagement Guérin et al. [24], found that early experiences of positive physical activity as a child, coupled with good social support and nearby good quality welcoming facilities, were key factors. Hirvensalo and Lintunen [25] also found that it is difficult for women to become active if they have no previous history of being active, especially if they hold strong perceptions of sport being a male pursuit. This is especially the case for older women, though the transition to retirement can offer some the opportunity to re-visit sport and other forms of physical activity as a means of engaging in new, and health-enhancing, activities.

According to the Women’s Sports Foundation,⁶ women drop out of sport due to:

Women’s participation in sport generally tends to be strongly linked to their socioeconomic circumstances and also to their age, with younger women and those in the highest socioeconomic quintile being more likely to participate, and with the most vulnerable women, those living in socially disadvantaged communities, being the least likely to participate in organised sport or be physically active and having high levels of sedentary behaviour [26]. An Australian survey of women’s participation in organised sport also noted that women’s educational attainment, level of poverty, ethnicity, proficiency at English and level of social contact were all implicated in their likelihood of engaging. A German project aimed at getting women with difficult life situations into sport found that often it was existing policies and procedures relating to usage of facilities that were a significant barrier [27]. What was required was a careful analysis of available assets along with negotiation with external organisations to make progress.

The power struggles that exist within women’s sport can also create an unwelcoming environment for extended female participation. Velija [28] notes that in women’s cricket there are divisions based on social class and sexuality that influence how women engage with the sport (see also Flintoff et al. [29] and Sartore and Cunningham [30]). The perception of women’s sport as having a strong lesbian component can also lead to negative press coverage in some countries, which may also influence participation rates [31]. Another factor which could negatively affect an individual’s decision to participate in sport is the often very public scrutiny of female athletes’ physical appearance, such as the persistent online abuse faced by British Olympic swimmer Rebecca Adlington (although it is worth noting that neither the perpetrators nor victims of such internet ‘trolling’ are exclusively male or female [32]).

Melnick and Wann [33] note that, for boys, their peers are the strongest determinant of which club they are associated with, whereas girls have a broader range of factors that affect their choice, with parents being particularly important [34, 35]. Ben-Porat [16] found that, in his Israeli cohort of female fans, it was parents, followed by male friends/boyfriends who helped decide which team to support and the intensity of their interest in the game. This importance of early male influence on women’s identification with sport generally was also found in the work of Liston [36], such that, by the time girls leave childhood, they will have already made lifelong decisions regarding their allegiance, or not, with any particular sport and club.

In all sports there has always been a strong female presence, with passionate support given to teams, but this has only recently been acknowledged and studied within academic literature [37–40]. Within some sports, women now account for significant proportions of the match day attendances, with Rugby League in the United Kingdom [41] and Australian Rules Football (AFL) [39] standing out as having a very high and loyal female fan base. It is estimated that women comprise 43 % of the 33 million sports fans in the United Kingdom [42].

Significant changes in the match day experience in the United Kingdom arose as a consequence of the 96 deaths at the Liverpool vs. Nottingham Forest FA Cup semi-final match at the Hillsborough stadium in 1989 [43]. The report on the disaster by Lord Justice Taylor forced all the major clubs to move to all-seat stadia and this, along with more intensive stewarding of the crowds and the use of CCTV to reduce crowd hooliganism, created a safer, more ‘civilised’ [44, p. 472] environment for women and families.

Pope [44] also notes that increasing female spectatorship has been mirrored by other changes in the politics of sport, such as the realisation that women are now a key factor in the economic survival of the game, with the greater the club’s ability to be female-friendly, the greater the income. There is a view, however, that even though this financial benefit has been welcomed, from attendance through to being more likely to buy merchandise and clothing, women are still not fully accepted and are more seen as ‘token’ fans [45, p. 141] with women’s role as ‘authentic fans’ still being subject to question [43, 44].

Women’s willingness to engage in sport is limited by their restricted exposure to women’s sport, it generally being only the male game that is available for their consumption [46, 47]. The investment in sports stadia for essentially male sports has been criticised as a means of further belittling women’s place within society [48]. The creation of new arenas by mostly male benefactors can be viewed as positive in certain respects, but, at the same time, as having the effect of strengthening male dominance in a rapidly changing world. Preserving male supremacy has negative effects on both the male and the female population, through the limiting of a shared future and making the risk of continued harmful sexual stereotyping the more likely. In a world where equality should be the goal, opportunities are needed to mutually create an understanding of our potential and our failings, which can only happen in shared settings.

In the early days of organised sport, support for football and other sport was limited to attendance at the actual event, whereas with the emergence of radio and television, and now much greater use of social media, a far wider audience has become possible [16]. However, the media coverage of sport has had both a positive and a negative effect on women as spectators, as it carries with it messages that can be seen to be very gendered [49].

Women’s sport has seen an increase in its national and international coverage, but there is still less than 5 % of sports media coverage devoted to women’s sport.⁷ The coverage that does occur can be problematic, where women’s sport can find itself silenced or trivialised and sexualised [50, 51]. This lack of coverage also results in reduced female role models for girls and women to entice them into sport and physical activity.⁸

There is change happening, however, with the high profile sacking of two reporters on the Sky sports channel for their disparaging remarks relating to a female assistant referee [3]. The BlogHer profiles suggest a view of sport that rejects its perception as a male domain and considers it solely in terms of spectatorship; rather, they reflect women’s active and participatory relationship with sports [52].

Sport has a significant place in many men’s lives, through playing or watching or even ignoring, to the extent that many men’s whole sense of themselves as a man is tied up with their experiences of sport [53–56]. This is a worldwide phenomenon starting at an early age [57, 58] and sport is soon recognised as a possible career choice for boys [59, 60]. With the huge salaries paid to top footballers, and increasingly in other sports, it is seen as a profitable possible career for lads with talent and can act as an incentive to invest the time and effort required for success.

There is ample evidence that many boys and men have benefited greatly from having sport as a part of their lives. Taking part in sport gives an outlet to boys ‘physicality’ where they need to expend energy and enjoy the experience of being active, developing and honing new skills along with the pride in performing in front of others [61–63]. Participation in contact team sports is an expected part of a boy’s life, and has been seen to be a central component of the preparation for ‘manhood’ in many cultures [53, 64]. Ironically, it may also be the case that some of the supposed problems of men’s attitudes to ill-health—ignoring pain, fighting on, acting tough—may be a result of their sport participation socialisation process [2].

Being part of a team gives a sense of belonging, pride in achievement, a perspective on winning and losing, and also an acceptance of the need for commitment and passion in what you do [65]. Much of men’s social capital is caught up with locations and actions rather than a reliance on broad groups of friends, such that workplace, sports venues and pubs become settings where men ‘hang out with their mates’ [66]. Conversations about sport become a major part of the common linkage between men, with high levels of social capital caught up in knowledge of sport [67, 68].

The benefits of sport are also very evident in the improvement in health and both physical and mental well-being through the engagement in physical activity generally [63]. Emotional resilience is acquired through the development of self-esteem, self-confidence, communication skills, conflict resolution skills and a sense of belonging [65]. It is of note that sport is also one of the few arenas where men are seen to cry in public and to display emotions, sharing success and failure as a common experience [69].

Engaging in sport is an acceptable mechanism for increasing boys’ and young men’s social status and peer popularity; there is a significant amount of social standing tied up with their bodies and their performance at school, with the athletic muscular body seen as the archetypal male [54, 62, 70]. Sport also provides a forum for talking about the body and body image for adolescent boys that is not available elsewhere and as such helps to locate the boy’s body alongside his peers and in the eyes of potential partners [62, 70].