Promoting health through sports-medicine integration in China: a narrative and conceptual review of challenges, international

Physical inactivity and noncommunicable diseases (NCDs) pose sustained challenges to population health, while prevention, clinical care, rehabilitation, and community-based physical activity are often delivered through separate professional and administrative systems. In China, sports-medicine integration has been promoted as a strategy to connect national fitness, health promotion, chronic disease management, and rehabilitation. However, its conceptual boundaries, implementation mechanisms, evidence base, and potential risks require more critical examination. This article uses a narrative and conceptual review approach. This structured narrative and conceptual review used PubMed as the principal bibliographic database, supplemented by backward citation searching, targeted searches of authoritative governmental and professional sources, and relevant Chinese-language literature. Sources were screened according to predefined relevance criteria and critically appraised according to study design, methodological rigor, directness, recency, and source authority. Seminal conceptual sources were retained without a lower date limit, whereas evidence describing contemporary health systems and implementation was preferentially drawn from 2000-August 2026, with post-2020 literature prioritized where available. Peer-reviewed empirical studies, systematic/scoping reviews, and authoritative documents from national governments, the World Health Organization (WHO), and professional bodies were prioritized over commercial market reports, media commentary, and indirect citations. Evidence was synthesized thematically rather than quantitatively. The literature supports a stronger role for physical activity in health promotion and chronic disease prevention, but it does not justify treating sports-medicine integration as a self-evidently effective policy solution. China has important enabling conditions, including national policy support and growing exercise-prescription capacity, yet implementation remains constrained by administrative fragmentation, uneven local capacity, incomplete professional credentialing, financing uncertainty, and limited evaluation at scale. International experience illustrates complementary strengths: the United States has developed professional certification and health-system implementation models; Germany links medical recommendations with qualified community sport and insurance-based prevention; and Japan combines national physical activity guidance with health-promotion and community-care structures. Sports-medicine integration should be understood as a coordinated, risk-stratified health-service strategy rather than as the medicalization of all physical activity. Future development in China should emphasize clear governance, standardized referral pathways, recognized professional scopes of practice, sustainable financing, interoperable data systems, and explicit evaluation of effectiveness, cost-effectiveness, scalability, and equity.