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The article shows from a socio-historical analysis that the policy “Sport-Santé Bien-être” in France was built following a medical approach of prevention and a neo-liberal management of a sport offer. Sedentary lifestyle appears as a new risk factor and adapted physical activity as a new therapy. On the one hand, the medical prescription of a sport on prescription accentuates the medicalization and on the other hand the accessibility of an adapted physical activity offer depends on the competition of the means. The “sport-santé” is the result of a successful adequacy between a demand and an adapted sport offer. Following this approach, social inequalities in health are treated with reference to a redistributive model. However, current work allows us to envisage other solutions based on recognition. Citizen participation in the co-construction of the sport-health offer should make it possible to deal with the epistemic injustices that underlie social inequalities. The article develops some ways to use sport-health to innovate preventive actions in line with health democracy.