This blog post has been contributed by Rails-to-Trails Conservancy

To health professionals, planners and transportation experts, active transportation (i.e. walking and biking as an alternative to car travel) is a no-brainer. Communities that facilitate non-motorized modes as safe and convenient options for getting from A to B simply function better. They have less pollution, their population is healthier, downtown business areas are more vibrant, and real estate values are stronger as their neighborhoods reflect what more Americans are demanding of their environments these days - diversity of transportation choices.

Not only that, but these facilities make economic sense too. A mile of paved trail can cost the same as just a few yards of urban four-lane road, not to mention the associated savings of non-motorized transportation stemming from reduced oil consumption and spending on reactive health care. This is why building environments that encourage walking and bicycling is a key part of the National Physical Activity Plan, and a major component of its strategies.

Unfortunately, despite the overwhelming support of the public health community, local planners and officials, businesspeople and residents, there are still some political and financial barriers to building these kinds of environments. For example, the Transportation Enhancements (TE) program was recently an agenda item during government budget planning. TE is the nation's largest funding source for trails, walking and bicycling. Working with numerous partners, Rails-to-Trails Conservancy (RTC) led an effort to ensure our elected leaders knew how important walking and biking options were to their constituents. In the end, vital active transportation programs like TE were preserved intact.

RTC knows it is important to secure adequate funding for active transportation into the future. So, what we know to be a public health issue - the effort to increase physical activity in our everyday lives - is also an effort of political will.

In an era of fiscal constraint, presenting economic benefits could have the most weight when discussing the issue with policymakers. With walking and biking, it is an easy argument to make.

Biking and walking infrastructure account for less than two percent of the entire federal surface transportation budget, yet account for 12 percent of all trips taken in America. And trail construction projects have been shown to create more jobs, and more local jobs, for every $1 spent, than road construction. This is both smart financial investment and good health policy.

The voice of the health community, which understands so clearly that investing in walking and biking could translate into a significant reduction in our health care expenditure, adds yet another dimension to a case that is already hard to dismiss.

The great work being done through the National Physical Activity Plan will only be realized as health gains if we are able to maintain funding and support for facilities that encourage biking, walking, and active ways of getting around.

How will you encourage the funding of facilities that promote active transportation?

Pictured: Community trails like the Hudson River Greenway (top image) in New York and the Ojai Valley Trail in California are crucial in providing transportation options for residents that incorporate health and fitness into their daily lives.

Want to know more about how RTC is working to build a better landscape for walking and biking? Contact Kartik Sribarra at kartik@railstotrails.org.

Research published in the British scientific journal Age and Ageing found that older adults are highly knowledgeable about the health benefits of physical activity, yet many remain inactive due to the many barriers to participation. This article examines these barriers and suggests ways in which you and your organization can reduce or eliminate their impact on the physical activity levels of older adults.

1. Lack of interest (by far the #1 factor)

Prior to starting a program, have your older customer examine all their options. Would they prefer taking a class or going solo? Are they a morning or night person? Does indoor fitness appeal to them, or would they prefer to play outside? Could they dedicate large blocks of time to physical activity or could they fit only shorter, more frequent intervals into their schedule? What are their real world goals?

Young or old, people tend to enjoy things that interest them, that help them reach a goal or that is fun and social. By simply asking what they like to do you can break this barrier down one program at a time.

2. Shortness of breath

Shortness of breath can be due to a variety of health issues. It can also be that they are simply out of shape. Meet with their  healthcare provider to see whether you'll need to consider any special modifications before starting an exercise program. If necessary, get clearance to begin a program. Educate members that there are ways to address issues to improve their quality of life.

3. Joint pain

According to the Arthritis Foundation, regular, moderate exercise offers a whole host of benefits to people with arthritis. By exercising, your member can reduce joint pain and stiffness, build strong muscle around the joints, and increase flexibility and endurance.

4. Perceived lack of fitness

Education is the key here. Ensure that your members know they can start slowly, i.e. with 5-10-minute walks in the morning, at lunchtime and after dinner. With their resistance training, start them with only a couple of exercises and build up. DO NOT OVERWORK them or you will never see them again. Set long-term goals and show them how they will build their fitness level or workout over time.

5. Lack of energy

In many cases, this barrier is reversible and can be due to a low fitness level. It could also be from the interaction of multiple prescription drugs. The first step to a solution is to establish why they are lacking energy, then explain how being active will actually give them more energy. For many it can even reduce the number of expensive drugs they take.

6. Doubting that exercise can lengthen life

Ask your older customers about their quality of life. Are they able to do the things they want to do? Explain how exercise can improve their quality of life, no matter how long they live. What exercise will offer them is the ability to age on their own terms.

How are you reducing barriers that limit participation levels among your older customers?

Physical inactivity is a leading cause of death in the U.S. due to heart disease, stroke, diabetes, and cancer.  Physical activity is critical in the prevention of the detrimental effects of aging, obesity (33 to 35% of the US adult population), and chronic illnesses.  The Finnish Medical Society Duodecim, has also documented the importance of physical activity in the prevention, treatment and rehabilitation of diseases  .  Despite well‐documented evidence of the benefits of physical activity, we still have not approached the recommendations of the HHS Physical Activity Guidelines .  

What is the problem?  Approximately 70% of US adults are underactive,  40% of American adults do nothing to exercise, and  50% of individuals who start an exercise program drop out after 6 months.  (SportsEconomics:  Battling Attrition – A Study in Improving Member Retention at Health Club Facilities.  SportsEconomics Perspectives, Issue 3.  2001.)

Barriers to implementation  by physicians include limited time, lack of tools and skills, and lack of reimbursement.   Patient barriers to exercise include lack of time and confidence, presence of an injury, and incomplete/improper information regarding exercise relevance, content and dosing.    Research shows that  exercise advice given by a primary care physician may be effective in increasing physical activity in the short‐term [after two months], but not in the long‐term [after four and twelve months], due to insufficient support, accountability, and implementation strategies.

Who is currently in position?  The health and fitness industry is uniquely positioned to meet the growing need for easily accessible, supportive, and guided fitness venues.  They clearly have a role but  health clubs average a loss of 1 to 6 of every 10 members, and experience a mean attrition rate of 40% annually.,  Furthermore, program planning at most health clubs is targeted towards individuals who have already committed  to making physical activity a habit (which may explain why so many new members drop off).

Who else can help?   Successful exercise among those individuals who see more barriers than benefits to exercise depends on four key provider-driven characteristics:  clear, credible data; specific, attainable goals; directed programming; and appropriate reinforcement/support.

What’s Our Solution?  Conduct Annual Physical Therapist‐based Fitness Physicals to establish objective, norm‐referenced baseline measures of strength, flexibility, postural habits, cardio respiratory fitness, risks for injury, and readiness for change.  Develop individual fitness plans to specifically address findings; provide patient education, support, and ongoing feedback; establish multi‐modal fitness strategies including home exercise, private fitness training, and/or group fitness classes to best fit patient’s lifestyle, level of confidence and commitment, and experience; provide structured accountability and positive re‐enforcement systems.

What is your organization doing to engage communities to be more physically active?

Written by: Jennifer M. Gamboa, DPT, OCS, MTC