Written by Janet Fulton, Centers for Disease Control and Prevention

How were the physical activity objectives developed?

The Centers for Disease Control and Prevention in partnership with the President's Council on Fitness, Sports and Nutrition worked with a team of federal agency representatives to formulate the objectives for the physical activity topic area. The availability of recent and ongoing nationally-representative data were a necessary requirement for inclusion of an objective; public comments provided further guidance for the final objectives. The Healthy People 2020 default method (10% relative beneficial change) was most commonly used to set the target for each objective.

What's new for Healthy People 2020?

The 2008 Physical Activity Guidelines for Americans provided an evidence-based framework by which the Healthy People 2020 physical activity behavioral objectives were revised. For adults and youth, objectives PA-2 and PA-3 are now consistent with the Guidelines. Because aerobic and muscle-strengthening activities are BOTH required to fully meet the Guidelines, sub-objectives for youth and adults that combine aerobic and muscle-strenghtening activities are now included.

School-based physical activity is reflected in modified objectives for physical education (PA-4 and PA-5) and in two new objectives for elementary school recess (PA-6 and PA-7). More than 60% of pre-school

children attend child care. Therefore, enacting policies that require physical activity in the child care setting (PA-9) is a strategy to modify the physical activity environment for children. Given the ubiquitous role screen time plays in society, the modified objective for youth to reduce screen time through telelvision viewing and computer use (PA-8) is an increasingly important goal.

A new objective for Healthy People 2020 (PA-11) will monitor physician counseling about exercise. Given the recent emphasis on physician counseling about physical activity by the American College of Sports Medicine's Exercise is Medicine program, it is timely that physical activity guidance in the health care setting is tracked at the national level.

Where do we go from here?

With less than 20% of adults meeting the Guidelines for aerobic and muscle strengthening activities and a similarly low percentage of youth meeting the Guidelines for aerobic physical activities, a multidisciplinary approach is needed to facilitate improvements in recommended levels of physical activity.

The importance of having reliable, nationally-representative data sources to track the metrics associated with physical activity cannot be overstated. Important and novel topics were discussed by the Work Group, only to learn that a suitable data source was unavailable. For example, improving the environment for physical activity is a recommended strategy, although there is no acceptable national data source that tracks individual access to green spaces or parks. The same is true for physical activity in the work place. It is imperative to continue support of current Healthy People 2020 data sources and to support future collection of strategic priority topic areas for physical activity promotion.

It is our hope that as these Healthy People objectives disseminate across states and into the schools, businesses, and organizations that make up our communities, there will be an interest in working across sectors to affect real change in physical activity behaviors. The National Physical Activity Plan provides an excellent multi-sectoral framework along with strategies and specific tactics for action. Time and again the health benefits of physical activity have been well documented. Let's work together to move the dial on physical activity this decade!

As Congress wrestles with complex, contentious issues of health care reform, I’d like to propose a step anyone can take to improve health and likely cut health care costs. This isn’t a legislative bombshell—I’ll leave that for the politicians. And it isn’t a new idea, though research keeps adding to the body of supporting evidence. Let me help you make the case for physical activity.

It’s not about exercising for weight loss, though most people know there’s a connection. Simply put, I’m advocating physical activity for health. Exercise repeatedly has been shown to help prevent chronic diseases such as diabetes, overweight and obesity, osteoporosis, coronary heart disease, hypertension, depression and anxiety, and even some forms of cancer. Surely, if there were a pill with all these benefits (along with some very pleasant side effects), everybody would ask to have it prescribed.

Truly, exercise IS medicine, and it’s readily available to everyone. Very little is required to get started: a pair of walking shoes, or maybe a jump-rope. Playing with your children is free of charge. (I highly recommend it, and I don’t even know your kids.) People of any physical condition can become more active and start feeling better. No prescription is needed, though more and more physicians are calling for specific doses of exercise for their patients.

On the job and active

Employers, squeezed ‘til it hurts by soaring costs, have found that it pays to encourage employees to be physically active. Published reports on workplace wellness programs show that cost savings for every dollar invested range from $2.90 (Prudential Insurance) to $5.96 (Bank of America). DuPont reported a 14-percent decline in absent days among blue-collar workers. Pacific Bell’s FitWorks program saved $2 million and $4.7 million in short-term disability costs in just one year.

Workplace wellness programs bring other benefits, too. Fit Swedish workers committed 27 percent fewer errors on tasks involving concentration and short-term memory, and a Canadian program found that 47 percent of employee wellness program participants felt more alert, had better rapport with co-workers, and generally enjoyed their work more.

Bottom line

Sure, it’s great to save those dollars—particularly nowadays—but the total benefits are incalculable. What price can you put on feeling better, living longer, or avoiding a debilitating illness? Think about ramping up your level of physical activity, and bring someone along with you. If you need help getting started, you’ll find plenty of resources on the Exercise is Medicine website.

It may take Congress a while yet to figure out health care reform. Meanwhile, I vote for healthy lifestyles as prevention. All in favor? Please share your organization’s perspectives on exercise as medicine.

What is your organization's perspective and involvement in the topic of exercise as prevention?