Co-Lead Agencies:		Centers for Disease Control and Prevention President’s Council on Physical Fitness and Sports

[Note: The Healthy People 2010 Information Access Project provides dynamic, pre-formulated PubMed searches for selected objectives in this focus area so that current information and evidence-based strategies related to these objectives are easier to find. The National Library of Medicine has also provided PubMed links to available references that appear at the end of this focus area document.]

Contents

GoalPage 22-3

Overview. Page 22-3

Issues and Trends. Page 22-3

Disparities. Page 22-4

Opportunities. Page 22-6

Interim Progress Toward Year 2000 Objectives. Page 22-6

Healthy People 2010—Summary of Objectives. Page 22-7

Healthy People 2010 Objectives. Page 22-8

Physical Activity in Adults. Page 22-8

Muscular Strength/Endurance and Flexibility. Page 22-13

Physical Activity in Children and Adolescents. Page 22-17

Access. Page 22-25

Related Objectives From Other Focus Areas. Page 22-33

Terminology. Page 22-35

References. Page 22-36

 

Goal

Improve health, fitness, and quality of life through daily physical activity.

Overview

The 1990s brought a historic new perspective to exercise, fitness, and physical activity by shifting the focus from intensive vigorous exercise to a broader range of health-enhancing physical activities. Research has demonstrated that virtually all individuals will benefit from regular physical activity.[1] A Surgeon General’s report on physical activity and health concluded that moderate physical activity can reduce substantially the risk of developing or dying from heart disease, diabetes, colon cancer, and high blood pressure.1 Physical activity also may protect against lower back pain and some forms of cancer (for example, breast cancer), but the evidence is not yet conclusive.[2], [3]

Issues and Trends

On average, physically active people outlive those who are inactive.[4], [5], [6], [7], [8] Regular physical activity also helps to maintain the functional independence of older adults and enhances the quality of life for people of all ages.[9], [10], [11]

The role of physical activity in preventing coronary heart disease (CHD) is of particular importance, given that CHD is the leading cause of death and disability in the United States. Physically inactive people are almost twice as likely to develop CHD as persons who engage in regular physical activity. The risk posed by physical inactivity is almost as high as several well-known CHD risk factors, such as cigarette smoking, high blood pressure, and high blood cholesterol. Physical inactivity, though, is more prevalent than any one of these other risk factors. People with other risk factors for CHD, such as obesity and high blood pressure, may particularly benefit from physical activity.

Regular physical activity is especially important for people who have joint or bone problems and has been shown to improve muscle function, cardiovascular function, and physical performance.[12] However, people with arthritis (20 percent of the adult population) are less active than those without arthritis.[13] People with osteoporosis, a chronic condition affecting more than 25 million people in the United States, may respond positively to regular physical activity, particularly weight-bearing activities, such as walking,[14] and especially when combined with appropriate drug therapy and calcium intake. Increased bone mineral density has been positively associated with aerobic fitness, body composition, and muscular strength.[15]

Although vigorous physical activity is recommended for improved cardiorespiratory fitness, increasing evidence suggests that moderate physical activity also can have significant health benefits, including a decreased risk of CHD. For people who are inactive, even small increases in physical activity are associated with measurable health benefits. In addition, moderate physical activity is more readily adopted and maintained than vigorous physical activity.[16] As research continues to illustrate the links between physical activity and selected health outcomes, people will be able to choose physical activity patterns optimally suited to individual preferences, health risks, and physiologic benefits.

For individuals who do not engage in any physical activity during their leisure time, taking the first step toward developing a pattern of regular physical activity is important. Unfortunately, few individuals engage in regular physical activity despite its documented benefits. Only about 23 percent of adults in the United States report regular, vigorous physical activity that involves large muscle groups in dynamic movement for 20 minutes or longer 3 or more days per week. Only 15 percent of adults report physical activity for 5 or more days per week for 30 minutes or longer, and another 40 percent do not participate in any regular physical activity.

Public education efforts need to address the specific barriers that inhibit the adoption and maintenance of physical activity by different population groups. Older adults, for example, need information about safe walking routes. Persons with foot problems need to learn about proper foot care and footwear in order to reach appropriate activity levels. People with CHD and other chronic conditions must understand the importance of regular physical activity to maintain physical function. Each person should recognize that starting out slowly with an activity that is enjoyable and gradually increasing the frequency and duration of the activity are central to the adoption and maintenance of physical activity behavior. Along with the public education efforts, public programs in a variety of settings (recreation centers, worksites, health care settings, and schools) need to be developed, evaluated, and shared as potential models. The availability of group activities in the community is important for many.

Disparities

Disparities in levels of physical activity exist among population groups. The proportion of the population reporting no leisure-time physical activity is higher among women than men, higher among African Americans and Hispanics than whites, higher among older adults than younger adults, and higher among the less affluent than the more affluent. Participation in all types of physical activity declines strikingly as age or grade in school increases. In general, persons with lower levels of education and income are least active in their leisure time. Adults in North Central and Western States tend to be more active than those in the Northeastern and Southern States. People with disabilities and certain health conditions are less likely to engage in moderate or vigorous physical activity than are people without disabilities. Health promotion efforts need to identify barriers to physical activity faced by particular population groups and develop interventions that address these barriers.1

Data demonstrate that major decreases in vigorous physical activity occur during grades 9 through 12. This decrease is more profound for girls than for boys, whether the measure is engaging in vigorous physical activity in general or in team sports. The President’s Council on Physical Fitness and Sports concluded that because of the physical health and emotional benefits of physical activity, it should have an increasingly important role in the lives of girls.[17] Adolescents’ interest and participation in physical activity differ by gender.17 Therefore, strategies to increase the amount of physical activity for boys and girls must address these differences and must begin before the disparities in levels of physical activity manifest themselves. Compared to boys, girls are less likely to participate in team sports but more likely to participate in aerobics or dance. Often girls and boys perceive different benefits from physical activity, with boys viewing such activity as competition and girls as weight management. These factors must be considered in developing programs to address the needs of girls. Because boys are more likely than girls to have higher self-esteem and greater physical strength, programs addressing the needs of girls should provide instruction and experiences that increase their confidence and their opportunities to participate in activities, as well as social environments that support involvement in a range of physical activities.17

Opportunities

The Healthy People 2010 objectives offer opportunities to ensure that physical activity and fitness become part of regular healthy behavioral patterns. Encouraging any type or amount of physical activity in leisure time can provide important health benefits, compared to a sedentary lifestyle.

Activities that promote strength and flexibility are important because they may protect against disability, enhance functional independence, and encourage regular physical activity participation. These benefits are particularly important for older people—a good quality of life means being functionally independent and being able to perform the activities of daily living.

Young people are at particular risk for becoming sedentary as they grow older. Therefore, encouraging moderate and vigorous physical activity among youth is important. Because children spend most of their time in school, the type and amount of physical activity encouraged in schools are important components of a fitness program and a healthy lifestyle.

The major barriers most people face when trying to increase physical activity are time, access to convenient facilities, and safe environments in which to be active. Counseling by primary care providers about the need to participate in physical activity also is an important way to change behavior. In addition, facilities need to be accessible to people with disabilities.

Interim Progress Toward Year 2000 Objectives

Of the 13 physical activity and fitness objectives, 1 has been met—increasing worksite fitness programs. Four objectives show solid gains, indicating that the message about increased physical activity is reaching some segments of the population. The message that a sedentary lifestyle plays a role in both overweight and weight loss needs to be addressed better, as does the role primary care providers can play in counseling individuals to increase their daily activities. Both the quantity and quality of school physical education have slipped. Data to evaluate access and availability of community fitness facilities are not available.

Note: Unless otherwise noted, data are from the Centers for Disease Control and Prevention, National Center for Health Statistics, Healthy People 2000 Review, 1998–99.

Healthy People 2010—Summary of Objectives

Physical Activity and Fitness

Goal: Improve health, fitness, and quality of life through daily physical activity.

Number	Objective Short Title
Physical Activity in Adults
22-1	No leisure-time physical activity
22-2	Moderate physical activity
22-3	Vigorous physical activity
Muscular Strength/Endurance and Flexibility
22-4	Muscular strength and endurance
22-5	Flexibility
Physical Activity in Children and Adolescents
22-6	Moderate physical activity in adolescents
22-7	Vigorous physical activity in adolescents
22-8	Physical education requirement in schools
22-9	Daily physical education in schools
22-10	Physical activity in physical education class
22-11	Television viewing
Access
22-12	School physical activity facilities
22-13	Worksite physical activity and fitness
22-14	Community walking
22-15	Community bicycling

 

Healthy People 2010 Objectives

Physical Activity in Adults

22-1.		Reduce the proportion of adults who engage in no leisure-time physical activity.

Target: 20 percent.

Baseline: 40 percent of adults aged 18 years and older engaged in no leisure-time physical activity in 1997 (age adjusted to the year 2000 standard population).

Target setting method: Better than the best.

Data source: National Health Interview Survey (NHIS), CDC, NCHS.

Adults Aged 18 Years and Older, 1997	No Leisure-Time Physical Activity
	Percent
TOTAL	40
Race and ethnicity
American Indian or Alaska Native	46
Asian or Pacific Islander	42
Asian	42
Native Hawaiian and other Pacific Islander	41
Black or African American	52
White	38
Hispanic or Latino	54
Not Hispanic or Latino	38
Black or African American	52
White	36
Gender
Female	43
Male	36
Education level (aged 25 years and older)
Less than 9th grade	73
Grades 9 through 11	59
High school graduate	46
Some college or AA degree	35
College graduate or above	24
Geographic location
Urban	39
Rural	43
Disability status
Persons with disabilities	56
Persons without disabilities	36
Select populations
Age groups
18 to 24 years	31
25 to 44 years	34
45 to 64 years	42
65 to 74 years	51
75 years and older	65
Persons with arthritis symptoms	43
Persons without arthritis symptoms	38