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Physical activity plays an essential role in promoting good health and preventing chronic diseases and is a leading component of President Bush's Healthier US Initiative, launched June 20, 2002. (More information on the initiative is available at www.whitehouse.gov/infocus/fitness/.) Overall, the President's fiscal year 2003 budget for HHS provides more than $16 billion for disease prevention programs and research.

BACKGROUND

Regular physical activity substantially reduces the risk of dying of coronary heart disease, the nation's leading cause of death, and decreases the risk for colon cancer, diabetes and high blood pressure. It also helps to control weight; contributes to healthy bones, muscles, and joints; reduces falls among the elderly; helps to relieve the pain of arthritis; reduces symptoms of anxiety and depression; and is associated with fewer hospitalizations, physician visits, and medications. Moreover, physical activity need not be strenuous to be beneficial; people of all ages benefit from moderate physical activity, such as 30 minutes of brisk walking five or more times a week.

Despite the proven benefits of physical activity, more than 60 percent of American adults do not get enough physical activity to provide health benefits. More than 25 percent are not active at all in their leisure time. Activity decreases with age and is less common among women than men and among those with lower income and less education.

Insufficient physical activity is not limited to adults. More than a third of young people in grades 9-12 do not regularly engage in vigorous physical activity. Daily participation in high school physical education classes dropped from 42 percent in 1991 to 29 percent in 1999.

HHS PROGRAMS TO SUPPORT HEALTH PROMOTION

HHS supports a number of programs to promote better health for Americans of all ages through physical activity. These programs were created to engage the public and community organizations in taking steps to promote and encourage increased physical activity.

• HealthierUS.gov. HHS works with the White House to sponsor this Web site, which supports the President's Healthier US Initiative and is designed to be a source of credible, accurate information to help Americans choose to live healthier lives.

• Healthy Communities Innovation Initiative. President Bush's fiscal year 2003 budget includes $20 million for a new Healthy Communities Innovation Initiative, an effort to bring together community-wide resources to help prevent diabetes, asthma and obesity. The initiative will fund demonstration projects in five communities to enhance access to services, encourage positive behavioral changes and improve community health. Given the relationship between physical inactivity and overweight and obesity, programs to increase physical activity will likely play an integral role.

• President's Council on Physical Fitness and Sports (PCPFS). The PCPFS serves as a catalyst to promote, encourage and motivate Americans of all ages to become physically active and participate in sports. The PCPFS advises the President and the Secretary of Health and Human Services on how to encourage more Americans to adopt and maintain an active and fit lifestyle while earning Presidential recognition. More information is available at www.fitness.gov.

• Healthy People 2010. Healthy People 2010, a comprehensive set of objectives for the nation to meet by the end of this decade, identifies the most significant preventable threats to health and establishes national goals to reduce these threats. One of the Healthy People 2010 goals is improving Americans' health, fitness and quality of life through daily physical activity with targets established both for adults and for children. More information on Healthy People 2010 is available at www.health.gov/healthypeople/.

• Leading Health Indicators. The first annual report on the 10 leading health indicators, critical factors that have a profound influence on the health of individual communities and the nation, will be released this year. The 10 leading health indicators were identified as part of the Healthy People 2010 process and include increasing levels of physical activity as one of the indicators. They represent the major public health concerns in the United States where individuals and communities can take action to realize significant health improvements.

• Active Community Environments (ACEs) Initiative. Through this initiative, CDC works with partners to promote the development of accessible recreation facilities, including more opportunities for walking and cycling. Projects include:

1. A partnership with the National Park Service's Rivers, Trails and Conservation Assistance Program to promote the development and use of neighborhood parks and recreation facilities.
2. The development of a guidebook for public health practitioners to use in partnering with transportation and city-planning organizations to promote walking, cycling and neighborhood recreation facilities.
3. CDC's Kids Walk-to-School Program encourages children to walk to and from school in groups accompanied by adults. Walking to school helps children be more physically active, practice safe pedestrian skills, and learn about their environment.
4. The GreenStyles Survey, developed by CDC and the Environmental Protection Agency, assesses the effects of environmental, social and personal variables on walking and cycling.

More information is available at www.cdc.gov/nccdphp/dnpa/aces.htm.

• Hearts N' Parks. This national, community-based program is supported by the National Heart, Lung, and Blood Institute (NHLBI) at NIH and by the National Recreation and Park Association. It aims to reduce the growing trend of obesity and the risk of coronary heart disease by encouraging Americans of all ages to aim for a healthy weight, follow a heart-healthy eating plan and engage in regular physical activity. Information is available at www.nhlbi.nih.gov/health/prof/heart/obesity/hrt_n_pk/.

• Programs for Older Americans. HHS works with numerous partners to promote physical activity among older adults. CDC and the National Institute on Aging at NIH have collaborated with AARP, the American College of Sports Medicine, the American Geriatrics Society, the American Society on Aging, the Robert Wood Johnson Foundation and the National Council on Aging to develop activities to increase physical activity among older adults, including the release of the "National Blueprint: Increasing Physical Activity among Adults Aged 50 and Older." Information on the blueprint is available at www.cdc.gov/nccdphp/dnpa/press/archive/blueprint.htm.

• National Bone Health Campaign. HHS' Office on Women's Health, CDC and the National Osteoporosis Foundation launched the National Bone Health campaign to educate and encourage girls ages 9-12 years to establish lifelong healthy habits, especially increased calcium consumption and physical activity, that will help reduce their risk for osteoporosis later in life. Information is available at www.cdc.gov/powerfulbones/.

  Engaging the Health Care Sector. CDC has worked with the health care sector to support and encourage health care professionals in managed care and other health care settings to promote physical activity among patients or health plan members. Efforts include conferences and physical activity assessment and counseling tools that providers can use to encourage patients to be more active.

HHS SURVEILLANCE AND RESEARCH INTO PHYSICAL ACTIVITY

Surveillance activities related to physical activity are guided by the mission to understand and promote physical activity to enhance health and quality of life, focusing on both youth and adults. Examples include:

• Lower Direct Medical Costs Associated with Physical Activity. This is the first study ever to examine direct medical costs associated with various levels of physical activity by reviewing actual medical expenditures. The study found that Americans 15 years and older who engaged in regular physical activity -- at least 30 minutes of moderate or strenuous physical activity three or more times a week -- had average annual direct medical costs of $1,019 versus costs of $1,349 for those who were inactive. More information is available at www.cdc.gov/nccdphp/dnpa/press/archive/lower_cost.htm.

• World Health Organization (WHO)/CDC Collaborating Center on Physical Activity. CDC's Division of Nutrition and Physical Activity (DNPA) is designated as a WHO Collaborating Center on Physical Activity. In working with WHO, priority areas include surveillance, economic and policy analysis, physical activity program development, partnership development and collaboration, consensus and community guidelines and active community environments.

• Active Community Environments (ACEs) - Policy and Environmental Interventions. Through the ACEs initiative, CDC conducts research into issues including the effects of community designs, government policies, individual characteristics and environmental factors on physical activity levels.

• Biannual Youth Risk Behavior Survey (YRBS). This survey provides data on physical activity behaviors of high school students across the nation. These data are used to track Healthy People 2010 objectives related to youth physical activity. The survey also collects data on television watching, self-reported height and weight, and dieting behaviors.

• School Health Policies and Programs Study. Conducted in 1994 and 2000, this is the largest study of what schools are doing to influence the health of their students. It includes detailed information on the quantity of physical education required and the nature of physical education provided across the nation.

• Healthy Youth Funding Database. This online database provides information on federal, foundation and state-specific funding sources for school health programs. The database is available at www.cdc.gov/nccdphp/dash/funding.htm.

• Enhanced Dissemination and Utilization Centers. Through this program, NHLBI partners with six community-based organizations to form the basis of a network of groups implementing targeted heart health education strategies to change local physician practices and patient behaviors. The organizations include a focus on physical activity as a way of improving cardiovascular health. More information is available at www.nhlbi.nih.gov/new/press/01-04-25.htm.

ADDITIONAL RESOURCES

• The Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity. This report outlines strategies that communities can use in helping to address the health problems associated with overweight and obesity, including requiring physical education at all school grades, providing more healthy food options on school campuses, and providing safe and accessible recreational facilities for residents of all ages. More information is available at www.surgeongeneral.gov/topics/obesity/.

• Physical Activity Evaluation Handbook. This resource outlines the six basic steps of evaluating physical activity programs for state and local agencies and community organizations and illustrates each step with program examples. Appendices provide information about physical activity indicators, practical case studies and additional evaluation resources. The handbook is available at www.cdc.gov/nccdphp/dnpa/physical/handbook/index.htm.

• State-based Physical Activity Program Directory. CDC has compiled this Web-based inventory of programs to promote physical activity with the involvement of state departments of health for use as a resource by groups also interested in promoting physical activity. It includes: information about program components, partners, settings, target populations, evaluation and products, and a profile of each state's efforts to promote physical activity.

• Bright Futures in Practice: Physical Activity. CDC, NHLBI, the National Association for Sports and Physical Education and the President's Council on Physical Fitness and Sports along with other organizations and individual researchers partnered with the National Center for Education in Maternal and Child Health (NCEMCH) to develop the Bright Futures in Practice: Physical Activity Guide, which provides developmental guidelines on physical activity for the periods of infancy through adolescence. More information is available at www.brightfutures.org/physicalactivity/.

• Physical Activity and Health: A Report of the Surgeon General. This landmark 1996 report brought together the results of decades of research on physical activity and health. Among its findings were that physical activity need not be strenuous to produce benefits and that inactive people can improve their health by becoming moderately active on a regular basis. The report is available at www.cdc.gov/nccdphp/sgr/sgr.htm.

• Physical Activity Recommendations from the Guide to Community Preventive Services. The Guide to Community Preventive Services provides recommendations that communities and health care systems can use to promote health and prevent disease, injury, disability and premature death. The guidelines include specific recommendations for how communities can encourage people to become more physically active. Information is available at www.cdc.gov/nccdphp/dnpa/physical/recommendations.htm.

• Promoting Physical Activity: A Guide for Community Action. CDC produced this guide as a resource for professionals and volunteers who wish to promote physical activity in almost any setting -- a community, a workplace, a school, a health care facility, an agency or a religious institution. Information on ordering the guide is available at www.cdc.gov/nccdphp/dnpa/pahand.htm.

• Guidelines for School and Community Programs to Promote Lifelong Physical Activity Among Young People. These guidelines identify strategies most likely to be effective in helping young people adopt and maintain a physically active lifestyle. The guidelines were developed in collaboration with experts from other federal agencies, state agencies, universities, voluntary organizations and professional associations. More information is available at www.cdc.gov/nccdphp/dash/guidelines/physact.htm.

• School Health Index for Physical Activity and Healthy Eating Self-Assessment and Planning Guide. This guide enables schools to identify strengths and weaknesses of their physical activity and nutrition policies and programs; develop an action plan for improving student health; and involve teachers, parents, students and the community in improving school services. Information is available at www.cdc.gov/nccdphp/dash/SHI/index.htm.

• Physical Activity Fundamental to Preventing Disease. This report pulls together data from various studies and scientific sources to illustrate the correlation between inactivity and poor health, particularly the onset of diseases such as diabetes, obesity and heart disease. It is available at aspe.hhs.gov/health/reports/physicalactivity/.

• Physical Activity and Older Americans: Benefits and Strategies. This report compiles data illustrating benefits and accessibility of physical activity for older Americans, finding that it is never too late to benefit from becoming physically active. The report also provides strategies that individuals, clinicians and communities can follow to foster greater activity among older Americans. It is available at www.ahrq.gov/ppip/activity.htm.

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