Progress Toward Healthy People 2010 Targets

The following discussion highlights objectives that met or exceeded their 2010 targets; moved toward the targets, demonstrated no change, or moved away from the targets; and those that lacked data to assess progress. Progress is illustrated in the Progress Quotient bar chart (see Figure 22-1), which displays the percent of targeted change achieved for objectives and subobjectives with sufficient data to assess progress.

Objectives that met or exceeded their targets. No physical activity and fitness objectives met their targets at the time of the midcourse review.

Objectives that moved toward their targets. Five physical activity and fitness objectives for adults and two for adolescents in grades 9 through 12 moved toward their targets. Reducing the proportion of adults who do not participate in some form of leisure-time physical activity (22-1) moved toward its target of 20 percent, achieving 15 percent of its targeted change. Compared with a baseline of 40 percent of the population being inactive in 1997, 37 percent reported no leisure-time physical activity in 2003. Regular moderate or vigorous physical activity (22-2) moved toward its target of 50 percent, achieving 6 percent of the targeted change. Regular vigorous physical activity (22-3) achieved 14 percent of the targeted change, moving toward its target of 30 percent. Muscular strength and endurance (22-4) and flexibility exercises among adults (22-5) also advanced toward their targets, achieving 17 percent and 8 percent of the targeted change, respectively.

Improvement in physical activity levels of Americans may relate to the steady increase in the visibility of physical inactivity as a health issue and to a growing number of initiatives that seek to promote physical activity. A public health initiative that identifies interventions to promote physical activity is the Community Guide to Preventive Services.² This resource for public health practitioners recommends evidence-based intervention strategies for modifying behavioral, environmental, and policy correlates of active lifestyles. In addition, many State health programs use national guidelines and recommendations to promote healthy behaviors to reduce the burden of cardiovascular disease, stroke, cancer, and obesity and to increase healthful behavior in youth.³

Gains were made among students in grades 9 through 12 for objectives addressing physical activity during physical education class (22-10) and television viewing time (22-11). The proportion of students in grades 9 through 12 who spent at least half of physical education class time being active reached 8 percent of its targeted change. The increased use of school-based programs may have contributed to the increase in active physical education time. For example, the Sports Play and Active Recreation for Kids (SPARK)⁴ and the Coordinated Approach to Child Health (CATCH)⁵ programs provide teachers with information and ideas on ways to increase activity time during physical education classes. The proportion of adolescents who limited television viewing to 2 or fewer hours a day increased from 57 percent in 1999 to 62 percent in 2003, achieving 28 percent of the targeted change and moving toward its target of 75 percent. An increase in time spent multitasking, such as playing video games, instant messaging, or doing homework while the television is on, might have influenced the change in television viewing.⁶

Objectives that demonstrated no change. None of the objectives for this focus area remained static since the launch of Healthy People 2010.

Objectives that moved away from their targets. The objective covering moderate physical activity among students in grades 9 through 12 (22-6) moved away from its target. From a baseline of 27 percent in 1999, the proportion of students who participated in such activity dropped to 25 percent in 2003, moving away from the target of 35 percent. Vigorous physical activity (22-7) and participation in daily physical education in schools (22-9) among students in grades 9 through 12 also moved away from their targets. Even though most States have mandates for physical education, decisions on curriculum content and specific requirements often fall to local school districts or individual schools, which leads to a wide range of requirements for students at all levels. Some schools may require 1 year of physical education, whereas other States or school districts may not require physical education beyond eighth grade.

Evidence suggests that adolescents may perceive vigorous physical activity as socially unacceptable.⁷ The same research also suggests that adolescents—as they become more independent—reject adult-oriented health goals. These findings, in addition to diminished school-based physical education, provide possible explanations for the decrease in moderate and vigorous activity among this population group.

One initiative to increase physical activity among adolescents was "VERB™ It's what you do." VERB was a national, multicultural, social marketing campaign coordinated by the Centers for Disease Control and Prevention that helped influence the values of young people aged 9 to 13 years ("tweens") by encouraging them to be active every day. Begun in 2002 and concluded in 2006, the VERB campaign combined paid advertising, marketing strategies, and partnership efforts to reach the distinct audiences of tweens and adults/influencers. VERB was successful in increasing physical activity levels among tweens.⁸ As these youth become high school students in the latter half of the decade, the long-term effects of VERB may be measured by the youth physical activity objectives.

Objectives that could not be assessed. Trend data were not available for the objectives regarding physical education requirements in schools (22-8), access to school physical activity facilities (22-12), worksite physical activity and fitness (22-13), and walking (22-14) or bicycling (22-15) for transportation. Data sources were identified for all of these objectives, and data to establish baselines and assess progress are anticipated by the end of the decade.

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