New Year, New Call to Action

January 10, 2019|10:53 a.m.| Marcus Plescia, MD, MPH | ASTHO chief medical officer

The recent release of the second edition of the Physical Activity Guidelines for Americans is timely. A goal to be more physically fit is a common New Year’s resolution. Given the increasing evidence cited in the report for both the immediate and long-term impact of physical activity on the public’s health, the guidelines are an opportunity for state and territorial health departments to examine and revise their efforts to increase participation in physical activity across the nation.

Changes from the first edition of the guidelines include recommending periods of active play in preschool age children (three hours per day), as well as encouraging adults to move more and sit less by removing the previous requirement that only 10-minute bouts of physical activity counted toward meeting the guidelines.

Most important is the significant increase in documented health benefits of physical activity. In addition to preventing heart disease, type 2 diabetes, as well as breast and colon cancer, we now know that physical activity can reduce the risk of eight types of cancer, fall-related injuries, and excessive weight gain.

Perhaps most impressive is the growing evidence that regular physical activity improves brain health and can mitigate and even reverse the symptoms of cognitive impairment. Many of the core recommendations remain the same. Each week, adults should get 150-300 minutes of moderate-intensity aerobic activity, as well as muscle-strengthening activity two days a week. Youth aged six through 17 need at least 60 minutes of moderate-to-vigorous activity each day.

The Move Your Way Campaign provides materials to help promote the new guidelines. However, with only one in five adults and youth fully meeting physical activity guidelines, interventions to increase physical activity must go beyond informational campaigns. CDC recently launched the Active People, Healthy Nation Campaign, a comprehensive national initiative with a goal of helping 27 million Americans become more physically active. The campaign is focused on increasing safe and convenient places to be active. Evidence-based interventions include adopting zoning code reforms, developing shared-use agreements, creating bicycle or pedestrian master plans, adopting complete streets policies, and participating in safe routes to schools programs. The campaign also explores new ways to document and monitor community infrastructure and environmental changes that support physical activity. CDC wants flagship states to use the initiative to brand their public health programs, with the goal of eventually expanding the campaign nationwide.

Last year, at ASTHO’s 2018 Policy Summit, the Community Health and Prevention Policy Committee made physical activity and nutrition a priority for ASTHO in 2019. An emphasis was placed on CDC’s State Physical Activity and Nutrition program, which currently funds only 16 states.

Funding should be increased to expand the program to every state and territory. As with many public health issues, states have led the way in adopting policies that will eventually lead to a comprehensive national response to support physical activity.

According to the Trust for America’s Health 2018 State of Obesity Report, every state (and Washington, D.C.) has regulations requiring allotted time for daily physical activity in licensed early childhood education programs. In addition, 29 states and Washington, D.C. have adopted complete streets policies with mandatory requirements, and 46 states and Washington, D.C. have adopted a shared use policy to require or recommend community access to schools' recreational facilities outside of school hours.

We clearly have the tools and will to take action on the increasingly important public health impact we now know regular physical activity can have in our communities. The evidence-base for public health interventions are increasingly robust and have been well documented by public health evidence reviews like those provided by the Community Guide.

With a modest increase in resources, states and territories can expand their partnerships and focus in multiple settings, such as schools, worksites, and community institutions. Most importantly, state and territorial health officials can provide the expertise, influence, and leadership to help drive policy changes such as increasing physical education in schools and creating environments that are convenient and conducive to physical activity in our daily lives.

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