Physical Activity is Essential
As we head into 2012, the Human Capital Blog asked Robert Wood Johnson Foundation (RWJF) staff, program directors, scholars and grantees to share their New Year’s resolutions for our health care system, and what they think should be the priorities for action in the New Year. This post is by by Rashawn Ray, PhD, RWJF Scholar in Health Policy Research, University of California, Berkeley.
My New Year's resolution for the United States health care system is to more systematically include physical activity to get people moving to a healthier lifestyle. The health care system is more than markets and insurance. It includes prevention, maintenance and community resources to get people healthy and keep them that way. Physical activity is one key way to accomplish these goals.
Physical activity increases life expectancy, reduces the likelihood of obesity, some cancers, and chronic diseases (e.g., type-2 diabetes, hypertension, cardiovascular disease), improves self-rated health, mental health and quality of life, enhances productivity at work, helps maintain full functioning and independence among the elderly, and decreases the costs of late life care.
Despite these benefits, 60 percent of adults do not engage in the recommended amount of physical activity, which is at least 30 minutes per day, five times per week. Like other outcomes, there is a racial difference in who attains the recommended amount of physical activity. Roughly 50 percent of blacks are physically inactive, compared to one-third of whites. These percentages correspond to the percentage of individuals who are obese.
Therefore, a main priority of action for 2012 should be for physical activity to play a more central role in the policy discourse. As work hours continue to increase, the pressures families face to have a dual income persist, and the struggles of single women with children expand (especially with the increasing divorce rate), we must think of innovative and productive ways to help working individuals be more physically active.
Considering that less than 65 percent of obese adults receive advice about physical activity and healthy eating from their doctors, primary care providers (e.g., doctors, nurse practitioners, physician assistants) may hold the key. Preliminary findings from my study on racial differences in physical activity among the middle class imply that recommendations from primary care providers would increase physical activity. Since middle class suburban blacks are less physically active and more obese than their urban lower income counterparts, this recommendation could have a huge payoff for altering the health trajectories of African Americans.
Primary care providers should not worry about offending their patients/clients. Beating around the bush is not beneficial to those in need of increasing physical activity and losing weight. A script can be empirically tested that is comfortable for providers to say and effective for racial minorities. This important, yet simple and minimum, change could really help facilitate increases in physical activity and alter the health care system from costs to utilization.
In sum, the health care system is located in more places than hospitals and doctors’ offices. People spend most of their time in community settings. It is time we start realizing the overall benefits of considering local neighborhoods as the healthy person's playground for longevity, happiness, and lower health care costs for individual families and the federal government.
Rashawn Ray is a Robert Wood Johnson Foundation Health Policy Research Scholar at the University of California, Berkeley/UCSF and an Assistant Professor of Sociology at the University of Maryland at College Park. He is editor of “Race and Ethnic Relations in the 21st Century: History, Theory, Institutions, and Policy”and is currently working on a project examining racial differences in barriers and incentives to physical activity.