A Big Fat Crisis (27 page)

Two of my sons loved soccer and wanted to play on the high school team. But their high school had more than 3,500 students and only one soccer team. Even though they were decent soccer players, neither was skilled enough to make the team, and both were shut out of the physical activity they loved.

Few schools have intramural sports teams that allow those who don’t make the varsity teams to participate. There is typically only one gym or field for soccer, football, or baseball, and these are reserved for the talented few. Is it fair that only a limited number of students can use the field every day for practice, while the majority can merely watch?

Even more egregious is when the high-school level of competition is emulated among younger children. One friend told me her eight-year-old son was kicked off a community-based track team that had been advertised as open to any child. The coaches said he was too slow. Is winning trophies and ribbons for eight-year-olds more important than inclusion? Can you imagine how that kind of rejection would make a child never want to even try the sport again?

We have to stop treating sports and vigorous physical activity as something restricted to serious athletes and professionals. Instead, we need to rediscover fun, teamwork, and tolerance.

In 1972 Congress passed Title IX, which says that “no person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or be subjected to discrimination
under any education program or activity receiving federal financial assistance.” This legislation opened up high school and college sports to females, allowing them to benefit from the resources that were directed at sports that previously only males enjoyed.

Today we need new legislation that allows youths in public schools to participate in sports even if they don’t make varsity teams. Yes, it makes sense that every high school should have a varsity team, but training should not come at the expense of the majority of students. Students who are not athletically gifted should not be excluded and condemned to sedentary activities.

If
any
student can participate in a school sport, then
every
student who wants to play should be able to. This means that schools with large student bodies and competitive varsity teams should also offer less competitive intramural sports teams. A rotating schedule will allow every team to use limited fields. On days the fields are being used by one team, the other teams can do conditioning exercises and activities elsewhere that will keep them in shape. All students should have access to facilities and coaches who are supported by tax dollars. Children need all the support they can get to stay active.

Physical Activity for Adults

If children need daily exercise in school, isn’t it logical that employed adults should engage in daily exercise at work? Especially if our jobs force us to sit for eight hours a day, shouldn’t some effort be made to mitigate the risk we find ourselves bearing? After all, employers are required to mitigate risk for other worksite hazards. In eight states, including California, where I work, employers are required to give their workers a ten-minute break every four hours. But if this work is sedentary, shouldn’t it be an exercise break?

Once a week I participate in a yoga class at work, but I have to pay for it and do it on my lunch hour. The type of yoga available focuses mainly on stretching and flexibility and doesn’t provide enough moderate-to-vigorous physical activity.

If I had ten or twenty minutes set aside in my schedule (on the time clock) and my employer expected me to be active during that
time—either in an exercise class, walking up and down the stairs, or dancing in the corridors—I would definitely do it. And I am confident that most of my coworkers would also become more active, especially if our employers showed us they cared by pleading with us to take regular “action” breaks to avoid long-term health problems from steadfastly sticking to our desks.

A study on heart disease in the 1950s, among the earliest of its kind, found that sedentary workers in London like bus drivers and mail sorters had higher rates of heart disease and heart attacks than ambulatory ticket collectors and postal workers.
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Sitting too long can also lead to the development of low back pain and herniated discs.
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Musculoskeletal complaints arising from occupational activities cost hundreds of millions of dollars in workers’ compensation claims every year.

Recently, some researchers have argued that sitting for prolonged periods can create health risks, even if a person gets exercise at other times.
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The evidence for this is still inconclusive, but the thinking is that muscular inactivity may lead to metabolic syndrome, a condition marked by high blood pressure, as well as too much sugar and cholesterol in the blood, all of which increase the risk of heart disease and diabetes.
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Whether or not sitting leads to metabolic syndrome, the evidence that excessive sitting can reduce the lifespan is very strong.
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Dr. Toni Yancey, a Professor at the UCLA School of Public Health, left an invaluable legacy called Instant Recess—a ten-minute exercise program that can be used in schools or at the workplace. Where it has been adopted, benefits include improved attitudes, higher productivity among employees, lower injury rates, and lower absenteeism.
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Yancey claimed that the monetary benefits from decreased workers’ compensation payouts and lower absenteeism make this a highly cost-effective approach. You just pop in a DVD, and an instructor on the video models how everyone should move in time with the music. Everyone just copies the leader. With peppy music and silly moves, it can be a lot of fun.

The Instant Recess concept is extremely promising, and may one day be a standard part of our work environments and other professional settings and meetings—if we advocate for it.

Graduating from high school or college shouldn’t end routine physical
activity. Continuing PE on a modified basis in the workplace will surely help our population stay in better shape. Policies that help everyone stay active and reduce the harms from sedentary jobs would show we are all in this together.

Modifying Urban Design

Although office workers would benefit from worksite exercise programs, not everyone works in an office. Another approach to encouraging more physical activity is to change the design of our neighborhoods and cities so we can be active when we leave home to do errands or go to work, by walking, bicycling, or even taking mass transit.

Over the past six decades the car has come to dominate our cities and suburbs. During this time, old methods of mass transportation, including streetcars and trolleys, were mostly eliminated, and our roads were widened and developed to accommodate an increasing number of cars.

By studying the physical activity patterns of people who live in different cities and neighborhoods, we have recognized that in areas that are walkable, where destinations can be reached on foot and people live fairly close together, more people walk and enjoy better health.
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Moreover, if parking spots are scarce and mass transit is plentiful, people are more likely to use mass transit, and as a result to walk to or from their destinations.

The populations of countries that have invested in mass transit tend to be more active. Japan, for example, has done an outstanding job of managing its national transportation system. The Japanese have not only made mass transit convenient; they have also made car ownership expensive and parking less convenient than using city trains and buses. Japan’s bullet trains and subways get people where they need to go quickly and reliably. Another important reason why the Japanese are slimmer than Americans may be their higher levels of physical activity. Not only do Japanese eat less, but they also walk considerably more, burning a few hundred more calories a day than the average American.
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Using mass transit is an automatic way to get exercise.

As a nation, America is way behind other countries in having a
reliable mass transit infrastructure, except in a few cities. In 2007–2008, the city of Charlotte, North Carolina, expanded its light rail system. I worked with several RAND researchers to evaluate whether this new system would pay dividends in health among light rail users.
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We surveyed individuals living within one mile of the planned light rail line before it opened and then a year later, after it began running. At each time point we asked about their levels of physical activity and their height and weight.

When comparing those who started using the light rail to those who did not, we found that light rail users increased their physical activity and reduced their risk of obesity. The weight of nonusers increased by more than six pounds compared to the light rail users. Although we can’t be sure about the magnitude of the effect, because it was based on self-report rather than objectively measured weight, the study does seem to support the potential health benefits of mass transit.

Yet instead of emphasizing mass transit or concentrating our populations in a way that makes mass transit a sensible alternative, America has invested heavily in building roads so homes can be spread out. Our nation now has large areas of sprawling suburbs, such that in many parts of the country one must have a car to go anywhere, even to pick up a quart of milk or a local paper.

In a study I conducted with my colleague Roland Sturm on the impact of urban sprawl, we found that the health of people who live in cities like Atlanta, where the average person drives four to five miles to a supermarket, is much worse than among those who are otherwise similar but live in cities like Pittsburgh or San Antonio, where it is much easier to walk to a local grocery store. For every thousand residents, Atlanta’s citizens chalk up ninety-six more health problems than residents of Pittsburgh or San Antonio. That number is roughly equivalent to giving the residents of Atlanta the health problems of people four years older than they are, as if living in sprawl ages a person by four years.
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This is one of the reasons why where we live is an important determinant of our health.

Changing urban design so that we can get out of our cars and walk more, however, is a long-term process, necessary not only to improve health but also to address problems like global warming, because transportation
accounts for about 27 percent of all greenhouse gas emissions in the United States.
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Leisure-Time Physical Activity

If you haven’t gotten your dose of physical activity at work or on your way to wherever you go, then you can still catch up in your leisure time. After all, most people still work about forty hours per week, making it theoretically possible to carve out thirty minutes before or after work to get some physical activity. But the reality is, unless there is a draw to be active, few will.

Therefore, it is incumbent on our society to invest in making leisure-time physical activity as attractive, available, and ubiquitous as junk food, so more people will be likely to participate.

What would such a society look like? Over the past ten years I have focused a good portion of my research on studying the use of parks and other open spaces. What I have found is that even when people live right near a beautiful park, they may not use it, especially if there is nothing interesting going on or if they are not aware of its programs or facilities.

How parks are managed varies considerably across America and depends on the resources available through local taxes. Even in the wealthiest communities, a minimal proportion of those resources is usually devoted to marketing park use or encouraging physical activity there.

Consider this: the entertainment industry spends hundreds of millions of dollars to encourage people to watch electronic media and passive entertainment. Is it any wonder people are more likely to watch others be active than to be active themselves?

Neighborhood parks are among the most logical places where we should be promoting physical activity, because most people live within two to five miles of a public park and their wide-open spaces are uniquely designed for moderate-to-vigorous activity like running and playing sports. And there are many other reasons to be outdoors. An important one is to be exposed to sunlight, which creates vitamin D, important for bones and a healthy heart. Insufficient levels of vitamin
D are epidemic in the United States, particularly among the elderly; such deficiency could be cured if people spent more time in the sun.

Although people of all age groups need to be outside and stay active, most park programs are primarily designed for children and teens. There are many children’s soccer and basketball leagues, a few for adult men, but almost none for women of all ages or for seniors. In fact, in our research we count the people in neighborhood parks by their age group and, except in Asian communities where a lot of seniors do Tai Chi, we seldom see older adults, and considerably fewer adults than would be expected if all residents used their parks equally. It’s as if we intend for people to be less active as they age. If we want to encourage physical activity for everyone, we should be sponsoring sports leagues and programs for all age groups, not just children.

Will such investments pay off?

Brazil is a country where a substantial effort is being made to encourage more physical activity for adults. There is some evidence that the community-wide physical activity promotion programs in São Paulo are leading to reductions in hospitalizations for problems like hypertension.
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A local campaign called Agita encourages community leaders to creatively stimulate physical activity in any way they can. They have repaired sidewalks, built more running and cycling tracks, scheduled citywide walking events, offered classes in parks, and even promoted walking around a cemetery.