Childhood Obesity: Using School Programs to Encourage Increased Physical Activity Among Youth

Background

Lack of physical activity and poor diet are tied as the second leading causes of preventable death in the United States (2). One in eight American children have been identified as seriously overweight (5) placing them at risk for diabetes, high blood pressure, cardiovascular disease, certain types of cancer, as well as a potentially reduced quality of life due to social, academic, and job discrimination (8).
 
The correlation between physical activity and health is widely acknowledged (3, 7), yet 73 percent of U.S. high school students fail to attain the minimum level of physical activity prescribed to maintain health (2). Research confirms that daily, structured physical activity such as that provided in schools significantly reduces signs of obesity as well as improves measurable endurance fitness (6). Since most youths between the ages of six and sixteen years of age attend school, promoting physical activity within the schools could result in "population-wide" benefits (6).
 
The National Association for Sport and Physical Education (NASPE) developed a set of standards to define the physically educated individual: 1) has learned skills necessary to perform a variety of physical activities; 2) is physically fit; 3) participates regularly in physical activity; 4) knows the implications of and the benefits from involvement in physical activities; and 5) values physical activity and its contribution to a healthy lifestyle (4). These standards have since been acknowledged as a useful guide for the development of physical education programs in schools in order to promote increased physical activity among youth.
 

Policies

1. Enact local policies requiring physical education for all students (grades K-12).

While 93 percent of all high schools require at least one physical education class to meet graduation requirements, only 26 percent require three years of physical education (6). By their senior year, only 14 percent of female high school seniors participate in daily physical education classes (1). Both the Surgeon General and Healthy People 2010 recommend mandating physical education throughout all school levels as a means of improving overall student health, and school physical education programs for young children can begin early to teach physical activity as part of an overall healthy lifestyle (6, 7).
 
Policies to encourage physical activity can include the adoption of education standards for physical education as a separate area of study, as well as the strict enforcement of those standards and current physical education mandates.
 

2. Increase active participation by all students in physical education classes.

Most physical education classes focus on team sports requiring sporadic and/or limited individual activity. By encouraging more alternative and lifestyle activities as part of the physical education curriculum--jogging, weight lifting, personalized fitness programs--rather than traditional team sports, the amount of time actually spent in physical activity may be significantly increased (2). If all students were a) enrolled in physical education classes and b) physically active during half of each P.E. class, they would meet or exceed established guidelines for physical activity (7). To monitor student participation and progress, schools can require that performance evaluations include physical fitness test results, and that parents receive written notification of these results.
 
 

3. Create or enhance access to safe places for physical activity within communities. 

Lack of access to appropriate, safe facilities is a common obstacle to physical activity (6, 7). One method of encouraging increased physical activity is to utilize facilities or programs that already exist. For example, opening schools for after-hours activities is one means of addressing this issue, or developing after school programs with organized physical activity using state or federal funding is another. Many children already attend after school programs, so it is imperative that these programs provide organized and structured opportunities for active recreation (6). Other possible options include encouraging building of schools within a walkable distance of the students served and providing safe walking / bicycling trails for their use (2).
 

4. Increase funding provided for school physical education programs.

Enacting policies to increase state or federal funding to school physical education programs will allow those programs to be more effective. Funding can be used by schools to decrease physical education class size to equal other courses, or a sufficient number of credentialed physical education teachers can be hired for all schools in a district. Professional development support for physical education teachers can result in programs that are more effective at increasing physical activity among students, while being more interesting and enjoyable (6).
 

Effectiveness Data

Increased activity in physical education classes has been shown to improve overall student health and, specifically, aerobic fitness by an average of 8 percent (3). In addition, increased physical activity has been linked to improved academic performance and is inversely related to risk behaviors such as cigarette smoking and marijuana use (5).
 
Providing safe and affordable venues for physical activity is strongly recommended by the Surgeon General (6). In addition to the increased health benefits cited previously, increased access to facilities has been linked to reductions in crime and violence in communities (6, 7).
 

Resources

American Alliance for Health, Physical Education, Recreation, and Dance (AAHPERD)
http://www.aahperd.org
The American Alliance for Health, Physical Education, Recreation and Dance (AAHPERD) is the largest organization of professionals supporting and assisting those involved in physical education, leisure, fitness, dance, health promotion, and education and all specialties related to achieving a healthy lifestyle.
 
KaBOOM!
http://www.kaboom.org
A national, non-profit organization providing resources, references, as well as links to corporate funders in order to assist communities in building safe playgrounds.
 
North Carolina Prevention Partners
http://www.ncpreventionpartners.org/activity/
NCPP has compiled a list of state and national resources on physical activity for all ages.
 
Planet Health
http://www.hsph.harvard.edu/prc/planet.html
(617) 432-3840
Planet Health, a project of The Harvard Prevention Research Center, is an interdisciplinary curriculum for middle school students. Planet Health integrates health/physical education instruction into social studies, language arts, math, and science through 32 "Classroom Lessons" and 30 Physical Education "Micro-Units" and "Fit-Checks."
 

References

1. Centers for Disease Control and Prevention. (1998). CDC surveillance summaries: Youth risk behavior surveillance-United States, 1997. Morbidity & Mortality Weekly Report, 47(SS–3, p. 25). Retrieved May 9, 2002, from http://www.cdc.gov/mmwr/PDF/ss/ss4703.pdf

 

2. Centers for Disease Control and Prevention. (2001). Increasing physical activity: A report on recommendations of the Task Force on Community Preventive Services. Morbidity and Mortality Weekly Report, 50(RR–18, pp. 1, 9, 13).

 

3. Centers for Disease Control and Prevention. (n.d.). Physical Education classes in schools are strongly recommended to increase physical activity among young people. Guide to Community Preventive Services. Retrieved November 5, 2001, from http://www.thecommunityguide.org/GUIDE/PhA/PEschools.htm

 

4. National Association for Sport and Physical Education. (n.d.). National standards for physical education: Moving into the future. Retrieved December 9, 2002, from http://www.aahperd.org/NASPE/template.cfm?template=publications-nationalstandards.html

 

5. Partnership for Prevention. (2000). Physical activity promotion: Regular physical activity in schools. Retrieved May 9, 2002, from http://www.prevent.org/Winword/pb_PDF_physed.pdf

 

6. U.S. Department of Health and Human Services. (1996). Physical activity and health: A report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion.

 

7. U.S. Department of Health and Human Services. (2000). Objectives for improving health. Healthy People 2010: Vol. 2. (2^nd ed., pp. 22-3, 22-24, 22-26, 22-32). Washington, DC: U.S. Government Printing Office.

 

8. U.S. Preventive Services Task Force. (1996). Guide to Clinical Preventive Services (2^nd ed., p. 220). Alexandria, VA: International Medical Publishing.

 

Acknowledgements

William H. Dietz, Jr., MD, PhD, Director, Division of Nutrition and Physical Activity, National Center for Chronic Disease Prevention & Health Promotion, Centers for Disease Prevention and Control, Atlanta, GA
 
Harold M. Goldstein, DrPH, Executive Director, California Center for Public Health Advocacy, Davis, California
 
Pamela Luna, DrPH, Vice President, California Association for Health, Physical Education, Recreation and Dance, Riverside, CA
 
Anthony D. Moulton, PhD, CDC Public Health Law Program, Centers for Disease Control and Prevention, Atlanta, Georgia
 
A special thanks to the Public Health Law Program, Centers for Disease Control and Prevention; portions of this document have been adapted, with permission, from the materials presented at their June 2002 The Public's Health and the Law in the 21^st Century conference.