The High Price of Inactivity

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Inactivity is killing us. Researchers in the United States, as well as those from universities and think tanks in Europe, Australia and China have documented the causal relationship between inactivity and poor health in general, and between inactivity, obesity and diabetes in particular.

In the U.S., inactivity is now the No. 2 cause of death, ranking just behind the No. 1 cause (smoking) and ahead of No. 3 (alcohol).

Costs are enormous for what the Canadian Fitness and Lifestyle Research Institute calls “the constellation of unhealthy diet, physical inactivity and excess body weight.” An estimated 6 to 10 percent of America’s total health care costs can be directly attributed to a lack of physical activity. Total medical costs related to inactivity approximate those attributable to smoking. Other costs of inactivity are more difficult to quantify and include lost productivity in the workforce and the well-documented effects of inactivity on mental and emotional health.

Fortunately, there is a growing movement that refuses to take this bad news about inactivity lying down. The rapidly expanding field of “active-living research” seeks solutions for the many problems caused by ever-more-sedentary lifestyles. Supporters promote active living, a way of life that integrates physical activity into daily routine and an approach to good health that goes way beyond efforts to encourage more exercise.

“Typically the popular media respond to our research findings with, ‘Kids Watch Too Much TV and Are Getting Fat’ features but do not go deeper into underlying causes or complex solutions,” explained Dr. James Sallis, director of Active Living Research, a think tank funded by the Robert Wood Johnson Foundation. “We need solutions based on good science and intelligent advocacy.”

Sallis points with pride to a decade of quality transdisciplinary research in the field, but admits that only very recently has active living become a hot-button topic.

For a half century or so, U.S. researchers have charted the decline of physical activity among the populace, and the most recent numbers are appalling: Two-thirds of American adults are overweight and nearly two-thirds of adolescents do not meet the U.S. Surgeon General’s recommendations for daily physical activity.

The newest standards set forth by the U.S. Department of Health and Human Services suggest 60 minutes of exercise a day for children and 30 minutes of moderate exercise a day for adults. According to recent surveys, as few as 10 to 12 percent of American adults meet these minimal standards of exercise; these figures are down from 1998 statistics from the Centers for Disease Control and Prevention that showed that only 25 percent of adults met the government’s recommendation for physical activity. More than one in four American adults get no activity at all in an average day.

Active-living research encompasses 40 academic disciplines from psychology to urban planning, Sallis explained. Architects, traffic engineers, city planners and park directors are among the professionals on board, along with an array of health care professionals from pediatricians to gerontologists, and nurses to nutritionists.

Some researchers focus on the built environment — including neighborhoods, transportation systems, buildings, parks and open space. Others study human behavior — literally and figuratively what moves us and what does not.

Active-living researchers use observation tools called SOPARC (system for observing play and recreation in communities) and SOPLAY (system for observing play and recreation in play and leisure activity in youth).  They also use acclerometers and GPS tracking devices in order to measure the movements of individuals. (The latest high-tech measurements reveal Americans are even less active than they say they are in surveys. In that vein, a 2006 Physical Activity Survey of American adults by AARP reported that “When respondents were asked if they had ever overestimated the amount of time they exercise when asked by their doctor, less than 1 percent reported having done so.”)

A recent active-living research conference held in San Diego attracted academics from all over the world. One session examined the differences in physical activity between adults living in “walkable” communities versus those who do not in locales as diverse as Hong Kong, Belgium, Kansas and Oregon. In another session, researchers from North America, Europe and South America pondered how cultural attitudes influence activity. Why, for instance, do children walk and cycle to school in some countries but not in others, even when the distances are the same?

“While the excellent research has not (gotten) the attention from policymakers or the public it deserves, there are encouraging signs active living is becoming part of the policy debate taking place in Congress and in city halls across the country,” Sallis declared.

In the Salt Lake City area, where physical inactivity results in some $400 million per year in direct medical costs, according to the Utah Department of Health, government officials have adopted transportation planning guidelines that emphasize walking and biking. Policymakers were swayed by the research and advocacy of Shaunna Burbidge, assistant professor of geography at Brigham Young University. In deciding to change the way it plans for active modes of transportation through Utah’s most populous corridor, regional officials became the first in the nation to do so for reasons of improved public health.

Burbidge credits “highly relevant research to a clearly identified problem and years of relationship building” as the keys to her success. Active-living research is moving from the margins of academia to mainstream discussions, she explained, adding she expects many more of her fellow researchers’ recommendations to be implemented in the coming years. “‘Active living’ is actually becoming a buzzword and we couldn’t be more pleased.”

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