We really do not know why people don’t exercise enough.
This isn’t a bad thing to admit, even considering the massive amounts of energy, funding, research, public health campaigns, and efforts of health and wellness professionals.
As a health professional, however, it is a troubling realization.
It is inherently problematic to the work of designing and promoting wellness programs and health services because all of the evidence points to the fact that the more we learn about health, the less we actually practice it.
Simply put, there’s a growing disconnect between what we know and what we do.
What we know is that increasing exercise alone will increase health benefits and mitigate risks, more than any other health intervention. What we do with this information, is, well, questionable.
Recent worksite wellness surveys indicate that less than 45% of adults get any sort of exercise weekly. In Wisconsin, 19% reported absolutely no physical activity in the past month. Nationally, only 3% of adults in national survey data released earlier this year fulfill the minimal Healthy People and Presidential Fitness weekly recommendations.
For years, we have been witness to study after study advocating better health through exercise and the benefits of exercising have been exhaustively promoted.
Last week, a report in the Journal of Pediatrics, found that teens who participated in team sports were 39% less likely to be obese. Those that actively commuted to school (walking or biking) had a 33% lower risk of obesity than those who drove or rode the bus. Yet, in the same report, only 10% actually walked or biked to school, and only 17.4% played at least one team sport.
Another study from Stanford University concluded that obese 4th and 5th graders who participated in an after-school soccer program three to four days a week for six months had significantly greater weight loss than obese 4th and 5th graders who only participated in a health education after-school program.
The study also highlighted other health benefits from regular sport participation: friendships from being part of a team, positive support and modeling from coaches and mentors, having opportunities to demonstrate skills, and most importantly, motivation through fun activity.
Unfortunately, on the highway to well, there are many detours. Easy access off-ramps entice you with the lure of brightly lit golden arches, crispy cut fries, buffet lines, chocolate fountains, and mocha frappucinos oozing with cookie bits and caramel swizzle.
And on our journeys through life, we are trending towards sedentary. Jobs with little physical activity, our culture of convenience, and, to some degree, social isolation hinders healthy action.
Perhaps it is part of our national guilt, but we’re quick to blame barriers: We don’t have time, we don’t have access, equipment, or knowledge and skills. We tend to scapegoat on these core “barriers” but if research suggests we’re hardly even moving, we’re making the barriers’ job pretty easy.
If we’re going to get to the core of why people do not exercise, we need to delve deeper into our national psyche.
First, we greatly underestimate the psychology involved in exercise behaviors and the roles we play in our families. Recent studies show that women, more than men, feel guilty about taking time for themselves and feel pressure to care for others first. This keeps them from exercising.
Second, we are fearful.
For some, going to the gym or using equipment is terrifying. Some are fearful of huffing and puffing and sweating in a crowd.
Third, we learn from each other.
People are less likely to take a walk if they don’t see other men or women exercising, and they take cues from their own gender. Moreover, people don’t exercise because of a lack of encouragement.
Fourth, access is more than gym memberships, it is cultural. Some people don’t feel safe, or fear that exercise is not an accepted norm.
Fifth, we also know that people don’t get easily motivated to exercise for the long-term health benefit.
There’s a big-picture issue here.
By not exercising as much as we should, increasing amounts of Americans, with increasing amounts of health issues are increasingly not choosing healthy behaviors, which increase health care costs.
In fact, illuminated by the national health care debate, a recent Robert Wood Johnson Foundation study concluded that based on current health care expenditures (i.e., not “after Obamacare”), Americans’ lives are nearly four years shorter than would be expected. Read that again. We live shorter lives than what we pay for.
The study noted that we have a predicted life expectancy of 81.4 years, but we actually live only 77.5. What’s even more perplexing is that in comparison to other countries, we pay more per person but live shorter lives.
In Japan, health expenditures are $2,000 per person, yet they live to be 82. In Canada, health expenditures are approximately $3,000 a person, but life expectancy is closer to 80 years. In Sweden, expenditures are close to $2,700 a person and their life expectancy is nearly 80 years.
In the U.S., current health expentitures are about $6,000 per person, and our life expectancy is 77.5 years. Our projected life expectancy based on these health expenditures should be 81.4 years. This is a sliding downward trend.
Studies also show that American live a longer life of chronic disease than most industrial counties, which means we are living less “well” years, in addition to dying earlier.
Back to exercise: We know exercising will lower health risks and costs, especially with heart disease, stroke, cancers, diabetes and blood pressure. Exercise helps with weight control, arthritis pain and reduces depression. The more we exercise, the more we cut down on hospital visits, medical interventions, medication and the more fun we have living – daily.
What do we need to change?
We need to stop assuming information and education matter most, and we need to cultivate a culture of support, promote self-efficacy and foster environmental changes where healthy activity is central. We need to remove, or re-frame traditional barriers that seemingly don’t even allow most of us to get started thinking about exercising, and we need to celebrate the daily benefits of exercising.
Key things you can do:
- Take time for yourself. And encourage loved ones to take their own time. Everyone benefits.
- Create supportive cultures at home, work and school that promote exercise. Encourage people to participate in programs. Active participation increases self-efficacy and aptitude. Both of which are positive influences on active living.
- Make teams! Surround yourself with people who embody active living. Research shows people do what their neighbors and friends do. Active living is contagious. Allow it to flourish. Join a class, sign-up for runs in groups, or invite people to join in activity with you.
- Start slow, set some goals, and find the joy of daily exercise.
Ultimately, it is basic math. Behavior change + environmental change = healthy changes. Nobody said it would be easy; we just need to get back to the start.
About the author: Derek Bell is the Occupational Health Educator, Ministry Medical Group Occupational Medicine. A native of Tulsa, Okla., he now lives in Stevens Point where he gets the chance to share runs with his much faster wife, epic front-yard soccer matches with his step-daughter, and every new experience with his new-born son.