Healthy People 2020 and Solstice: Glimmers of Hope



Dec. 21 marked the winter solstice (Northern Hemisphere), signaling the long-awaited return of longer days and the warmth of spring. The solstice, coinciding with traditional holiday celebrations, has always given hope to people struggling with the challenges of cold weather and long, dark nights.

The month of January offers more reason for hope in the form of Healthy People 2020, a collaborative process by which the CDC provides science-based, 10-year national objectives for improving the health of all Americans. The proposed objectives for physical activity and fitness show the influence of ACSM and its members, including in-person testimony by Past President Angela Smith, M.D., FACSM and online comments by numerous members/experts.

ACSM was not a lone voice crying in the wilderness, however. Many experts, speaking alone or on behalf of professional societies and other organizations, cited the demonstrated importance of physical activity for health. Their consensus informs the plan, which includes baseline measures, 10-year targets and data sources.

A few observations:

  • Healthy People 2020 will serve as a companion to the National Physical Activity Plan (a frequent topic on this blog). The Plan provides a roadmap for achieving the changes needed to reach the targets spelled out in HP2020. Taken together—and taken seriously—the two can be transformative.
  • The baseline measures document the need. For example, 36.2 percent of adults engaged in no leisure-time physical activity in 2008, according to the CDC’s National Health Interview Survey.
  • The targets are modest, calling for a 10-percent improvement across the board. Surely, our nation can move the needle in 10 years so that, for instance, 8.7 percent of physician office visits include counseling about exercise.

The latter (part of Objective 11) was proposed by ACSM, expanding the original objective which called for counseling about exercise for patients with chronic diseases. Both embody the essence of Exercise is Medicine®. Acting on them would profoundly affect the well-being of millions of people and vastly reduce health care costs.

As we prepare for the chills of January, physical activity advocates will be warmed by the prospect of other objectives we have long supported. HP2020 also calls for the following, to choose a few:

  • Increasing the proportion of adults and adolescents who meet physical activity guidelines (Objectives 2 and 3, respectively).
  • More trips by walking (13) and bicycling (14).
  • Changes to the built environment to expand opportunities for physical activity (15). Sound familiar? This is a bedrock principle of the National Physical Activity Plan.
  • More physical education (4, 5) and recess (6, 7) in schools; less screen time for kids (8).
  • Opening public and private school facilities outside of school hours to provide opportunities for physical activity for the community (10).

Healthy People 2020 is comprehensive, measurable and laden with the potential for positive change—the fruit of a well-managed public/private collaboration. Implementing it falls to all of us: states, cities, communities, organizations of all types, and individuals. I propose we each seek our role, using the MAP-IT framework familiar to those involved with implementing public health interventions. Let’s insist on success and get to work on a decade of change.

Which objectives of Healthy People 2020 relate most directly to your work?
Which could have the greatest impact on your community?