Chapter 8: Taking Action: Increasing Physical Activity Levels of Americans
The low level of physical activity among Americans is a major
contributor to the burden of chronic disease. This burden is costly in terms of
quality of life and economic resources needed to provide medical care. Like
life in other modern societies around the world, life in the United States
requires very little daily physical activity. The amount of physical activity
we do is largely a matter of personal choice and the environmental conditions
under which we live. So far, little progress has been made in meeting our
national health objectives for physical activity.
Based on a careful review of the science, the Physical Activity
Guidelines provides essential guidance to help Americans achieve the
health benefits of regular physical activity. However, providing guidance by
itself is not enough to produce change. Action is necessary. Regular physical
activity needs to be made the easy choice for Americans.
To accomplish this goal, public health research suggests the use of a
"socio-ecologic" approach. This comprehensive approach involves
action at all levels of society: individual, interpersonal, organizational,
community, and public policy. Example actions include:
- Personal goal setting (individual level);
- Social support and encouragement to be active (interpersonal level);
- Promotion of physical activity as part of worksite health promotion
- Good access to parks and recreational facilities in neighborhoods
- Promotion of policies that support families who want their children
to walk or bike to school (public policy).
To give a sense of how to make regular physical activity the easy
choice, the remainder of this chapter first considers steps individuals can
take to adopt an active lifestyle. Then it considers steps society can take to
support and facilitate active lifestyles.
The purpose is to illustrate achievable steps that will make a
difference, not to address everything that needs to be done.
What Can Adults Do To Get Enough Physical Activity?
Adults can find advice on how to be active from many sources, including
fitness professionals, health-care providers, books, and Web sites. Here are
three commonly cited steps adults can take to help meet the Guidelines.
Personalize the Benefits of Regular Physical Activity
Adults need to identify benefits of personal value to them. For many
people, the health benefits, which are the focus of the Physical Activity
Guidelines for Americans, are compelling enough. For others, different
reasons are key motivators to be active. For example, physical activity:
- Provides opportunities to enjoy recreational activities, often in a
- Improves personal appearance;
- Provides a chance to help a spouse lose weight;
- Improves the quality of sleep;
- Reduces feelings of low energy; and
- Gives older adults a greater opportunity to live independently in
Set Personal Goals for Physical Activity
The Guidelines alone don't provide enough information for
individuals to decide the types and amounts of activity that are appropriate
for them. Individuals should set goals for activity that allow them to achieve
benefits they value. Simple goals are fine. For example, a brisk walk in the
neighborhood with friends for 45 minutes 3 days a week and walking to lunch
twice a week may be just the right approach for someone who wants to increase
both physical activity and social opportunities.
In setting goals, people can consider doing a variety of activities and
try both indoor and outdoor activities. In particular, public parks and
recreation areas in the United States offer opportunities to experience nature
and be physically active at the same time.
The best physical activity is the one that is enjoyable enough to do
Develop Knowledge To Attain Goals
It is important to learn about the types and amount of activity needed
to attain personal goals. For example, if weight loss is a goal, it's
useful to know that vigorous-intensity activity can be much more time-efficient
in burning calories than moderate-intensity activity. If running is a goal,
it's important to learn how to reduce risk of running injuries by
selecting an appropriate training program and proper shoes. If regular walking
is a goal, learning about neighborhood walking trails can help a person attain
Using a Pedometer To Track Walking
For adults who prefer walking as a form of aerobic activity,
pedometers or step counters are useful in tracking progress toward personal
goals. Popular advice, such as walking 10,000 steps a day, is not a Guideline
per se, but a way people may choose to meet the Guidelines. The key to using a
pedometer to meet the Guidelines is to first set a time goal (minutes of
walking a day) and then calculate how many steps are needed each day to reach
Episodes of brisk walking that last at least 10 minutes count toward
meeting the Guidelines. However, just counting steps using a pedometer
doesn't ensure that a person will achieve those 10-minute episodes. People
generally need to plan episodes of walking if they are to use a pedometer and
step goals appropriately.
As a basis for setting step goals, it's preferable that people
know how many steps they take per minute of a brisk walk. A person with a low
fitness level, who takes fewer steps per minute than a fit adult, will need
fewer steps to achieve the same amount of walking time.
One way to set a step goal is the following:
- To determine usual daily steps from baseline activity, a person
wears a pedometer to observe the number of steps taken on several ordinary days
with no episodes of walking for exercise. Suppose the average is about 5,000
steps a day.
- While wearing the pedometer, the person measures the number of
steps taken during 10 minutes of an exercise walk. Suppose this is 1,000 steps.
Then, for a goal of 40 minutes of walking for exercise, the total number of
steps would be 4,000 (1,000 × 4).
- To calculate a daily step goal, add the usual daily steps (5,000)
to the steps required for a 40-minute walk (4,000), to get the total steps per
day (5,000 + 4,000 = 9,000).
Each week the person gradually increases the time walking for
exercise until the step goal is reached. Rate of progression should be
individualized. Some people who start out at 5,000 steps a day can add 500
steps per day each week. Others, who are less fit and starting out at a lower
number of steps, should add a smaller number of steps each week.
How Can We Help Children and Adolescents Get Enough Physical
Many children and adolescents are naturally physically active, and they
need opportunities to be active and to learn skills. They benefit from
encouragement from parents and other adults. Adults can promote age-appropriate
activity in youth through these steps:
- Provide time for both structured and unstructured physical activity
during school and outside of school. Children need time for active play.
Through recess, physical activity breaks, physical education classes,
after-school programs, and active time with family and friends, youth can learn
about physical activity and spend time doing it.
- Provide children and adolescents with positive feedback and good
role models. It has been said that if you do not practice what you teach, you
are teaching something else. Parents and teachers should model and encourage an
active lifestyle for children. Praise, rewards, and encouragement help children
to be active. Using physical activity as punishment does not help children to
- Help young people learn skills required to do physical activity
safely. As appropriate for their age, youth need to understand how to regulate
the intensity of activity, increase physical activity gradually over time, set
goals, use protective gear and proper equipment, follow rules, and avoid
- Promote activities that set the basis for a lifetime of activity.
Children and adolescents should be exposed to a variety of activities,
including active recreation, team sports, and individual sports. In this way,
they can find activities they can do well and enjoy. Include exposure to
activities that adults commonly do, such as jogging, bicycling, hiking, and
swimming. Young people should experience non-competitive activities and
activities that do not require above-average athletic skills.
Communities can provide many opportunities for physical activity, such
as walking trails, bicycle lanes on roads, sidewalks, and sports
What Can Communities and Government Do To Help People Be Active?
Actions by communities and government can influence whether regular
physical activity is an easy choice. Communities can provide many opportunities
for physical activity, such as walking trails, bicycle lanes on roads,
sidewalks, and sports fields. Organizations in the community have a role to
play as well. Schools, places of worship, worksites, and community centers can
provide opportunities and encouragement for physical activity.
Use Evidence-Based Approaches and Tailor Them to the Needs of
To be effective, physical activity promotion efforts should use an
"evidence-based" approach. The CDC's Guide to Community
Preventive Services1 has reviewed
many community-level approaches to promote physical activity, including these
five strongly recommended strategies:
- Community-wide campaigns that combine physical activity messaging
(distributed through television, newspapers, radio, and other media) with
activities such as physical activity counseling, community health fairs, and
the development of walking trails.
- Point-of-decision prompts to encourage stair use. These are signs
placed at points where people make the decision either to use the stairs or to
use an elevator or escalator. The signs encourage the active option of stair
- Physical education classes to increase activity. Physical education
classes should use a curriculum that increases the amount of time students are
active during class.
- Approaches that increase the reach of individual-level
interventions. For example, evidence-based, individual-level interventions can
reach more people when they are delivered in group settings or over the
- Interventions that increase social support for physical activity.
These interventions start or enhance social-support networks, and include
efforts such as organizing a buddy system (two or more people who set regular
times to do physical activity together), walking groups, and community dances.
- Programs to create or enhance access to places to be physically
active. This can include building walking trails and providing public access to
school gymnasiums, playgrounds, or community centers. This also includes
worksite activity programs that provide access to onsite or offsite fitness
rooms, walking breaks, or other opportunities to engage in physical activity.
Interventions to improve access should also include outreach that increases
awareness of the opportunity to be active.
Implementing community-level approaches to physical activity requires
collaboration across sectors.
Involve Many Sectors in Promoting Physical Activity
Interventions to improve access should also include outreach that
increases awareness of the opportunity to be active.
- Policies and programs that support street-scale design principles
and practices that promote physical activity. For example, these types of
policies and programs use crosswalks, sidewalks, traffic calming, and other
safety measures to make it easier and safer for people to choose active
- Policies and programs that support community- scale design
principles and practices that promote physical activity. Community-scale design
includes zoning that facilitates bicycling and walking by allowing schools,
housing, and businesses to be built near one another.
The following list identifies relevant sectors and illustrates roles
they play in promoting physical activity. The division of functions in the
community into the following sectors does not use mutually exclusive
categories. These sectors were chosen simply to illustrate how parts of the
community have a role to play in promoting physical activity. Some communities
may use different names and divisions of functions.
- Parks and recreation. This sector plays a lead role
in providing access to places for active recreation, such as playgrounds,
hiking and biking trails, basketball courts, sports fields, and swimming pools.
- Law enforcement. Concern about crime can deter
people from outdoors recreation. Law enforcement can promote a safe environment
that facilitates outdoor activity.
- Urban planning. Urban planning. The Guide to
Community Preventive Services recommends both street-scale and community-scale
design principles to promote physical activity. Urban planners have a lead role
in implementing design principles to promote physical activity.
- Transportation. The transportation sector has a
lead role in designing and implementing options that provide areas for safe
walking and bicycling. Mass transit systems also promote walking, as people
typically walk to and from transit stops. Programs that support safe walking
and bicycling to school help children be more physically active.
- Education. The education sector takes a lead role
in providing physical education, after-school sports, and public access to
school facilities during after-school hours.
- Architecture. Architects and builders can design
and construct buildings with active options, such as access to stairs. Campuses
should allow pedestrians pleasant and efficient methods of walking within and
- Employers and private organizations. Employers and
private organizations. Employers can encourage workers to be physically active,
facilitate active transportation by supplying showers and secure bicycle
storage, and provide other incentives to be active. Private and faith-based
organizations can support community physical activity initiatives financially
or by providing space for programs. Health and fitness facilities and community
programs can provide access to exercise programs and equipment for a broad
range of people, including older adults and people with disabilities. Local
sports organizations can organize road races and events for the public. Senior
centers can provide exercise programs for older adults.
- Health care. Health-care providers can assess,
counsel, and advise patients on physical activity and how to do it safely.
Health-care providers can model healthy behaviors by being physically active
- Public health. Public health departments can
monitor community progress in providing places and opportunities to be
physically active and can track changes in the proportion of the population
meeting the Physical Activity Guidelines for Americans. They can also
take the lead in setting objectives and coordinating activities among sectors.
Public health departments and organizations can disseminate appropriate
messages and information to the public about physical activity.
The Physical Activity Guidelines for Americans gives guidance
on the amount of physical activity that will provide health benefits for all
Americans. Broad, comprehensive strategies are needed to help all Americans
meet the Guidelines. Implementing a comprehensive strategy to increase physical
activity requires an evidence-based approach that occurs at multiple levels and
in all sectors. A comprehensive and coordinated strategy will help Americans
take action to ensure that regular physical activity is the easy and accepted
choice for everyone.
1 Centers for Disease Control and
Prevention. (Last updated February 21, 2008). Physical Activity. In Guide to
Community Preventive Services Web site. Retrieved April 17, 2008, from
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