Friday, January 30, 2009

American Fitness Index

I had the pleasure earlier in the week of attending a board meeting of the National Coalition for Promoting Physical Activity (NCPPA). As usual, the meeting was lively, congenial, and long on exciting ideas about how to promote physical activity in America. One of the highlights of the meeting for me was receiving a copy of the American Fitness Index (published by The American College of Sports Medicine) - a wonderful advocacy tool that ranks the health and community fitness status of the 50 largest metropolitan areas. Copies of the American Fitness Index can be downloaded here.

How does your community rank?

How can your club improve your community’s rank?

-Tom Richards

Wednesday, January 28, 2009

The West Wing

I've had several opportunities to attend meetings at the Hubert H. Humphrey building in Washington, DC, which is the home of the U.S. Department of Health and Human Services. It is a fine, stately building, heavy on bureaucratic chic, and a worthy anchor of our nation's health care system. However, for better or worse, it is also about a mile and a half from the White House. While distance may be, generally, inconsequential in the era of teleconferencing and blackberries, there is still no substitute, in my mind, for physical proximity to power.

I am therefore placing much significance on the fact that President Obama's designated "Health Czar" and nominee for Secretary of Health and Human Services, Tom Daschle, has secured an office in the West Wing of the White House, eliminating the 1.5 miles he otherwise would have needed to trek to come before the most powerful person in the world. To me, this is a clear signal that President Obama is serious about health care reform, sooner rather than later. The time for advocacy and action is now. Anyone interested in eliminating the tax on employee fitness benefits or reducing the cost of physical activity is encouraged to contact IHRSA immediately.

- Tom Richards

Kung Fu Boomers?

Baby Boomers are exactly that, a booming population. The U.S. Census Bureau considers a Baby Boomer to be someone born between 1946 and 1964, meaning today, Boomers are between the ages of 45 and 63.

According to Colin Milner, CEO of the International Council on Active Aging (ICAA), “Baby boomers, the largest, richest, and fastest-growing segment of the population, are beginning to accumulate in middle age. As a matter of fact, this group’s numbers will increase by 25% over the next eight years, unlike the 18-49-year-olds, who will experience virtually no growth over the same period. With a greater number of older consumers, the demand for products and services designed for, and marketed specifically to, them will certainly grow.”

A story on an ABC affiliate in Los Angeles yesterday, focused on a fitness and defense class for seniors called “Cane Fu”. What an interesting concept; helping an older population to be physically active, while simultaneously teaching them how to protect themselves. The defense classes, at a health club called Nifty over Fifty, have empowered older populations, including Boomers, and given them a new lease on life.

Nifty Over Fifty is among a growing niche market of health clubs geared toward aging populations, it offers unique programming, including a driving simulator to help users improve upon driving skills, customized exercise programs, physical therapy, brain aerobics, spa services, and nutrition programming.

Similar clubs include Peoplefit, in Woburn, MA serves a clientele averaging 60 years of age, Silver Sneakers, Avalon Woods Health Club for Mature Adults, in Toronto, Ontario, and AgeWell Personal Training Center, in Salt Lake City, Utah.

Given the spending power of Boomers, (77 percent of all financial assets in the US are owned by people 50 or older, according to the ICAA), and their desire to remain healthy and stave of the effects of aging, I am certain we will see a boom (pardon the pun) in clubs catering to this demographic.

- Kara Thompson

Tuesday, January 27, 2009

Duke U. New Medical Team - What it's missing

Duke University recently decided to tackle the issue of why more people are seeking treatment in hospital ER's even when they have access to primary care providers. They asked patients two questions: What isn't working for you? and What could we do better? Then they listened. The changes made to the Duke Family Practice Medical Offices, focusing on decreasing waiting time and increasing service, sound great. Patients can interact with the office online, know if they are going to have to wait and how long, but most importantly they created a new type of medical team.

Each team has a physician, nurses, pharmacists, social workers, and physicians assistants. It's an interesting concept and one that cold provide tremendous benefits, especially for the patients at most risk in our health care system.

When I was watching the segment on the NBC Nightly News, I was struck by the forward thinking of the changes but also I couldn't help but wonder, what if the teams also had nutritionists and personal trainers? If these teams could help people actually implement lifestyle changes it could make them healthier, and as a result, require less medical care.

The clip showed a patient who was overweight. The doctor was listening to her carotid artery and another member of the team was reminding her to skip the salt on food. The woman likely has cardiovascular issues. The team approach will probably help her but imagine the difference if there were a nutritionist that could show her proper portion sizes, what kinds of foods to purchase at the grocery store and how to cook delicious and healthy recipes. Now imagine that there were a personal trainer that could show this woman simple ways to to start building exercise into her life. Helping her learn how to strength train and start a cardio regimen. The results would be far beyond what a reminder to pass on the salt could ever bring about.

There are stories all the time about people whose doctors tell them they need to eat better and exercise. Somewhere between the doctor's office and the patients home that advice falls short. Many people simply don't know how to change their habits to lead a healthier life. It's not their fault, but they don't know where to gain that knowledge. If the medical community took steps to build a bridge between what patients are doing and what they should be doing, there could be an incredible change in the health of our nation. There is a role here for the fitness industry and it's up to the passionate people in this community to make it a reality.



- Breanne McGahey

Tuesday, January 20, 2009

A Government That Works

"The question we ask today is not whether our government is too big or too small, but whether it works." - President Obama, Inaugural Address

Of all the rhetoric packed into today's 20 minute inaugural address, I found the passage above the most revealing, and hope that our public health community agrees. If truly acted upon, such an approach will result in a search for new solutions, first and foremost, with less regard for custom. For an industry like ours, with so much to offer, but without a long history of direct engagement with public health officials, a new approach to our nation's health problems is a wonderful opportunity.

As noted in the latest issue of Men's Fitness, our leaders could take a big, new step toward solving our nation's health problems - obesity, in particular - by passing the IHRSA-supported WHIP and PHIT bills.

- Tom Richards

Thursday, January 15, 2009

Mental Health

The physical health benefits of exercise are well-documented and, relatively, well known. Less understood, however, are the mental health benefits of exercise. Intuitively, I think most people would nod along with any suggestion that exercise improves overall mood, but the science seems less understood and considered. If the public discussion included more emphasis on the mental health benefits of exercise, wouldn't that strengthen the political case for including health clubs in public health initiatives? This article tells me we are heading in the right direction.

- Tom Richards

Wednesday, January 14, 2009

Paterson’s State of the State Hypocrisy


Some casual observers of New York politics may be surprised to hear that Governor David Paterson would tax health clubs, especially given his high profile comments in recent weeks about childhood obesity and the need to get New York healthier. I commend any effort by Paterson that recognizes that the growing waistlines and children and adults is a serious public health issue. He, like the other politicians referenced in Mr. Richard’s post below, are increasing awareness about wellness.

Here is an excerpt from his State of the State address [full text available http://ny.gov/governor/press/press_0107091.html].

“While we have made some progress, we still incentivize the wrong care in the wrong setting at the wrong price. Where we are overpaying for inpatient or institutional care, we must shift funding to primary, preventive and community-based care. Preventing illness is a good investment. It saves taxpayer money, improves patient care, and unburdens our economy.

This is why we should aggressively address the greatest threat to our children’s health today, the epidemic of obesity. One out of every four New Yorkers under 18 years of age is obese.

Childhood obesity causes serious health problems including Type 2 diabetes, high blood pressure and high cholesterol. The American Heart Association reports that obese children have blood vessels that look like they belong to 45 year olds. These children have much greater risks of having heart attacks, suffering strokes, and losing limbs.

Obesity not only blights our children’s futures — it creates a significant economic burden on our health care spending. New York spends $6.1 billion each year to treat obesity-related health problems— the second-highest level of spending in the nation.”

He continues on to say: “By protecting our children from obesity, we protect their health and our health care system. That is why this matters.“

Bravo Governor. Well said. Now the praise stops here.

I cannot wrap my head around hearing this rhetoric then reading his proposed Executive Budget that calls for a tax on health club dues. It counters everything he said in his own speech about obesity-related health problems and our health care system. While there is clearly a massive budget deficit that must be resolved, it cannot be done on the backs of New Yorkers who are taking initiative to lead healthy lifestyles by exercising at a fitness facility. Sure, there are plenty of other services being targeted but health clubs should not be included among them.

It’s like taxing someone’s annual check-up at their physicians. You don’t discourage healthy habits, especially those that create significant long-term cost savings. Paterson himself acknowledges that taxing a behavior can discourage it. That is exactly why he included his so-called “obesity tax” on sugary, non-diet sodas in his budget. [Check out page 28 - http://publications.budget.state.ny.us/eBudget0910/2009-10ExecutiveBudgetPresentation.pdf]

The hypocrisy is off the charts. As people that believe in healthy lifestyles, we need to speak out loudly and together against this attack on healthy lifestyles. Today IHRSA launched its first Grassroots Initiative campaign of 2009. We sent out a call to action for fitness professionals across the Empire State to voice their opposition. This needs to be stopped.

If you don’t live in New York, watch out. Similar legislation is coming down the pike in a number of other states…

- Breanne McGahey

This City Is Going On A Diet

If I was a political adviser to a governor, mayor, or town supervisor, I would urge my boss to launch a "wellness initiative." Aside from the obvious health benefits that such an initiative could provide to constituents, it also would associate my boss with several positive political attributes. Who would not want to be associated with wellness? "Wellness" is good, positive, buoyant, vigorous, vital - all wonderful traits for a politician to possess, or, at the very least, appear to possess.

In fact, several municipalities are taking the lead on wellness in their communities and enjoying great results. For example, in Oklahoma City, Mayor Mick Cornett is spearheading a brilliant anti-obesity campaign titled, "This City Is Going On A Diet," which, among other things, directs citizens to local fitness centers. In Carmel, Indiana, the Carmel Mayor's Wellness Challenge just kicked off its third year. And, as has been noted in several national media outlets, Somerville, MA is conducting a groundbreaking initiative titled Shape Up, Somerville.

I believe the success of these municipal programs, and the positive attention they've received, should give any club the confidence to approach its own elected officials to discuss the possibility of partnering to create a local wellness initiative. The officials should be thankful for the opportunity - it would be good for their constituents and it would be good for their political careers. Have any clubs tried this yet?

- Tom Richards

Monday, January 12, 2009

The Ones We Have Been Waiting For

President-elect Obama famously stated "We are the ones we have been waiting for" during his triumphant primary campaign. He used the line as a rallying cry for his supporters, urging them to get involved with his campaign, rather than wait for someone else to affect the change he and his supporters were seeking. I think most people, regardless of political stripe, would agree that this was an effective message.

This article on the importance of primary prevention, written by a personal trainer in Fort Collins, CO, gives me hope for a rousing chorus of voices coming from the fitness industry as our nation's policymakers debate the shape and form of our next health care system. I know firsthand, from my experiences at IHRSA's Legislative Summit, that fitness professionals can be astonishingly effective advocates, simply by explaining their passion for fitness. IHRSA's public policy team stands waiting to assist any fitness professionals that wish to get involved and, if i may bring the post full-circle, "be the ones we have been waiting for."

I want to also give credit to article's author, Mr. Mark Gomez, for distinguishing primary prevention - such as physical activity and nutrition counseling - from secondary prevention, which includes things like regular screenings. These two types of prevention are typically lumped together in media articles, especially to argue that "prevention" doesn't save money. Of course, primary prevention certainly saves money (e.g. increased physical activity to reduce the risk of diabetes), which is why the government should encourage it, while secondary prevention saves lives, which is also a more than reasonable government interest.

- Tom Richards

Sunday, January 11, 2009

New interest from faith communities?

This article (Exercising Body & Soul: 2 Greenwood megachurches use fitness centers as a ministry tool; Indianapolis Star online) does a fair job of articulating the broad range of issues, from theology to tax policy, associated with the emerging issue of tax-exempt competition from religious institutions. The impact of this new frontier in tax-exempt competition is relatively unclear right now, and we will certainly remain attentive and watchful, but for now, I wonder if the bigger story isn't the enormous amount of interest attracted by these fitness centers. It seems like personal fitness is gaining importance among some faith communities.

Are there promising opportunities for IHRSA members to reach out to local religious institutions? Are any health clubs offering educational seminars to religious groups? Advertising in bulletins?

- Tom Richards

Thursday, January 8, 2009

Healthy People 2020

I spent my morning at the U.S. Department of Health and Human Services building, attending a meeting of the Advisory Committee charged with making recommendations for the next set of public health objectives known as Healthy People 2020. These meetings are particularly notable for the existence of two competing dynamics. On one side, you have the rather exhilarating experience of listening to extremely intelligent, qualified people discuss our nation's public health goals for the next decade. On the other, you have the bleak, rainy Monday morning, life draining vibe that permeates a federal committee meeting. Fortunately, the former is typically stronger than the latter, especially when the committee room is on the same floor as the coffee machine.

A portion of the morning's discussion focused on best practices for creating the HP2020 objectives. Of course, many of the ideas could benefit any organization looking to create objectives. For example: 1) Achieving objectives requires coordination and leadership; 2) Fewer objectives allow for greater focus; 3) An immeasurable objective isn't worth pursuing; 4) Objectives require frequent progress measurement; and 5) Objectives should be aspirational.

The meeting also impressed upon me that taxpaying health clubs are still considered, generally, outside the purview of "public health," despite their inherent value as providers of safe and healthy exercise, and, often times, bastions of fitness and nutrition expertise. Clearly, taxpaying clubs are obvious partners in any public health effort to combat the obesity epidemic, but i don't think public health officials are yet making that connection. Are any clubs working with public health officials - if so, what is the best approach?

- Tom Richards

Wednesday, January 7, 2009

Sanjay Gupta as the new Surgeon General?

As reported in today's issue of Capitol Report, Dr. Sanjay Gupta, a practicing neurosurgeon and chief medical correspondent for CNN, is rumored to be the Obama Administration's top choice for Surgeon General. His appointment could be good for the fitness industry. He's a supporter of healthy lifestyles and helped to bring the issue to millions of American's through the 2008 Fit Nation series. Having someone in public health who is a proponent of exercise in a prominent public office is almost always a good thing.

Since the news broke yesterday, blogs across the web have been taking up the idea of a CNN correspondent in such a high profile government position. The New York Times Well Blog had a great round-up of some of the commentary. My favorite of the bunch: “Public health needs a rock star.” It comes from the Technology, Health & Development blog. The author makes a great point that "rock stars" such as Bono, Bill Gates and Bill Clinton have helped to shed light on the global health crisis. Maybe Dr. Gupta could do the same for public health issues here in the US while building bridges between government policy, global initiatives, and the average American.

In terms of connecting with the average American, I don't think you could do much better. He's known by the millions of people who watch CNN and CBS. To put it in simple terms, he's got street cred. Given all of the years, effort and funds that have been channeled towards public health maybe we need someone like Dr. Gupta to really help move people towards making the hard changes neccessary to break the bad (but oh so easy to pick up) habits that hinder so many from leading a healthy lifestyle. On that same level, I think having the American public witness President-Elect Obama's regular gym visits will also raise the profile of exercise as part of a healthy lifestyle.

There are clearly many changes on the horizon in Washington. Maybe a new public health rock star will be one of them.

- Breanne McGahey

Tuesday, January 6, 2009

Community Outreach

Earlier today, the U.S. Department of Health and Human Services (HHS) held a conference call to discuss organizational efforts to promote HHS's landmark Physical Activity Guidelines. The call, which attracted over 700 participants, featured four speakers: Dr. Bill Kraus of the American Heart Association, Dr. Jim Pivarnik of the American College of Sports Medicine, Sheila Franklin of the National Coalition for Promoting Physical Activity, and IHRSA's standard bearer, Joe Moore. Melissa Johnson, executive director of the President's Council on Physical Fitness and Sports, acted as moderator.

Joe's comments highlighted the commercial fitness industry's enthusiastic embrace of the Physical Activity Guidelines, especially as a tool for community outreach. In fact, IHRSA's Guidelines Report, a 6 issue email newsletter to help IHRSA members implement the guidelines within their communities, has been one of the most popular IHRSA offerings since its inception in October. The call strengthened my belief that commercial clubs are at the forefront of promoting physical activity on a community-wide level.

I can't shake the feeling, however, that clubs are still undervalued by the public and not recognized, generally, as "community" facilities - or, rather, front of mind community resources for typical Americans. Earning that recognition, I imagine, will be one of the great industry struggles of the next decade, requiring continued substantive outreach and intensified public relations at both the national and local levels. To be sure, there are already some fantastic examples of clubs that are entrenched in the minds and affairs of their local communities, and their achievements should be celebrated and studied, but my hunch is that there's still room for explosive growth on this front.

I'd love to hear about what clubs are already doing - and ideas for what they could be doing - to become front of mind community resources...

- Tom Richards