Outrage

Yesterday’s headlines probably signal the end of the “public option” in the health care plan, a measure championed by liberals and charred by conservatives. The “public option” issue, with its ability to extract vile insults from its protagonists and opposers, is tailor-made for media stories. The legislation, of course, is dreary, but the passion it induces is wonderful theater.

The theater, however, has crowded out several issues deserving of greater public awareness.

Of particular note, (this is a blog about physical activity, after all) is the lack of any provision in the health care proposals that would incentivize Americans to live healthier lifestyles. No WHIP. No PHIT.

Perhaps a few facts will help muster up enough public outrage to warrant a grainy YouTube video from a townhall meeting...

- Individuals who live unhealthy lifestyles are more likely to develop a chronic disease
- Chronic disease accounts for 75% of health care costs
- Active adults spend less money on health care

Are you outraged? Join the Campaign for a Healthier America and help lead the charge for health reform based on healthy living. Also, make sure the batteries in your video camera are charged.

- Tom Richards

IOM Top 20

My virtual lunch companions for the day were the dutiful members of the HHS Secretary’s Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2020, who held a high noon Webinar to update the world on their progress toward creating objectives for Healthy People 2020.

Today's meeting alerted me to the coming launch of StateOfTheUSA.org, which promises to "assemble high-quality measures and data that can be used to assess the progress of the United States." As part of its pre-launch activities (the site is up and running, but not fully functioning), State of the USA teamed up with the Institute of Medicine to release a list of the top 20 key measures that "reflect the overall health of the nation and the effectiveness of U.S. health systems."

I was thrilled to see that "physical activity" has made the cut.

The highlight of the report summary:

"Regular physical activity is an important contributor to health, and yet fewer than 50 percent of people in the U.S. report engaging in moderate physical activity," the committee said. It's proposed measure: the percentage of adults meeting the recommendation for moderate physical activity – at least five days a week for 30 minutes a day of moderate-intensity activity or at least three days a week for 20 minutes a day of vigorous-intensity activity."

Let's make sure that our legislators are reminded of this report during health care reform negotiations.

The press release, and link to the full report, are here.

Tom Richards

Joining Forces for Fitness

The political power of an association is derived from representing a vast collection of constituents. IHRSA, for example, speaks on behalf of its 6000 U.S. members (and the many thousand employees of those members) when weighing in on federal legislative initiatives. I believe it is a position of strength, made stronger by the legendary passion of fitness professionals.

I imagine the United States Professional Tennis Association feels similarly about its position as a representative for its 15000 members.

As was announced in this press release, IHRSA has joined forces with the USPTA to harmonize our collective voices and urge Congress to embrace the health benefits of physical activity. Together, i think we make an extremely compelling case. In particular, the USPTA's "Tennis - for the Health of It" campaign fits seemlessly with IHRSA's "Vision for a Healthier America."

I am thrilled with this partnership and hope that it becomes a blueprint for other advocacy relationships. It's the type of focused, mutually respectful relationship that can work at all levels of government advocacy. I hope that clubs interested in affecting change at any level - from town hall to the white house - will consider strengthening their position by joining with other passionate fitness professionals.

- Tom Richards

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

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

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

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

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

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

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

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

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