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- Patterns and Trends in
Physical Activity
- Physical Activity and
Health: A Report of the Surgeon General
This chapter documents patterns and
trends of reported leisure-time physical activity of adults and adolescents in
the United States and compares the findings to the goals set by Healthy
People 2000 (U.S. Department of Health and Human Services [USDHHS] 1990; see
Chapter 2, Appendix A, for the 1995 revised Healthy People 2000
objectives for physical activity and fitness). The information presented here is
based on cross-sectional data from national- and state-based surveillance
systems, sponsored by the Centers for Disease Control and Prevention (CDC), that
track health behaviors including leisure-time physical activity. Although
self-reported survey information about physical activity is likely to contain
errors of overreporting, there is no other feasible way to estimate physical
activity patterns of a population. Moreover, there is no widely accepted
"gold standard" methodology for measuring physical activity (see
Chapter 2).
Occupational and most domestic physical
activities are not presented because such information is not available. Most
national goals address leisure-time rather than occupational physical activity
because people have more personal control over how they spend their leisure time
and because most people do not have jobs that require regular physical exertion.
Nonetheless, measuring only leisure-time physical activity leads to an
underestimate of total physical activity, especially for those people with
physically demanding jobs.
Five surveys provided data on physical
activity for this review: 1) the National Health Interview Survey (NHIS), which
included questions on physical activity among adults in 1985, 1990, and 1991; 2)
the Behavioral Risk Factor Surveillance System (BRFSS), a state-based survey of
adults that was conducted monthly by state health departments, in collaboration
with the CDC, and included questions on physical activity from 1986 through 1992
and in 1994; 3) the Third National Health and Nutrition Examination Survey (NHANES
III) of U.S. adults from 1988 through 1994 (data from Phase I, 1988 - 1991, were
available for presentation in this report); 4) the 1992 household-based NHIS
Youth Risk Behavior Survey (NHIS-YRBS) of 12- through 21-year-olds; and 5) the
national school-based Youth Risk Behavior Survey (YRBS), which was conducted in
1991, 1993, and 1995 among students in grades 9 - 12. The methodologies of these
surveys are summarized in Table 5-1 and are described in detail in Appendices A
and B of this chapter.
When adult data from the NHIS, BRFSS, and
NHANES III are presented for comparison, they are shown from the most nearly
contemporaneous survey years. Otherwise, the most recent data are presented. For
determining trends, BRFSS data are restricted to those states that collected
physical activity information each year.
Responses to questions included in the
surveys were compiled (see Appendix B) into categories approximately
corresponding to the Healthy People 2000 physical activity objectives.
These objectives are based on the health-related physical activity dimensions of
caloric expenditure, aerobic intensity, flexibility, and muscle strength (Caspersen
1994). Thus the "regular, sustained physical activity" category used
here pertains to total caloric expenditure and includes a summation of
activities of any intensity, whereas the "regular, vigorous" category
pertains to aerobic intensity and therefore includes only activities of vigorous
intensity. Because some activities (e.g., vigorous activity of 30 minutes
duration) fall into both of these categories, the categories are not mutually
exclusive. Adding together the proportion of people in each category thus yields
an overestimate of the proportion of people who are regularly physically active.
More clear-cut is the category of inactivity, which is considered to be the most
detrimental to health and is thus important to monitor as an indicator of need
for intervention. Measures of stretching and strength training are also derived,
when possible, from the survey responses.
The various surveys differ in the means by
which they are conducted, in the wording of questions, in the time of year, in
population sampling frames, in response rates, and in definitions of physical
activity - all of which may cause differences in the resulting physical activity
estimates. However, even with these differences, the data from the several data
collection systems reveal a number of consistencies in patterns and trends in
self-reported leisure-time physical activity.
Conclusions
Adults
- Approximately 15 percent of U.S.
adults engage regularly (3 times a week for at least 20 minutes) in
vigorous physical activity during leisure time.
- Approximately 22 percent of adults
engage regularly (5 times a week for at least 30 minutes) in sustained
physical activity of any intensity during leisure time.
- About 25 percent of adults report no
physical activity at all in their leisure time.
- Physical inactivity is more prevalent
among women than men, among blacks and Hispanics than whites, among older
than younger adults, and among the less affluent than the more affluent.
- The most popular leisure-time
physical activities among adults are walking and gardening or yard work.
Adolescents and Young Adults
- Only about one-half of U.S. young
people (ages 12-21 years) regularly participate in vigorous physical
activity. One-fourth report no vigorous physical activity.
- Approximately one-fourth of young
people walk or bicycle (i.e., engage in light to moderate activity) nearly
every day.
- About 14 percent of young people
report no recent vigorous or light to moderate physical activity. This
indicator of inactivity is higher among females than males and among black
females than white females.
- Males are more likely than females to
participate in vigorous physical activity, strengthening activities, and
walking or bicycling.
- Participation in all types of
physical activity declines strikingly as age or grade in school increases.
- Among high school students,
enrollment in physical education remained unchanged during the first half
of the 1990s. However, daily attendance in physical education declined
from approximately 42 percent to 25 percent.
- The percentage of high school
students who were enrolled in physical education and who reported being
physically active for at least 20 minutes in physical education classes
declined from approximately 81 percent to 70 percent during the first half
of this decade.
- Only 19 percent of all high school
students report being physically active for 20 minutes or more in daily
physical education classes.
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Division of Cancer Prevention and Control
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