Physical Activity and Fitness

Background

Heart disease continues to be the leading cause of death in both the U. S. and West Virginia. The state's statistics, however, are even more frightening than those for the nation. In 1994, West Virginia's rate of heart disease death was 15% higher than the national average.

Sedentary lifestyle and obesity are two of the behavioral risk factors that have led West Virginia to such a high rate of death from heart disease. The prevalence of both of these risk factors has been steadily increasing in the state since monitoring began with the Behavioral Risk Factor Surveillance System (BRFSS) in 1984.

Living a physically inactive life predisposes an individual to a higher risk of obesity, hypertension, non-insulin dependent diabetes, and osteoporosis. Research has shown that even a small amount of physical activity can greatly increase the quality of life and the chance for a longer life.

With support from the Centers for Disease Control and Prevention (CDC), the WV Bureau for Public Health (WVBPH), Division of Health Promotion, formed the West Virginia Coalition for Physical Activity (WVCfPA) in 1993 to develop strategies to reverse the upward trends in sedentary lifestyle and obesity.

The Objectives

OBJECTIVE 1.1 Reduce the rate of sedentary lifestyle among resident adults to 60%.

UPDATE Sedentary lifestyle is defined as engaging in leisure-time physical activity for less than 20 minutes at least three times a week. According to the Behavioral Risk Factor Survey, the 1994 prevalence of sedentary lifestyle among adult West Virginians was 67.9%. This continued the overall upward trend begun in 1984, when the rate was 60.7% (see Figure 1). Women were at slightly greater risk from sedentary lifestyle in 1994 than were men. At the present rate of increase, the year 2000 prevalence of sedentary lifestyle is forecast to be 69.2%.

OBJECTIVE 1.2 Reduce the state's overall prevalence of obesity to 26%.

UPDATE The problem of obesity is becoming more serious in both West Virginia and the United States as a whole. The prevalence of obesity in the state has ranged from a low of 25.7% in 1984 to a high of 36.6% in 1995 (see Figure 2). With few exceptions, the percentage of the adult population that is obese has increased annually. Obesity is defined by the BRFSS as being at least 20% over one's ideal weight according to the Metropolitan Life Insurance Company's 1959 height and weight chart. Men and women were at similar risk from obesity in 1995. If the rate of increase is not checked, the year 2000 prevalence is forecast to be 41.4%.

Meeting the Objectives

The WV Cardiovascular Disease Program, with the WV Coalition for Physical Activity, will develop a plan to address Objectives 1.1 and 1.2, using the channels listed above to reach the communities (see the Introduction to this report for a detailed discussion of the six channels). The Program Manager of the Cardiovascular Disease Program, Division of Health Promotion, WVBPH, is the contact person for plan development and implementation.

The Coalition was established in 1993 to address inactivity and the associated objectives. Its mission is to Aimprove the health of all West Virginians by promoting a physically active lifestyle.@ Members of the Coalition have included representatives from state and local health agencies, higher education, schools, community organizations, hospitals, and health care centers. Several members have received national recognition in their respective professions in the field of physical activity.

One of the WVCfPA's most significant accomplishments to date is the Walk Across West Virginia, an annual event begun in 1995 in which groups collectively log the mileage it would take to travel the distance across the state. The Walk Across West Virginia was implemented in all the health promotion channels that make up the broad-based approach to reaching state residents, i.e., schools, higher education, wellness centers, worksites, community groups, local Planned Approach To Community Health (PATCH) groups, medical centers, churches, homemakers, hospitals, weight management centers, and senior citizens.

Other activities that have been initiated at the community level include the Mary Ingles Trail Wellness Walk and Alive with Five, a physical activity incentive program piloted through the

Kanawha County PATCH. The Coalition has assisted in promoting local activities such as the Volksports Walks and the Senior Games. Community-based initiative grants were awarded to local groups to implement physical activity projects. In addition, the WVCfPA has provided technical assistance to many other groups.

Worksite efforts implemented by the Coalition include conducting activity breaks, trainings, and health enhancements at annual conferences and regional meetings for the State Health Education Council, the WV Department of Education Leaders of Learning, the WV Public Health Association, and the WV Wellness Council.

In the area of policy, the WVCfPA supported recent legislation passed to support outside group use of school facilities. Although this is a county-level decision, it can potentially provide safe and accessible facilities for physical activity use. Jessica Wright, Program Manager for the Cardiovascular Disease Program, WVBPH, and Coalition member, was one of twelve persons chosen nationally to participate in the first Practitioner's Course on Physical Activity: Policy and Environmental Approaches, held in September 1996.

The Coalition has also been instrumental in several research projects conducted on physical activity in the state, including The Status of Leisure-Time Physical Activity in West Virginia (with the WVBPH) and a telephone survey, Barriers to Participating in Leisure-Time Activity (with WVU and the Prevention Research Center).

Future projects include the development of "how-to" modules for physical activity: how to coordinate a community-wide bike/walk/run event, begin an aquatics exercise program, implement activity breaks, etc. A Walk at Work program is being developed to monitor activity during the workday, and a plan for statewide trail development (with the WV Trails Coalition) is under development.

In order to reverse the negative trends noted for both sedentary lifestyle and obesity among West Virginia residents, the WVCfPA recognizes the need for intensified and more diversified efforts statewide. The Coalition will explore opportunities for further collaboration with exemplary school, worksite, and community programs to be replicated throughout the state, as well as increased collaboration with health care professionals in advocating physical activity. The Coalition plans to utilize the Internet as an additional outlet to promote physical activity.

Much work needs to be done in order to effect a significant change in the behaviors that have led to the increasing prevalences of sedentary lifestyle and obesity shown by the BRFSS. West Virginia residents need to hear the message about the positive benefits of physical activity reinforced throughout their communities, in their schools, in their worksites, from their health care providers, and through the media and then be given the time and opportunity to increase their activity levels.

Physical Activity - Meeting the Objectives

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