Focus Area 22:Physical Activity and Fitness

Richard J. KleinNational Center for Health Statistics

Progress ReviewJune 26, 2008

• Decreases the risk of obesity and chronic diseases, including osteoporosis

• Better control of body weight, blood pressure, blood glucose, and cholesterol

• Improved mood and feelings of well-being

• Enhances independent living among older adults

• Improves quality of life for people of all ages

Physical Activity and Fitness Benefits

Individual behavior22-1. No physical activity22-2. Moderate or vigorous physical activity for adults22-7. Vigorous physical activity for adolescents

Highlighted Objectives

Environmental intervention and programs22-9. Participation in daily physical education in

schools22-10. Physical activity in physical education class22-11. Television viewing

Organizational policy22-8 a, b. Physical education requirement in schools22-12. Access to school physical activity facilities

Improving Getting worse

Little or no change* Baseline onlyTarget met

Note: *Percent of targeted change achieved is between -10% and 10%, and/or change not statistically significant.

Leisure Time Physical Activity Among Adults

Note: Data are for ages 18 years and over, age adjusted to the 2000 standard population. Regular leisure-time physical activity is a moderate/vigorous physical activity (moderate activity 30+ minutes/5+ times per week or vigorous activity 20+ minutes/3+ times per week). Source: National Health Interview Survey (NHIS), NCHS, CDC.

1997

None40%

Regular 32%

Some28%

Objs. 22-1,

2

2006

None39%

Regular31%

Some30%

0

Percent

4020 80

1997

2006

60

Total

25-44 years

Female

75 years +

Male

18-24 years

45-64 years

65-74 years

No Leisure Time Physical Activity Among Adults

Note: Data are for ages 18 years and over. Except for age-specific estimates data are age adjusted to the 2000 standard population. I = 95% confidence interval.Source: National Health Interview Survey (NHIS), NCHS, CDC. Obj. 22-1

2010 Target: 20

Decrease desired

0

10

20

30

40

50

1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Percent

2010 Target

0 20 40 60 80

Hispanic

No Leisure Time Physical Activity Among Adults, 2006

Total

White

American Indian

Asian

Black

Some college

High school graduate

College graduate or higher

Obj. 22-1

Decrease Desired

Percent

Note: Except for education levels, data are for adults 18 years and over; education-level data are for adults 25 years and over. Data are age adjusted to the 2000 standard population. American Indian includes Alaska Native. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Respondents were asked to select one or more races. Data for the single race categories are for persons who reported only one racial group. I = 95% confidence interval. Source: National Health Interview Survey (NHIS), NCHS, CDC.

2010 Target: 20

Less than high school

0

Percent

6020 40 80

1997

2006

Total

25-44 years

Female

75 years +

Male

18-24 years

45-64 years

65-74 years

Age-adjusted percent

Regular Leisure Time Physical Activity Among Adults

Note: Except for age-specific estimates, data are for adults 18 years and over and are age adjusted to the 2000 standard population. Regular leisure-time physical activity is a moderate or vigorous physical activity (moderate activity 30+ minutes/5+ times per week or vigorous activity 20+ minutes/3+ times per week). I = 95% confidence interval.Source: National Health Interview Survey (NHIS), NCHS, CDC.

Obj. 22-2

2010 Target: 50

Increase Desired

0

10

20

30

40

50

1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

2010 TargetPercent

0 20 40 60 80

Hispanic

Regular Leisure Time Physical Activity Among Adults, 2006

Total

White

American Indian

Asian

Black

Some college

High school graduate

College graduate or higher

Obj. 22-2

Percent

Note: Except for education levels, data are for adults 18 years and over; education-level data are for adults 25 years and over. Data are age adjusted to the 2000 standard population. Regular leisure-time physical activity is moderate or vigorous physical activity (moderate activity 30+ minutes/5+ times per week or vigorous activity 20+ minutes/3+ times per week). American Indian includes Alaska Native. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Respondents were asked to select one or more races. Data for the single race categories are for persons who reported only one racial group. I = 95% confidence interval. Source: National Health Interview Survey (NHIS), NCHS, CDC.

2010 Target: 50

Increase Desired

Less than high school

Likelihood of Selected Health Problems by Leisure Time Physical Activity Level, 2006

Note: Data are for adults 18 years and older. Odds ratios are adjusted for sex, age, race/ethnicity, educational, and poverty status. Data are age adjusted to the 2000 standard population. Inactive is no moderate or vigorous physical activity; some activity is physical activityless than the regular activity. Regular activity is a moderate (30+ min /5+ time per week) or vigorous activity (20+ min/ 3+ times per week) orboth. Serious psychological distress includes negative moods during the past 30 days: sad, nervous, restless, hopeless, feeling everything is aneffort, and worthless. I = 95% confidence interval.Source: National Health Interview Survey (NHIS), NCHS, CDC.

Odds Ratio

Diagnosed diabetes

Fair or poor health

Serious psychological

distress

0

0.5

1

1.5

Inactive Some activity Regular activity

0Percent

4020

Total

White

Female

Hispanic

Male

Black

1999

2007

60 80 100

Regular Vigorous Physical Activity Among Adolescents

Note: Data are for students in grades 9 through 12. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Persons were asked to select one or more races. The categories black and white include persons who reported only one racial group. Regular vigorous physical activity is a regular activity 20+ minutes on 3+ of the past 7 days that make students sweat or breathe hard. I = 95% confidence interval.Source: Youth Risk Behavior Surveillance System (YRBSS), NCCDPHP, CDC.

Obj. 22-7

0

20

40

60

80

100

1999 2001 2003 2005 2007

Percent

2010 Target

2010 Target: 85

Increase Desired

Physical Activity Measured by Accelerometer

• Physical activity monitor component of NHANES 2003-06

• Measures intensity and duration of common activities such as walking and running

• Has a pedometer (step-counter) feature

• Worn over the right hip on an elasticized belt for 7 days

• More than 12,000 persons 6+ years wore accelerometers.

• Results may be linked to interview, health (BMI, functional status, bone status, blood pressure, etc.), and laboratory data.

Percent

6-11 years 12-15 years 16-19 years

6-11 years12-15 years16-19 years

16-19 years20-59 years

60+ years

16-19 years20-59 years

60 + years

Recommended Levels of Physical Activity

60+ min/5-7 days

30+ min/5-7 days

0 20 3010 6040 50

Female

Female

Male

Male

Note: Adherence: for ages 6–19 years - 60 or more minutes of moderate- or greater-intensity activity on 5 of 7 days; for ages 16 years and older – 30 or more minutes of moderate- or greater-intensity activity on 5 of 7 days, accumulated in 10-min “bouts.” I = 95% confidence interval.Source: Troiano, RP, et al. Physical Activity in the United States Measured by Accelerometer. Medicine & Science in Sports & Exercise. 2008, 40(1): 181-188.National Health and Nutrition Examination Survey (NHANES), NCHS, CDC.

Middle and junior high schools

2000

Senior high schools

2006

Daily Physical Education Requirement in Schools

Obj. 22-8a, bNote: Data are for public and private middle, junior, and senior high schools. Source: School Health Policies and Programs Study (SHPPS), NCCDPHP, CDC

0

5

10

15

20

2010 Target: 9.4

2010 Target: 14.5

Increase Desired

Percent

0

20

40

60

Participation in Daily Physical Education in Schools

Note: Data are for students in grades 9 through 12.I = 95% confidence interval.Source: Youth Risk Behavior Surveillance System (YRBSS), NCCDPHP, CDC.

Percent

Obj. 22-9

9th grade

10th gradeTotal 11th grade 12th grade

2010 Target: 50

Increase Desired1999 2007

Physical Activity in Physical Education Class

Note: Data are for students in grades 9 through 12 enrolled in physical education class. Physical activity in physical education class includes 21+ minutes exercising or playing sports 3 to 5 times a week. I = 95% confidence interval.Source: Youth Risk Behavior Surveillance System (YRBSS), NCCDPHP, CDC.

Percent

Obj. 22-10

9th grade

10th gradeTotal 11th grade 12th grade0

20

40

60

80

2010 Target: 50

Increase Desired1999 2007

2000

Community Access to School Physical Activity Facilities

Obj. 22-12

Note: Data are for public and private elementary, middle/junior, and senior high schools, that provide access to their physical activity spaces and facilities for all persons outside of normal school hours. Source: School Health Policies and Programs Study (SHPPS), NCCDPHP, CDC.

0

20

40

60

2010 Target: 50

Increase Desired

2006

Percent

Adolescents Who View Television Two or Fewer Hours on a School Day

Note: Data are for students in grades 9 through 12. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Persons were asked to select one or more races. The categories black and white include persons who reported only one racial group. I = 95% confidence interval.Source: Youth Risk Behavior Surveillance System, NCCDPHP, CDC.

Percent

Obj. 22-11

Female MaleTotal Black Hispanic0

20

40

60

80 2010 Target: 75

Increase Desired1999 2007

White

Physical Activity and Fitness Objectives

Physical Activity among Adults

22-1. No leisure time physical activity22-2. Moderate regular physical activity22-3. Vigorous physical activity22-4. Muscular strength and endurance22-5. FlexibilityPhysical Activity among

Adolescents22-6. Moderate physical activity22-7. Vigorous physical activity22-8. Physical education requirement in schools a. Middle/junior high schools b. Senior high schools

22-9. Participation in daily school PE22-10. Physical activity in PE class22-11. Television viewing22-12. Access to school physical activity facilities

Worksites and Communities22-13. Worksite physical activity and fitness programs22-14. Community walking a. Adults b. Children and adolescents22-15. Community bicycling a. Adults b. Children and adolescents

Getting worse

Baseline onlyTarget met

Improving Little or no change*

Note: *Percent of targeted change achieved is between -10% and 10%, and/or change not statistically significant.

Methodological Issues

Time / intensity

Recall period / accuracy

Question order

“Leisure” / “work” / “incidental”

Self-report / measured

No standard methodology

Changes in measurement over time

• Individual physical activity behaviors for adolescents and adults are essentially unchanged.

• Physical education requirements levels in middle and junior school remain low. Senior high school levels are very low and have declined.

• Most high school students do not participate in daily physical education.

• Disparities persist for many objectives.

• Complex measurement issues

Summary

Acknowledgements

Asel RyskulovaCDC/National Center for Health Statisticsavr0@cdc.gov

Contributors:Sandra Ham, CDC/NCCDPHPJane Wargo, DHHS/OS/OPHSChristine Spain, DHHS/OS/OPHSSarah Lee, CDC/NCCDPHPTimothy McManus, CDC/NCCDPHPEllis Davis, HHS/ODPHP

Elizabeth Jackson, CDC/NCHSLeda Gurley, CDC/NCHS Charlotte Schoenborn, CDC/NCHSMargaret Mc Dowel, CDC/NCHSLesley Agress, CDC/NCHS Christopher Barrett, HHS/ODPHP

Progress review data and slidescan be found on the web at:

http://www.cdc.gov/nchs/hphome.htm

http://www.cdc.gov/nchs/hphome.htm