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The Fitness Challenge:The Fitness Challenge:Can It Improve Our Well-being?Can It Improve Our Well-being?
Jennifer Dillaha, MDArkansas Department of Health,
UAMS College of Public Health and College of Medicine
What does it mean to be “old”?What does it mean to be “old”?
• Weak• Frail• Feeble• Incompetent• Impotent• Incapacitated
What does it REALLY mean to What does it REALLY mean to be “old”?be “old”?
• Strong
• Robust
• Wise
PowerfulRespectedEmpowering
What is “Health”?What is “Health”?
• Physical, mental and social well-being, Physical, mental and social well-being, not merely the absence of disease and not merely the absence of disease and infirmity infirmity (WHO, 1948)(WHO, 1948)
• A resource for everyday life, not the A resource for everyday life, not the objective of living objective of living (WHO Ottawa Charter, 1986)(WHO Ottawa Charter, 1986)
Physical activity Physical activity will make youwill make you healthierhealthier..
• Live longerLive longer
• Less chronic diseaseLess chronic disease
• Less painLess pain
Physical activity levels are related to all-cause mortality.
The more physical activity you do, the more you can reduce your risk
of dying.
Figure 1. Top Ten Leading Causes of Death Figure 1. Top Ten Leading Causes of Death Among Adults 65 Years and Older, Among Adults 65 Years and Older,
Arkansas, 2005Arkansas, 20055933
4348
1553 1275786 680 553 514 401 369
0
1000
2000
3000
4000
5000
6000
Heart
Diseas
e
Cance
r
Stroke
CLRD *
Flu/P
neum
onia
Alzheim
ers
Diabe
tes
Nephri/
Nephro
Septic
emia
Accid
ents
Num
ber
of d
eath
s
Source: Arkansas Center for Health Statistics Online Query system * Chronic Lower Respiratory DiseasesArkansas Center for Health Statistics Online Query system * Chronic Lower Respiratory Diseases
Figure 2. Prevalence of Angina or Coronary Figure 2. Prevalence of Angina or Coronary Heart Disease by Age, Arkansas, 2005Heart Disease by Age, Arkansas, 2005
0 0.31.5
3.5
10.3
14.5
0
4
8
12
16
20
18-24 25-34 35-44 45-54 55-64 65+
Age-groups
Per
cent
Source: CDC BRFSS, http://apps.nccd.cdc.gov/brfss
Physical activity for chronic Physical activity for chronic disease preventiondisease prevention
• ArthritisArthritis• CancerCancer• Congestive Congestive
Heart FailureHeart Failure• Coronary Artery Coronary Artery
DiseaseDisease• DepressionDepression
• GoutGout• Mobility Impairment, FallsMobility Impairment, Falls• OsteoporosisOsteoporosis• StrokeStroke• Type 2 Diabetes MellitusType 2 Diabetes Mellitus• Urinary Stress Urinary Stress
IncontinenceIncontinence
Figure 4. Death Rates due to All Cancers by Figure 4. Death Rates due to All Cancers by Age, Arkansas, 2000-2004Age, Arkansas, 2000-2004
15.1 27.9 57.3 111.4190.7338.6
506.1701.9
952.4
1251.1
1545.11780.2
0
500
1000
1500
2000
30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+
Age-groups
Rat
e pe
r 10
0,00
0 po
pula
tion
Source: Arkansas Central Cancer Registry
Figure 3. Prevalence of Hypertension by Figure 3. Prevalence of Hypertension by Age, Arkansas, 2005Age, Arkansas, 2005
6.411.8
19.9
32.9
45.6
53.7
0
10
20
30
40
50
60
18-24 25-34 35-44 45-54 55-64 65+
Age-groups
Per
cent
Source: CDC BRFSS, http://apps.nccd.cdc.gov/brfss
Figure 12. Prevalence of Hypertension Figure 12. Prevalence of Hypertension by Race, Arkansas, 2005by Race, Arkansas, 2005
28.2
39.4
*19.9
*28.2
0
10
20
30
40
50P
erce
nt
White Black Hispanic Other
Race
Source: CDC BRFSS, http://apps.nccd.cdc.gov/brfss
*Sample size less than 50
Figure 6. Prevalence of Diabetes by Age, Figure 6. Prevalence of Diabetes by Age, Arkansas, 2006Arkansas, 2006
1.4 2.2
4.9
8.7
13.7
16.6
0
4
8
12
16
20
18-24 25-34 35-44 45-54 55-64 65+
Age-groups
Per
cent
Source: CDC BRFSS, http://apps.nccd.cdc.gov/brfss
Figure 11. Prevalence of Diabetes by Figure 11. Prevalence of Diabetes by Race, Arkansas, 2006Race, Arkansas, 2006
8.08.9
*4.3
*10.2*11.8
0
3
6
9
12
15P
erce
nt
White Black Hispanic Other MultiRacial
Race
Source: CDC BRFSS, http://apps.nccd.cdc.gov/brfss
*Sample size less than 50
Physical activity as disease Physical activity as disease prevention and treatmentprevention and treatment
• ArthritisArthritis• Chronic InsomniaChronic Insomnia• COPDCOPD• Chronic Renal Chronic Renal
FailureFailure• Congestive Heart Congestive Heart
FailureFailure• Coronary Artery Coronary Artery
DiseaseDisease
• DepressionDepression• HypertensionHypertension• ObesityObesity• OsteoporosisOsteoporosis• Peripheral Vascular Peripheral Vascular
DiseaseDisease• Venous Stasis Venous Stasis
DiseaseDisease
Physical activity improves Physical activity improves chronic pain.chronic pain.
Figure 7. Prevalence of Arthritis by Age, Figure 7. Prevalence of Arthritis by Age, Arkansas, 2005Arkansas, 2005
7.5 9.5
22.1
37.1
48.455.1
0
10
20
30
40
50
60
18-24 25-34 35-44 45-54 55-64 65+
Age-groups
Per
cent
Source: CDC BRFSS, http://apps.nccd.cdc.gov/brfss
Figure 13. Prevalence of Arthritis by Figure 13. Prevalence of Arthritis by Race, Arkansas, 2005Race, Arkansas, 2005
30.8 31.0
*19.9
*28.2
0
10
20
30
40
50P
erce
nt
White Black Hispanic Other
Race
Source: CDC BRFSS, http://apps.nccd.cdc.gov/brfss
*Sample size less than 50
Physical activity Physical activity will make youwill make you wealthierwealthier..
• Less disabilityLess disability
• Spend less on medical billsSpend less on medical bills
• Richer, fuller lifeRicher, fuller life
Figure 8. Prevalence of Disability by Age, Figure 8. Prevalence of Disability by Age, Arkansas, 2005Arkansas, 2005
10.3 11.117.0
24.2
31.4 30.8
0
10
20
30
40
50
60
18-24 25-34 35-44 45-54 55-64 65+
Age-groups
Per
cent
Source: CDC BRFSS, http://apps.nccd.cdc.gov/brfss
Physical activity can prevent Physical activity can prevent and improve disability.and improve disability.
• Low levels of physical activity and Low levels of physical activity and strength are among the strongest strength are among the strongest indicators of future disability.indicators of future disability.
• Chronic diseases associated with Chronic diseases associated with inactivity are all risk factors for inactivity are all risk factors for disability. disability.
Annual Medical CostsActive & Inactive Women Without
Physical Limitations
1,000
1,500
2,000
2,500
3,000
3,500
45-54 55-64 65-74 >75
Age Group
Med
ical
Cos
t ($)
Active
Inactive
M. Pratt, CA Macera, G Wang. Higher Direct Medical Costs Associated with Physical Inactivity. Physician Sportsmed. 2000; 28:63-70.
Figure 9. Prevalence of Overweight and Figure 9. Prevalence of Overweight and Obesity by Age, Arkansas, 2005Obesity by Age, Arkansas, 2005
26.1
*16.9
38.0
27.2
*19.9
31.2
*28.234.4
42.4
30.8
40.8
19.8
0
10
20
30
40
50
Per
cent
18-24 25-34 35-44 45-54 55-64 65+
Age-group
Overweight Obesity
Source: CDC BRFSS, http://apps.nccd.cdc.gov/brfss
*Sample size less than 50; Overweight = BMI 25-29.9; Obese = BMI >=30
Figure 15. Prevalence of Overweight and Figure 15. Prevalence of Overweight and Obesity by Gender, Arkansas, 2006Obesity by Gender, Arkansas, 2006
43.6
27.030.4
26.9
0
10
20
30
40
50
Per
cent
Male Female
Race
Overweight ObeseSource: CDC BRFSS, http://apps.nccd.cdc.gov/brfss
*Sample size less than 50; Overweight = BMI 25-29.9; Obese = BMI >=30
Figure 16. Prevalence of Overweight Figure 16. Prevalence of Overweight and Obesity by Race, Arkansas, 2006and Obesity by Race, Arkansas, 2006
36.8
26.0
37.0 36.8
*19.4
*27.3*29.1
0
10
20
30
40
Per
cent
White Black Hispanic Other MultiRacial
Overweight Obese
N/A N/A N/A
Source: CDC BRFSS, http://apps.nccd.cdc.gov/brfss
*Sample size less than 50; Overweight = BMI 25-29.9; Obese = BMI >=30
Physical activity Physical activity will make youwill make you happierhappier..
• Less depressionLess depression
• Sleep betterSleep better
• Believe in yourselfBelieve in yourself
Depression among Older Depression among Older AmericansAmericans
• Untreated depression is deadlyUntreated depression is deadly
• Of the nearly 35 million Americans age Of the nearly 35 million Americans age 65 years and older…65 years and older…
• an estimated 2 million have a an estimated 2 million have a depressive illnessdepressive illness
• another 5 million may have another 5 million may have depressive symptomsdepressive symptoms
Physical activityPhysical activityimproves quality of sleep.improves quality of sleep.
• Decreased insomnia Decreased insomnia
• Decreases depressive symptomsDecreases depressive symptoms
• Decreased painDecreased pain
• Quality fatigue Quality fatigue
Physical activity helps you Physical activity helps you believe in yourself.believe in yourself.
• Physical activity can be the key to living independently.
Figure 10. Prevalence of Physical Inactivity Figure 10. Prevalence of Physical Inactivity by Age, Arkansas, 2006by Age, Arkansas, 2006
23.620.9
25.031.5 32.7
37.4
0
10
20
30
40
50
60
18-24 25-34 35-44 45-54 55-64 65+
Age-groups
Per
cent
Source: CDC BRFSS, http://apps.nccd.cdc.gov/brfss
* Physical Inactivity = Did not participate in any physical activity in the past month
Why aren’t we more Why aren’t we more physically active?physically active?
• Myth #1: The physical decline associated Myth #1: The physical decline associated with old age is a normal part of aging.with old age is a normal part of aging.
• Myth #2: Exercise is risky for persons with Myth #2: Exercise is risky for persons with health problems.health problems.
• Myth #3: Sweating makes you ugly.Myth #3: Sweating makes you ugly.
Why people aren’t more active Why people aren’t more active
05
101520253035404550
All LessActiveAge 60+
Do you know what the Do you know what the physical activity physical activity
recommendations are?recommendations are?
RecommendationsRecommendations• Aerobic endurance: Aerobic endurance: 30 minutes most days
• Strength activities: Strength activities: at least twice a week
• Balance activities: aBalance activities: at least twice a week
• Stretching activities: eStretching activities: every day
Promoting physical activity Promoting physical activity is a public health priority.is a public health priority.
We should make physical We should make physical activity a priority for ourselves!activity a priority for ourselves!
Physical activity can mean a healthier, wealthier, and
happier life.
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•Second levelSecond level
•Third levelThird level
•Fourth levelFourth level
•Fifth levelFifth level
Formerly the Arkansas Fitness Challenge
Introducing
HistoryHistory
• Outgrowth of the Outgrowth of the Cardiovascular Task Cardiovascular Task Force Force
• 2003 - Collaboration of 2003 - Collaboration of Arkansas Blue Cross Arkansas Blue Cross Arkansas Department Arkansas Department of Healthof Health
• 2004 – First 2004 – First “Challenge” between “Challenge” between Department of Health Department of Health and Arkansas Blue and Arkansas Blue CrossCross
• 2004 – Employer kit 2004 – Employer kit developeddeveloped
• 2005/2006 – Employer 2005/2006 – Employer kits distributedkits distributed
• 2006 – Employer 2006 – Employer website pilotedwebsite piloted
• 2007 – Employer 2007 – Employer website open to publicwebsite open to public
•2005 —2005 — 4545 Employer GroupsEmployer Groups
•20062006 —— 6060 Employer GroupsEmployer Groups
•20072007 —— 5353 Employer/ Community Employer/ Community Groups Groups (official, (official, reporting data)reporting data)
• 7,135 7,135 ParticipantsParticipants
Past Past ParticipationParticipation
•2008—1252008—125Employer/Community Employer/Community
Groups Groups (official, (official, reporting data)reporting data)
•>61,000 >61,000 eligible eligible participantsparticipants
What is it?What is it?• Virtual “race” across
the United States
• Starts and ends in Arkansas—Where it all began!
• 92 unique stops--30 to Win!
• 3 month duration, March – May
To encourage already To encourage already
exercising employees to exercising employees to
exercise in eligible exercise in eligible
categories 30 minutes categories 30 minutes
every day.every day.
To engage non-exercising
employees in consistent
exercise in eligible
categories 30 minutes at
least 3 times per week.
Contest StructureContest Structure
30 minutes of eligible exercise to 30 minutes of eligible exercise to advance to next check pointadvance to next check point
• Walking/jogging/running• swimming laps/water aerobics• Bicycling• Court sports• Aerobics (jazzercise, low/high
impact, step aerobics, etc.)• Aerobic machines (treadmill,
stepper, rower, elliptical, skier, stationary bike, etc.)
• Other
Highest average of days exercised per
week35 points
Highest percentage of employees completing 30
or more checkpoints35 points
Lowest dropout rate10 points
Highest percentage of employees participating
20 points
Winning Measures
Registration ends on
February 29
Contact InformationContact Information
Jennifer Dillaha, MDJennifer Dillaha, MDDirector, Center for Health AdvancementDirector, Center for Health AdvancementArkansas Department of HealthArkansas Department of Health
Office: 501-661-2199Office: 501-661-2199Jennifer.Dillaha@Arkansas.govJennifer.Dillaha@Arkansas.gov
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