The Fitness Challenge: Can It Improve Our Well-being? Jennifer Dillaha, MD Arkansas Department of Health, UAMS College of Public Health and College of

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


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


*Sample size less than 50

http://apps.nccd.cdc.gov/brfss

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


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




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


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




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


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


*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



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




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


* 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: [email protected]@Arkansas.gov

Documents

The Fitness Challenge: Can It Improve Our Well-being? Jennifer Dillaha, MD Arkansas Department of Health, UAMS College of Public Health and College of