Physical Education Physical Education & Childhood Obesity& Childhood Obesity
Community Pediatrics Community Pediatrics
Legislative Advocacy ProjectLegislative Advocacy Project
John Babineau, MD John Babineau, MD
Jason Freedman, MDJason Freedman, MD
BackgroundBackground
A 2003 study by the NYC Department of A 2003 study by the NYC Department of Education and Department of Health and Education and Department of Health and Mental Hygiene confirmed that Mental Hygiene confirmed that NYC is NYC is following a national trendfollowing a national trend
Nearly half of all of our public elementary Nearly half of all of our public elementary school students are overweight or obeseschool students are overweight or obese
One in five kindergarten students enters One in five kindergarten students enters our school system already clinically our school system already clinically obese. obese.
Why this is criticalWhy this is critical
Regular physical activity, combined Regular physical activity, combined with healthy eating, is among the with healthy eating, is among the best strategies for preventing and best strategies for preventing and combating childhood obesity, combating childhood obesity, diabetes, and other obesity-related diabetes, and other obesity-related illness. illness.
Why this is criticalWhy this is critical
A 2001 study from the California A 2001 study from the California Department of Education identified a Department of Education identified a direct correlation between students’ direct correlation between students’ performance on literacy and math performance on literacy and math tests, and their performance on tests, and their performance on measures of physical fitness. measures of physical fitness.
The scope of the problemThe scope of the problemCongress makes the following findings:Congress makes the following findings:1.1. Obesity-related diseases cost the US economy more Obesity-related diseases cost the US economy more
than $100,000,000,000 every year.than $100,000,000,000 every year.
2.2. 23 percent of all deaths in the US are linked to sedentary 23 percent of all deaths in the US are linked to sedentary lifestyles that now begin at childhood.lifestyles that now begin at childhood.
3.3. Overweight adolescents have a 70-percent chance of Overweight adolescents have a 70-percent chance of becoming overweight adults, increasing their risk for chronic becoming overweight adults, increasing their risk for chronic disease, disability, and death.disease, disability, and death.
4.4. Childhood obesity has reached epidemic proportions in the Childhood obesity has reached epidemic proportions in the US.US.
5.5. In 2004, an estimated 9,900,000 children and adolescents In 2004, an estimated 9,900,000 children and adolescents ages 6 through 19 were considered overweight.ages 6 through 19 were considered overweight.
6.6. The Department of Health and Human Services estimates The Department of Health and Human Services estimates that, that, by 2010, 20 percent of children and youth in the by 2010, 20 percent of children and youth in the United States will be obese.United States will be obese.
The scope of the problemThe scope of the problem
7.7. A decline in physical activity has contributed to the A decline in physical activity has contributed to the unprecedented epidemic of childhood obesity.unprecedented epidemic of childhood obesity.
8.8. Part of the decline in physical activity has been in our Part of the decline in physical activity has been in our Nation's schools, where physical education programs Nation's schools, where physical education programs have been cut back in the past 2 decades.have been cut back in the past 2 decades.
9.9. Between 1991 and 2003, enrollment of high school Between 1991 and 2003, enrollment of high school students in daily physical education classes fell from students in daily physical education classes fell from 41.6 percent to 28.4 percent.41.6 percent to 28.4 percent.
10.10. Among children ages 9 to 13, 61.5 percent do Among children ages 9 to 13, 61.5 percent do not participate in any organized physical not participate in any organized physical activity during out-of-school hours.activity during out-of-school hours.
11.11. In a 2005 Government Accountability Office report on In a 2005 Government Accountability Office report on key strategies to include in programs designed to key strategies to include in programs designed to target childhood obesity, “increasing physical activity” target childhood obesity, “increasing physical activity” was identified as the most important component in was identified as the most important component in any such program.any such program.
The scope of the problemThe scope of the problem
12.12. The Dietary Guidelines for Americans recommend that The Dietary Guidelines for Americans recommend that children engage in at least 60 minutes of physical children engage in at least 60 minutes of physical activity on most, preferably all, days of the week.activity on most, preferably all, days of the week.
13.13. The national standard for physical education The national standard for physical education frequency is 150 minutes per week in elementary frequency is 150 minutes per week in elementary school and 225 minutes per week in middle and school and 225 minutes per week in middle and high school.high school.
14.14. Regular physical activity is associated with a healthier, Regular physical activity is associated with a healthier, longer life and a lower risk of cardiovascular disease, longer life and a lower risk of cardiovascular disease, high blood pressure, diabetes, obesity , and some high blood pressure, diabetes, obesity , and some cancers.cancers.
15.15. Evidence suggests that physical activity may have Evidence suggests that physical activity may have a positive impact on academic performance, self-a positive impact on academic performance, self-concept, and symptoms of anxiety and depression.concept, and symptoms of anxiety and depression.
16.16. Approximately 81 percent of adults believe daily physical Approximately 81 percent of adults believe daily physical education should be mandatory in schools.education should be mandatory in schools.
NY State MandateNY State Mandate
Grades K-3Grades K-3 should participate in physical should participate in physical education on a daily basiseducation on a daily basis
Grades 4-6Grades 4-6 shall participate in physical shall participate in physical education for at least 120 minutes per education for at least 120 minutes per calendar weekcalendar week
Grades 7-12Grades 7-12 need at least 3 periods of need at least 3 periods of physical education per calendar week physical education per calendar week (many loopholes here, however)(many loopholes here, however)
per NYS office of Commissioner last updated per NYS office of Commissioner last updated 19951995
What about New York City?What about New York City?
2004 – Report 2004 – Report released by Public released by Public AdvocateAdvocate
Survey of 100 NYC Survey of 100 NYC public schools across public schools across 5 boroughs to test 5 boroughs to test compliance with compliance with state mandate for state mandate for physical educationphysical education
NYC Public Advocate Survey: NYC Public Advocate Survey: FindingsFindings
Twenty percent of the public elementary schools surveyed lack regular access to physical education classes
All elementary schools surveyed are in violation of New York State regulations requiring daily physical education for students in Kindergarten through third grade
http://pubadvocate.nyc.gov/policy/pdfs/AllWorkandNoPlay3-23-04.pdfhttp://pubadvocate.nyc.gov/policy/pdfs/AllWorkandNoPlay3-23-04.pdf
NYC Public Advocate Survey: NYC Public Advocate Survey: FindingsFindings
Three-quarters of the schools with students in grades four through six are in violation of New York State regulations mandating at least 120 minutes of physical education for those students
Only four percent of all schools surveyed have an athletic team
Only 10 percent have an after-school athletic program
14 percent do not have a physical education teacher
http://pubadvocate.nyc.gov/policy/pdfs/AllWorkandNoPlay3-23-04.pdfhttp://pubadvocate.nyc.gov/policy/pdfs/AllWorkandNoPlay3-23-04.pdf
At the local level:At the local level:PS 128 in Washington HeightsPS 128 in Washington Heights
PS 128 Elementary School on 169PS 128 Elementary School on 169thth StreetStreet
2002 Healthy Lifestyles Campaign2002 Healthy Lifestyles Campaign Of the 1400 students, 47% have BMI Of the 1400 students, 47% have BMI
reflecting moderate to severe obesityreflecting moderate to severe obesity Students at the school found to have Students at the school found to have
approximately 30 minutes of physical approximately 30 minutes of physical education per weekeducation per week
At the local level:At the local level:PS 128 in Washington HeightsPS 128 in Washington Heights
Problems citedProblems cited
Lack of space and equipment to conduct Lack of space and equipment to conduct PE classesPE classes
Difficulty finding ways to have physical Difficulty finding ways to have physical activity in the classroomactivity in the classroom
Teachers feel they are without training to Teachers feel they are without training to supervise a PE experience for their classsupervise a PE experience for their class
Teachers find it difficult to compete for Teachers find it difficult to compete for time given importance placed upon time given importance placed upon standardized testing results by their standardized testing results by their administrationadministration
Parents lack of compliance at homeParents lack of compliance at home
How can we ensure adequate How can we ensure adequate physical education for our physical education for our
school-aged children?school-aged children?
The bill: The bill: FIT Kids ActFIT Kids Act
FIT Kids Act (Introduced in Senate)FIT Kids Act (Introduced in Senate)S 2173 IS; 110th CONGRESS, 1st SessionS 2173 IS; 110th CONGRESS, 1st Session
S. 2173S. 2173 To amend the Elementary and Secondary To amend the Elementary and Secondary
Education Act of 1965 to improve Education Act of 1965 to improve standards for physical education. standards for physical education.
IN THE SENATE OF THE UNITED IN THE SENATE OF THE UNITED STATESSTATES
The bill: The bill: FIT Kids ActFIT Kids Act
To amend the Elementary and To amend the Elementary and Secondary Education Act of 1965 to Secondary Education Act of 1965 to improve standards for physical improve standards for physical education. education.
This Act may be cited as the `Fitness This Act may be cited as the `Fitness Integrated with Teaching Kids Act' or Integrated with Teaching Kids Act' or the `FIT Kids Act'.the `FIT Kids Act'.
The bill: The bill: FIT Kids ActFIT Kids Act
FFitness itness IIntegrated with ntegrated with TTeaching eaching
KIDSKIDS Act Act
Requires state accountability systems (expanding Requires state accountability systems (expanding the Elementary and Secondary Education Act of the Elementary and Secondary Education Act of 1965) to measure not only student academic 1965) to measure not only student academic progress, but their progress toward a national goal progress, but their progress toward a national goal of 150 minutes of weekly physical education in of 150 minutes of weekly physical education in elementary school and 225 minutes of weekly elementary school and 225 minutes of weekly physical education in middle and high schools.physical education in middle and high schools.
The bill: The bill: FIT Kids ActFIT Kids Act
Amends the ESEA to require annual Amends the ESEA to require annual state and local educational agency state and local educational agency report cards to include specified report cards to include specified information on school health and information on school health and physical education programs.physical education programs.
The bill: The bill: FIT Kids ActFIT Kids Act
Includes the promotion of healthy, Includes the promotion of healthy, active lifestyles by students within ESEA active lifestyles by students within ESEA grant programs that support school grant programs that support school counseling, safe and drug-free schools counseling, safe and drug-free schools and communities, smaller learning and communities, smaller learning communities, community learning communities, community learning centers, parental involvement in their centers, parental involvement in their childrens’ education, and the childrens’ education, and the construction of healthy high-performing construction of healthy high-performing schools.schools.
The bill – The bill – additional provisionsadditional provisions Professional development – Professional development – Revises professional Revises professional
development of teachers and principals to include training development of teachers and principals to include training for physical and health education teachers, and training on for physical and health education teachers, and training on improving students' health habits and participation in improving students' health habits and participation in physical activities.physical activities.
Studies/Grants – Studies/Grants – Directs the Secretary to contract with the Directs the Secretary to contract with the National Academy of Sciences to conduct a study and National Academy of Sciences to conduct a study and provide recommendations regarding school programs to provide recommendations regarding school programs to improve student health and participation in physical improve student health and participation in physical activities.activities.
Assessments – Assessments – Authorizes the Secretary to award grants to Authorizes the Secretary to award grants to states to implement assessments effectively measuring states to implement assessments effectively measuring cognitive development in physical education and physical cognitive development in physical education and physical activity skills, motor skills development, and how much activity skills, motor skills development, and how much students value physical activity for health, enjoyment, students value physical activity for health, enjoyment, challenge, self-expression, and social interaction.challenge, self-expression, and social interaction.
Section 6. IOM StudySection 6. IOM StudyThe Secretary of Health and Human Services shall collaborate The Secretary of Health and Human Services shall collaborate
with thewith theSecretary of Education and the Director of the Centers for Disease Secretary of Education and the Director of the Centers for Disease Control and Prevention, to fund a study conducted by the Institute Control and Prevention, to fund a study conducted by the Institute
of of Medicine of the National Academy of Sciences that will:Medicine of the National Academy of Sciences that will:
1.1. examine and make recommendations regardingexamine and make recommendations regardingA.A. various means that may be employed to incorporate various means that may be employed to incorporate
physical activity into Head Start and childcare settings, physical activity into Head Start and childcare settings, elementary, middle, and high school settings, and elementary, middle, and high school settings, and before- and after-school programs; andbefore- and after-school programs; and
B.B. innovative and effective ways to increase physical innovative and effective ways to increase physical activity for all students;activity for all students;
2.2. study the impact of health, level of physical activity, and study the impact of health, level of physical activity, and amount of physical education on students' ability to learn and amount of physical education on students' ability to learn and maximize performance in schoolmaximize performance in school
Section 6. IOM StudySection 6. IOM Study
3.3. study and provide specific recommendations study and provide specific recommendations forfor
A.A. effectively measuring the progress of students, at the effectively measuring the progress of students, at the school level, in improving their health and well-being, school level, in improving their health and well-being, including improving theirincluding improving theiri.i. knowledge, awareness, and behavior changes, related to knowledge, awareness, and behavior changes, related to
nutrition and physical activity;nutrition and physical activity;
ii.ii. cognitive development, and fitness improvement, in physical cognitive development, and fitness improvement, in physical education;education;
iii.iii. knowledge of lifetime physical activity and health promotion;knowledge of lifetime physical activity and health promotion;
iv.iv. decrease in obesity ; anddecrease in obesity ; and
v.v. levels on overall health indicators; andlevels on overall health indicators; and
B.B. effectively measuring the progress of students, at the effectively measuring the progress of students, at the school level, in increasing physical activity.school level, in increasing physical activity.
Status of the billStatus of the bill
Latest Major Action:Latest Major Action: 9/19/2007 9/19/2007
ReferredReferred to House subcommittee. to House subcommittee.
Status:Status: Referred to the Referred to the Subcommittee on Early Childhood, Subcommittee on Early Childhood, Elementary, and Secondary Elementary, and Secondary Education.Education.
AAP Policy StatementAAP Policy Statement ””Physicians should advocate for the reinstatement of Physicians should advocate for the reinstatement of
compulsory, quality, daily PE classes in all schools compulsory, quality, daily PE classes in all schools (kindergarten through grade 12) taught by qualified, (kindergarten through grade 12) taught by qualified, trained educators.”trained educators.”
““The curricula should emphasize enjoyable The curricula should emphasize enjoyable participation in physical activity that helps students participation in physical activity that helps students develop the knowledge, attitudes, motor skills, develop the knowledge, attitudes, motor skills, behavioral skills, and confidence required to adopt behavioral skills, and confidence required to adopt and maintain healthy active lifestyles.”and maintain healthy active lifestyles.”
““Commitment of adequate resources for program Commitment of adequate resources for program funding, trained PE personnel, safe equipment, and funding, trained PE personnel, safe equipment, and facilities is also recommended.”facilities is also recommended.”
Active Healthy Living: Prevention of Childhood Obesity Through Increased Physical Activity; May 2006 Active Healthy Living: Prevention of Childhood Obesity Through Increased Physical Activity; May 2006
CreatingCreating FIT KIDS:FIT KIDS:Advocacy starts with usAdvocacy starts with us
What can fellow residents do if they What can fellow residents do if they are interested in supporting are interested in supporting legislation around this topic? legislation around this topic?
CreatingCreating FIT KIDS:FIT KIDS:Advocacy starts with usAdvocacy starts with us
Residents should have access to Residents should have access to information regarding gyms facilities, information regarding gyms facilities, pools, parks in the communitypools, parks in the community
Letter writing to congressmen to Letter writing to congressmen to increase funding for more physical increase funding for more physical education in schools and outside of education in schools and outside of schoolschool
Resources to our patients – handouts Resources to our patients – handouts available onlineavailable online
Resources for patientsResources for patients
http://www.nyc.gov/html/doh/downloads
Resources for patientsResources for patients
http://www.nyc.gov/html/doh/downloads
Other legislative efforts: Other legislative efforts: AHAAHA
http://www.americanheart.org/downloadable/heart/1154609406727Obesity%20Policy%20Backgrounder.http://www.americanheart.org/downloadable/heart/1154609406727Obesity%20Policy%20Backgrounder.docdoc
Other legislative efforts:Other legislative efforts: NCPPA NCPPA
http://www.ncppa.org/Letter%20of%20Support-Sanchez%20Bill.dochttp://www.ncppa.org/Letter%20of%20Support-Sanchez%20Bill.doc
Other legislative efforts: Other legislative efforts: PEP grant programPEP grant program
The Carol M. White Physical Education The Carol M. White Physical Education for Progress (PEP) grant programfor Progress (PEP) grant program
Introduced by Sen. Ted Stevens (R-Alaska)Introduced by Sen. Ted Stevens (R-Alaska) Signed into law in December 2000Signed into law in December 2000 Established a way for the U.S. Department Established a way for the U.S. Department
of Education to award grants directly to of Education to award grants directly to schools to create, expand, and improve schools to create, expand, and improve physical education programs for all K-12 physical education programs for all K-12 students. students.
Other legislative efforts: Other legislative efforts: House Bill 3141House Bill 3141
Requires 150 minutes/week of physical Requires 150 minutes/week of physical education for grades kindergarten through 5 education for grades kindergarten through 5
Requires 225 minutes/week for grades 6 Requires 225 minutes/week for grades 6 through 8. through 8.
Half of that time must be used for moderate Half of that time must be used for moderate physical activity. physical activity.
(Law passed July 27, 2007 from Oregon (Law passed July 27, 2007 from Oregon House Bill 3141)House Bill 3141)
We can make a We can make a differencedifference
January 30January 30thth: : Hearing on Physical EducationHearing on Physical Education
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