The Need for Physical Activity and Physical Education in Our Schools

1. The Need for Physical Activity and Physical Education in Our Schools Presenter’s Name Presenter’s Title

2. Health and achievement go hand in hand. • “An effective, long-lasting, sustainable school reform initiative can only succeed if it is based on a healthy school system. If our children, their families, administrators, and teachers are healthy, then they will come to school and, just as important, they will be ready and able to teach and to learn. . . . • “If we are serious about saving a generation of kids, ensuring that not one of them is left behind, we must see that health and achievement go hand in hand. Only when children are healthy and safe will we be able to focus on improving their academic performance.” • -- Pat Cooper, Superintendent, • McComb Separate School District, Mississippi Cooper 2003

3. Childhood obesity has reached epidemic proportions. • Obesity/overweight is considered a national epidemic. • In the last two decades, there has been a threefold increase in overweight children and teens. • Children’s increasingly sedentary lifestyles compound the problem. • Unhealthy/sedentary lifestyles result in $100 billion in costs and 300,000 deaths annually. U.S. Surgeon General’s Report 2001

4. The number of overweight children in the U.S. has grown dramatically. CDC: NHANES, JAMA. 2002 288:1723-1727

5. More children are developing “adult” diseases, such as Type 2 diabetes. • “Adult onset” diabetes is now called “type 2” diabetes because of the sharp rise of the disease in children. • In one study, type 2 diabetes in adolescents increased 10-fold between 1982 and 1994. • The CDC warns that one in three U.S. children born in 2000 will become diabetic unless many more people start eating less and exercising more. Pinhas-Harniel 1996, Associated Press 2003

6. This rise in disease is leading to greater health care costs. • Increasing incidence of disease leads to rising health care costs: from 1979 to 1999, annual hospital costs for treating obesity-related diseases in children tripled (from $35 million to $127 million). • The CDC estimates that, if all physically inactive Americans became active, we would save $77 billion in annual medical costs. • Diabetes alone costs the nation $105 billion annually—and this figure is expected to rise as the incidence of the disease rises. Wang & Dietz 2002, Pratt, Macera & Wang 2000; Diabetes Research Working Group 1999

7. Children’s physical activity is declining over time. • Fewer than 1 in 4 children get 20 minutes of vigorous physical activity per week, and less than 1 in 4 get at least 30 minutes of physical activity per day. • Over one-third of adolescents aged 12 to 17 are physically active less than 3 out of 7 days a week. International Life Sciences Institute 1997; Action for Healthy Kids National Profile 2002

8. And physical activity declines rapidly as children get older. • By the time they reach their teens, nearly half of America’s youth are not vigorously active on a regular basis. • In grade 9, 72% of students get regular physical activity, but by the time they reach grade 12, only 55% of them are physically active. • Nearly 10% of students in grades 9-12 participate in no vigorous or moderate physical activity on a weekly basis. CDC 1997; Action for Healthy Kids National Profile 2002

9. In short . . . • “Our nation’s young people are, in large measure, inactive, unfit, and increasingly overweight.” • Department of Health and Human Services/Department of Education DHHS/DOE Report to the President 2000

10. Schools play a critical role in students’ fitness. • Schools are identified as a key setting for change by the U.S. Surgeon General’s report. • School serves as kids’ “work” and social world. • Decisions and behavior of leadership have strong impact. • Students need consistency between educational messages and “real life” messages. • In sum, our schools offer an extraordinary opportunity to guide and shape healthy physical activity habits. U.S. Surgeon General’s Office 2001

11. But activity is declining at school as well. • 85% of students travel to school by car or bus. Only 13% walk or bike to school. • Only 4.1% of states require and 22.4% recommend that elementary schools provide students with regularly scheduled recess. • Nearly half of the nation’s children (45%) do not play on sports teams during the year. Action for Healthy Kids National Profile 2002; CDC 2002; NASPE Shape of Our Nation’s Children

12. And participation in physical education programs has sharply declined as well. • From 1991 to 1999, the number of students who took physical education on a daily basis dropped from 42% to 29%. • Most high school students take only one year of physical education between grades 9 and 12. • Less than a third of high school students attend physical education class daily. • A quarter of the nation’s children do not attend any school physical education classes. NASPE2001; CDC 1999-2000; CDC 2003 Physical activity and good nutrition;Action for Healthy Kids National Profile 2002

13. NCYFS (1984, 1986) YRBS 2001 The percentage of students enrolled in PE classes drops as children get older. NCYFS = National Child and Youth Fitness Study; YRBS = National Youth Risk Behavior Survey

14. The percentage of high school students who attend PE classes on a daily basis has declined. CDC, National Youth Risk Behavior Survey

15. Formal physical education programs have been threatened throughout the U.S. • No federal law requires physical education to be included in public schools • Only one state enforces daily physical education requirements in grades K-12. • Although most states have some mandate for physical education, most states require only that physical education be provided. Local districts have control over content and format. NASPE2001; Action for Healthy Kids National Profile 2002

16. 60 52 51 51 51 50 50 40 40 32 Percent of schools 26 30 25 20 13 10 6 10 5 0 K 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th Schools require less physical education the older students get. CDC, School Health Policies and Programs Study 2000

17. Many high school students are not enrolled in physical education classes. Percentage of high school students who are not enrolled in P.E. classes, 1999 CDC/NCCDP 2002

18. Physical activity and education does not weaken academic performance. • “Evidence suggests that time spent in physical education does not decrease learning in other subjects. Youth who spend less time in other subjects to allow for regular physical education have been shown to do equally well or better in academic classes.” • President’s Council on Physical Fitness and Sports President’s Council, 1999

19. In fact, physical education helps to create more well-rounded students. • “Physical education plays a critical role in educating the whole student. Research supports the importance of movement in educating both mind and body. The healthy, physically active student is more likely to be academically motivated, alert, and successful. Throughout the school years, quality physical education can promote social, cooperative, and problem-solving competencies.” • National Association for Sport and Physical Education NASPE “Physical Education”

20. Exercise and fitness are linked to academic achievement. • Physical activity and physical education lead to: • Improved self-esteem and mental health • Reduced anxiety and stress in teens • Better attendance rates • A more positive attitude to school • Superior academic achievement • “The physical well-being of students has a direct impact on their ability to achieve academically. We now have the proof we've been looking for: students achieve best when they are physically fit.” • California State Superintendent of Public Instruction Cooper 2003; Sallis et al 1999; Keays & Allison 1995; Shephard 1996; NASPE 2002; NASPE 2001; Shephard et al 1984; Shephard 1997; Symons et al 1997; NASPE 2001; NASPE 2002

21. Educational leaders understand the link between health and learning. • “Physically active, healthy kids learn better!” • National Association for Sport and Physical Education • “Students who don’t get enough exercise and have proper nutrition simply don’t perform as well academically.” • National Association of Elementary School Principals (NAESP) and National Association of Secondary School Principals (NASSP) • “Health does equal achievement.” • Former U.S. Surgeon General David Satcher NASPE 2001; Ferrandino and Tirozzi 2002; Satcher and Bradford 2003

22. Students and parents want more physical activity and physical education. • A majority of student leaders (72%) feel schools should make physical activity for all students a priority, with 81% calling for more students to get involved in physical activity and 56% stressing the importance of having more physical education classes. • The vast majority of parents (95%) think “physical education should be part of a school curriculum for all students in grades K-12.”

23. National groups call for physical activity and physical education. • Former U.S. Surgeon General David Satcher • daily physical education • National Association for Sport and Physical Education (NASPE) • standards-based physical education as an integral part of K-12 education • CDC • sequential daily physical education with students active for a large percentage of class time • U.S. Department of Health and Human Services • daily physical education for all students • U.S. Department of Education • daily physical education for preK-12 Satcher 2002; NASPE 2001; CDC 1997; Healthy People 2010 2000; DHHS/DOE Report to the President 2000

24. The message is clear. • “Physical education is an integral part of the total education of a child.” • National Association of School Boards (NASBE) • “Improving children’s health and well-being contributes to their success in school.” • National Association of Elementary School Principals (NAESP) • “School physical education programs are an important part of the overall education process.” • American College of Sports Medicine • Physical education is “an essential part of the total curriculum.” • National Association for Sport and Physical Education • “Academic achievement begins with a studentwho is healthy and alert.” • National Association of Secondary School Principals (NASSP) Bogden 2000; NAESP 2000; NASPE 2001

25. The task is clear. • “To pass legislation that discourages participation in physical activity in the name of having more time for academics is shortsighted.” “Policymakers must create laws that will allow schools to emphasize physical and health education during the school day. . . . Not only will it enhance their academic success, it will also promote healthy lifestyles.” • Vincent L. Ferrandino, Executive Director, NAESP, & Gerald N. Tirozzi, Executive Director, NASSP

26. State programs 51 Action for Healthy Kids state teams (in all states & D.C.) California Adolescent Nutrition and Fitness Program (CANFit) Exemplary Physical Education Curriculum (EPEC) (Michigan) Healthy Hawaii Initiative Healthy Kids Learn Better, Oregon School Boards Association Local programs Fitness Center, Chula Vista Middle School (California) KEEP 57, Wilson Central School District (New York) Kids on the Move (Atlanta) Move Across America (Kansas) Movin’ Schools (Wisconsin) Success-Oriented P.E. (Seattle) National, state, and local programs are working across the U.S. Examples of some programs: • National programs • Action for Healthy Kids • Coordinated School Health Programs • Healthy Hearts for Kids • Healthy Kids Challenge • Kids Running/Run to Read and Write • Kids Walk-to-School Program • Operation FitKids • President's Challenge Physical Activity and Fitness Awards Program • Project Fit America • SPARK Physical Education

27. In conclusion . . . • “Achieving optimal health status is closely linked to success in all life domains, and a comprehensive education that addresses mental, emotional, spiritual and physical elements is essential. Physical education is a key component of such an education.” • National Association for Sport and Physical Education • “Exercise and recreation are as necessaryas reading. I will say rather more necessary because health is worth more than learning.” • Thomas Jefferson NASPE 2001

28. Call to ActionDavid Satcher, MD, PhD, Chair, Action for Healthy Kids “Academic achievement and good nutrition and exercise, in fact, are not mutually exclusive. Studies continue to confirm that when children's and adolescents' basic nutritional and fitness needs are met, they learn better. Physical activity is an integral part of this equation, because providing more time for increased physical activity (by reducing class time) leads to increased test scores. Good nutrition and proper exercise in schools can help to bolster academic achievement.” Satcher 2002

29. To find extensive resources on physical activity and physical education, visit the AFHK website. www.ActionForHealthyKids.org

30. Additional slides

31. “Commitment to Change”: Physical Activity and Physical Education • Provide age-appropriate and culturally sensitive instruction in health education and physical education that help students develop the knowledge, attitudes, skills and behaviors to adopt, maintain and enjoy healthy eating habits and a physically active lifestyle. • Provide students in pre-kindergarten through grade 12 with behavior-focused nutrition education integrated into the curriculum that is interactive and teaches the skills they need to adopt healthy eating habits. • Ensure that meals offered through all school feeding programs meet federal nutrition standards. • Adopt policies ensuring that all foods and beverages available on school campuses and at school events contribute toward eating patterns that are consistent with the Dietary Guidelines for Americans. • Provide food options that are low in fat, calories and added sugars, such as fruits, vegetables, whole grains, and low-fat or nonfat dairy foods. • Ensure that healthy snacks and foods are provided in vending machines,school stores and other venues within the school’s control.

32. “Commitment to Change”: Physical Activity and Physical Education • Prohibit student access to vending machines, school stores, and other venues that contain foods of minimal nutritional value and compete with healthy school meals in elementary schools and restrict access in middle, junior and high schools. • Provide an adequate amount of time for students to eat school meals; schedule lunch periods at reasonable hours around midday. • Provide all children, from pre-kindergarten through grade 12, with quality daily physical education that helps develop the knowledge, attitudes, skills, behaviors and confidence needed to be physically active for life. • Provide daily recess periods for elementary school students, featuring time for unstructured but supervised active play. • Provide adequate co-curricular physical activity programs, including fully inclusive intra-mural programs and physical activity clubs. • Encourage the use of school facilities for physical activity programs offeredby the school and/or community-based organizations outside of school hours.

33. Obesity* is rising among U.S. adults: 1996 CDC 2003 Nutrition and physical activity

34. Obesity* is rising among U.S. adults: 1997 CDC 2003 Nutrition and physical activity

35. Obesity* is rising among U.S. adults: 1998 CDC 2003 Nutrition and physical activity

36. Obesity* is rising among U.S. adults: 1999 CDC 2003 Nutrition and physical activity

37. Obesity* is rising among U.S. adults: 2000 CDC 2003 Nutrition and physical activity

38. Obesity* is rising among U.S. adults: 2001 CDC 2003 Nutrition and physical activity

39. Recess is crucial to the development of children. • “For the elementary school students, recess provides an opportunity for needed physical activity. Unstructured time also contributes to creativity, cooperation, and learning about social interaction. Play is an essential element of children’s social development.” • National Association for Sport and Physical Education NASPE 2001

40. Recess is linked to academic performance. • Research shows that play enhances cognitive development: “children learn through play.” • According to early childhood experts, “Children develop intellectual constructs and cognitive understandings through the hands-on, manipulative, exploratory behavior that occurs during play. . . .” • Research finds that “children can remember more, focus better, and regulate their own behavior better in play than in any other context.” NAECP 2002; Guddemi et al 1999

41. But recess is being eliminated at schools across the nation. • 97% of elementary schools provide recess for at least some students, 71% provide it for all students • Only 4% of states require • But 40% of elementary schools in the United States have reduced, eliminated, or are considering eliminating recess CDC SHPPS 2002; Action for Healthy Kids National Profile 2002; NAECP 2002

42. Before-/after-school programs provide more opportunities for physical activity. • The CDC and Healthy People 2010 recommends: • giving students access to school buildings and community facilities outside of school hours • Using these before-/after-school programs to reach out to a greater range of students: “specific adolescent and young adult populations, such as racial and ethnic minority groups, females, personal with disabilities, and low-income groups.” • “49% of schools offer intramural activities or physical activity clubs for students. Among these schools, 15%provide transportation home for students who participate.” • “99% of co-ed middle/junior high and senior high schools offer interscholastic sports.” CDC Kids Media 2000; Healthy People 2010; CDC SHPPS 2000

43. Schools, districts, and states across the country are exploring programs that work. • Best Friends (Maryland): After-school self-confidence program for girls features physical fitness classes • School-based fitness center (California): Middle school creates free fitness center for students and parents • Kids on the Move (Atlanta): After-school program integrates physical activity with health/nutrition education • U Move with the Starzz (Utah): Middle school-aged kids work with members of the WNBA Utah Starzz basketball team to integrate physical activity and healthy behaviors into their daily lives. • CATCH Kids After-School Program (Texas): Research study examining physical activity and nutrition in an after-school program. • Kids Walk to School (CDC): National initiative encourages kids and parents to walk to school Best Friends Foundation; Neely 2003; Children’s Healthcare; ILSI PAN program; CDC 2002

44. References Action for Healthy Kids. 2002. National Profile. Associated Press. Diabetes in children set to soar. MSNBC. June 16, 2003. Best Friends Foundation. http://www.bestfriendsfoundation.org Bogden, J. 2000. Fit, Healthy, and Ready to Learn: A School Health Policy. National Association of State School Boards. Centers for Disease Control and Prevention. 1997. Guidelines for School and Community Programs to Promote Lifelong Physical Activity among Young People. MMWR Recommendations and Reports 46 (RR-6): 1-36. Centers for Disease Control and Prevention. 1999-2000. National Health and Nutrition Examination Survey (NHANES). Centers for Disease Control and Prevention (Division of Adolescent and School Health). 2000. School Health Policies and Programs Study (SHPPS). Centers for Disease Control and Prevention. 2002. Fact sheet. Kids Walk-to-School Program. Centers for Disease Control & Prevention. 2003. Physical activity and good nutrition: essential elements to prevent chronic diseases and obesity. At a Glance. Centers for Disease Control and Prevention. National Youth Risk Behavior Survey. Centers for Disease Control and Prevention. 2003. Nutrition and physical activity: U.S. obesity trends 1985 to 2001. Centers for Disease Control and Prevention/National Center for Chronic Disease Prevention and Health Promotion. 2002. The burden of chronic diseases and their risk factors: national and state perspectives. Children’s Healthcare of Atlanta. Kids on the Move. http://www.choa.org/chda/kids_move.shtml Cooper, P. 2003. Our journey to good health. School Administrator. Diabetes Research Working Group.1999. Conquering Diabetes: A Strategic Plan for the 21st Century. Ferrandino, V. L., and Tirozzi, G. N. 2002. Principals’ perspective: healthy students are better students [advertisement]. Education Week October 9. Guddemi, M., Jambor, T., & Skrupskelis, A. (Eds.). (1999). Play in a Changing Society. Little Rock, AR:SECA.

45. References, continued International Life Sciences Institute. 1997. Improving Children’s Health through Physical Activity: A New Opportunity, A Survey of Parents and Children about Physical Activity Patterns. International Life Sciences Institute. Physical Activity and Nutrition (PAN) Program. CATCH Kids After-School Program. JAMA. 2002;288:1723-1727 Keays, J., and Allison, R. 1995. The effects of regular moderate to vigorous physical activity on student outcomes: A review. Canadian Journal of Public Health 86: 62-66. National Association of Early Childhood Specialists in State Departments of Education. A position statement on young children and recess. 2002. National Association of Elementary School Principals (NAESP). 2000. Platform. National Association for Sport and Physical Education (NASPE). 2001. Shape of the Nation Report. National Association for Sport and Physical Education (NASPE). 2002. New study supports physically fit kids perform better academically. National Association for Sport and Physical Education (NASPE). No date. Shape of Our Nation’s Children. National Association of Sport and Physical Education/Council of Physical Education for Children. 2001. Physical education is critical to a complete education. National Child and Youth Fitness Study, 1984 and 1986. National Governors Association Center for Best Practices. http://www.nga.org/center/1,1188,,00.html. Neely, L. Fitness center has students pumped. San Diego Union-Tribune. May 11, 2003. Pinhas-Harniel, O., et al. 1996. Increase incidence of non-insulin-dependent diabetes mellitus among adolescents. The Journal of Pediatrics 128: 608-615. President’s Council on Physical Fitness and Sports. 1999. Physical activity promotion and school physical education. Physical Activity and Fitness Research Digest.

46. References, continued Sallis, J. F., McKenzie, T. L., Kolody, B., Lewis, M., Marshall, S., and Rosengard, P. 1999. Effects of health-related physical education on academic achievement: Project SPARK. Research Quarterly for Exercise and Sport 70: 127-134. Satcher, D. 2002. Pound-foolish. Education Week. Satcher, D., and Bradford, M.T. 2003. Healthy schools, healthy kids: proper diet and exercise are keys to improving student achievement. American School Board Journal. Shephard, R.J. 1996. Habitual physical activity and academic performance. Nutrition Reviews 54(4 supplement): S32-S36. Shephard, R.J. 1997. Curricular physical activity and academic performance. Pediatric Exercise Science 9: 113-126. Shephard, R.J., Volle, M., Lavalee, M., LaBarre, R., Jequier, J.C., Rajic, M. 1984. Required physical activity and academic grades: a controlled longitudinal study. In: Limarinen and Valimaki, editors. Children and Sport. Berlin: Springer Verlag, 58-63. Symons, C.W., Cinelli, B., James, T.C., Groff, P. 1997. Bridging student health risks and academic achievement through comprehensive school health programs. Journal of School Health 67(6): 220-227. University of Utah. U Move with the Starzz. http://www.health.utah.edu/outreach/starzz.html U.S. Department of Health and Human Services. 2000. Healthy People 2010: Understanding and Improving Health. 2nd ed. Washington, DC: U.S. Government Printing Office. U.S. Department of Health and Human Services. 2001. The Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity.  U.S. Department of Health and Human Services/U.S. Department of Education. 2000. Promoting Better Health for Young People Through Physical Activity and Sport. Wang, G., and Dietz, W. 2002. Economic burden of obesity in youths aged 6 to 17 years: 1979-1999. Pediatrics 109: e81.