Obesity-related health care costs in the United States for one year --- 2008 --- were an estimated $147 billion, according to a recent Centers for Disease Control study. That's nearly a quarter of what the latest health care reform proposal will cost over the next 10 years.
It seems clear that reforming the amount and quality of school-based physical education programs is fundamental to improving America's health care. Yet, this idea is conspicuously absent from the health care debate as overweight and obesity among both adults and youth reach epidemic proportions.
If schools are places where responsible citizenship is fostered, they should also have an obligation to help children develop the skills, knowledge and confidence necessary to maintain a healthy lifestyle that can prevent or reduce costly future health care.
PE is at the core of promoting healthy choices. A comprehensive school program includes PE, health education, healthy food options, recess for elementary school students, intramural sport programs and physical activity clubs, and interscholastic sports for high school students. Ideally, schools would also include physical activity breaks, walk/bike to school programs, appropriate physical activity in after-school child care programs, and staff wellness programs.
While preventative health care measures have been included in the Obama administration's proposals, none include school-based PE reform. When will health care reform focus on what should be done to prevent obesity-related illnesses?
A 2009 report from the California Center for Public Health Advocacy on the annual economic costs of physical inactivity, obesity and being overweight in California estimated that in 2006 physical inactivity cost $20.19 billion, being overweight and obesity $20.98 billion. That's more than $41 billion in economic costs for Californians alone.
The preponderance of these costs were shouldered by the public and private employers in the form of health insurance and lost productivity, the report said. But an estimated $612 billion could be saved by improving physical activity rates and healthy weight maintenance by only 5 percent over five years.
A seemingly simple solution, yes, but one that is missing a crucial component: People must learn how to move, value physical activity, make good food choices and avoid risky behavior. While this might occur outside of schools, improving school-based PE will increase the potential for American youth to learn and apply this information now and later, as adults.
Improving prevention measures such as PE is certainly cheaper than treating disease. Properly funded, supported and utilized, health-related PE is a nearly universal means to increase physical activity, curtail obesity rates and decrease the numbers of people who suffer from the multitude of diseases and lifelong health problems linked to obesity. While some say PE has no proven effect on children's health or long-term activity patterns, there is evidence clearly linking increased physical activity to lower disease risk.
The National Association for Sport and Physical Education's 2006 "Shape of the Nation Report" shows shocking underuse of PE by most states in the U.S. Only 8 percent of elementary schools, 6.4 percent of middle/junior high schools and 5.8 percent of high schools require daily PE. In spite of data revealing that 85 percent of parents and 81 percent of teachers believe that students should be required to take PE every day at every grade level, such programs are nonexistent in many places.
Think your child is getting the physical education he or she needs? Consider this: The Georgia state rule for the amount of health and physical education elementary students are to receive is 90 hours per year. Ask your child how many times a week he or she attends a PE or health class and calculate the time for the year. Many area schools allow for only 60 minutes of physical education a week. Over a 36-week school year that translates to only 36 hours per year --- 54 hours less than what the state recommends.
Some would claim the shortage is due to an "unfunded mandate" but that claim is misused. The real culprit is the emphasis on federal and state pressure for high-stakes testing and the impact those results have on teachers' jobs and salaries.
However, increasing the amount of PE alone is not the solution. The quality of PE students' need is glaringly omitted in anyone's talking points in the health care debate. Overcrowded gymnasiums, insufficient or outdated resources, and sometimes inhumane working conditions (no air conditioning in gyms when school begins in August) are archetypal for many PE programs.
Further, 33 percent of states reacting, again, to federal mandates for "highly qualified" teachers have relaxed licensure requirements for PE teachers. To help young people develop into physically educated individuals, a specialist with a body of knowledge and skills is needed in every school. The days of the ball-rolling, coffee-swilling, game-prepping PE "coach" have contributed to the current obesity rate increase.
Unlike any of the current proposals from those engaged in the health care reform debate, this is one solution with financial and preventative health ramifications that would actually benefit all involved, especially children. Given the dramatic rise of childhood obesity, the associated health consequences and derivative costs of obesity have also steadily risen. Failing to address school-based PE reform as a high priority item in health care reform is at best, ignorant, and at worst, societal suicide.
Bryan McCullick is an associate professor of physical education in The University of Georgia's College of Education and is research coordinator for the National Association for Sport and Physical Education.
Copyright 2009 The Atlanta Journal-Constitution