Inaccessibility of Exercise

It is widely accepted that widespread physical inactivity plays a role in the current high prevalence of excess weight. Physical activity, or exercise, may both prevent and reverse obesity. In addition, even when little or no weight loss occurs, regular physical activity can mitigate many of the detrimental health conditions associated with obesity. Unfortunately, most people do not get enough exercise even when they understand its benefits and would like to be more active. Studies have found that inaccessibility of exercise programs and places to exercise is a major barrier for many people. Exercise may be inaccessible for many reasons including lack of convenience, awareness, affordability, and appropriateness for age, culture, or ability.

National and international organizations such as the Centers for Disease Control and Prevention and the World Health Organization recognize the issue of exercise accessibility because improving access has the potential to influence entire populations, not just individuals. Public health is undergoing a paradigm shift toward approaches that promote physical activity by addressing structural and design factors in the environment, as well as personal and social factors. Along these lines, places to exercise include not just athletic facilities, health clubs, and sports fields. Current thinking encompasses a myriad of ordinary public places—parks, streets, trails, schools, waterfronts, and even indoor staircases—as places where people can be physically active regardless of income or ability. It also broadens the scope of exercise beyond push-ups and tennis to include such everyday activities as walking and bike riding for transportation as well as recreation, gardening, playing catch, and taking the stairs instead of the elevator. Such activities can be integrated into daily life more easily and less expensively than trips to the gym. Evidence is building that improving the actual and perceived availability, awareness, and appeal of public spaces would enable many more people to engage in “active living.”

Some segments of the population such as children, minorities, immigrants, people of low socioeconomic status, seniors, and people with activity limitations such as mobility disabilities and visual impairments are at particular risk for obesity as well as insufficient access to exercise. Therefore, increasing the accessibility of places to be physically active would benefit everyone, especially those who are currently at a disadvantage. For example, schoolchildren would benefit from more and better sidewalks, shorter distances to schools, and less trafficked streets, enabling a greater number to walk or bike to school. Communities with low incomes and ethnic disparities would benefit from free or low-cost exercise and recreation facilities including trails and parks, especially if culturally appropriate activities were featured.

[Page 394]As research continues to fine-tune knowledge about the role and characteristics of accessibility, efforts are already under way to act on the knowledge that already exists. Such efforts encompass a range of actions, from simply posting reminder signs to employees to take the stairs, to fundamental changes in policies and practices that govern the places where people can be more active. Some communities are implementing existing policies such as enforcing the mandated amount of physical activity required in school by hiring or training more staff and providing safe attractive school yards. Some are improving existing policies such as incorporating more bicycle lanes of a design that is more parent/child/senior friendly. Still others are enacting new policies such as guaranteed funding for parks or legislation giving tax breaks to employers who provide workplace fitness programs and facilities. These and other efforts, it is hoped, will combine to create activity-friendly communities that provide for more accessible exercise and thus increased physical activity.

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