Regular physical activity has many positive health benefits, including protection against chronic disease, improved physical and mental health and cognitive function, and better health-related related quality of life. Moreover, lack of physical activity is associated with higher health care costs and utilization. Many Americans, however, do not get the recommended levels of physical activity. For Veterans, Veterans Affairs (VA) health care users are less likely to meet physical activity recommendations and more likely to be physically inactive compared with Veterans who do not use VA health care. Multiple personal, social, and environmental factors influence participation in physical activity. Providing memberships to fitness centers may be a viable option to increase physical activity and the positive health outcomes associated with such activity. Given that most Americans have access to some form of health insurance, health plan promotion of and coverage for fitness center memberships has the potential to address multiple barriers to physical activity (e.g., cost, access) and extend fitness center access to many Americans. Our objective in this evidence synthesis was to summarize the results of diverse studies of health plan-sponsored fitness center memberships in an effort to understand how these benefits affect physical activity, clinical outcomes, health care costs and utilization, retention of plan members, and member satisfaction.
Regular physical activity has many positive health benefits, including protection against chronic disease, improved physical and mental health and cognitive function, and better health-related related quality of life. Moreover, lack of physical activity is associated with higher health care costs and utilization. The current U.S. guidelines recommend that adult Americans (1) engage in at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity each week (or an equivalent mix of moderate- and vigorous-intensity aerobic activity) and (2) perform strengthening activities that target all major muscle groups on at least 2 days a week. However, many Americans do not get the recommended levels of physical activity. More Veterans are sufficiently active than non-Veterans. However, Veterans who use Veterans Affairs (VA) health care are more likely to be physically inactive (22.6% vs. 14.9%) and are less likely to meet physical activity recommendations (42.6% vs. 46.7%) compared with Veterans who do not use VA health care. Multiple personal, social, and environmental factors influence a person's participation in physical activity. Consequently, multiple internal and external barriers to obtaining regular physical activity exist. Internal barriers include a lack of time and motivation, health problems, and emotional difficulties. External barriers involve weather; cultural issues; safety concerns; limited access to facilities, equipment, and transportation; and monetary expenses such as those associated with attending a fitness center. The perceived cost of engaging in physical activity is a significant barrier that increases the likelihood of sedentary behaviors and decreases the likelihood of participation in vigorous physical activity. Thus, reducing the cost of being physically active through providing full or partial memberships to fitness centers may be a viable option to increase physical activity and the positive health outcomes associated with such activity. Given that most Americans (84%) have access to some form of health insurance, health plan promotion of and coverage for fitness center memberships has the potential to address multiple barriers to physical activity (e.g., cost, access) and extend fitness center access to many Americans. The effects of physical activity on health care utilization and costs, various health outcomes, and general well-being are well established. However, the evidence base on health plan-sponsored benefits—specifically involving fitness center memberships—that support these outcomes has not been synthesized. Our objective in this evidence synthesis was to summarize the results of diverse studies of health plan-sponsored fitness center memberships in an effort to understand how these benefits affect physical activity, clinical outcomes, health care costs and utilization, retention of plan members, and member satisfaction. The final key questions (KQs) were: KQ 1. What are the effects of policy/benefits packages that include vouchers, rebates, premium reductions, or other economic incentives to encourage physical activity through fitness center memberships on: (a) Physical activity participation rates among plan members? (b) Health outcomes demonstrated to be improved by physical activity (i.e., weight, pain, glucose, blood pressure, health-related quality of life)? (c) Overall health care costs and health care utilization? KQ 2. What are the effects of policy/benefits packages that include vouchers, rebates, premium reductions, or other economic incentives to encourage physical activity through fitness center memberships on satisfaction with the health plan and retention of members in the health plan? KQ 3. Do the effects of policy/benefits packages to encourage physical activity vary by specific characteristics of the package (premium vs. lump sum) or age, sex, and physical illness of participants?
Physical activity has far-reaching benefits for physical, mental, emotional, and social health and well-being for all segments of the population. Despite these documented health benefits and previous efforts to promote physical activity in the U.S. population, most Americans do not meet current public health guidelines for physical activity. Surveillance in public health is the ongoing systematic collection, analysis, and interpretation of outcome-specific data, which can then be used for planning, implementation and evaluation of public health practice. Surveillance of physical activity is a core public health function that is necessary for monitoring population engagement in physical activity, including participation in physical activity initiatives. Surveillance activities are guided by standard protocols and are used to establish baseline data and to track implementation and evaluation of interventions, programs, and policies that aim to increase physical activity. However, physical activity is challenging to assess because it is a complex and multidimensional behavior that varies by type, intensity, setting, motives, and environmental and social influences. The lack of surveillance systems to assess both physical activity behaviors (including walking) and physical activity environments (such as the walkability of communities) is a critical gap. Implementing Strategies to Enhance Public Health Surveillance of Physical Activity in the United States develops strategies that support the implementation of recommended actions to improve national physical activity surveillance. This report also examines and builds upon existing recommended actions.
The report investigates the characteristics of workplace wellness programs, their prevalence and impact on employee health and medical cost, facilitators of their success, and the role of incentives in such programs. The authors employ four data collection and analysis streams: a literature review, a survey of employers, a longitudinal analysis of medical claims and wellness program data from a sample of employers, and five employer case studies.
TRB Special Report 282: Does the Built Environment Influence Physical Activity? Examining the Evidence reviews the broad trends affecting the relationships among physical activity, health, transportation, and land use; summarizes what is known about these relationships, including the strength and magnitude of any causal connections; examines implications for policy; and recommends priorities for future research.
Physical inactivity is a key determinant of health across the lifespan. A lack of activity increases the risk of heart disease, colon and breast cancer, diabetes mellitus, hypertension, osteoporosis, anxiety and depression and others diseases. Emerging literature has suggested that in terms of mortality, the global population health burden of physical inactivity approaches that of cigarette smoking. The prevalence and substantial disease risk associated with physical inactivity has been described as a pandemic. The prevalence, health impact, and evidence of changeability all have resulted in calls for action to increase physical activity across the lifespan. In response to the need to find ways to make physical activity a health priority for youth, the Institute of Medicine's Committee on Physical Activity and Physical Education in the School Environment was formed. Its purpose was to review the current status of physical activity and physical education in the school environment, including before, during, and after school, and examine the influences of physical activity and physical education on the short and long term physical, cognitive and brain, and psychosocial health and development of children and adolescents. Educating the Student Body makes recommendations about approaches for strengthening and improving programs and policies for physical activity and physical education in the school environment. This report lays out a set of guiding principles to guide its work on these tasks. These included: recognizing the benefits of instilling life-long physical activity habits in children; the value of using systems thinking in improving physical activity and physical education in the school environment; the recognition of current disparities in opportunities and the need to achieve equity in physical activity and physical education; the importance of considering all types of school environments; the need to take into consideration the diversity of students as recommendations are developed. This report will be of interest to local and national policymakers, school officials, teachers, and the education community, researchers, professional organizations, and parents interested in physical activity, physical education, and health for school-aged children and adolescents.
The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.
