Physical Inactivity: A Global Health Issue, Research Paper Example

Introduction

As globalization occurs at increasing ratios, significant shifts in international relations and behaviors are inevitable consequences.  Many are advantageous to the societies and governments so interacting, as advances in technology promote extensions of commerce.  Nonetheless, these same advances are also encouraging trends harmful to all populations.  More precisely, it seems the increased omnipresence of Western culture is generating heightened levels of physical inactivity on an international scale.  Exact figures are difficult to obtain, as what precisely defines physical inactivity is a matter of some debate.  In general terms, however, the prospect is not encouraging; in 2008, for example, it was estimated that nearly one-third of all adults aged 15 or older were physically inactive to a degree likely impacting on their health (WHO).  Societies evolve, not unexpectedly, to take advantage of new technologies reducing the need for human effort.  At the same time, this modernization brings with it a great deal of food highly processed, heavy in fat and sugar content, and invariably lacking in nutrition.

The cycle is then set in place, so to speak, and globally: people everywhere engage in lessened physical activity because the need is lessened and their diets do not promote it, and the minimal activity then discourages an increase, as the energy levels of the individuals decline.  Health is suffering, and internationally, with vast consequences to be explored in the following.  However, certain cultures and nations, globalization notwithstanding, reveal ideologies still in place that promote physical activity, and at levels the United States would do well to emulate.  If the U.S. is to truly fulfill its role as a Western model for other nations, its own culture must reexamine those practices and ideologies in place encouraging physical inactivity, and adopt those proving valuable within other nations, specifically in regard to Sweden.

Background

While there are important variations historically in regard to physical activity levels, it is reasonable to note one, relatively unchanging factor: simply, people are invariably more active when they are younger.  This is documented as true today as it has likely been since recorded history, for the inescapable reason that, with youth, there is pronounced physical energy present.  Recent studies in the U.S. affirm the reality; nearly two-thirds of adolescents engage in rigorous physical activity at least three times per week, as opposed to 16 percent of adults over the age of 18 (Gurung 230).  There are cultural and racial differences to be noted later, but the evidence universally supports the fundamental reality, in that children and young people are naturally inclined to expend more energy in physicality.

With regard to how physical activity has been perceived and conducted historically, the field is as varied and immense as may be anticipated.  Certain truisms are, in fact, validated by study, and the ancient Greek and Roman cultures of the West did indeed place an emphasis on the development of the human body.  As far back as 480 B.C.E., the Greek physician Herodicus incorporated concepts of physical concerns as reflecting aesthetic ideals with biological practicality, and introduced the idea of exercise as being purely therapeutic, as an agent to promote longer life and lessened illness (Dishman, Heath, & Lee  4).  In the East, and prior to this, ancient Sanskrit texts have been uncovered which endorse physical exercise as highly effective in combating rheumatism, as well as controlling diabetes.  Then, if the Middle Ages are perceived as an unenlightened epoch, there was nonetheless a carrying over of such precepts, and in both hemispheres.  In 1025 C.E., The Canon of Medicine, written by a Persian physician, was translated into Latin and introduced widely throughout Europe (Dishman, Heath, & Lee 5).  An entire chapter is devoted to walking, and with specific regard to geriatric concerns.

Ensuing centuries would see further examples of encouragement in the form of medical treatises disseminated widely.  In 1569, for example, the Italian Hieronymous Mercurialis published his Six Books on the Art of Gymnastics,  whose title belies a great deal of its groundbreaking content.  More exactly, these books reintroduced ideas in place today, in terms of physical exercise as a rehabilitative agent for the elderly and those recovering from injury.  What is important to note, however, is that Mercurialis’s work here was very much a response to Renaissance attitudes by no means embracing of physical exercise.  If the art of the Renaissance drew inspiration from idealized human forms, it seems the population was disinclined to personally pursue such goals for themselves, as the physicians of the day typically endorsed the least exertion as beneficial for health (Dishman, Heath, & Lee  5).  This seeming contradiction between societal practice and aesthetics, both fueled by and defied by medical advice, appears an ongoing facet of humanity’s course.  More precisely, the many centuries wherein physical exertion was both urged and refrained from indicate an unsurprising reality of the human condition; simply, people may appreciate the benefits of physical activity, but engaging in it is not felt to be a desirable thing.

In later years, it may be observed that isolated voices of physicians, certainly in the West, periodically emphasized an insistence on physical activity as a neglected health benefit.  In 1802, for example, a British doctor named William Heberden documented a case of a man recovering from heart disease, and thoughtfully observed that, through cutting wood by hand for half and hour every day, recovery was assured (Dishman, Heath, & Lee  6).  Generally speaking, however, public resistance was too strong, and cultural precepts did not attach actual significance to physical activity.  This would change following the Civil War years, for it was then that the medical community at large embraced the thinking that exercise was an effective means of promoting health.  It seems that what triggered this uniform endorsement was the acceptance of such activity serving as a preventive measure. By 1904 and the publication of Dr, Dudley Sargent’s Health, Strength, and Power, what had been a questionable ideology was established as a societal certainty, or credo.  This in itself would give rise to the modern epidemiology of physical activity, which is traced as commencing in the 1940s, and in the work of London’s Dr. Jeremy Morris (Dishman, Heath, & Lee  7-8).  Conceptions were now scientific fact, and research was undertaken greatly supporting that adherence to moderate physical fitness agendas provided benefits of a virtually unlimited scope, and particularly in regard to heart health.  That this understanding has been solidly in place, certainly in recent history and on an international scale, is critical in truly comprehending the difficulties in promoting physical activity today, the consequences of when this is ignored, and why certain societies surpass the U.S. in evincing a greater commitment to it.

Modern Circumstances

Assessing how physical activity is both practiced and perceived on an international level today is something of a challenge, and for more than one reason.  First and foremost, information gathering here is rendered problematic because different nations hold to different frameworks regarding activity parameters; what constitutes a recommended expenditure of activity in South Africa, for example, is at striking variance with a Japanese model.  Then, there are inevitable complications arising from age, gender, and socio-economic conditions; the culture that encourages passivity in women, for example, is inherently distanced in statistical terms from the culture promoting gender equality, just as poorer nations confront issues clearly affecting physical activity levels.  Nonetheless, recent efforts to establish a fundamental idea of just how physical activity is maintained internationally have yielded results, if of an unpromising character.  Between 2002 and 2004, a standardized protocol was created incorporating all variables from 20 countries, and the prevalence study emerging from it reveals interesting information.  Self-reporting from the surveyed participants provides, surprisingly, a relatively accurate representation of the results obtained non-subjectively.  For example, out of the 20 nations studied, the only reporting of physical activity conducted at moderate levels to reach 50 percent derives from Hong Kong, which is supported by findings of a greater activity level in China, in general.  New Zealand self-assessment reveals a minimal amount of moderate physical activity, but a percentage of a higher range exceeding 60 percent, which is confirmed by the objective findings.  Perhaps most strikingly, U.S. self-reporting is, in a word, bold; only 15 percent admit to low physical activity, while over 62 percent of the surveyed population asserts high or vigorous levels.  The reality of the subjective assessment, however, places the U.S. range at a midpoint (Bauman, Bull, Chey, Craig,  Ainsworth, Sallis, Bowles, Hagstromer, Sjostrom, & Pratt).

The study is valuable in more ways than one.  To begin with, it represents international concerns taking concrete action to obtain necessary information in regard to what an international issue.  Then, it presents a dilemma perhaps not fully addressed by modern nations, in that obesity levels are rising despite seemingly acceptable levels of physical activity.  It was made evident that all participating nations conduct practices encouraging activity, and few percentages reflect a truly dangerous lack of awareness or effort; China and India, for example, reveal the lowest percentages of intense activity, yet their moderate ranges are in keeping with other nations (Bauman et al).  Then, as noted, the immensity of China alone accounts for wide disparities, as Hong Kong citizens appear to engage in extensive physical activity to the degree they themselves report.  Nonetheless, the problem remains, and the authors of the study reach the only logical conclusion possible:  perceptions of what constitutes an adequate degree of physical activity must be inadequate, simply because obesity and other health issues resulting from insufficient activity are too prevalent (Bauman et al).  This seeming inevitability, or dilemma, goes very much to U.S. perceptions and realities as well.  As noted, there is a pronounced dichotomy between the two and, when even realistic activity levels are deemed lacking, it is all the more critical for the U.S. to shift its thinking and cultural practices.  The onus is as well multifaceted for, if the U.S., is to maintain its position as the leading entity of the West and consequently a vast influence over other cultures, it is as obligated to attend to physical activity for this reason as it is to secure the health of its own population.

Approaches and Refutations: Pros and Cons

On a basic level, and as has been extensively noted, physical inactivity is linked to issues with profound consequences for any society.  It also appears that Western nations are in the most serious danger, as at least 40 percent of men and 50 percent of women have been determined as engaging in insufficient activity (WHO).   The physical effects of such a lack are both widely known and less intently regarded.  It is universally accepted, for instance, that lessened physical activity presents potential health concerns, most of which are interrelated; with an absence of exercise comes obesity often, and obesity impacts on health in virtually all arenas.  The heart is strained and more vulnerable to disease, the likelihood of developing diabetes is increased, and the physical malaise created by this sort of inertia weakens the entire body, thus weakening the body’s natural defenses (Gurung 233)..  There are as well, however, crucial emotional and mental factors.  As there is no strict dichotomy between physical and mental well-being, lessened vitality in the former typically translates to diminished health of the latter.  More exactly, there is a substantial reason why people who engage in consistently moderate or vigorous activity assert that they generally “feel good”:  when the body is maintained properly, the cognitive and emotional processes must benefit.

It is also necessary to view this issue of physical inactivity in the U.S. through a wider lens, that of cultural and societal consequences.  On one level, and inescapably, the link between physical activity and illness is costly: “The direct costs of inactivity and obesity account for some 9.4% of the national health care expenditures in the United States” (Colditz).  What renders such figures all the more alarming is that these causal factors are completely preventable, as opposed to illness epidemics or other forms of disease.  The U.S. spends billions of dollars in combating the effects of physical inactivity and, the health considerations aside, the strain on the economy must harm the society.  Connected to this is the cultural factor of diet, and Americans notoriously exercise poor choices here.  Physical activity, in plain terms, promotes health by burning off excess caloric intake but, when a diet is suffused with fatty foods lacking in nutritional value, the activity faces two daunting challenges.  It must be more rigorous to attend to the higher fat and calorie levels, and it is typically less engaged in because a poor diet discourages exertion.  Then, another cultural repercussion arising from this combination of factors is a rise in eating disorders, which themselves are usually accompanied by excesses in physical activity (Gurung  226).  It is troubling and ironic that failure to attend to basic needs, such as diet and exercise, generate within the society such dangerous deviations related to both.

Consequently, it would seem that the U.S. is well-advised to take advantage of modern resources and turn for guidance to those nations and cultures that more effectively reflect physical activity.  It is important to note here that such a position by no means equates to a recommendation that the U.S. abandon its identity, or even most of what comprises its culture and foundations.  What matters, in fact, is that U.S. culture is inherently composed of multiple elements; consequently, seeking to enhance itself through the adoption of another society’s practices is perfectly in keeping with the nation’s own evolution.  This in mind, Sweden provides an excellent template, in regard to physical activity.  New Zealand, as noted, may seem to offer a better template, but Sweden is selected here primarily because, like the U.S., it represents essentially a Western culture.  Then, and the study to be cited temporarily aside, one fact strongly urges such a course: obesity in Sweden is at 9 percent, and at 30 percent in the U.S.  (Hagstromer, Troiano, Sjostrom, & Berrigan).  The conclusion is then irrefutable; however it happens, Swedes are more physically fit, which must in some measure derive from a difference in activity levels.

As to the study itself, which acknowledges the disparity within U.S. self-reporting and actual data, self-reporting was disregarded and a complex analysis was made between U.S. and Swedish men and women representing all age groups.  The findings reveal an interesting aspect, in that the Swedes typically spend more time in both sedentary and physically active pursuits, and this is true of both men and women (Hagstromer et al).  What forms the physical activity takes were deemed unimportant, although walking and running were acknowledged as common forms of exertion.  This is also a vital consideration, in regard to the recommendation that the U.S. investigate more thoroughly Sweden’s activity patterns.  More exactly, what is crucial here is not the nature of the activity, but that it occurs.  Clearly, there is in Sweden some element within the culture going to lifestyle, and one that promotes physical activity as, not a chore, but as a desirable norm.  It seems that in the U.S. the converse is true; many people openly profess to wanting to be fit, but the American culture has somehow, and insidiously, tainted the objective as disagreeable.

It may be then argued that, ostensible reasoning aside, the idea of the U.S. inculcating the habits of another society in this manner is unfeasible.  Cultures are organic entities, after all, and it is specious to assume that a single component of one, such as a widespread adherence to physical activity, may be neatly transferred to another.  Then, other obstacles arise, all going to societal differences easing activity in Sweden and hindering it in the U.S.  Sweden, for example, does not abide the the American ideology of work ethic, it may be said.  This is not to denigrate the nation, but rather to emphasize that, as Sweden is certainly less concerned with maintaining a stature as a major world power, its people live less pressured lives and are more free to attend to their personal needs.  Then, there exists the factor of topography; America is greatly urbanized, and offers less in the way of natural inducements to pursue activity.  Lastly, and not inconsequentially, it may be viewed as demeaning to U.S. sensibilities to turn to a “lesser” nation for guidance in any regard.

Fortunately for the future of physical activity in the U.S., these contrary points are easily diffused.  To begin with, and as noted, the U.S. has a long history of an actual reliance upon other cultures to forge its identity.  The entire approach here, in fact, reflects utilitarianism theory at its most pragmatic, as the history of the U.S. indicates the urgency of adopting varying cultural models as essential to its well-being.  With regard to the “modular” concern in obtaining a single element of Swedish life, it is inescapably true that Americans tend to embrace isolated influences, ranging from European fashions to Asian cuisines, and on a national level.  Then, if the U.S. is under pressures Sweden cannot comprehend, the incentive to adopt the latter’s better activity ideologies is all the more necessary, as it is equally important to recall that Swedes “relax” even longer than do Americans.  As for concerns regarding opportunities to engage in activity as hampered by American urbanization, the argument is immediately dismissed by the fact that such arenas afford even greater varieties of means to engage in fitness, from running parks to advanced health and fitness centers.  Finally, and blatantly, U.S. prestige itself can only be enhanced when its population better reflects ideals of health and wellness, as acknowledging a better way practiced elsewhere irrefutably demonstrates innate confidence and wisdom.

Conclusion

As globalization exponentially occurs, so too do serious concerns regarding the wellness of all people demand investigation, and physical inactivity remains a profoundly impactful factor in impeding this.  Different nations reveal different conditions, yet the issue is very much an international one.  This, however, enables action.  The U.S. suffers from high obesity levels, which promote disease, harm the economy, and generally impair the society as well as the individual.  With the advantages of today’s international interactions in place, it is also poised to identify, and then emulate, the course taken by a nation more successful in promoting physical activity: Sweden.  The U.S. would do well to thoroughly investigate what societal forces enable Sweden’s success in this arena, and then translate them into its own society.  In no uncertain terms,  the U.S. must reexamine those customs and ideologies in place that enable physical inactivity, and adopt what is effective in other nations, specifically that of Sweden.

Works Cited

Bauman, A., Bull, F., Chey, T., Craig, C. L., Ainsworth, B. E., Sallis, J. F., Bowles, H. R.,       Hagstromer, M., Sjostrom, M., & Pratt, M.  “The International Prevalence Study on Physical Activity: Results from 20 Countries.”  International Journal of Behavioral      Nutrition and Physical Activity  6.21 (2009):  6-21.  Web.  Retrieved from    http://www.ijbnpa.org/content/6/1/21

Colditz, C. A.  “Economic Costs of Obesity and Inactivity.”  Medicine and Science in Sports and Exercise  31.11 (1999): 663-667.  Web.  Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/10593542

Dishman, R. K., Heath, G. W., & Lee, I.  Physical Activity Epidemiology, 2^nd Ed. Champaign: Human Kinetics, 2012.  Print.

Hagstromer, M., Troiano, R. P., Sjostrom, M., & Berrigan, D.  “Levels and Patterns of Objectively Assessed Physical Activity—A Comparison Between Sweden and the United       States.” American Journal of Epidemiology  171.10  (2010): 12055-1064. Web. Retrieved from http://aje.oxfordjournals.org/content/171/10/1055.full

Gurung, R. A. R.  Health Psychology: A Cultural Approach.  Belmont: Cengage Learning, 2009. Print.

World Health Organization (WHO).  Physical Inactivity: A Global Public Health Problem.  2012. Web.  Retrieved from             http://www.who.int/dietphysicalactivity/factsheet_inactivity/en/index.html