The Urgent Need to Combat Physical Inactivity 

Physical inactivity has created a public health crisis with far-reaching implications for physical and mental health, including national security. Being more physically active is imperative to creating a more resilient future for generations to come.

An unrecognized crisis is stealthily impacting our health and well-being, and even our national security. Sedentary lifestyle, or physical inactivity and its consequences are significant for individuals and our nation as a whole. Our inactive lifestyles are not just a personal choice but a public health crisis with far-reaching implications. 

 Only 24% of US adults and only 1 in 5 adolescents meet the US Physical Activity Guidelines for aerobic and muscle strengthening activity with existing disparities across income, age, sex, education and race/ethnicity. In terms of our youth, the 2024 United States Report Card on Physical Activity for Children and Youth reported its overall physical activity grade for children and youth remained low at D-, the same grade it received in 2022, the last time a report was made.  Over the past decade, the prevalence of physical inactivity has remained “unacceptably high,” according to a study in The American Journal of Medicine, despite continued efforts to improve fitness at individual and population levels. The ramifications of this inactivity epidemic are staggering in terms of human suffering and financial unsustainability. The growing prevalence of inactivity now even threatens U.S. national security, affecting recruitment eligibility and active-duty readiness. 

Skyrocketing rates of chronic disease such as obesity, cardiovascular disease, type 2 diabetes, and mental health disorders are just part of the picture. Studies have found decreased hip mobility as the result of inactivity is one of the main reasons that older people tend to fall, often with catastrophic outcomes. Researchers from UCLA discovered that adults without dementia who spent more time sitting in the day had greater thinning of the medial temporal lobe, an area of the brain that is important for making memories.  

Beyond the toll on individual health, physical inactivity exacts a heavy toll on individuals’ pocketbooks, healthcare systems, and national economies. The World Health Organization estimates that physical inactivity costs global healthcare systems billions annually. The Centers for Disease Control and Prevention (CDC) says $117 billion in annual U.S. health care costs are related to low physical activity. 

Lost productivity due to absenteeism and decreased workplace performance further exacerbates the economic strain. Moreover, marginalized communities often bear the brunt of this burden, facing disproportionate barriers to active living infrastructure and other supports for physical activity and suffering from compounded health disparities. 

Physical inactivity is not merely a matter of personal choice; it’s a complex interplay of societal, environmental, and individual factors. From the layout of our communities that discourages walking or cycling to the proliferation of screens that tether us to our seats, today’s landscape is rife with obstacles to an active lifestyle. 

The time to address this crisis is now, and the solutions will require a collective effort that spans governments, communities, businesses, and individuals. It demands a paradigm shift. 

Change will require a whole-of-government approach to instituting policies and structures that tilt the landscape in favor of physical activity. We must reshape our built environments to prioritize movement, recognizing and addressing the social drivers that are barriers to access and safety. Municipal planning should prioritize pedestrian-friendly spaces, cycling lanes, and green areas that invite people to move. Schools must reinstate comprehensive school physical activity programs as a core component of the school day, fostering active habits from an early age and improving student learning and academic performance. Employers can play a pivotal role by promoting healthy physical activity in work environments and policies. Physicians and other health professionals must be trained in exercise prescription and must be reimbursed for integrating assessment, prescription and referral into patient care. Our military must develop and implement evidence-based physical activity programs as part of a team-based approach to improving physical fitness, in order to reduce the incidence and prevalence of musculoskeletal injuries, mental illness, and chronic disease. 

Empowering individuals with knowledge about the benefits of physical activity and providing access to affordable, safe recreational opportunities are also crucial steps. Becoming more active does not need to be overwhelming. Regular physical activity can include sports and other physical activities that move your body and expend energy. Physical activity can even include active transportation like walking to work, gardening, or parking farther away to business entrances. 

Leveraging technology for good can help counteract the sedentary trends it often perpetuates. From fitness apps that gamify exercise to virtual reality experiences that make physical activity immersive and engaging, technology can be a powerful ally in the fight against physical inactivity. 

We must embrace a culture that prioritizes physical activity as an unquestioned cornerstone of health, well-being, and happiness. And this needs to start at the top. 

In honor of National Sports and Fitness Month, in May 2024 more than 400 bipartisan Members of Congress and their staff participated in the Physical Activity Alliance (PAA)’s fourth annual Congressional Physical Activity Challenge, a friendly competition to bring legislative awareness to the issue. The event is just one of the ways the PAA, the nation’s largest coalition dedicated to improving health and well-being through physical activity, is working collaboratively with its members to make the active choice the easy choice.  

ACLM has been supporting the work of the PAA since 2020, sharing information with our members about the PAA’s work and engaging in regular member meetings. We have incorporated the validated exercise vital sign (EVS) into our Lifestyle Medicine Short Form assessment tool and also have connected the PAA with LM clinicians across the country who are incorporating exercise assessment and prescription into clinical practice. We are also leveraging the PAA’s HL7 FHIR interoperability guide, used to facilitate the exchange of electronic health information between systems, in our work to build lifestyle medicine into electronic health records. 

The time for action is now. The stakes are high, but the rewards of a more active, vibrant society are immeasurable. Together, let us rewrite the narrative of physical inactivity, shaping a healthier, more resilient future for generations to come.