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The US is in the midst of a "physical inactivity" pandemic

Recent findings shed light on the relationship between physical inactivity, social vulnerability, unhealthy lifestyle behaviors, and health characteristics in the United States.

This comprehensive study, conducted by researchers from esteemed institutions, highlights the distinct geographic variances and disparities within the nation.

These findings support the adoption of precision medicine approaches to target specific groups of individuals and communities, aiming to alleviate these disparities and improve overall health outcomes.

The physical inactivity pandemic

Dr. Ross Arena is a leading expert from the University of Illinois Chicago’s College of Applied Science and the Founder of the Healthy Living for Pandemic Event Protection (HL–PIVOT) Network in Chicago.

Ross emphasizes the urgency of the situation, stating, “The findings of the current investigation indicate a crisis within a crisis with respect to a physical inactivity pandemic in the US. On a national level, physical activity is unacceptably low and has not appreciably improved over the past decade, while high levels of social vulnerability and physical inactivity are concentrated in specific geographic regions.”

Engaging in regular physical activity contributes not only to one’s healthspan but also to their lifespan, known as “healthy longevity”. Even small increases in activity can have significant positive effects on an individual’s overall health and well-being.

However, the COVID-19 pandemic, with its social distancing measures and stay-at-home orders, has led to a reduction in physical activity levels for many Americans.

Social vulnerability and physical inactivity

To delve deeper into the relationship between social vulnerability and physical inactivity, researchers conducted a spatial analysis comparing county-level data on physical inactivity prevalence with the Social Vulnerability Index (SVI).

The study also took into consideration the unique regional cultures in the United States, as defined by the American Nations model. The in-depth statistical analysis yielded several important findings:

  • Social vulnerability significantly influences the prevalence of physical inactivity in the United States, particularly when it is associated with socioeconomic status and household characteristics.
  • The American Nations model revealed clear and statistically significant heterogeneity in social vulnerability across distinct regions of the United States. Similar to the well-known “stroke belt,” there is evidence of a “social vulnerability belt” sweeping across a large portion of the southern US region. Additionally, northern and western Alaska are areas of concern.
  • The distribution of the Social Vulnerability Index (SVI) aligns considerably with the prevalence of physical inactivity, suggesting a regional cultural influence on these adverse phenomena.
  • High levels of social vulnerability and physical inactivity are concentrated within specific geographic regions, indicating the need for tailored solutions to address health disparities.

Complex factors that influence lifestyle

The study emphasizes that external factors influencing lifestyle choices are heterogeneous. Cultural and geographic overlays, historical effects from early settlers, and competing migration patterns of settler-colonizers have laid the foundation for diverse cultural traditions, as well as varied political and socioeconomic preferences.

The investigators stress that traditional health messaging and individual counseling approaches to address the physical inactivity crisis have suffered from an all-or-none approach.

Co-investigator Dr. Nicolaas P. Pronk, President and Chief Science Officer of HealthPartners, Bloomington, MN, highlights the need to consider influencing factors. He states, “Typically, we’ve said, ‘Being physically active is good for everyone and hence all people should be more physically active and exercising 150 minutes or more per week on most if not all days of the week at a moderate intensity is ideal.’ Little attention is paid to factors that influence a person’s decision to be physically active.”

Co-investigator Colin Woodard, Director of the Nationhood Lab at Salve Regina University’s Pell Center for International Relations and Public Policy in Newport, RI, adds that historical and cultural drivers of physical inactivity have often been overlooked.

He emphasizes the importance of understanding what truly motivates behavioral change, stating, “Our goal with this study is to start getting to the bottom of what really motivates behavior and behavior change. Data-driven intelligence and the work of historians and cultural geographers can help us find the best ways to encourage healthy lifestyle choices and ultimately make people healthier.”

Physical inactivity and precision medicine

Dr. Arena concludes by emphasizing the significance of considering social vulnerability and regional characteristics when designing physical activity health promotion campaigns and tailoring individual counseling.

He states, “Our findings indicate social vulnerability and deep-seated characteristics of the United States’ distinct regions are likely influencing physical activity decisions. These factors should be considered when designing physical activity health promotion campaigns and tailoring individual counseling. We need to figure out how to help specific communities and individuals make behavior changes. What tools do they need? What messaging will resonate with them? It’s time to apply a precision medicine approach to healthy living medicine.”

In summary, this study highlights the detrimental effect of increased social vulnerability on unhealthy lifestyle behaviors, physical inactivity, and health characteristics in the United States. By recognizing the unique geographic variances and disparities and adopting precision medicine approaches, it is possible to target specific groups and communities, ultimately reducing health disparities and improving overall health outcomes.

Through a comprehensive understanding of the factors influencing behavior and the deployment of tailored solutions, we can promote healthier lifestyle choices and pave the way for a healthier nation.

The full study was published in the American Journal of Medicine.


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