Research Quarterly for Exercise and Sport
ISSN: 0270-1367 (Print) 2168-3824 (Online) Journal homepage: http://www.tandfonline.com/loi/urqe20
The Role of School Physical Education in Public Health Harold H. Morris To cite this article: Harold H. Morris (1991) The Role of School Physical Education in Public Health, Research Quarterly for Exercise and Sport, 62:2, 143-147, DOI: 10.1080/02701367.1991.10608703 To link to this article: http://dx.doi.org/10.1080/02701367.1991.10608703
Published online: 26 Feb 2013.
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Date: 03 November 2015, At: 07:56
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Research Quarterlyfor Exerciseand Sport
© 1991bythe American Alliance for Health, Physical Education, Recreation and Dance Vol. 62, No. 2, pp.143·147
The Role of School Physical Education in Public Health Harold H. Morris
Downloaded by [University of Otago] at 07:56 03 November 2015
Key words: physical activity, physical education, public health, exercise
M
Ost students in elementary and secondary schools in the u.s. take physical education (Ross, Dotson, Gilbert, & Katz, 1985; Ross, Pate, Corbin, Delpy, & Gold, 1987). The objectives of school physical education have been delineated by numerous authors (e.g., Bucher & Wuest, 1987) and include the acquisition of various psychomotor skills, knowledge, and psychosocial perspectives as well as physical fitness. Sallis and McKenzie (1991) indicate "the public health community is increasingly interested in the potential contributions of school physical education to child health." They specify "the public health goal for physical education is to prepare children for a lifetime of regular physical activity" (p. 133). From the view of many professionals, the goal advocated by Sallis and McKenzie is implicit in the objectives of physical education. For example, Siedentop, Mand, and Taggart (1986) state, "health-related fitness is of major importance to the well-being of our society and a necessary elemen t in physical education programs" (p.22). In addressing the perspectives Sallis and McKenzie have advanced, it is important to restate accepted definitions of health and public health. The World Health Organization has defined health as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity" (Breslow, 1990, p. 9). Public health is "dedicated to the common attainment of the highest level ofphysical, mental and social well-being and longevity consistent with available knowledge and resources at a given time and place" (Hanlon & Pickett, 1979, p. 4). The recently released Healthy people 2000: National health promotion and disease prevention objectives (USDHHS, 1990) outlines the public health goals for the United States for the year 2000; it includes 298 objectives organized into 22 priority areas. Under physical activity and
Harold H. Morris is a professor andchairperson of theDepartment of Kinesiology at Indiana University-Bloomington. He is the current president of theAmerican Alliance for Health, Physical Education, Recreation andDance anda former president of the Research Consortium ofAAHPERD.
ROES: June 1991
fitness, the first priority area, 12 objectives have been enumerated. Among these are Objectives 1.8 and 1.9, which specifically address school physical education. 1.8 Increase to at least 50 percent the proportion of children and adolescents in 1st through 12th grade who participate in daily school physical education. (Baseline: 36 percent in 1984-1986) 1.9 Increase to at least 50 percent the proportion of school physical education class time that students spend being physically active, preferably engaged in lifetime physical activities. (Baseline: Students spent an estimated 27 percent of class time being physically active in 1984) According to Sallis and McKenzie, these objectives were developedwith the input ofa "few interested physical educators" but without the input, development, and promotion ofany organization representing the physical education profession. These objectives are consistent with the call for a public health goal for physical education made by Sallis and McKenzie and support both more time for and a change in current physical education programs. Although the objective of increased physical activity will, no doubt, be endorsed by professional physical educators, it will represent a change of emphasis in various school physical education programs (Ross et al., 1985,1987). Sallis and McKenzie indicate the objective of increased physical activity should be accompanied by the objective of activity planning skills, but these objectives should notreplace current goals; they should expand the current physical education program. Further, they recommend physical educators debate this issue and COnductresearch on the effects ofhealth-oriented programs. Is there sufficient evidence to support this change in focus-that is, can physical education programs produce changes in student behaviors thatwill ultimately result in improved adult health? A conceptual model forwarded to describe the possible causal relationships between childhood exercise and adult health (Blair, Clark, Cureton, & Powell, 1989) is illustrated in Figure 1. The double arrows between exercise and health indicate these variables can influence each other (i.e., increasing
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Morris
the level ofexercise is expected to improve health and an improvement in health would enable a greater capacity for exercise). The single direction arrows between childhood exercise or childhood health and adult exercise and adult health imply long-term benefit ofa healthy childhood that featured adequate physical activity.
Downloaded by [University of Otago] at 07:56 03 November 2015
The Benefits of Physical Activity The health benefits of regular physical activity have been well documented, especially for adults. In a 1960 review of over 100 studies, Hein and Ryan (1960) concluded: (a) exercise can playa role in preventing obesity and preserving the physical characteristics ofyouth, and (b) a high level of activity throughout the lifespan can inhibit vascular degeneration. In his recent review of the literature Blair (1988) concluded the evidence "strongly supports the beneficial impact ofprolonged exercise and physical activity on various measures of disability, functional capability, morbidity, and mortality" (p. 479). Certain studies are worthy of note, including the Harvard Alumni Study, which found a weekly physical activity expenditure of 2,000 kcal was associated with both decreased risk of disease and increased longevity (Paffenbarger, Hyde, Wing, & Hsieh, 1986). In the sevenyear Multiple Risk Factor Intervention Trial over 12,000 men in the upper 15% of risk factors for cardiovascular disease were studied for seven years (Leon, Connett, Jacobs, & Rauramaa, 1987). Energy expenditure was calculated from data obtained via interviews; a moderate level of exercise was associated with a significant reduction in death by coronary heart disease, in the rate of death by sudden death, and in the all-causes death rate. From another perspective, cardiovascular fitness was found to be related to a reduction in absenteeism, and the relationship remained significant after adjusting for
Figure 1. Conceptual model of how childhood exercise habits may affecthealth throughoutlife (a rrowsindicatepossible relationships).
Childhood Exercise
! Adult Exercise
.. ..
.,
Childhood Health
!
•
Adult Health
Note. From "Exercise and Fitness in Childhood: Implications for a lifetime of health" by S. N. Blair,D. G. Clark, K. J. Cureton, and K. E. Powell, 1989. In C. V. Gisolfi & D. R. Lamb, Perspectives in Exercise ScienceandSports Medicine, vol. 2. Youth Exercise andSport(p. 402). Indianapolis, IN: Benchmark Press.
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such factors as age, gender, and income (Tucker, Aldana, & Friedman, 1990). This sustains the findings of Cox, Shephard, and Corey (1981), who reported moderate differences in absenteeism when comparing participants with nonparticipants in a worksite fitness program. In view of the literature, there is considerable support for the relationship between adult exercise and adult health as outlined in the Blair et al. (1989) model, represented in Figure 1.
Childhood Exercise andFitness The model presented by Blair et al. (1989) includes a relationship between childhood exercise and childhood health parallel to that established between adult exercise and adult health. Does the literature support such a relationship in children?
Assessment of Childhood Activity To establish a relationship between physical activity and health requires the capacity to accurately measure or assess each of these variables. Assessment of physical activity is beset by various problems outlined by LaPorte, Montoye, and Caspersen (1985) and Caspersen (1989). These difficulties include the diversity of operational definitions of what constitutes physical activity and the absence of assessment instruments that can be used in studies with validity and reliability. Further, in the case of studying the relationship between physical activity and health, measurement procedures must be sensitive to the health-related components of physical activity. Studies measuring physical activity in young children in large population surveys are limited because children are not as conscious of elapsed time as adults, and, therefore, self-report data are of questionable validity for this subpopulation (Simons-Morton, O'Hara, SimonsMorton, & Parcel, 1987). Efforts have recently been made to improve the procedures for assessing physical activity in children (Baranowski et al., 1984; Noland, Danner, DeWalt, McFadden, & Kotchen, 1990; O'Hara, Baranowski, Simons-Morton, Wilson, & Parcel, 1989), but further research on this topic is needed.
HowActiveandFitAre Children? According to Sallis and McKenzie (1991), "Among professionals and the lay public there has been widespread concern about the fitness ofAmerican children" (p.125). This is true, butthenecessityofthis concern has been considered by Blair et al. (1989). They concluded few close examinations were made of the data that labeled children in the U.S. unfit (e.g., the nature of the measures used in many of the studies can be questioned as to the ability to assess health-related fitness). Further their view is that much ofthe concern about the fitness of
ROES: June 1991
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Morris
children in the U.S. is based on comparisons with children of other countries rather than on whether our youth possess an adequate level of fitness. In contrast, the results of a year-by-year assessment of the fitness levels ofchildren using the AAU Physical Fitness Testinclude the findings that the age-adjusted bodyweight of children in the schools of the U.S. has been increasing with no commensurate increase in height (Updyke, 1989) . Although no assessment was made oflean body mass, the increase in bodyweightwasaccompanied by an increase in the time required to complete an endurance run (i.e., a decrease in circulorespiratory endurance). Further, the proportion ofstudents that reached the minimal standards (based on four required tests) declined over the decade from 43 to 32%, apparently due to the decline in performance on the endurance run. With regard to the level of activity children exhibit, Hovell, Bursick, Sharkey, and McClure (1978) studied 274 third through sixth grade students during recess. Observations of activity levels were made every 5 s and rated as inactive, moderate, or vigorous. Students were found to be physically active only 60% of the recess period, leading the authors to conclude "children do notvoluntarily engage in sufficient aerobic activity during recess" (p. 460). Sallis, Patterson, McKenzie, and Nader (1988) observed 33 fouryear-olds during a 30-min unstructured recess atpreschool. The students engaged in moderate and vigorous activity 42% ofthe time and were classified as exhibiting sedentary behavior 58% of the time. Blair et al. (1989) analyzed the data from the National Children and Youth Fitness Study I (Ross et al., 1985). The energy expenditure values for each of the activities in which children reported participating were multiplied by the timespentin that activity per day. These values were used to calculate an estimate of the energy expended per day. The students were categorized as active if their energy expenditure level equaled or exceeded the approximate level found by Leon etal. (1987) and Paffenbarger et al. (1986) to be sufficient for a reduction in coronary heart disease. Of those students with complete activity data, 88% of the girls and 94% of the boys were classified as active. The literature is equivocal with regard to the fitness and activity levels of children, primarily because of variation in the operational definitions and measuremen t procedures used to assess these variables. Without agreement on whether youth possess an acceptable level of physical fitness or whether they maintain an adequate level of activity, establishing a verifiable relationship between childhood activity and childhood health is impossible.
Childhood Activity andAdult Health The Blair etal. (1989) model implies a causal effect of childhood exercise and childhood health on adult
ROES: June 1991
health. It also implies an effect of childhood health and exercise level on adult exercise, which, as the previously reviewed literature sustains, is related to adult health. This aspect of the model is congruent with the hypothesized public health benefits of a health-related physical education program (Sallis & McKenzie, 1991). Sallis and McKenzie indicate childhood risk factors are predictors of risk factor levels in later life and physical activity is an appropriate intervention in childhood obesity and a factor in the uptake of calcium in the bones, as well as in the development of muscular strength and flexibility. Cardiovascular disease (CVD), however, accounts for the largest number of deaths in the U.S. each year, and the relationship between physical activity and CVD has been well established. If the level of exercise influences adult exercise, it can directly or indirectly affect health during the adult years. Although this is an attractive hypothesis, SimonsMorton et al. (1987) state there is little evidence as to what type of physical activity is likely to assure adult participation.
Physical Education, Physical Fitness, and Physical Activity The challenge Sallis and McKenzie present to physical educators is to "adopt a new role and pursue a public health goal for physical education. "Theyadvocate physical educatorsjoin with other public health officials to prepare students for a lifetime of physical activity. Although this objective is implicit in mostphysical education programs, it is less certain the curriculum and methods appropriate to assure its accomplishment are regularly employed. Teachers vary in what they believe is the most important objective for physical education. In a survey of teachers who used the AAU Physical Fitness Test in their classes, 46% listed physical fitness as their primary objective; motor ability was the choice ofan additional 34% (Updyke, 1989). Even more interesting was that 60% of the teachers considered the enhancemen t ofself-esteem the primary outcome ofphysical fitness and 34% believed the preven tion of disease was the primary benefit. Is selfesteem an important casual link in the development of habits of regular physical activity (cf, Fox, 1988), or should teachers be primarily oriented to the disease prevention aspects of physical activity? At what grade level should the concepts of the relationship between physical activity and disease be introduced? And how much emphasis should be given to the development of motor skill? The findings of the National Children and Youth Fitness Studies I and II (Ross et al., 1985, 1987) were fundamental to the development of Objectives 1.8 and 1.9 ofthe health promotion objectives, Healthypeople 2000 (USDHHS, 1990). The intent of Objective 1.9 is to increase to 50% the proportion of the time students spend being physically active in school physical educa-
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tion classes. It has been reported that in school physical education only 27% of the class period was spent in physical activity, with instruction, administrative tasks, and waiting occurring 26,22, and 25% of the remaining time, respectively (Siedentop, 1983). Unfortunately, a lack of instructional equipment, inadequate facilities, and large classes, and a wide range of children's skill and fitness levels can confound the instructional task. In view of this finding physical educators are encouraged to examine their instruction practices to provide more time for physical activity. A quality physical education program can make a difference. A recently reported two-year study compared the effects of a daily physical education program using a developmental movemen t approach with an every-otherday traditional physical education program (Carlisle, Cole, & Steffen, 1991). The students began the program as kindergartners and continued throughout the first grade. Although the primary focus was on the acquisition ofmature fundamen tal movement patterns, at the end of the first grade students in the daily program were found to be superior in fitness measures and to have higher selfconcept scores as well as having established more mature fundamental movement patterns. Unfortunately, only about 36% of the children in the U.S. participate in daily school physical education (RossetaI., 1985,1987). These findings were cited in the development of the Objective 1.8 of Healthy people 2000, the intent ofwhich is to increase to a minimum of50% the proportion of school children who participate in daily physical education. Since the average elementary school physical education class meets for 33.4 min (Ross et aI., 1987), it follows that a large portion of the school children in the U.S. do not have sufficient time in physical education class each week to accomplish commonly accepted objectives. One suggestion is to include a daily 20-min fitness program for the entire school as an extension of the physical education program (Siedentop etal., 1986).
Physical Education andPublic Health The call by Sallis and McKenzie for physical educators to pursue a public health goal for school physical education and to join other public health professionals in the pursuit of improved health for the citizens of the U.S. is both appropriate and timely. Although the current literature is equivocal regarding the causal links between childhood exercise and adult health, a hypothesis that includes such a link is attractive, given the established relationship between adult exercise and adult health. To maximize the effectiveness of school physical education programs in the long-term prevention ofCVD, it is appropriate they be linked with other programs that have a similar intent. Examples ofsuch programs include Moving Children: Healthy Children Project (Elliot, Tehan, & Leach, 1990); Heart Smart (Downey, Cresanta,
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& Berenson, 1989); and Child and Adolescent Trial for
Cardiovascular Health (CATCH) (Perry et aI., 1990). The Jump-Rope-For-Heart program, jointly sponsored by the American Heart Association and the American Alliance for Health, Physical Education, Recreation and Dance, is another example of how physical education programs can be linked with another agency for mutual benefit. In a similar vein, Green (1988) and Mason (1989) have advocated linking school health education programs with various agencies outside the school. The proposed joint projects would involve the participation of both health and physical educators and the school medical staff. If a public health goal is adopted for school physical education, professional physical educators will find themselves joined with a variety of professions that have a broad objective ofimproving the health of the citizenry of the U.S. Physical educators will identify a number of other threats to the health of the youth of this country, threats they as professionals can assistin reducing (Blum, 1987). In addition to understanding the objectives of Healthy people 2000, every educator should understand the implications of Code blue, the report of the National Commission on the Role of the School and the Community in Improving Adolescent Health (1990). If the important role physical educators can play in improving health is better understood by public health professionals, support for quality physical education programs will increase.
References Baranowski, T.,Dworkin, R.]., Cieslik,C.J., Hooks,P., Clearman, D. R., Ray, L., Dunn,]. K., & Nader, P. R. (1984). Reliability and validityofself report of aerobic activity: Familyhealth project. Research Qy,arterlyforExercise and Sport, 55, 309-317. Blair, S. N. (1988). Exercise, health, and longevity. In D. R. Lamb & R. Murray (Eds.), Perspectives in exercise science and sports medicine, uol: 1. Prolonged exercise (pp. 443449). Indianapolis, IN: Benchmark Press. Blair, S. N., Clark, D. B., Cureton, K.]., & Powell, K. E. (1989). Exercise and fitness in childhood: Implications for a lifetime of health. In C. V. Gisolfi & D. L. Lamb (Eds.), Perspectives in exercise science and sports medicine, voL 2. Youth, exercise, and sport (pp. 401-430). Indianapolis, IN: Benchmark Press. Blum, R. (1987). Contemporary threats to adolescent health in the United States.JournaloftheAmericanMedicalAssociation, 257, 3359-3390. Breslow, L. (1990). A health promotion primer for the 1990's. Health Affairs (Summer): 6-21. Bucher, C. A., & Wuest, D. A. (1987). Foundations of physical education (LOth ed.). St. Louis: Times Mirror/Mosby. Carlisle, C. S., Cole, S., & Steffen,]. (1991,January). The effects of a two year quality daily physical education program on the achievement ofmature movement patternsin six and sevenyear
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old children. Paper presented at the annual meeting of the National Association for Physical Education in Higher Education, Atlanta, Georgia. Caspersen, C.]. (1989). Physical activity epidemiology: Concepts, methods, and applications to exercise science. In K B. Pandolf (Ed.), Exercise and sports sciences reviews, vol. 17. Indianapolis, IN: Benchmark Press. Cox, M., Shephard, R, & Corey, P. (1981). Influences of an employee fitness programme upon fitness, productivity and absenteeism. Ergonomics, 24,795-806. Downey, A. M., Cresanta,]. L., & Berenson, G. S. (1989). Cardiovascular health promotion in children: "Heart Smart" and the changing role of physicians. American Journal ofPreventive Medicine, 5, 279-295. Elliot, M., Tehan,]., & Leach, K (1990). The moving children project A conceptual, process-oriented model for skills development in children. Journal ofSchool Health, 60, 397417. Fox, K R (1988). The self-esteem complex and youth fitness. Qy,est, 40, 230-246.
Green, L. W. (1988). Bridging the gap between community health and school health. AmericanJournal ofPublic Health, 78,1149. Hanlon,].]., & Pickett, G. E. (1979). Public health. St. Louis: Mosby. Hein, F. V., & Ryan, A.]. (1960). The contribution of physical activity to physical health. Research Qy,arterly, 31, 263-285. Hovell, M. F., Bursick.]. H., Sharkey, R, & McClure,]. (1978). An evaluation of elementary students' voluntary physical activity during recess. Research Qy,arterly, 49,460-474. LaPorte, R E., Montoye, H. j., & Caspersen, C. J. (1985). Assessment of physical activity in epidemiologic research: Problems and prospects. PublicHealth Reports, 100, 131-146. Leon, A. S., Connett,]., Jacobs, D. R, & Rauramaa (1987). Leisure-time physical activity levels and risk of coronary heart disease and death. The multiple risk factor interven tion trial. Journal ofthe American MedicalAssociation, 258, 2388-2395. Mason.]. O. (1989). Forging working partnerships for school health education. Journal ofSchool Health, 59, 18-20. National Commission of the Role of the School and the Community in Improving Adolescent Health. (1990). Code blue: Uniting for healthier youth. Alexandria, VA: National Association of School Boards of Education. Noland, M. P., Danner, F., DeWalt, K, McFadden, M., & Kotehen,J. M. (1990). The measurementofphysical activity in young children. Research Quarterly for Exercise and Sport, 61,146-153. O'Hara, N. M., Baranowski, T., Simons-Morton, B. G., Wilson, B. S., & Parcel, G. S. (1989). Validity of the observation of
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children's physical ac tivity. Research QJi,arterlyfor Exerciseand Sport, 60, 42-47.
Paffenbarger, R S.,Jr., Hyde, R T., Wing, A. L., & Hsieh, C. C. (1986). Physical activity, all-cause mortality, and longevity ofcollege alumni. NewEnglandJournalofMedicine, 314, 605613. Perry, C. L., Stone, E.]., Parcel, G. S., Ellison, R. C., Nader, P. R, Webber, L. S., & Luepker, R V. (1990). School-based cardiovascular health promotion: The child and adolescent trial for cardiovascular health (CATCH). Journal of School Health, 60,406-413.
Ross,]. G., Dotson, C. 0., Gilbert, G. G., & Katz, S.]. (1985). What are kids doing in school physical education? Journal ofPhysical Education, Recreation, andDance, 56(1),32-34. Ross,]. G., Pate, R R, Corbin, C. B., Delpy, L. A., & Gold, R. S. (1987). What is going on in the elementary physical education program? Journal ofPhysical Education, Recreation, and Dance, 58(9), 78-84. Sallis.]. F. (1987). A commentary on children: A public health perspective. Research Qy,arterlyforExercise and Sport, 58, 326330. Sallis.]. F., & McKenzie, T. L. (1991). Physical education's role in public health. Research Qy,arterlyforExercise and Sport, 62, 124-137. Sallis, J. F., Patterson, T. L., McKenzie, T. L., & Nader, P. R. (1988). Family variables and physical activity in preschool children. Journal ofDevelopmental and Behavioral Pediatrics, 9,57-61. Siedentop, D. (1983). Developing teaching skills in physical education. Palo Alto, CA: Mayfield. Siedentop, D., Mand, C., & Taggart, A. (1986). Physical education: Teachingand curriculum strategiesforgrades 5-12.Palo Alto, CA: Mayfield. Simons-Morton, B. G., O'Hara, N. M., Simons-Morton, D. G., & Parcel, G. S. (1987). Research Quarterly for Exercise and Sport, 58, 295-302. Tucker, L. A., Aldana, S. G., & Friedman, G. M. (1990). Cardiovascular fitness and absenteeism in 8,301 employed adults. AmericanJournal ofHealth Promotion, 5, 140-145. U.S. Department ofHealth and Human Services. (1990). Healthy people 2000: National health promotion and disease prevention and disease prevention objectives. (Stock Number 017-001-
00474-0) Washington, D. C.: U.S. Government Printing Office. Updyke, W. F. (1989). Fitness trends in a large population of610 year old children 1980-1989. (A summary report of the Chrysler-AAU Physical Fitness Testing Program, Populars Building, Bloomington, IN)
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ISSN: 0270-1367 (Print) 2168-3824 (Online) Journal homepage: http://www.tandfonline.com/loi/urqe20
The Role of School Physical Education in Public Health Harold H. Morris To cite this article: Harold H. Morris (1991) The Role of School Physical Education in Public Health, Research Quarterly for Exercise and Sport, 62:2, 143-147, DOI: 10.1080/02701367.1991.10608703 To link to this article: http://dx.doi.org/10.1080/02701367.1991.10608703
Published online: 26 Feb 2013.
Submit your article to this journal
Article views: 6
View related articles
Citing articles: 11 View citing articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=urqe20 Download by: [University of Otago]
Date: 03 November 2015, At: 07:56
RQES Forum
Research Quarterlyfor Exerciseand Sport
© 1991bythe American Alliance for Health, Physical Education, Recreation and Dance Vol. 62, No. 2, pp.143·147
The Role of School Physical Education in Public Health Harold H. Morris
Downloaded by [University of Otago] at 07:56 03 November 2015
Key words: physical activity, physical education, public health, exercise
M
Ost students in elementary and secondary schools in the u.s. take physical education (Ross, Dotson, Gilbert, & Katz, 1985; Ross, Pate, Corbin, Delpy, & Gold, 1987). The objectives of school physical education have been delineated by numerous authors (e.g., Bucher & Wuest, 1987) and include the acquisition of various psychomotor skills, knowledge, and psychosocial perspectives as well as physical fitness. Sallis and McKenzie (1991) indicate "the public health community is increasingly interested in the potential contributions of school physical education to child health." They specify "the public health goal for physical education is to prepare children for a lifetime of regular physical activity" (p. 133). From the view of many professionals, the goal advocated by Sallis and McKenzie is implicit in the objectives of physical education. For example, Siedentop, Mand, and Taggart (1986) state, "health-related fitness is of major importance to the well-being of our society and a necessary elemen t in physical education programs" (p.22). In addressing the perspectives Sallis and McKenzie have advanced, it is important to restate accepted definitions of health and public health. The World Health Organization has defined health as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity" (Breslow, 1990, p. 9). Public health is "dedicated to the common attainment of the highest level ofphysical, mental and social well-being and longevity consistent with available knowledge and resources at a given time and place" (Hanlon & Pickett, 1979, p. 4). The recently released Healthy people 2000: National health promotion and disease prevention objectives (USDHHS, 1990) outlines the public health goals for the United States for the year 2000; it includes 298 objectives organized into 22 priority areas. Under physical activity and
Harold H. Morris is a professor andchairperson of theDepartment of Kinesiology at Indiana University-Bloomington. He is the current president of theAmerican Alliance for Health, Physical Education, Recreation andDance anda former president of the Research Consortium ofAAHPERD.
ROES: June 1991
fitness, the first priority area, 12 objectives have been enumerated. Among these are Objectives 1.8 and 1.9, which specifically address school physical education. 1.8 Increase to at least 50 percent the proportion of children and adolescents in 1st through 12th grade who participate in daily school physical education. (Baseline: 36 percent in 1984-1986) 1.9 Increase to at least 50 percent the proportion of school physical education class time that students spend being physically active, preferably engaged in lifetime physical activities. (Baseline: Students spent an estimated 27 percent of class time being physically active in 1984) According to Sallis and McKenzie, these objectives were developedwith the input ofa "few interested physical educators" but without the input, development, and promotion ofany organization representing the physical education profession. These objectives are consistent with the call for a public health goal for physical education made by Sallis and McKenzie and support both more time for and a change in current physical education programs. Although the objective of increased physical activity will, no doubt, be endorsed by professional physical educators, it will represent a change of emphasis in various school physical education programs (Ross et al., 1985,1987). Sallis and McKenzie indicate the objective of increased physical activity should be accompanied by the objective of activity planning skills, but these objectives should notreplace current goals; they should expand the current physical education program. Further, they recommend physical educators debate this issue and COnductresearch on the effects ofhealth-oriented programs. Is there sufficient evidence to support this change in focus-that is, can physical education programs produce changes in student behaviors thatwill ultimately result in improved adult health? A conceptual model forwarded to describe the possible causal relationships between childhood exercise and adult health (Blair, Clark, Cureton, & Powell, 1989) is illustrated in Figure 1. The double arrows between exercise and health indicate these variables can influence each other (i.e., increasing
143
Morris
the level ofexercise is expected to improve health and an improvement in health would enable a greater capacity for exercise). The single direction arrows between childhood exercise or childhood health and adult exercise and adult health imply long-term benefit ofa healthy childhood that featured adequate physical activity.
Downloaded by [University of Otago] at 07:56 03 November 2015
The Benefits of Physical Activity The health benefits of regular physical activity have been well documented, especially for adults. In a 1960 review of over 100 studies, Hein and Ryan (1960) concluded: (a) exercise can playa role in preventing obesity and preserving the physical characteristics ofyouth, and (b) a high level of activity throughout the lifespan can inhibit vascular degeneration. In his recent review of the literature Blair (1988) concluded the evidence "strongly supports the beneficial impact ofprolonged exercise and physical activity on various measures of disability, functional capability, morbidity, and mortality" (p. 479). Certain studies are worthy of note, including the Harvard Alumni Study, which found a weekly physical activity expenditure of 2,000 kcal was associated with both decreased risk of disease and increased longevity (Paffenbarger, Hyde, Wing, & Hsieh, 1986). In the sevenyear Multiple Risk Factor Intervention Trial over 12,000 men in the upper 15% of risk factors for cardiovascular disease were studied for seven years (Leon, Connett, Jacobs, & Rauramaa, 1987). Energy expenditure was calculated from data obtained via interviews; a moderate level of exercise was associated with a significant reduction in death by coronary heart disease, in the rate of death by sudden death, and in the all-causes death rate. From another perspective, cardiovascular fitness was found to be related to a reduction in absenteeism, and the relationship remained significant after adjusting for
Figure 1. Conceptual model of how childhood exercise habits may affecthealth throughoutlife (a rrowsindicatepossible relationships).
Childhood Exercise
! Adult Exercise
.. ..
.,
Childhood Health
!
•
Adult Health
Note. From "Exercise and Fitness in Childhood: Implications for a lifetime of health" by S. N. Blair,D. G. Clark, K. J. Cureton, and K. E. Powell, 1989. In C. V. Gisolfi & D. R. Lamb, Perspectives in Exercise ScienceandSports Medicine, vol. 2. Youth Exercise andSport(p. 402). Indianapolis, IN: Benchmark Press.
144
such factors as age, gender, and income (Tucker, Aldana, & Friedman, 1990). This sustains the findings of Cox, Shephard, and Corey (1981), who reported moderate differences in absenteeism when comparing participants with nonparticipants in a worksite fitness program. In view of the literature, there is considerable support for the relationship between adult exercise and adult health as outlined in the Blair et al. (1989) model, represented in Figure 1.
Childhood Exercise andFitness The model presented by Blair et al. (1989) includes a relationship between childhood exercise and childhood health parallel to that established between adult exercise and adult health. Does the literature support such a relationship in children?
Assessment of Childhood Activity To establish a relationship between physical activity and health requires the capacity to accurately measure or assess each of these variables. Assessment of physical activity is beset by various problems outlined by LaPorte, Montoye, and Caspersen (1985) and Caspersen (1989). These difficulties include the diversity of operational definitions of what constitutes physical activity and the absence of assessment instruments that can be used in studies with validity and reliability. Further, in the case of studying the relationship between physical activity and health, measurement procedures must be sensitive to the health-related components of physical activity. Studies measuring physical activity in young children in large population surveys are limited because children are not as conscious of elapsed time as adults, and, therefore, self-report data are of questionable validity for this subpopulation (Simons-Morton, O'Hara, SimonsMorton, & Parcel, 1987). Efforts have recently been made to improve the procedures for assessing physical activity in children (Baranowski et al., 1984; Noland, Danner, DeWalt, McFadden, & Kotchen, 1990; O'Hara, Baranowski, Simons-Morton, Wilson, & Parcel, 1989), but further research on this topic is needed.
HowActiveandFitAre Children? According to Sallis and McKenzie (1991), "Among professionals and the lay public there has been widespread concern about the fitness ofAmerican children" (p.125). This is true, butthenecessityofthis concern has been considered by Blair et al. (1989). They concluded few close examinations were made of the data that labeled children in the U.S. unfit (e.g., the nature of the measures used in many of the studies can be questioned as to the ability to assess health-related fitness). Further their view is that much ofthe concern about the fitness of
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children in the U.S. is based on comparisons with children of other countries rather than on whether our youth possess an adequate level of fitness. In contrast, the results of a year-by-year assessment of the fitness levels ofchildren using the AAU Physical Fitness Testinclude the findings that the age-adjusted bodyweight of children in the schools of the U.S. has been increasing with no commensurate increase in height (Updyke, 1989) . Although no assessment was made oflean body mass, the increase in bodyweightwasaccompanied by an increase in the time required to complete an endurance run (i.e., a decrease in circulorespiratory endurance). Further, the proportion ofstudents that reached the minimal standards (based on four required tests) declined over the decade from 43 to 32%, apparently due to the decline in performance on the endurance run. With regard to the level of activity children exhibit, Hovell, Bursick, Sharkey, and McClure (1978) studied 274 third through sixth grade students during recess. Observations of activity levels were made every 5 s and rated as inactive, moderate, or vigorous. Students were found to be physically active only 60% of the recess period, leading the authors to conclude "children do notvoluntarily engage in sufficient aerobic activity during recess" (p. 460). Sallis, Patterson, McKenzie, and Nader (1988) observed 33 fouryear-olds during a 30-min unstructured recess atpreschool. The students engaged in moderate and vigorous activity 42% ofthe time and were classified as exhibiting sedentary behavior 58% of the time. Blair et al. (1989) analyzed the data from the National Children and Youth Fitness Study I (Ross et al., 1985). The energy expenditure values for each of the activities in which children reported participating were multiplied by the timespentin that activity per day. These values were used to calculate an estimate of the energy expended per day. The students were categorized as active if their energy expenditure level equaled or exceeded the approximate level found by Leon etal. (1987) and Paffenbarger et al. (1986) to be sufficient for a reduction in coronary heart disease. Of those students with complete activity data, 88% of the girls and 94% of the boys were classified as active. The literature is equivocal with regard to the fitness and activity levels of children, primarily because of variation in the operational definitions and measuremen t procedures used to assess these variables. Without agreement on whether youth possess an acceptable level of physical fitness or whether they maintain an adequate level of activity, establishing a verifiable relationship between childhood activity and childhood health is impossible.
Childhood Activity andAdult Health The Blair etal. (1989) model implies a causal effect of childhood exercise and childhood health on adult
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health. It also implies an effect of childhood health and exercise level on adult exercise, which, as the previously reviewed literature sustains, is related to adult health. This aspect of the model is congruent with the hypothesized public health benefits of a health-related physical education program (Sallis & McKenzie, 1991). Sallis and McKenzie indicate childhood risk factors are predictors of risk factor levels in later life and physical activity is an appropriate intervention in childhood obesity and a factor in the uptake of calcium in the bones, as well as in the development of muscular strength and flexibility. Cardiovascular disease (CVD), however, accounts for the largest number of deaths in the U.S. each year, and the relationship between physical activity and CVD has been well established. If the level of exercise influences adult exercise, it can directly or indirectly affect health during the adult years. Although this is an attractive hypothesis, SimonsMorton et al. (1987) state there is little evidence as to what type of physical activity is likely to assure adult participation.
Physical Education, Physical Fitness, and Physical Activity The challenge Sallis and McKenzie present to physical educators is to "adopt a new role and pursue a public health goal for physical education. "Theyadvocate physical educatorsjoin with other public health officials to prepare students for a lifetime of physical activity. Although this objective is implicit in mostphysical education programs, it is less certain the curriculum and methods appropriate to assure its accomplishment are regularly employed. Teachers vary in what they believe is the most important objective for physical education. In a survey of teachers who used the AAU Physical Fitness Test in their classes, 46% listed physical fitness as their primary objective; motor ability was the choice ofan additional 34% (Updyke, 1989). Even more interesting was that 60% of the teachers considered the enhancemen t ofself-esteem the primary outcome ofphysical fitness and 34% believed the preven tion of disease was the primary benefit. Is selfesteem an important casual link in the development of habits of regular physical activity (cf, Fox, 1988), or should teachers be primarily oriented to the disease prevention aspects of physical activity? At what grade level should the concepts of the relationship between physical activity and disease be introduced? And how much emphasis should be given to the development of motor skill? The findings of the National Children and Youth Fitness Studies I and II (Ross et al., 1985, 1987) were fundamental to the development of Objectives 1.8 and 1.9 ofthe health promotion objectives, Healthypeople 2000 (USDHHS, 1990). The intent of Objective 1.9 is to increase to 50% the proportion of the time students spend being physically active in school physical educa-
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tion classes. It has been reported that in school physical education only 27% of the class period was spent in physical activity, with instruction, administrative tasks, and waiting occurring 26,22, and 25% of the remaining time, respectively (Siedentop, 1983). Unfortunately, a lack of instructional equipment, inadequate facilities, and large classes, and a wide range of children's skill and fitness levels can confound the instructional task. In view of this finding physical educators are encouraged to examine their instruction practices to provide more time for physical activity. A quality physical education program can make a difference. A recently reported two-year study compared the effects of a daily physical education program using a developmental movemen t approach with an every-otherday traditional physical education program (Carlisle, Cole, & Steffen, 1991). The students began the program as kindergartners and continued throughout the first grade. Although the primary focus was on the acquisition ofmature fundamen tal movement patterns, at the end of the first grade students in the daily program were found to be superior in fitness measures and to have higher selfconcept scores as well as having established more mature fundamental movement patterns. Unfortunately, only about 36% of the children in the U.S. participate in daily school physical education (RossetaI., 1985,1987). These findings were cited in the development of the Objective 1.8 of Healthy people 2000, the intent ofwhich is to increase to a minimum of50% the proportion of school children who participate in daily physical education. Since the average elementary school physical education class meets for 33.4 min (Ross et aI., 1987), it follows that a large portion of the school children in the U.S. do not have sufficient time in physical education class each week to accomplish commonly accepted objectives. One suggestion is to include a daily 20-min fitness program for the entire school as an extension of the physical education program (Siedentop etal., 1986).
Physical Education andPublic Health The call by Sallis and McKenzie for physical educators to pursue a public health goal for school physical education and to join other public health professionals in the pursuit of improved health for the citizens of the U.S. is both appropriate and timely. Although the current literature is equivocal regarding the causal links between childhood exercise and adult health, a hypothesis that includes such a link is attractive, given the established relationship between adult exercise and adult health. To maximize the effectiveness of school physical education programs in the long-term prevention ofCVD, it is appropriate they be linked with other programs that have a similar intent. Examples ofsuch programs include Moving Children: Healthy Children Project (Elliot, Tehan, & Leach, 1990); Heart Smart (Downey, Cresanta,
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& Berenson, 1989); and Child and Adolescent Trial for
Cardiovascular Health (CATCH) (Perry et aI., 1990). The Jump-Rope-For-Heart program, jointly sponsored by the American Heart Association and the American Alliance for Health, Physical Education, Recreation and Dance, is another example of how physical education programs can be linked with another agency for mutual benefit. In a similar vein, Green (1988) and Mason (1989) have advocated linking school health education programs with various agencies outside the school. The proposed joint projects would involve the participation of both health and physical educators and the school medical staff. If a public health goal is adopted for school physical education, professional physical educators will find themselves joined with a variety of professions that have a broad objective ofimproving the health of the citizenry of the U.S. Physical educators will identify a number of other threats to the health of the youth of this country, threats they as professionals can assistin reducing (Blum, 1987). In addition to understanding the objectives of Healthy people 2000, every educator should understand the implications of Code blue, the report of the National Commission on the Role of the School and the Community in Improving Adolescent Health (1990). If the important role physical educators can play in improving health is better understood by public health professionals, support for quality physical education programs will increase.
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Paffenbarger, R S.,Jr., Hyde, R T., Wing, A. L., & Hsieh, C. C. (1986). Physical activity, all-cause mortality, and longevity ofcollege alumni. NewEnglandJournalofMedicine, 314, 605613. Perry, C. L., Stone, E.]., Parcel, G. S., Ellison, R. C., Nader, P. R, Webber, L. S., & Luepker, R V. (1990). School-based cardiovascular health promotion: The child and adolescent trial for cardiovascular health (CATCH). Journal of School Health, 60,406-413.
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