Promoting Physical Activity in an Impoverished Population
Explanation of the Problem
Manypeople today live in poverty. Poverty creates obstacles for people to achieve their goals and improve their condition. Poverty is associated with a higher prevalence of physical inactivity than those people in higher income populations (R. C. Brownson, Baker, Housemann, Brennan, & Bacak, 2001; C. J. Crespo, Smit, Andersen, Carter-Pokras, & Ainsworth, 2000; Lindstrom, Hanson, & Ostergren, 2001; Yen & Kaplan, 1998). Approximately 13% of the United States reported population is impoverished (Wikipedia contributors, ). Public policy should take an initiative to provide an environment that facilitates physical activity.
Populations Affected / At Risk
The 37 million people living at or below the poverty line are at greater risk for all cause and cardiovascular morbidity, mortality, and physical inactivity than those in higher socioeconomic groups (Johnson-Down, O'Loughlin, Koski, & Gray-Donald, 1997; Lantz et al., 1998; Lindstrom et al., 2001; Wikipedia contributors, ). The children in less affluent school districts have less frequent and less active physical education classes of less quality than more affluent districts (Sallis, Zakarian, Hovell, & Hofstetter, 1996).
Poor people do not have equal access to physical activity. Barriers to physical activity are associated with a lower socioeconomic status of lack of money, lack of transport, illness and disability (Lindstrom et al., 2001). Neighborhood crime also presents a barrier for physical activity with 40% more exposure to crime among low-income groups (R. C. Brownson et al., 2001; Giles-Corti & Donovan, 2002). These barriers represent sociological obstacles because the cultural environment makes it difficult for the individual to become more active.
All these barriers contribute to high levels of physical inactivity among those with less education and those below the poverty line (C. J. Crespo, Ainsworth, Keteyian, Heath, & Smit, 1999). Their children also show high proportions of overweight or obesity (Johnson-Down et al., 1997). Childhood obesity and physical inactivity may set a precedent for the rest of that individual's life. It is important to consider the patterns and habits that people form during childhood to combat the threat of obesity.
Discussion of the Issue
There are several factors to consider when approaching the relationship between poverty and physical activity. The individual has the ultimate choice in the matter but several norms may dictate that individual's choices. High levels of capital, implies a strong sense of being able to influence one's own health, increasing the extent of leisure-time physical activity (Lindstrom et al., 2001). Income may reflect access to medical care resources, good housing, and abundance of food, good working conditions, and more social amenities (C. J. Crespo et al., 1999; C. J. Crespo et al., 2000). Poor social conditions, resulting from low socioeconomic status, may contribute to low levels of physical activity (Lindstrom et al., 2001). The actual and or perceived quality of the neighborhood has an impact on physical activity. Poor quality neighborhood environments provide fewer opportunities and cultural norms for recreational walking (Giles-Corti & Donovan, 2002). Education is important to consider because education influences healthy lifestyle behaviors through exercise, diet, problem solving capacity, and values (C. J. Crespo et al., 1999).
The poor are often stigmatized as lazy failures with no ambition for success. There are several factors to consider. Taking care of children and elders, lack of free time, lack of economic resources, lack of social support and low self-efficacy in exercise may be critical factors in explaining the higher prevalence of leisure time inactivity among those living below the poverty line (C. J. Crespo et al., 2000). It is possible that those living below the poverty line work in occupations requiring more energy expenditure and are not interested in pursuing physical activity (C. J. Crespo et al., 1999).
Impoverished communities face an uphill struggle. Insufficient psychosocial resources in some socioeconomic groups are a part of the differences in leisure time physical activity (Lantz et al., 1998; Lindstrom et al., 2001). The perceived access to indoor and outdoor places to engage in physical activity presents a barrier to people in lower socioeconomic groups (R. C. Brownson et al., 2000; R. C. Brownson et al., 2001). Community policy also presents barriers to physical activity among those in lower socioeconomic strata. Public health policies and interventions that exclusively focus on individual risk behaviors have limited potential for reducing socioeconomic disparities in mortality (Lantz et al., 1998).
Local municipalities implement programs to increase physical activity. Environmental and policy approaches to increase physical activity include walking and bicycle trails, funding for public facilities, zoning and land use, facilitating activity in neighborhoods, mall walking programs, policies and incentives promoting physical activity during the workday, and policies requiring comprehensive school health education programs (R. C. Brownson et al., 2000; R. C. Brownson et al., 2001). These are all policies that present an adequate attempt at addressing the situation.
The goal is often to promote the individual's physical activity. Interventions need to consider the environments in which people live. Policies that focus on the individual are often ineffective because they fail to consider the social and environmental obstacles to activity. Improvements of the physical environment are essential. Organizations should offer group exercise as well as community and workplace policies to promote activity (Lindstrom et al., 2001).
It is most important to provide an adequate, supportive and nurturing environment for people to be physically active. Our goal as a society should be modeled after efforts to create healthy communities that provide health promoting information and social support to enable people to develop healthier lifestyles (R. C. Brownson et al., 2001). Walking trails are especially an effective and inexpensive tool. Walking trails can be implemented at an estimated cost of $2000 to $4000 per trail (R. C. Brownson et al., 2000). Even then, local public and private agencies would be willing to donate time and materials toward trail building and maintenance. Implementing this strategy among all neighborhoods and improving the quality of the environment will provide greater opportunity for those in lower socioeconomic strata to become active and positively influence social norms (Giles-Corti & Donovan, 2002).
Conclusion / Summary
Those people in the lower socioeconomic strata face many obstacles to their health and well being. Poverty is associated with a higher prevalence of physical inactivity. This presents more obstacles to health such as childhood obesity and cardiovascular disease. The impoverished must deal with greater obstacles to pursue the benefits of physical activity than those in higher socioeconomic classes. A lack of money, lack of transport, and increased rates of crime are all barriers to physical activity. The environment caters to those with more capital and so the benefits of city planning fall on the shoulders of the wealthy. Social status affects the perception of the built environment in the way that people in lower socioeconomic strata live in areas that are not as conducive to walking for exercise.
The construction of attractive walking trails that provide a nurturing environment for people to become active is an easy and effective way for policymakers to promote physical activity and well being. This will help communities, not necessarily individuals, to pursue the benefits of physical activity in a way that can improve social cohesion. This is an opportunity for public policy to provide an environment where people can be active.
Brownson, R. C., Housemann, R. A., Brown, D. R., Jackson-Thompson, J., King, A. C., & Malone, B. R., et al. (2000). Promoting physical activity in rural communities: Walking trail access, use, and effects. American Journal of Preventive Medicine, 18(3), 235-241.
Brownson, R. C., Baker, E. A., Housemann, R. A., Brennan, L. K., & Bacak, S. J. (2001). Environmental and policy determinants of physical activity in the united states. American Journal of Public Health, 91(12), 1995-2003.
Crespo, C. J., Ainsworth, B. E., Keteyian, S. J., Heath, G. W., & Smit, E. (1999). Prevalence of physical inactivity and its relation to social class in U.S. adults: Results from the third national health and nutrition examination survey, 1988-1994. Medicine and Science in Sports and Exercise, 31(12), 1821-1827.
Crespo, C. J., Smit, E., Andersen, R. E., Carter-Pokras, O., & Ainsworth, B. E. (2000). Race/ethnicity, social class and their relation to physical inactivity during leisure time: Results from the third national health and nutrition examination survey, 1988-1994. American Journal of Preventive Medicine, 18(1), 46-53.
Giles-Corti, B., & Donovan, R. J. (2002). Socioeconomic status differences in recreational physical activity levels and real and perceived access to a supportive physical environment. Preventive Medicine, 35(6), 601-611.
Johnson-Down, L., O'Loughlin, J., Koski, K. G., & Gray-Donald, K. (1997). High prevalence of obesity in low income and multiethnic schoolchildren: A diet and physical activity assessment. The Journal of Nutrition, 127(12), 2310-2315.
Lantz, P. M., House, J. S., Lepkowski, J. M., Williams, D. R., Mero, R. P., & Chen, J. (1998). Socioeconomic factors, health behaviors, and mortality: Results from a nationally representative prospective study of US adults. JAMA : The Journal of the American Medical Association, 279(21), 1703-1708.
Lindstrom, M., Hanson, B. S., & Ostergren, P. O. (2001). Socioeconomic differences in leisure-time physical activity: The role of social participation and social capital in shaping health related behaviour. Social Science & Medicine (1982), 52(3), 441-451.
Sallis, J. F., Zakarian, J. M., Hovell, M. F., & Hofstetter, C. R. (1996). Ethnic, socioeconomic, and sex differences in physical activity among adolescents. Journal of Clinical Epidemiology, 49(2), 125-134.
Wikipedia contributors. Poverty in the united states. Retrieved November 13, 2006, from http://en.wikipedia.org/wiki/united_states_of_america/poverty?oldid=92090167
Yen, I. H., & Kaplan, G. A. (1998). Poverty area residence and changes in physical activity level: Evidence from the alameda county study. American Journal of Public Health, 88(11), 1709-1712.