1. The Fitness Challenge: Can It Improve Our Well-being? Jennifer Dillaha, MD Arkansas Department of Health, UAMS College of Public Health and College of Medicine

2. What does it mean to be “old”? Weak Frail Feeble Incompetent Impotent Incapacitated

3. What does it REALLY mean to be “old”? Strong Robust Wise Powerful Respected Empowering

4. What is “Health”? Physical, mental and social well-being, not merely the absence of disease and infirmity (WHO, 1948)Physical, mental and social well-being, not merely the absence of disease and infirmity (WHO, 1948) A resource for everyday life, not the objective of living (WHO Ottawa Charter, 1986)A resource for everyday life, not the objective of living (WHO Ottawa Charter, 1986)

6. Physical activity will make you healthier. Live longerLive longer Less chronic diseaseLess chronic disease Less painLess pain

7. Physical activity levels are related to all-cause mortality. The more physical activity you do, the more you can reduce your risk of dying.

8. Figure 1. Top Ten Leading Causes of Death Among Adults 65 Years and Older, Arkansas, 2005 Arkansas Center for Health Statistics Online Query system * Chronic Lower Respiratory Diseases Source: Arkansas Center for Health Statistics Online Query system * Chronic Lower Respiratory Diseases

9. Figure 2. Prevalence of Angina or Coronary Heart Disease by Age, Arkansas, 2005 Source: CDC BRFSS, http://apps.nccd.cdc.gov/brfss

10. Physical activity for chronic disease prevention ArthritisArthritis CancerCancer Congestive Heart FailureCongestive Heart Failure Coronary Artery DiseaseCoronary Artery Disease DepressionDepression Gout Mobility Impairment, Falls Osteoporosis Stroke Type 2 Diabetes Mellitus Urinary Stress Incontinence

11. Figure 4. Death Rates due to All Cancers by Age, Arkansas, 2000-2004 Source: Arkansas Central Cancer Registry

12. Figure 3. Prevalence of Hypertension by Age, Arkansas, 2005 Source: CDC BRFSS, http://apps.nccd.cdc.gov/brfss

13. Figure 12. Prevalence of Hypertension by Race, Arkansas, 2005 Source: CDC BRFSS, http://apps.nccd.cdc.gov/brfsshttp://apps.nccd.cdc.gov/brfss *Sample size less than 50

14. Figure 6. Prevalence of Diabetes by Age, Arkansas, 2006 Source: CDC BRFSS, http://apps.nccd.cdc.gov/brfss

15. Figure 11. Prevalence of Diabetes by Race, Arkansas, 2006 Source: CDC BRFSS, http://apps.nccd.cdc.gov/brfsshttp://apps.nccd.cdc.gov/brfss *Sample size less than 50

16. Physical activity as disease prevention and treatment ArthritisArthritis Chronic InsomniaChronic Insomnia COPDCOPD Chronic Renal FailureChronic Renal Failure Congestive Heart FailureCongestive Heart Failure Coronary Artery DiseaseCoronary Artery Disease Depression Hypertension Obesity Osteoporosis Peripheral Vascular Disease Venous Stasis Disease

17. Physical activity improves chronic pain.

18. Figure 7. Prevalence of Arthritis by Age, Arkansas, 2005 Source: CDC BRFSS, http://apps.nccd.cdc.gov/brfss

19. Figure 13. Prevalence of Arthritis by Race, Arkansas, 2005 Source: CDC BRFSS, http://apps.nccd.cdc.gov/brfsshttp://apps.nccd.cdc.gov/brfss *Sample size less than 50

20. Physical activity will make you wealthier. Less disabilityLess disability Spend less on medical billsSpend less on medical bills Richer, fuller lifeRicher, fuller life

21. Figure 8. Prevalence of Disability by Age, Arkansas, 2005 Source: CDC BRFSS, http://apps.nccd.cdc.gov/brfss

22. Physical activity can prevent and improve disability. Low levels of physical activity and strength are among the strongest indicators of future disability.Low levels of physical activity and strength are among the strongest indicators of future disability. Chronic diseases associated with inactivity are all risk factors for disability.Chronic diseases associated with inactivity are all risk factors for disability.

23. Annual Medical Costs Active & Inactive Women Without Physical Limitations M. Pratt, CA Macera, G Wang. Higher Direct Medical Costs Associated with Physical Inactivity. Physician Sportsmed. 2000; 28:63-70.

24. Figure 9. Prevalence of Overweight and Obesity by Age, Arkansas, 2005 Source: CDC BRFSS, http://apps.nccd.cdc.gov/brfsshttp://apps.nccd.cdc.gov/brfss *Sample size less than 50;Overweight = BMI 25-29.9; Obese = BMI >=30

25. Figure 15. Prevalence of Overweight and Obesity by Gender, Arkansas, 2006 Source: CDC BRFSS, http://apps.nccd.cdc.gov/brfsshttp://apps.nccd.cdc.gov/brfss *Sample size less than 50;Overweight = BMI 25-29.9; Obese = BMI >=30

26. Figure 16. Prevalence of Overweight and Obesity by Race, Arkansas, 2006 N/A Source: CDC BRFSS, http://apps.nccd.cdc.gov/brfsshttp://apps.nccd.cdc.gov/brfss *Sample size less than 50;Overweight = BMI 25-29.9; Obese = BMI >=30

27. Physical activity will make you happier. Less depressionLess depression Sleep betterSleep better Believe in yourselfBelieve in yourself

28. Depression among Older Americans Untreated depression is deadlyUntreated depression is deadly Of the nearly 35 million Americans age 65 years and older…Of the nearly 35 million Americans age 65 years and older… an estimated 2 million have a depressive illnessan estimated 2 million have a depressive illness another 5 million may have depressive symptomsanother 5 million may have depressive symptoms

29. Physical activity improves quality of sleep. Decreased insomniaDecreased insomnia Decreases depressive symptomsDecreases depressive symptoms Decreased painDecreased pain Quality fatigueQuality fatigue

30. Physical activity helps you believe in yourself. Physical activity can be the key to living independently.

31. Figure 10. Prevalence of Physical Inactivity by Age, Arkansas, 2006 Source: CDC BRFSS, http://apps.nccd.cdc.gov/brfsshttp://apps.nccd.cdc.gov/brfss * Physical Inactivity = Did not participate in any physical activity in the past month

32. Why aren’t we more physically active? Myth #1: The physical decline associated with old age is a normal part of aging.Myth #1: The physical decline associated with old age is a normal part of aging. Myth #2: Exercise is risky for persons with health problems.Myth #2: Exercise is risky for persons with health problems. Myth #3: Sweating makes you ugly.Myth #3: Sweating makes you ugly.

33. Why people aren’t more active

34. Do you know what the physical activity recommendations are?

35. Recommendations Aerobic endurance:Aerobic endurance: 30 minutes most days Strength activities:Strength activities: at least twice a week Balance activities: aBalance activities: at least twice a week Stretching activities: eStretching activities: every day

36. Promoting physical activity is a public health priority.

37. We should make physical activity a priority for ourselves! Physical activity can mean a healthier, wealthier, and happier life.

39. Click to edit Master title style Click to edit Master text stylesClick to edit Master text styles Second levelSecond level Third levelThird level Fourth levelFourth level Fifth levelFifth level  Formerly the Arkansas Fitness Challenge Introducing 

40. History Outgrowth of the Cardiovascular Task ForceOutgrowth of the Cardiovascular Task Force 2003 - Collaboration of Arkansas Blue Cross Arkansas Department of Health2003 - Collaboration of Arkansas Blue Cross Arkansas Department of Health 2004 – First “Challenge” between Department of Health and Arkansas Blue Cross2004 – First “Challenge” between Department of Health and Arkansas Blue Cross 2004 – Employer kit developed2004 – Employer kit developed 2005/2006 – Employer kits distributed2005/2006 – Employer kits distributed 2006 – Employer website piloted2006 – Employer website piloted 2007 – Employer website open to public2007 – Employer website open to public

41. 2005 — 45 Employer Groups2005 — 45 Employer Groups 2006 — 60 Employer Groups2006 — 60 Employer Groups 2007 — 53 Employer/ Community Groups (official, reporting data)2007 — 53 Employer/ Community Groups (official, reporting data) 7,135 Participants 7,135 Participants Past Participation 2008—1252008—125 Employer/Community Groups (official, reporting data) >61,000 eligible participants>61,000 eligible participants

42. What is it? Virtual “race” across the United States Starts and ends in Arkansas—Where it all began! 92 unique stops--30 to Win! 3 month duration, March – May

43. To encourage already exercising employees to exercise in eligible categories 30 minutes every day. To engage non-exercising employees in consistent exercise in eligible categories 30 minutes at least 3 times per week.

44. Contest Structure 30 minutes of eligible exercise to advance to next check point Walking/jogging/running swimming laps/water aerobics Bicycling Court sports Aerobics (jazzercise, low/high impact, step aerobics, etc.) Aerobic machines (treadmill, stepper, rower, elliptical, skier, stationary bike, etc.) Other

45. Highest average of days exercised per week 35 points Highest percentage of employees completing 30 or more checkpoints 35 points Lowest dropout rate 10 points Highest percentage of employees participating 20 points Winning Measures

46. Registration ends on February 29

48. Contact Information Jennifer Dillaha, MD Director, Center for Health Advancement Arkansas Department of Health Office: 501-661-2199 Jennifer.Dillaha@Arkansas.gov