Friday, 23 September 2011

#27: From Us to You

I just spent my entire Friday morning writing this blog post; I hope it's a good one.

So, I’ve been trying to come up with interesting ideas for blog posts and went from having nothing a few days ago to being overwhelmed with ideas and topics. I began by composing my personal thoughts and feelings on the topics of euthanasia and physician assisted suicide which I’ll argue (in support of) should be as much about compassion and respect as about ethics and economics. I become instantly overwhelmed in the discourse and literature so have put that off for another day (stay tuned). I then read a Globe and Mail article about fertility treatments for the obese and of course had a few things to say about that (I think they should be banned on the grounds that being biologically infertile due to obesity is a clear sign that one should not be having children as well as that I worry about the environment the resulting child will be raised in). There was also an article about another (very unoriginal) women raising money for charity by “running” a marathon and eating nothing but McDonald’s for a month (if you missed it I think this is ridiculous, foolish and doesn’t even deserve a comment). Then yesterday during my second lecture in public health policy, I (and the whole class) was challenged by the professor to actually do something to contribute to our collective understanding of the topic which is what I will attempt do today...

So I’m taking (another) course called ‘ An Intro to Public Health Policy’, which is an area I am entirely new too. I was accepted to a special program called the CIHR (Canadian Institute of Health Research) Strategic Training Program in Public Health Policy and thus am required to take some additional courses, attend ‘policy rounds’, ‘lunch and learns’ (can’t argue with free food), ‘institutes’ and ‘training pods.’

Essentially what this means is that we (40 or so students) get a comprehensive overview of the public health system here in Canada as well as what are current topics and issues being addressed. My ‘expertise’ in this area or what I bring to the table is my passion for physical activity and our dire need to get people active. I am thus going to briefly give an overview of public health and more specifically the relevance and implication of physical activity/exercise for the topic. So here it goes...

A good definition of Public Health taken straight from Wikipedia is: "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" (1920, C.E.A. Winslow).

Another one is: “Many, but not all, of its activities deal with the health of populations. Much, but not all, of the focus is on prevention. Some, but not all, of the activities are carried out by organizations designated as ‘public health” (Deber).

Public health ‘outcomes’ or goals include, but are not restricted to, the “health protection and promotion” functions such as disease surveillance, disease and injury prevention, health protection, health emergency preparedness and response, health promotion and relevant research undertakings (Kirby and LeBreton). I won’t talk at all about policy (since I still know nothing about it) but just know that public health policy is essentially concerned with the rules, laws, regulations and legislation that is concerned with any public health issue.

Confused? Relevant public health topics might include community/city water treatment and fluoridation; pesticide and chemical use; immunization for the flu, and other infectious diseases; tobacco use and second hand smoke; obesity; healthy eating and nutrition (labels on food); alcohol and drug regulation; physical activity and exercise and there are many many more.

Remember that health is multidimensional and includes physical, emotional and social components. It is not merely the absence of disease or illness. While Western cultures and societies routinely attribute ‘health’ to mean physical/physiological health, it is far more complex than this. Each individual ‘aspect’ of health is known to affect (both good and bad) the others: good physical health is known to contribute to positive emotional and social health outcomes; poor social health can compromise physical and emotional health; good social health can enhance emotional health but compromise physical health; and so on and so forth. It’s complicated!

The point I want to make is that physical activity is, should or at least can be a major component of positive health and wellbeing. It certainly contributes to good physical health (fitness) but can also benefit one’s emotional and social health as well. It is thus an important topic and aspect of public health. One’s individual health is thus not only a personal responsibility but also a social responsibly. “Personal responsibilities are social responsibilities” (MDF Doyle). Our health attitudes and behaviours both directly and indirectly impact others and society as a whole.

Currently very few Canadians are physically active. In fact only about 15% of Canadian adults meet the recommendations for daily and weekly physical activity (Colley et al., 2011). The recommendations endorsed by Health Canada (through ParticipACTION and the Canadian Society of Exercise Physiologists (CSEP)) as well as by the World Health Organization (WHO) and the American College of Sports Medicine (ACSM) are as follows:

“For adults:

To achieve health benefits, adults aged 18-64 years should accumulate at least 150 minutes of moderate- to vigorous-intensity (think brisk walking, cycling, jogging, cross-country skiing) aerobic physical activity per week, in bouts of 10 minutes of more. It is preferred that activity be achieved as at least 30 minutes on 5 days of the week.

It is also beneficial to add muscle and bone strengthening activities using major muscle groups, at least 2 days per week.

More physical activity provides greater health benefits.”

The recommendation for older adults (65 years and older) are essentially the same as for adults, while children and youth are suggested to accumulate at least 60 minutes of exercise EVERY day and vigorous and strength training activities at least 3 times per week. See the following link for more detailed info:

Now I’ve said it before and I’ll say it again: telling people to go out and exercise for 30 minutes a day, 5 times a week at so and so intensity (heart rate) is NOT going to work. Exercise sucks; it’s terrible! No one wants to be told they have/need to do something and certainly not told that they need to do it continuously and indefinitely, especially if it’s actually kinda hard and demanding (physically, mentally and perhaps socially). I understand why I (and we) need to do it (to become healthier and more fit), and luckily I’ve found a way to actually want to do it and to enjoy it; but I acknowledge that it’s not going to work for everyone. The idea of physical activity is far more important than exercise. It has to become enjoyable, pleasurable, and fun. It has to become routine and normalized; a lifestyle. It should become something we/you want to do, not something you need to do it. And let’s face it; you don’t need to do it! Choosing to be physically active is a personal choice; no one is going to force you to do it.

Physical activity: It can be fun too!

I’ve rambled on much longer than I should so I’m going to stop. I hope by now you a) better understand what public health is and why it’s important; b) understand that physical activity (and dare I say exercise) is an important aspect of personal AND public health; and c) what the physical activity recommendations are for you and your loved ones. I didn’t say why physical activity is important or why recommendations for it are necessary but I hope you can begin to see why they are.

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