#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: http://www.csep.ca/english/view.asp?x=804



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.

#20: Being for the Benefit of Mr Kite!

A confession.

My true thoughts on exercise and the relentless pursuit of health.



I will begin my saying that what I do as a runner, I do not classify as exercise. I am an athlete who trains and competes. Thus running to me is a sport, a way of life, and something from which I gain considerable rewards both personal (self-actualization, -expression, -gratification, -conception, -enrichment) and social (social attraction and group accomplishment).

Exercise is defined as any planned, purposeful, structured and repetitive engagement of physical activity with the aim of improving or maintaining physical fitness which encompasses a number of components such as body composition, cardiovascular fitness, muscular strength and endurance (Caspersen, Powell & Christenson 1985).

When I think about this definition I see people exercising for the sole purpose of getting in better 'shape' or attaining improved health and fitness. While this purpose is surely important to me and is definitely used to motivate my continued (exercise) behaviours; it is NOT the primary reason that I run. Rather I run for the pure enjoyment of the activity, the pursuit of athletic achievement and success (which is highly personal), the competition, and the continuous goal to always improve myself upon past performance. I would continue to run even if I knew it would decrease my lifespan, even if it meant I would compromise my health, even if it led to financial ruin, perhaps even if it led to personal self-destruction and death!

But I am not like most people. Most people who run, or walk, or work out, or whatever are doing it for a very specific reason (albeit far from the only one). They do it because 'we' (government, media, the industry) tell them it is good for them: that exercise will increase their fitness, decrease their weight and improve their overall well-being. That it will make them live longer and have a better life. We tell them that it will make them happier and 'healthier!' And perhaps it will... in fact, I would argue that it often will!

But why is this so important? That is the fundamental question. Why are we telling people to be healthier. Moreover what does health even mean? Can it be defined? Certainly not in simple terms.

Health is a multidimensional phenomenon. It involves physical, mental and social determinants which all play a unique role in establishing an individual’s well-being (Lox, Martin Ginis & Petruzzello, 2006). Health is "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity." (World Health organization, 1946). I have no interest in defining health or arguing over what it means. For me, health is a highly personal concept that above all else means being physically functional and capable, socially fulfilled and emotionally happy and content with the person you are each and every day.

I'm sure that I've shocked many people at this point. I mean, aren't I the guy who goes around pushing physical activity on everyone and shaming and blaming those who are fat and lazy. Well yes, I am.

For me, physical activity, exercise, sport...whatever you want to call it, has brought me a plethora of benefits and rewards and has enhanced my life in numerous ways. Therefore, I personally have nothing but wonderful things to say about it and highly recommend it. But I also know that this isn't likely to be the case for many, perhaps most, others. Exercise is physically exerting, it's time-consuming, and it's even becoming expensive...

So going back to the big question: Why is physical activity, exercise, sport (and ultimately health) so important and why do we feel we need to force it on everyone?

Well here are some possibilities:

1. We have too! As a semi-socialist and democratic country, we have to at least pretend to care about our citizens and thus there is an obligation to take care of our people. Elected officials must appear to look out for the best interests of their voters, and thus make it seem as they are doing good for all people.

2. Our health care system. Isn't it great that we don't have to pay for health care?! Well no actually, because we do pay for it...and we pay a lot, with our taxes. Health care spending is becoming hugely expensive and will continue to do so. The demand for health care is also increasing and this is directly related to the deteriorating 'health' of our population. Heart disease, diabetes and cancer continue to become more prevalent. These conditions also just happen to be closely correlated with obesity...which can be prevented (in part) by physical activity. In theory, getting people more fit and less fat will reduce health care costs...in theory.

3. Capitalism. Isn't it funny how almost every problem with current society comes down to this little gem. Not only has the health and fitness industry become hugely commercialized within the past decades (think sports equipment, gyms and fitness centres, do it yourself exercise machinery, fitness apparel, books, videos, websites, personal trainers, coaching, etc. etc.), but the whole concept of being fit and healthy is inherently tied to increased productivity and thus financial gain. Paradoxically, by stressing personal health and fitness within this commercial environment, the industries actually make more profit due to failure than to success. The diet and food industries rack up billions each year and yet we continue to get more fat and less fit.

4. Social norms/ideals. How many people do you know that look like the guys and girls on the covers of Men's and Women's Health (magazine)?! Probably no one! And yet, these images are the ones we continuously consider to be the most ideal and strive toward (thin and slender females, muscular and mesomorphic males). Not only are these images entirely fake and unrealistic, but they also happen to be physically unattainable for the average person consuming them. It is no wonder that we as a society have failed to attain this ideal, and yet we continue to use it as a something to aim towards.

5. Human nature. The human body is a mortal and vulnerable object and everyone has a personal responsibility to themselves to care of it. We are told that exercise is a way in which to do this as evolutionary it has enabled the survival and success of our species. Moreover, it is natural that we want to take care of each other and look out for one another.

6. Elitism. We feel better about ourselves when we are able to do what others can not. Exercise has become an activity of the upper classes who feel a need to educate and improve the less fortunate social groups.

7. The betterment of society?! I often have a hard time believing this one although some people do consider it a realistic goal. Some people believe that an all-round 'healthier' society is also a better one.

To summarize:

Physical activity, exercise and sport can and should be used to enhance and add value to one's life. They have numerous physical, psychological and social benefits that are generally available to those who consume them. These benefits might contribute to overall 'health' which is a term that epitomizes ambiguity. For these and a number of other reasons, exercise and PA are considered valuable and important. But why do we push physical activity and exercise on our entire population? Why is it so important? Is being 'healthy' important? Is living a long time important? Would the world be a better place if everyone was fit and healthy?

If you think 'yes,' then I must ask: "why?"