MCHB ALL GRANTEES MEETING
Take the President’s Challenge For a Healthier US
October 4-7, 2004
MELISSA JOHNSON: Thank you so much, Michelle. It's such a pleasure to be here. What an impressive group. I understand there are 1,100 people here today. Wow. And, this is also the first time, I understand, that all of you have gotten together, and that’s very exciting. Because the power of partnership, the power of collaboration, is the key to addressing and solving any challenges that we’re all facing today and this is a true testament to collaboration. And I’ve heard, the table that I was at, just, everyone was talking about how wonderful it is that you’re all together and sharing all your ideas. I actually just returned. I attended Senator Frist, Childhood Obesity Hearing. And our chairman, Lynn Swann, just testified at that. And, it's just so relevant, it's so important right now, the childhood obesity. I understand you’ve heard about it, that there’s actually been a focus on it, the last couple days, and Deputy Secretary Claude Allen and former surgeon General Koop have already spoken to you, I understand, a lot about the nutrition, the eating side. So we’re going to talk today a little bit about the physical activity side of the balance equation.
It's an energy equation, what goes in and what goes out. And because of the obesity issue with children and adults in America today, it's extremely important that we all understand that we can be part of the solution. Because on the flip side of every crisis, is opportunity and we can all contribute to being part of the solution, and that’s what partnership and collaboration is all about. I will be telling you about some of our collaborations, and also inviting you to possibly use one of our tools, the president’s challenge program, in what you’re already doing today. I understand you have heard of the Healthier U.S. initiative. This is President Bush’s initiative. It has four basic, simple pillars. And we made it simple for a reason, so that everyone can understand and just get it and remember it. It's basically, nutritious eating, physical activity on a daily basis, get your preventive screenings, and avoid risky behaviors. And we at the President’s Council on Physical Fitness and Sports, we focus on that number two pillar, which is, physical activity every single day.
And as you know, Secretary Thompson has been extremely supportive of the Healthier U.S. initiative, and he has come up with his steps to a Healthier U.S. initiative, his steps to a Healthier U.S. grants, which have been announced and distributed to 40 communities, and this is $44 million this year and we’re asking for $125 million for next year. And I know that you have heard about the steps grants this past week, I think it was just yesterday. And I just want to say a word about Secretary Thompson. He truly, truly practices what he preaches. He wears a pedometer every single day. And I understand all of you received your pedometers and, raise your hand if you’re wearing it. Good. I like that. Make sure you go back and put it on, if you didn’t raise your hand. And, Secretary Thompson, he has put the department on a diet. He takes cigarettes out of people’s mouths outside of our office. He truly, truly, truly preaches prevention, as well as our president and our surgeon general, Dr. Richard Carmona. So the power of prevention and the power of partnership go hand in hand. I’m just going to give you a little bit of instruction on the pedometers.
I was told that some of you are asking, "Well, what does it mean, if it says 2,000, or 12,000, so what? What does that mean?" Kind of a rule of thumb to follow is, a mile is about 2,000 steps. Now, that obviously depends on a person’s stride, so, take that into consideration, but this is just a rule of thumb. How many of you have heard, go for the 10,000 steps? Yeah. We hear that a lot, don’t we? Ten thousand steps is generally equivalent to about five miles. That’s a lot. Now, that’s a great long term goal to shoot for. But I like to say, let’s start small. Start with 2,000 steps. You can roughly do that in about 15 minutes at a brisk walk, at a brisk pace. We at the President’s Council, and CDC, and the surgeon general’s report, we say 30 minutes a day, about five times a week. That’s just about 4,000 steps, maybe 5,000. That’s very, very doable. And then, you slowly work up to that 10,000 steps. You slowly add, maybe 500 steps a week onto it. Where, maybe in a couple months, you reach that 10,000 steps. The beauty of it is, you put that pedometer on your waist belt, and it's very motivational, 'cause you want to keep looking down.
And it's a very inspirational tool, and you start doing things like, taking the stairs instead of the elevator. Perhaps, if you take the Metro, you get off one stop earlier than normal and you walk the rest of the way. People start getting a little competitive with each other, too, and it's really fun to use the support system, where you’re accountable to another person, and you can kind of start comparing notes. But, we at HHS, and especially Secretary Thompson, we really want to get the point across that it's the small steps that count. You do not have to overhaul your life overnight to see significant change. In fact, have you heard of the book, "The Tipping Point," by Malcolm Gladwell? The premise of the book is that, it's the small steps that count. It's a small group of people that get together and decide to do something, and you see the significant changes down the road. It's just the small steps that count, and that’s what we really want to get across, okay? So you don’t have to do the 10,000 steps today. Perhaps you do 2,000, 3,000, 4,000 steps, and maybe two months down the road, you’re getting 10,000 steps. But you would be surprised, 'cause all the walking you do around, around this hotel even, back and forth between sessions.
When you’re at work, up and down the hallways. That counts. So, don’t think that you have to go out and do an hour a day, in addition to what you’re doing on your pedometer. That actually counts believe it or not. So, if we could have the first slide, please. And, I want to tell you a little bit about the President’s Council on Physical Fitness and Sports. Actually, we are part of Health and Human Services. We do report to the President through our Secretary, Tommy Thompson. And, a lot of people still associate us with that President’s Council Physical Fitness test. Who took that when you were a little kid and got your patch? Wow. Okay. I’m impressed. Well, believe it or not, that test has been around for 40 years. And it is still alive and strong and well, and that is conducted in schools nationwide. We send materials out to 220,000 schools, teachers, principals. And we have about 30,000 schools who are using our test. But, even before that test was designed, we started in 1956 under President Eisenhower, because he recognized that there was a need. He called it the President’s Council on Youth Fitness because he saw a study that showed that American children were less fit than European counterparts, so he wanted to do something about it.
Eventually, Kennedy changed the name to President’s Council on Physical Fitness to encompass the adults as well. And then, Johnson added "And Sports" to the end. So we’ve gone through a lot of changes. And then obviously, in 2002, President Bush signed a new executive order to reinvigorate our Council, and then he appointed our 20 member Council. So, basically, our mission is to advise the President through the Secretary of Health and Human Services on ways to get Americans active, all Americans of all ages and abilities. Luckily, this is key, because that’s what this conference is about, is partnership. We are lucky that we get to work in partnership with public private enterprise. We have a lot, we have up to 50 partnerships at the President’s Council. With corporations, with health care providers, with media. We count on that. And I feel very fortunate that this administration is open to those kind of partnerships. In fact, that’s what the Steps grants were all about, that’s what Steps partnerships are about as well. But we cannot do this on our own. In fact, that’s what the hearing was about today, Senator Frist’s hearing.
Everyone was in agreement that this, the obesity epidemic, has to be attacked or approached or addressed, in collaboration that no one entity can do this alone. And, also, we provide a lot of health information and incentives and literature to all Americans, and it's all provided free of charge. Just a little picture of the President and our Council here, promoting active lifestyles. And as Michelle said, Lynn Swann is our chair. Many of you may know him just simply as Swanny. But he was a Pittsburgh Steeler, USC Trojan. He’s currently an ABC commentator for football. He’s the national spokesperson for Big Brothers, Big Sisters, so we’re extremely blessed and fortunate to have him serve as our Chair. Dr. Dot Richardson is an orthopedic surgeon, you may remember her from the Olympics, back in ’96. She was a gold medal softball Olympian, and she serves as our Vice Chair, and she lives down in Florida . We also have other members, like Denise Austin, who’s here locally, Nomar Garcia Para, and a whole host of people who really serve in the trenches.
We have some high profile, yes, but we also have those who are working as physical education teachers, civic leaders, business leaders at the grass roots local level, which, as you know, that’s where the major change takes place. This is our message, just be physically active, every single day. It's very simple to remember. Now, I understand that you did hear a little bit about what the problem is. And in order to come up with a solution, we have to know what the problem is. And we are, like I said, it's an epidemic. But, the obesity crisis is actually traveling across the world, and it's becoming an international pandemic. In fact, I recently met with Secretary Thompson, we recently met with the King of Jordan, who is now looking at the President's Council as a model, to replicate in Jordan . They want to do a youth physical activity program in schools for Jordanian children. Chile is now talking to us as well. So, there are other countries now who are really understanding the benefits of regular physical activity. Poor diet and sedentary lifestyles kill 400,000 Americans a year. These are 400,000 deaths that could be prevented just by taking those small steps I was talking about. Just by going out and doing 30 minutes of moderate walking a day.
By changing lifestyles a little bit in terms of what we eat, maybe we don’t have to eat the whole piece of cake, we can eat half the piece of cake. Or we just eat half the portion on our plate, and we take the rest home and have it for the next meal. But, believe it or not, these are 400,000 preventable deaths. In fact, I understand that you heard this statistic already, but sedentary lifestyles is actually number two as the leading cause of preventable deaths and chronic disease. Right on, nipping at the heels of tobacco. So, 17 percent of deaths can be attributed to poor diet and physical inactivity. Not sure if any of you have seen these, perhaps some of the HRSA folks have, because, these are very, very compelling slides from CDC, to show how obesity has grown over the years. And I’m sorry to show these right after lunch, and, not trying to make anyone feel guilty. I’m just showing that, I’m just trying to show what is, and what we can do about it. But, keep your eye on the screen, and watch the country as it changes from white and light blue, all the way up to 2002. You’re going to see the country getting darker and darker blue, and then some red, and then some yellow and this is showing, how the obesity crisis has been growing.
Here’s ’85, ’88, ’90, ’92, ’94, ’96, ’97, ’98, ’99, 2000., and 2001, and here we go at 2002, that was the latest statistics we have. Isn’t that compelling? We have Mississippi , Alabama and West Virginia as the three highest obesity rates, with over 25 percent obese. Now, keep this in mind, and you’ll probably like to know this, we at the President's Council, we’re not saying be skinny, be thin. Absolutely not. That is not our message. In fact, you might see a lot of skinny people out there. But, you know what? Maybe they smoke, maybe they have high cholesterol, maybe they have high blood pressure, and they’re very sedentary. It is not about being skinny and please know that. That doesn’t mean you’re healthy, just because you’re thin. We would rather have someone 15 pounds heavier, but making sure they’re active. In fact, some of you may be aware of the Cooper Center down in Dallas , Texas . And one of the preeminent exercise scientists is Dr. Stephen Blair. And his motto is, "It's better to be fit and fat than skinny and sedentary," and so, I want to echo that. The couch isn’t going anywhere, are you? Almost two-thirds, or 64 percent of American adults are overweight or obese.
Also, keep in mind that the cost to our nation, up to $117 billion per year. Add the cost of type 2 diabetes, and we have a whopping, staggering $250 billion per year. There are many diseases or conditions related to overweight or obesity. And, there’s actually something called sedentary lifestyle syndrome, sudden death syndrome, but it's actually sedentary syndrome. But there’s just a host of conditions that could be prevented, simply just by walking, swimming, getting on your bike, chopping wood. No, I’m kidding. Who chops wood around here? I don’t. But anyway, heart disease, high blood pressure, type 2 diabetes, some cancers, chronic pulmonary disease, anxiety and depression. That last one is something I always like to emphasize, because many people are walking around with possibly low-grade depression, relying on antidepressants. And believe it or not, a simple walk outside can boost your mood like nothing else can. And you’ll find, if those of you perhaps aren’t exercising right now, and you find, just go out and get the feel of it. And after a couple weeks, after a few weeks of just regular walking, you don’t have to sweat in a gym or run a marathon, it's really fun, it's simple, and that’s what I really want you to know.
That it's not grueling. "No pain, no gain, "oh, that’s out. That was out years ago. This is fun. And, it really elevates your mood and it really can combat depression. About 55 percent of American adults don’t get at least the 30 minutes of moderate activity most days of the week. And women traditionally get less activity than men. And, amongst women who are 75, sometimes it's with one to two women over 75 don’t get activity at all. So here’s adult needs, again, just to reemphasize, a minimum of 30 minutes per day, five or more days per week. Additional health benefits. Stretching. I love to do yoga, Pilates, stretching. Who does some yoga or some Pilates? Yeah, there are a lot of hands out there. It doesn’t have to be traditional kind of exercise, there’s so many kinds of creative, fun activities out there now to choose from. And resistance training. Yes, if you’d like to join a fitness center and do the weights, that’s great. But there’s so many other ways to do it, with thera bands, and surgical tubing, and cans of soup, anything. So, here you go. Thirty minutes of brisk walking on most days of the week leads to better health.
Okay, what is moderate intensity physical activity anyway? And, without having to go into the exercise physiology descriptions of oxygen consumption and energy expenditure, just the simple talk test. We call it the talk test. Can you have a conversation easily when you’re out there? You don’t’ want to go too slow. But if you’re huffing and puffing, and you just can’t keep a conversation, you’re a little bit higher than moderate, and that’s okay, but that’s a higher intensity. And you can actually get significant health benefits just by slowing down and following the simple talk test. Okay. Let’s focus on youth a little bit right now. Again, that’s what this hearing was about this morning. We have 15 to 16 percent, or 9 million of our youth, are either overweight or obese, or, let’s just say, overweight. A little bit higher with minorities, it's 20 percent. And then preschool, ages two to five , we have 10 percent. And, someone at the hearing mentioned today that children who are overweight as children, have a 70 percent chance of staying that way or being overweight as adults.
And we all know, you work with children, it's easier to start and establish a good habit at a young age. And they’re more apt to continue that through life, and through adulthood, and carry those good habits through adulthood. And this last statement is just very sad to me, it's very appalling, that this generation of children, for the first time in history, may not outlive their parents, simply because of lifestyle. High blood pressure, type 2 diabetes, and high cholesterol. We used to just see that in adults. They’re all showing up in young children, as young as seven, eight, nine, 10 years old. In fact, type 2 diabetes, that’s really critical. That’s truly, customarily, used to be an adult onset disease. And that is the non-insulin dependent type of diabetes. But, the fact that that’s showing up in young children is something we all need to pay attention to. Why are we where we are at? I mean, people ask me that all the time, you know. Obesity has doubled in the last 20 years for children. Why? How did we get here? Why are adult Americans just growing in size as well? There’s a lot of different reasons. Can’t point our finger at any one thing. This is a multi-factorial, multidimensional issue. And the only we’re going to solve it, again, is through partnerships and collaboration.
But let’s take a look at children. They’re watching an average of 18 hours of TV a week. This is on top of all the work on the computer, playing on computer games, Xbox. Physical education is no longer mandated in any state on a daily basis, except Illinois . Every state does have their own standards, but they’re not necessarily enforced. A lot of states, they have it, maybe 20 minutes a day, three times a week. But it just used to be more rampant and available and accessible to children. It's often the first thing that’s cut out of budgets, along with music and art. So they’re not getting it at school. And then, as far as being sedentary at home, again, it's not necessarily anyone’s fault, it's just that, perhaps mothers are a little bit afraid to have their children play outside right now, especially in urban areas. There’s drive by shootings, it's perhaps not as safe as it once was. Suburban sprawl, let’s take a look at that. People drive everywhere. I mean, I used to walk to school. Did anyone used to walk to school when they were kids? A lot of us here used to walk to school. But now, people are living much farther and farther away from school, and from work.
So there’s just a lot of, they’re just driving more. And, so, a lot of neighborhoods don’t have sidewalks. They’re not walkable or bike-able communities. So, there’s a whole movement around what’s called the built environment. How can we make our communities more walkable and bike-able? How can we make our communities more safe, so parents want their children to go out and play in parks. Mostly in parks, because a lot of communities don’t even have parks. Some schools don’t even have playgrounds. So, again, it's the infrastructure we’re looking at that’s also changed over time. Kids need a little bit more to stay healthy. I mean, we are just trying to get adults just off the couch and out. But kids, we’re all created to move and, in fact, do you know that our bodies are the only machine, if you want to call it a machine, I think our bodies are just a wonderful miracle, but our bodies are the only machine that break down when not used. So, think about that. In fact, if all the benefits of physical activity could be put into one pill, it would be the most widely prescribed medication in the country.
So, kids, they need varied activity, no periods of extended inactivity. You don’t want a kid just sitting in front of a computer, you know, for three to four hours at a time. So, these are just some very, very, simple, basic ideas of thinking about ways that you can get physical activity into your everyday life. Let’s take work, for example. Take the stairs instead of the elevator. CDC actually is making their stairways all pretty, with artwork and pretty paint and artwork and music. So, I just think that’s really nice, they’re having a stairwell initiative there. Like I said before, get off the bus or the Metro a stop or two early. Organize a lunchtime walking group. This is something that’s very simple to do and very fun. And, when you’re out walking and talking, sometimes you don’t even realize that you’re exercising. In fact, we don’t even use that term much more, "exercise," we just like to use, movement. The joy of movement, the joy of motion, the joy of physical activity. And take five minutes every hour, just to stand up and stretch. So many of us are at our computers for hours at a time. The eye strain, the shoulders and the upper back get really tight.
So it's really important just to get up and just do some shoulder circles. At home, use a push mower, I don’t know how many people would want to use a push mower instead of the other kind. But, walk or bike to the store. Again, so many of us, maybe the store is four blocks away and we get in our car and drive. How much easier could it be just to walk? And, walk around the field at your child’s sports practices. And this is something I like to do. I’m on the 13 th floor of my apartment building, and as much as I can, I try and take the stairs instead of the elevator. Again, with family, you want to make it a multi-generational, fun activity, is, making it family time. Go for family walks or bikes, take the dog for a walk. So, what are we doing at the President's Council to get America active? This is where I would like to share our President’s Challenge Program. It is a free tool to use that you can actually use in your communities. I understand that there’s all different grantees here today. And I just want you to, I just invite you and encourage you, just to consider that this is something you could possibly use.
The President’s Challenge Program has been around, again the physical fitness test, but rather than only awarding and recognizing performance based, you know, how many, numbers of push ups and sit ups we can do, we still do that, but we’re, again, our mission is just to try and get everyone moving moderately. So we do have a website, and I just want to up front say, even though this is a web site, and you’re at your computer, after a certain number of clicks, a little sign comes up and says, get out, and go out and move. So, so you can’t use that against us, that we have a website. But it's basically, www.presidentschallenge.org. And this website was launched just a year ago, with the President in Texas . Just, here’s the portal page. There’s kids, teens, adults and seniors. There’s over 100 activities to choose from. So you can pick whatever you enjoy doing. Because, you know what? If you don’t enjoy walking, you’re not going to continue it. So you want to pick something you enjoy so you can continue it, whether it be swimming or yoga or Pilates or working out in the fitness center. But you must pick something you enjoy, because otherwise, what’s the point? Even housework counts and gardening.
I heard there’s a frost coming in tonight, and that the gardening days are over until next year. But, there’s a list of over 100 activities. And basically, you are working towards presidential recognition. And you, basically, you track your progress over time. You sign up, you can sign up as an individual, you can sign up as this group of 1,100 people. This conference could actually be a group, or all your different communities. I think it's fun when you sign up as a group, because it's more motivational, you’re accountable to other people, and there’s a built in support system, which is crucial. Basically, there are two paths. The first one is called the Presidential Active Lifestyle Award. This is a six week program. Basically you’re tracking just, 30 minutes a day, five times a day for a six week period, or kids would be 60 minutes. But, this is something that is a good kick start, because we don’t want people to quit after the initial six weeks. The point is to build in that physical activity as an important part of lifestyle. So, once someone does something for about six weeks, they realize how good it feels and they’re more apt to continue on, which is why we have the Presidential Champions Program.
And that can take up to a year to win, it's their are bronze, silver and gold medallions. But we found this is very effective in communities, in corporations, in youth groups, in senior groups. It's just a fun way to get people moving. In fact, we are launching the Healthier Feds physical activity challenge tomorrow. And, we took the President's Challenge Program, and we launched it as a pilot at HHS last fall. Now, we’re taking it to about a million federal employees across the country. We had 1,500 people sign up yesterday for the first day. But, OPM director Kay Coles James and Secretary Thompson and Lynn Swann will be kicking that off tomorrow in the morning at HHS headquarters. So, anyone out there that works for the federal government, especially the HRSA folks, I hope that you pledge to join our challenge. This is an important feature to grantees, to communities. This is free. This is a free program. It's in the public domain. It's very easy to use, very easy to implement. You can actually just tell people about it, or if some of you have websites, you can just link to it, link right to the registration page. And it's fun, 'cause you can customize it and you can call it your own challenge. It doesn’t have to be the "President’s Challenge."
There’s also, if you, some people don’t like computers, there’s a paper based option, there’s a log that you can use. But, again, it's just a friendly way to be physically active or compete against others. This is just of interest, the top 10 popular activities that we found; walking, running, bicycling, weight training and cardio machines are the top five. Here we go, is, our partnerships. Again, we cannot do anything that we do without our partners. We work with health care providers, businesses and corporations, educators, fitness and sports professionals, decision makers and legislation, public agencies, and the media. I just want to share three of our collaborative efforts. One is the, I Can Do It, You Can Do It Program. President's Council is partnered with the Office on Disability at HHS and we are taking our program, the President’s Challenge Program, to disabled organization, and they’re setting it up as a mentoring relationship, where they’re taking an adult and mentoring a youth with a disability, using our President’s Challenge Program, and we’re thrilled about that.
The You Can steps to healthier aging. This is through AOA, Administration on Aging. They are actually partnering with us, to promote physical activity to seniors. And National Trails Day is something that we partnered with the Department of Interior and the US Army Corps of Engineers, and basically, it's to support the President’s Healthier US initiative. But, we’re just promoting recreation. We’re showing the connection between public lands and physical activity. In fact, there is a piece of information that came out of CDC that I think can revolutionized America, that shows that volunteering on public lands, those who volunteer outdoors, actually have a higher propensity to reach their recommended levels of physical activity. And I think that’s nice, because then you’re kind of doing both at the same time. These are a few of our partnership products. We partnered with the American Association of Clinical Endocrinologists. This is a prescription that the endocrinologists have been taking into schools, to sixth graders, actually, where it's called the Power of Prevention program, and it's good, because the doctors are actually bringing the information into the schools.
The Blue Program for a Healthier America . We have partnered with Blue Cross/Blue Shield on their Walking Works Program. And again, this is a brochure that we distribute free of charge. This is something you might be interested, it's Kids in Action. And Kellogg’s has partnered with us. It's, Kids in Action is a booklet for birth to age five. These are movement and physical activities, and little games that infants can do, that mothers can do with infants, and this has been an extremely popular publication, we run out of it all the time. And, organizations call us, and they just want to get the CD and write the order and distribute it to their organization. And so, that’s been a real popular piece. We actually did a demo back in March, down in New Orleans , at Castle Kids Child Development Center . This is, we also partnered with NASPE, which is the National Association of Sport and Physical Education, and one of their members actually led this. It was a press conference, and it was also a program for infants and for kids, for babies and their mothers.
Here’s the portal site of Healthier Feds Challenge. Very excited that, in addition to the Healthier Feds, we are also talking to many state governors. And, there’s many governors who are interested in utilizing our tool as their state physical activity program. In fact, Governor Doyle, in Wisconsin , already launched this last spring. And now we are using the Wisconsin Governor’s Challenge as a template to take to other states and to other governors. Michigan already has a fabulous program, Oregon has a fabulous problem. But Minnesota , New York , there’s just, a lot of the states are extremely interested. You may know, Huckabee, Governor Huckabee is just our poster boy. I mean, he’s lost 100 pounds and he is really preaching the power of prevention through partnership. So, basically, what you can do. Very simple. Take the first small steps to being more active. You, yourself, just create a log, by going on to presidentschallenge.org and encourage your friends and co-workers and colleagues to sign up with you. So, I just wanted to, again, emphasize the main message of this conference; collaboration and partnership. We cannot do it alone. We have to do this together. And, we want to do it together. So, the President's Council just commends and applauds all of you for what you’re doing at the grass roots, local, community, state level. And, I just thank you very, very much. I appreciate being here today.