Today, leading experts consider physical inactivity to be one of the most critically important public health problems of our times (Blair, 2009; Sallis, 2009). In 2003, physical inactivity was estimated to be responsible for over 200,000 deaths each year in the United States (Pate et al., 2006). Additionally, the World Health Organization (WHO, 2002) estimates that worldwide, 2 million deaths per year can be attributed to physical inactivity, making it a global health crisis as well. For the second time in history, the United Nations met to focus on a public health issue: the problem of non-communicable diseases (NCDs). At this Summit, organized by the WHO, the critical need to better address the enormous global burden of these diseases was recognized. NCDs include heart attacks and strokes, cancers, diabetes, and chronic respiratory disease, and account for over 63% of deaths in the world (WHO, 2011). Every year, NCDs kill 9 million people under the age of 60. According to the WHO, “NCD’s are largely preventable by means of effective interventions that tackle shared risk factors, namely: tobacco use, unhealthy diet, physical inactivity, and harmful use of alcohol” (WHO, 2011, para. 1). Substantial improvements in health and quality of life are possible by including moderate amounts of physical activity in daily life, according to evidence-based findings from a major report updated in 2008 by the Surgeon General on physical activity and health (U.S. Department of Health and Human Services [U.S. DHHS], 1996, 2008). The health benefits of physical activity and its importance in promoting good overall health and in reducing the risk of many chronic diseases, such as heart disease, type 2 diabetes, depression, and some cancers, and obesity are well known (Blair, 2009; Pollard, 2003). Strong evidence is emerging on the role of physical activity in brain health and the delay of cognitive decline (Blair, 2009).

In spite of this evidence that regular physical activity is necessary for health promotion and disease prevention for all populations, individuals in age groups from children to adolescents to older adults are not engaging in sufficient physical activity to achieve these benefits. According to the WHO (2002), 60% of the world’s population does not get enough physical activity to achieve even the minimal recommendation of at least 30 minutes of moderate intensity activity per day. For
those who do not follow the minimum recommendations for physical activity, the risk of getting a cardiovascular disease increases by 1.5 times.

Further, the costs associated with inactivity and obesity accounted for some 9.4% of the national U.S. health expenditure, whereas in Canada physical inactivity accounted for about 6% of total healthcare costs in 1995. Data from 1998 indicate that in the United States, individuals who are physically active save an estimated $500 per year in healthcare costs. It is reported that inactivity alone may have contributed as much as $75 billion to U.S. medical costs in the year 2000 (WHO, 2002). In the United States, there has been no increase in the level of physical activity participation from 1986 through 2000 (Figure 12-1), implying that most of the strategies during this time period have been ineffective in increasing physical activity participation in Americans. Indeed, data for deaths from low (cardiorespiratory) fitness indicate that it kills more Americans than smoking, diabetes, and obesity (“smokadiabesity”) combined (see Figure 12-2) (Khan & Tunaiji, 2011).

Experts suggest that new strategies and innovative approaches are needed to impact physical activity participation and health outcomes (Blair, 2009; Pollard, 2003). As discussed, interventions of collaboration, coalition building, and community organizing can be effective in accomplishing this goal.