Walking business meetings and school lectures were among the actions U.S. Surgeon General Dr. Vivek Murthy suggested Americans take (PDF) to build up to a recommended minimum of 22 minutes a day of exercise needed to reduce the risk of diabetes and heart disease.
However, he didn't offer any federal funding to implement some urban planning ideas that could lead to healthier communities.
“You don't need a fancy gym membership or a special set of skills,” Murthy said before referencing the role walking has played in American history—such as the March on Washington led by Martin Luther King Jr. in August 1963 and the Women's Suffrage Parade of 1913.
Murthy recently told Modern Healthcare that he usually walks to work each day in about 30 minutes.
Calling walking “one of the most powerful things we can do to turn the tide on chronic diseases,” Murthy acknowledged that it isn't always as easy as it seems. Some communities lack streetlights and he cited a survey which found that 30% of Americans live in neighborhoods without sidewalks.
But he also cited the example of West Wabasso, Fla., a low-income community that had no sidewalks, streetlights or safe public parks. In 2004, he said the town, working with the Indian River County Health Department, undertook a 2½-year effort to install sidewalks and lighting, remove abandoned homes and improve local parks. After upgrades were complete, 95% of residents surveyed reported increased physical outdoor activity.
Murthy, however, did not mention the cost of these upgrades or how they were paid for.
“The economic risks and benefits of physical activity and of walking initiatives, programs and policy efforts are needed to guide decisions about resource allocation and program efforts,” Murthy's call to action report stated. “Calculations of the economic benefits of these interventions may need to include other potentially quantifiable savings that result from changes in environmental design or program implementation. Although some benefits (such as increased social interaction) may be difficult to directly quantify in economic terms, studies have quantified economic benefits related to factors such as fuel savings and reduced air pollution.”
Murthy announced the initiative with a host of speakers Sept. 9 at the Kaiser Permanente Center for Total Health in Washington. The speakers called for making communities safer and more accessible for wheelchairs but there was little mention of financing.
One exception was Betsy Laird, senior staff vice president on global public policy for the New York-based International Council of Shopping Centers. Laird noted that the nation's 114,000 shopping centers collect some $140 billion in sales taxes that are used to finance parks, sidewalks and other amenities called for by the surgeon general.
“Get out and walk, then get out and shop,” Laird told the audience.
Assistant Secretary for Transportation Policy Carlos Monje gave the human cost of unsafe streets. He noted that 700 pedestrians and 743 bicyclists were killed in motor vehicle accidents in 2013.
Jack Groppel, co-founder of the Johnson & Johnson Human Performance Institute, said there is a business case to be made since employees who move around are more focused, engaged and energized. He added that employee physical activity should be considered a key metric for business success and it's part of J&J's commitment to have “the healthiest workforce in the world.”
In his report, Murthy cites a 2012 study that found $117 billion in healthcare costs were associated with inadequate levels of physical activity.
Dr. Robert Sallis, co-director of Kaiser Permanente's sports medicine fellowship, said he “prescribes” walking to prevent and treat chronic disease. Sallis added that the hopes the surgeon general's call will signal a change in the priorities of the U.S. healthcare system and get it to invest more in keeping people healthy.
Kaiser has been part of this movement for years. Kaiser Vice President for Community Health Loel Solomon did not participate in the event, but he told Modern Healthcare how his organization has given residents cameras and instructed them to take pictures of barriers to physical activity in their neighborhoods.
“We use the pictures to build public will to make changes,” he said. “We've been doing this since 2005 in 50-plus communities and we're seeing a difference in people.”
