James H. Rimmer, Ph.D., Director

There is a wonderful book that I highly recommend to anyone interested in understanding how social change occurs within the 'macro' environment. The book is called the "The Tipping Point" and was written by Malcolm Gladwell. The term, tipping point, was actually coined by epidemiologists to describe sudden and dramatic increases in the incidence of a specific health condition such as the flu or AIDS virus. Suddenly, once a certain threshold is reached in terms of the number of people infected, things get much worse very quickly. Gladwell's premise is that in addition to applying to viruses, this type of pattern is observed in many other situations. He believes that changes that occur to a society or community usually start with a small group of people who align themselves towards a common goal.

I think we're starting to reach that 'tipping point' in health and fitness, as a growing number of people are becoming increasingly aware of the importance of physical activity in terms of improving their health. The mantra that is starting to reach a small number of HMOs, public health departments, and agencies is, "If you don't want to live a significant portion of your life tethered to doctors' offices, waiting rooms, hospitals, and medications, try losing weight by increasing your physical activity level and eating better foods."

While many of us who have been in this profession for several decades have chipped away at getting society to change its attitude about the importance of regular physical activity in improving and maintaining good health, only within the last few years have we drawn closer to that ever-important tipping point. We're not quite there yet, but we are getting closer. And this movement is starting to draw the attention of people with chronic conditions and disabilities. The NCHPAD newsletter is a good example of this slow but dynamic change. I am amazed at how many new programs are being developed for people with disabilities in the areas of recreation and sport. Every month we're receiving more and more information about new ski programs, sporting events, accessible nature trails or pools, and many more exciting programs that target people with disabilities.

The one 'tipping point' that we're striving for at NCHPAD is to remove barriers to fitness centers and health clubs. Many individuals with disabilities have expressed dissatisfaction with the level of accessibility at their local gyms. They don't feel comfortable working out in a setting where everyone looks 20 years younger and 40 pounds lighter. The locker rooms are impersonal and most don't have private changing rooms that allow someone needing personal assistance to clothe and unclothe in private. The equipment is either impossible to use or very difficult to get on and off; most display panels on the exercise equipment are hard to read or interpret; group classes such as Pilates, spinning, yoga, or aerobic dance are totally inaccessible; the front desk is too high and staff often don't see the person waiting below them; the people who work in health clubs are not knowledgeable about the ADA or specific accommodations for making the environment more disability-friendly; and the list goes on and on. Many people with disabilities have told us that when they enter the gym they feel isolated and uncomfortable. Some also have expressed that they feel like a nuisance if they ask for a specific accommodation. It's easy to understand why most people with disabilities choose not to use fitness facilities.

As we reach the 'tipping point' in society's understanding of the importance of physical activity, we must continue to strive for that same 'tipping point' for people with disabilities. Anything that is enjoyed by people without disabilities should be enjoyed by people with disabilities. In his book, Gladwell notes that 'connectors' are people who know a lot of other people and can spread an idea through multiple communities. Their presence makes an idea contagious. NCHPAD has taken on the role of being a 'connector' in reaching across various communities in an effort to assemble a critical mass of people with disabilities, professionals, disability and professional organizations, and governmental agencies who will support this movement and pay more attention to removing the many barriers that make it extremely difficult or impossible for people with disabilities to engage in a healthy lifestyle. We must maintain this momentum until we reach a 'tipping point' that will allow anyone with a disability equal access to health clubs and fitness facilities. This means not only getting through the front door, but just as important, having a friendly and warm environment that will make it an enjoyable experience.