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NCHPAD - Building Healthy Inclusive Communities

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November 2004


James H. Rimmer, Ph.D., Director
James H. Rimmer, Ph.D., Director
An eye-opening report published recently by the President's Council on Physical Fitness and Sports noted that much of the increase in obesity over the past two decades is related to several interacting environmental factors including less time and space to engage in physical activity; more time watching TV, surfing the Internet, and playing video games; less walking or riding bikes to school; larger portion sizes offered by the food industry; greater consumption of processed carbohydrates; and lack of time in schools and the workplace to provide physical activity breaks. Obesity leads to many health problems, most notably type 2 diabetes, joint pain, cardiovascular disease, arthritis, fatigue, and sleep disorders. The deadly combination of an inactive lifestyle and excessive fast food consumption has created an emerging condition known as environmental disability.

A few years ago, much of the blame for the growing number of Americans who entered the ranks of the obese or overweight was directed at genetics rather than the environment. Today, however, the pendulum has swung back to the other side and experts are blaming urbanization, mechanization, and the associated cultural and environmental changes with the incidence of out-of-control weight gain leading to environmental disability. The International Obesity Task Force published a report indicating that the environmental causes of obesity can be attributed to increased motorized transport; increased traffic hazards discouraging more walking and biking; fewer opportunities to recreate; increased sedentary behaviors; multiple TV channels available 24/7; availability of greater quantities and variety of energy-dense foods; increased promotion and marketing of these foods; easier access to food, including free home delivery; increasing number of fast food restaurants and one-stop stores offering low-nutrition food products; larger portions promoting better 'value' for the dollar; increased ease of obtaining food 24/7; rising consumption of soft drinks which contain high levels of corn syrup; and door-to-door transportation.

The environment exacerbates the health of people with disabilities more so than the general population. As difficult as it is for someone who is able to walk and drive a car to become physically active and eat well, think of what it would be like if you were unable to drive a vehicle, had limited ability to walk or were unable to walk, and had virtually no access to healthy foods because of income limitations and/or not being close enough to a grocery store that sells fresh fruits and vegetables. What is a person to do if he or she uses a manual or power chair for mobility and lives in a neighborhood where the grocery stores are more than a few blocks away? What happens to those who are unable to cook and must rely on inexperienced food preparers who have relatively little time or interest in cooking healthy meals? Where does someone go to exercise if he or she can't afford a gym membership or has no means to get to it? The challenges of eating well and becoming more active are greater for persons with disabilities, and the added layer of environmental disability creates new impairments and functional limitations.

This year's American Public Health Association annual meeting in Washington, DC will address environmental factors that mediate or moderate successful health practices among people with and without disabilities. It is intended to increase awareness among public health officials and policymakers that the environment creates new disabilities that will impose a serious burden on those with existing disabilities as well as those who are on the precipice of becoming disabled by living in an environment burdened by poverty and poor health. The phrase, environmental disability, may someday be linked to the creation of a new type of disability, one that emanates from poor eating habits and a sedentary lifestyle, targeting a generation who acquire their disability by being caught in the cross-hairs of an environment saturated with calorically dense foods and little or no opportunity to move.


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