A country's culture and its associated policies and programs create an environment that can promote or inhibit healthy lifestyles. In October, Mr. Mike Craven from the U.K.'s Manchester Learning Disability Partnership (http://www.ncpad.org/684/3055/2004-11-01#5) Fighting Fit program (http://www.ncpad.org/684/3055/2004-11-01#6) visited NCHPAD to compare American and British health promotion programs, particularly for adults with developmental disabilities. What follows are some of Mr. Craven's reflections from his visit:

Through the U.K.'s socialized system of medicine and social services, the government provides more health promotion services for persons with and without disabilities. One example is a governmental program called "Exercise on Referral," one-on-one fitness instruction. The government also expends more energy in nationwide campaigns encouraging citizens to become more physically fit (http://www.ncpad.org/684/3055/2004-11-01#7).

Though obesity is on the rise in the U.K. for persons with and without disabilities, it hasn't reached the epidemic proportions of that in the U.S. In comparison with English society, processed and fast foods appear to be a greater problem in the U.S., and food-oriented advertising can be quite intrusive. Moreover, systemic policy-oriented problems such as access to health insurance affects health status and quality of life for a significant proportion of the U.S. population.

The visit by Mr. Craven, who is a physiotherapist with a strong interest in fitness for people with developmental disabilities, provided an early dialogue of how the two countries can work together in building a better program of health and fitness for people with developmental disabilities. Both NCHPAD and Mr. Craven found this international exchange of perspectives to be quite illuminating. Such interchanges help us observe what alternative models may serve to improve U.S. and U.K. health promotion policy and programming for persons with developmental disabilities.