Immunizations

Immunizations protect more than just the individual.  The more people vaccinated in a community, the lower the chance that infections will spread.  If a disease is introduced to a population with low vaccination rates, it will spread and affect more people, causing a greater health problem.  An example is the measles outbreak that spread in Texas and New York.  The incidences occurred in areas with low vaccination rates as the disease quickly spread from person to person.

http://www.cdc.gov/vaccines/vac-gen/whatifstop.htm

Air quality

Nature lovers never think that being in the great outdoors could be detrimental to their health. Poor air quality affects everyone, some more directly than others but even the cyclists and runners come in contact with air pollutants. The leading causes of poor air quality include: high levels of traffic, industrial waste, and secondhand smoking, which lead to health issues like, asthma, lung cancer, heart disease, and respiratory illness such as pneumonia or bronchitis. Efforts have been put forth to help increase better air quality by inventions such as all electric cars, smokeless cigarettes, promotions for carpooling, and less industrial waste production.

How does smoking affect students on college campuses?: Programs and preventative measures that can help alleviate the issue

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In the time of '40s and '50s, cigarettes were one in the same with sex appeal and sophistication. Smokers could spark up just about anywhere. It wasn't until the 1960s when warnings against the dangers with reports linking cigarettes to cancer, heart disease and emphysema. Since then, we've come a long way in our understanding of smoking's health effects. It's now common knowledge that tobacco use can play a role in many other serious illnesses and health problems; not to mention how it directly or indirectly causes the death of hundreds of thousands each year. As a result, greater regulations have been placed on cigarettes, limiting their marketing, sale and use in a variety of ways. Why are smoking bans such a big deal on college campuses?

The Labors of Teen Pregnancy

What can be said about teenage pregnancy when it comes to public health policy and education? Is the solution to encourage safe-sex, preventative measures, and open discussion? Is there a healthy measure in accepting teen pregnancy as a societal norm and put funding into supporting the health of the mother and child? Is there any hope in abstinence only education? Evidence is gathering on the impact of teen pregnancy, both on the individual level and the populous level, and that evidence is suggesting both good and bad news.

Childhood Obesity: Not Just A Child's Problem

Childhood Obesity: Not Just A Child’s Problem

http://www.voluntarybenefitsmagazine.com/article/preventing-cancer.html

Childhood obesity is a serious issue that affects 12.7 million children in America. Most of you likely have a Aunt, cousin or friend who has dealt with some sort of weight issue. Obesity should not be taken lightly, many medical conditions that don't materialize until adulthood are occurring in children. Some of these diseases are hypertension, high cholesterol and type 2 diabetes. Children who suffer from obesity are also more likely to develop depression and low self-esteem (Centers for Disease Control, 2014). In the United States 18 % of children under the age of 12 are considered obese and this number has risen from 7% to 18% in the last thirty years (Anderson, 2006).

Depression

Poverty has been linked to a variety of health, learning and behavioral problems, including depressive symptoms for both adults and children (Butler, 2014).  Americans who are in poverty are more likely than those who aren’t to struggle with chronic health problems and depression disproportionately affects those in poverty the most.  According to Brown, about 31% of American in poverty say that have at some point been diagnosed with depression compared with 15.8% of those not in poverty (Brown 2013).  Some of the most common symptoms for both children and adults include feelings of loneliness, sadness, hopelessness, worthlessness, having little interest of pleasure in activities, fatigue, insomnia and thoughts of suicide. 

Winnable Battle: Tobacco Use

Tobacco use is the leading preventable cause of disease, disability, and the death in the United States (CDC, 2012). Smoking harms nearly every organ of the body, causing many diseases and negatively impacting the health of both smokers and nonsmokers who are exposed to secondhand smoke. According to the National Institute on Drug Abuse (NIDH), cigarette smoking accounts for about one-third of all cancers, including 90 percent of lung cancer cases. Smokeless tobacco (such as chewing tobacco and snuff) also increases the risk of cancer, especially oral cancers. In addition to cancer, smoking causes lung disease such as chronic bronchitis and emphysema and increases the risk of heart disease, including stroke, heart attack, vascular disease, and aneurysms. Smoking also harms and endangers the people who are exposed to smoke without smoking themselves. Nonsmokers who are exposed to secondhand smoke at home or work increase their lung cancer risk by 20–30%. Since 1964, 2.5 million nonsmokers have died from exposure to secondhand smoke.

AIDS in America

What is it?

HIV” stands for Human Immunodeficiency Virus. This virus hides in the body for a long time unlike the other infections that the immune system can detect. When the internal body’s environment is favorable the HIV starts to invade particular type of cells called T-cells. The invading virus forces the infected cell to make copies of the virus and destroy T-cells.

            AIDS is Acquired Immunodeficiency Syndrome. It is the last stage of HIV; although people who have HIV not always progress to AIDS. There is a treatment that helps the HIV virus to stop growing. Due to the fact that AIDS is an accumulation of more than one disease it is referred to as a syndrome (What is AIDS?, 2002).

What is Driving The Epidemic?

The AIDS epidemic is a health threat that touches the livesof many Americans today. AIDS is a silent killer that takes no prisoners and favors neither the young nor the old. The affect that a disease like AIDS can have on a population is no doubt devastating, but there are also troubling factors that come to light when the statistics are analyzed. These figures reveal a deeper cause of the persistence of the AIDS epidemic in America.

Simon Says, PLAY! : Why Childhood Inactivity Is Increasing

 Physical inactivity in children in the United States and around the world is and has been increasing. For example, “The World Health Organization estimates that 1.9 million deaths worldwide are attributable to physical inactivity” (Dobbins, De Corby, Robeson, Husson, & Tirilis, 2009 ). With the increase in physical inactivity, there will be an increase in acquiring illnesses such as cardiovascular, pulmonary, and metabolic diseases. Physical activity is imperative especially in children because it not only decreases the risk of developing chronic diseases, but it improves cognitive function; students are able to concentrate and be productive in their classrooms. The social determinants of health that affect physical activity in children could be the lack of distribution of government funds in prioritizing physical education in school systems, poor diet, socioeconomic status, and an increase in technology devices for which children are more drawn to; these are just a few of the many social determinants of health. In the United States, specifically in the Pacific Northwest, there are programs and non-profit organizations that advocate the importance of adopting a healthier lifestyle within children. These programs/non-profit organizations educate and coach the children and the family on how to implement healthier lifestyle habits, for which they’ve been affective.

Group 18 - Physical Activity

Group 18

Joseph Goldman

Amida 0mari

Leah Parker

Meagan Pettigrove

Leah Santiago

December 1, 2014

Blog Post: Physical Activity

         

      Amongst the CDC’s winnable battles is Nutrition, Physical Activity, and Obesity. According to the CDC between “1980 to 2000, obesity rates for adults doubled and rates forchildren tripled (CDC, 2014).” The primary causes of this increase in obesity are over consumption of calories and a decrease in physical activity. This problem exists everywhere in the United States. Not one single state in the US has an obesity rate lower than 15% (CDC, 2010). The CDC is attempting to tackle this problem from many angles. They are attempting to improve school lunch programs and improve access to fresh foods. We believe that tackling the lack of physical activity may be tougher to accomplish. The CDC is encouraging bicycling and the use of public transportation to promote physical activity, but that doesn’t go nearly far enough. A lot more physical activity in needed. So what is keeping people from the activity that they need? Environment, stress, food oases, too much screen time, and lack of physical education in schools all contribute to lack of physical activity and obesity. These are just a few of the things that contribute to the obesity epidemic in the U.S. The CDC believes that obesity is a winnable battle. They believe that through programs to change eating habits and increase activity, such as increasing green spaces and addressing food oases, these goals can be achieved.

Group 19: Childhood Obesity

The need to address childhood obesity has grown in the past few decades. According to the CDC (2014), cases of obesity have grown, doubling in children and quadrupling in teens during the past 3 decades as of 2012. The CDC also stressed that there is a difference between being overweight and obese, where the latter is “defined as having excess body fat” instead of simply having “excess body weight for a particular height from fat, muscle, bone, water, or combination of these factors”. Recent studies suggest that identifying the population at risk, children as young as three, will be the best to target for prevention and intervention, rather than proposing change as adults. As quoted by Kolata (2014), “Steven L. Gortmaker, a professor of the practice of health sociology at the Harvard School of Public Health, said young children can cross a line between being fat or normal weight by gaining or losing just a few pounds. For adults, it can be 20 to 30 pounds, or even 40 to 50 pounds” (p. 1). This is why maintaining an acceptable amount of body fat from a young age is crucial for prevention of childhood obesity. There is still a need to reverse the effects of inactive and unhealthy lifestyles right when the consequences of such begin to set in at a young age. This post will outline various social determinants that influence different populations, while exploring strategies for successful interventions that take these factors into account.

The social determinants of health are shaped by the communities we grow up in and the environmental conditions that surround us as we grow, work and age.  These circumstances are decided based on the distribution of money, power, family’s socioeconomic status and resources. As noted by the World Health Organization in 2014,  

These in turn shape the way society, both at national and local level, organizes its affairs, giving        rise to forms of social position and hierarchy, whereby populations are organized according to income, education, occupation, gender, race/ethnicity and other factors.  Where people are in the social hierarchy affects the conditions in which they grow, learn, live, work and age, their vulnerability to ill health and the consequences of ill health (p. 1)

Examining social determinants related to childhood obesity at macro, meso, and micro-levels will allow community members to identify the root causes of this issue in order to prevent it from occurring. 

At a macro-level, cultural norms and political agendas play a role in childhood obesity. It is widely known that the American diet consists of a lot of processed carbs, meats, and sugars. Slow cooked, fresh food isn’t as common as it was half a century ago where stay-at-home moms or multi-generational units cooked family meals daily. Now, there is a widening gap between the rich and poor, and both parents typically work a job, don’t share a home with their extended family, and/or may not have time to pack lunches or cook dinner. Parents often depend on institutions to provide their children’s meals. While the middle class has been disappearing, the amount of community investment has also dwindled. Meal plans at day cares and schools highly depend on the funding they receive as a result. The class status of children’s parents will determine where and what their children are fed. Those whose parents are upper class have more access to organic, fresh meals at their homes or schools. According to Kolata (2014), “most efforts to reduce childhood obesity concentrate on school-age children and apply the steps indiscriminately to all children, fat and thin — improving meals in schools, teaching nutrition and the importance of physical activity, getting rid of soda machines” (p. 1). To make a difference, we can support more funding for schools and lobby for the use of organic, fresh ingredients for children to consume, especially since parents are busier than ever and families may not have immediate access to grocery stores or expensive organic goods.

In an article written by Irwin & Solar (2010), the authors highlight the difference between levels of causation, distinguishing between the mechanisms by which social hierarchies are created, and the conditions of daily life, which then result from these social inequalities (p. 4).  At a meso-level, our family’s socioeconomic status, the neighborhood where their home is located, the city, the state, the country in which they reside, these all shape our social determinants of health, and yet, it is not a choice that we get to make.  The inefficient system in place is largely to blame for the obesity crisis we are experience here in the states; citizens of lower socioeconomic status don’t have as much power as their affluent white counterparts to control zoning laws in neighborhoods to not allow fast food restaurants to be built near their homes and neighborhoods. Also, they don’t have the money to petition against the city to change zoning laws. The obesity epidemic is not just a crisis due to the lack of available and affordable healthy foods, but also the lack of safe environments surrounding the supermarkets that are located in the lower income communities. This makes it even more difficult for individuals to change their behavior.

Furthering our scope to a micro-level, people of lower socioeconomic and ethnic minority status, typically have higher rates of obesity within a community. Obesity prevalence varies by age, gender, race, ethnicity and socioeconomic status, but is also associated independently with higher levels of physical inactivity and an increase in television viewing. As stated by Ebbeling (2002),  

Television viewing is thought to promote weight gain not only by displacing physical activity…US and British children are exposed to about ten food commercials per hour of television time (amounting to thousands per year), most for fast food, soft drinks, sweets, and sugar-sweetened breakfast cereal. Exposure to 30-second commercials increases the likelihood that 3–5-year-olds would later select an advertised food when presented with options (p. 475).

Children of lower socioeconomic status have increased risk of obesity due to the lack of affordable activity/sport programs that can replace sedentary entertainment like television. They also have the inability to control if their families can afford to buy healthy alternatives to cheap meal options, such as organic fruits and vegetables, and raw goods and poultry to cook a well-balanced meal. Coupled with the fact that there are increased amounts of fast food available to these areas, those who belong to a minority and are of lower socioeconomic status are at risk for becoming obese at a young age.

            Childhood obesity is not a new concept - obesity in children has existed throughout all decades. However, that is not the current problem in the realm of childhood obesity; the problem is the rate at which the population of overweight children is growing. The facts make for a solid argument to study ways to intervene and prevent childhood obesity from occurring. According to national research and data, the amount of overweight youth (6-17 year olds) has more than tripled in the past 50 years. Approximately 4% of youth in the 1960’s were overweight, compared to 15% in 2000 (Ritchie et al., 2001). The most recent data from the 2008 National Health and Nutrition Examination Surveys shows that 17% of youth is obese, and an additional 15% is overweight (“Childhood Obesity Prevention”).  More children are becoming overweight each year, which poses a threat to their overall health and well-being, sometimes following them into adulthood. Tackling the ongoing problem of overweight children is essential, because it is estimated that one-half of overweight youth remain overweight as adults, and one-third of overweight preschoolers remain overweight throughout adulthood as well (Ritchie et al., 2001). Obesity in adults has been linked to and associated with an increased risk of multiple health problems such as high cholesterol, high blood pressure and type 2 diabetes (Ritchie et al., 2001). There are a great deal of reasons why interventions and community based programs that teach children healthy eating and physical activity habits should be prevalent and widespread throughout the nation.

            One of the biggest lessons learned from overweight intervention studies is that healthy habits and lifestyles start in the home and are long-term. Parents and families play a major role in assessing the eating habits of children. Children learn from their parents, and tend to model the behaviors carried out by their parents such as food preparation, purchasing, and consumption (Ritchie et al., 2001). If a child grows up in a home where only fast-food is consumed, then chances are that child will grow up to have the same poor eating habits. Because children often carry out the same habits and behaviors all throughout life, parents should teach their children about healthy eating habits, cook healthy and nutritious meals, and limit access to oily and sugar-filled foods and beverages. Parents should also encourage their children to spend more time outdoors and participating in physical activities, and spend less time being sedentary by watching TV, playing on the computer or playing video games.

While the goal for many adults during interventions is focused around weight loss, the goal among children is weight maintenance (Ritchie et al., 2001). By teaching children to remain a healthy weight, children are able to learn healthy habits that lead to a healthier lifestyle rather than focusing on weight and body image. Weight status does not always directly correspond to health status, which is why improved health through multiple indicators and goals is used to measure and evaluate success in overweight interventions. Components of physical activity, a healthier diet and psychosocial adjustment are all used as indicators and measurements of a healthy lifestyle during interventions (Ritchie et al., 2001). These three strategies must be extended to our daycares and schools, too. Healthy habits start at home, but should also be continued in the places where children spend the majority of their time. This requires action at the individual level at home and at the community level through our voting practices, food quality expectations, and societal investment in our youth. Through each of these levels, we can prevent at-risk populations from developing obesity as a child.  

References

Childhood Obesity Facts. (2014, August 13). Retrieved November 19, 2014, from 

http://www.cdc.gov/healthyyouth/obesity/facts.htm

Childhood Obesity Prevention, About ‘We Can’! (2013, February 13). Retrieved November 21, 2014, from http://www.nhlbi.nih.gov/health/educational/wecan/about-wecan/background.htm

Ebbeling, C. B., Pawlak, D. B., & Ludwig, D. S. (2002). Childhood obesity: public-health crisis, common sense cure. The lancet, 360(9331), 473-482. Retrieved from

            http://www.sciencedirect.com/science/article/pii/S0140673602096782

Kolata, G. (2014, January 29). Obesity Is Found to Gain Its Hold in Earliest Years. Retrieved November 19, 2014, from http://www.nytimes.com/2014/01/30/science/obesity-takes-hold-early-in-life-study-finds.html?_r=0

Ritchie, L., Crawford, P., Woodward-Lopez, G., Ivey, S., Masch, M., Ikeda, & J. (2001). Prevention of Childhood Overweight - What Should Be Done?. Retrieved from http://cwh.berkeley.edu/sites/greeneventsguide.org.cwh/files/primary_pdfs/Prev_Child_Oweight_10-28-02.pdf

Solar O, Irwin A. (2010). A conceptual framework for action on the social determinants of health. Social Determinants of Health Discussion Paper 2 (Policy and Practice). Retrieved November 14, 2014 from http://www.who.int/sdhconference/resources/ConceptualframeworkforactiononSDH_eng.pdf

WHO. Taking action to improve health equity. (2014, January 8). Retrieved November 14, 2014, from http://www.who.int/social_determinants/action_sdh/en/

Obesity: The Stress of Being a Black Woman in America

Written by: The Fabulous Five (aka: group 3).
Anouh Phanthavong, Austin J. Blount, Eliya Matz, Jonathan Gonzales, and Hashmiyah Alkhars.           

 At this point in time it is relatively well-known that obesity in the United States of America is, simply put, an issue. This fact about our fair country is particularly embarrassing given that globally we single handedly spend the most money on health care, yet have some of the worst health outcomes. One of these terrible health outcomes is the aforementioned obesity rates. There are quite a few different factors that contribute to this. These include, but are not limited to, certain racial/ethnic groups, individual attitudes, and general access to things that support good health (CDC, 2010).

            Before diving into some common causes of obesity it should be made clear what exactly that is. There is a key difference between being obese and being overweight. One being something that you should keep an eye on and the other becoming a health concern, putting you at risk for certain diseases and dangers (e.g. high blood pressure and heart attacks). The two are often used interchangeably, this incorrectly. Supposedly the way to delineate between the two is by using the Body Mass Index or “BMI” formula. Generally the decision of whether a person is obese or not is determined by comparing the results of said BMI formula to a number that has been deemed an appropriate result and one that is not. According to the World Health Organization, those numbers are: 25≤ is overweight while 30≤ is obese (WHO, 2014). That is a very small window and is based on a number scale system ranging from 1-100.

Drinking and Driving and The Dangers it May Pose

http://patch.com/virginia/mountvernon/missing-grad-seen-man-sobriety-checkpoints-no-cougar-evidence-and-dcs-rude-drivers 

According to the Centers for Disease Control and Prevention, “Every day, almost 30 people in the United States die in motorvehicle crashes that involve an alcohol-impaired driver.” (October, 2014) Driving under the influence of intoxicants, or DUII, has been a difficult problem to overcome in the United States. DUII is categorized as driving under the influence of intoxicants that impair the brain’s ability to make rational and timely decisions. Examples of intoxicants are alcohol and illegal drugs. These intoxicants inhibit brain function and decision making skills. Due to the increasing number of cases involving DUII car accidents, the Oregon Department of Transportation (ODOT) has put in place campaigns to educate drivers of all ages on the dangers of driving while under the influence of alcohol. The Centers for Disease Control and Prevention considers this area a “winnable battle”, and according to the Transport Accident Commission there has been a sizable decrease in DUII related accidents since the late 1980’s (see table 1) (n.d.).

Physical Fitness (Or Lack Thereof)

Group 8

Our Comm/Our Hlth

Portland State University

12/01/14

Physical Fitness (Or Lack Thereof): A Winnable Battle

If asked, many of us would admit to being aware that we ‘should’ exercise more. Or if we already exercise, then we likely realize that our population as a whole could use a little more physical activity, and we are probably accustomed to hearing about how exercise promotes health, prevents disease, etc. So why, as a population, do we not engage in more physical activity? Some may hold the belief that Americans in general have gotten too lazy, or have become too busy. Or maybe it is simply that we have grown accustomed to living in a culture where everything is done for us instantly, and we would prefer to take a pill to mask a headache rather than take some uncomfortable steps (around the block, perhaps?) to prevent it in the first place.

Without a doubt, these could be valid excuses for lack of physical activity for certain parts of the population. However, we would do well to consider that there are many other social determinants that may influence whether a community or an individual participates in adequate physical activity. As stated in The Ottawa Charter for Health Promotion, we will find out that “health is created and lived by people within the settings of their everyday life; where they learn, work, play and love,” (World Health Organization, 1986). This means that there are many factors influencing the amount of physical activity in our lives, and while personal choices are important, there are forces that are much stronger that influence healthy behaviors.

Less than 48% of adults are getting the physical activity they need (CDC, 2014). However all this can be changed if adults take action for their workplace. Healthy employees means more productivity. There are many ways employers can make their employees healthy by promoting physical activity at the worksite. One way is have educational materials be distributed on the bulletin boards and cafeteria. The educational materials could be about facts about health or exercise classes, employees can sign up for. Companies can create sport teams or walking clubs and compete with other companies. This would help with participation and maintain the commitment to physical activity. Companies can also partner with local fitness facilities where employees will have increased access and reduced cost. If companies cannot partner with local fitness facilities then they can build their own gym. These gyms will have aerobic and weightlifting equipment and showers for joggers and exercisers. One of the simplest way of promoting health at the workplace is taking the stairs. Sometimes the simplest things can lead to bigger goals.

Sometimes, it is difficult for a person  to be able to exercise. They might make excuses that they don’t have money for expensive gym equipment, that they don't have a gym membership, or that the weather is too unpleasant to go outside for a jog. However, what they don’t understand is that some exercise is better than not doing anything. With that being said, a person can jump rope inside their home, or do stretches inside their house.

The exercises shown here can be done at home in less than 10 minutes. There is really no reason that a person should feel that they aren’t able to exercise. Not only does working out cause a person to be in good shape, but it also allows a person to be healthier, reduce stress and anxiety and help them live a longer, better and happier life.

Furthermore, our bodies are created to be active, we are created to run miles with our complicatedly engineered knees and legs, we are created to hunt for our food, or spend long times during the day to gather supplies; however somewhere throughout the centuries we have lost the connection we had with our bodies and being healthy, and have focused it on being lazy and finding the best possible way to make our lives easier. It might sound like it is too much to work out everyday for 30 min to a person in this day and age, but it shouldn’t.

There is also the aspect of capitalizations and the fact that its very hard to find open spaces or parks to exercise in, and the cost of gym membership is enough to feed a village in Africa. The fact is that even if a person is willing to exercise, this economy and system will find a way to stop that from happening. But it is not that hard to take 10 minutes, three times a day, in the comfort of our own home or work space, and just be active, walk around, stretch, or just dance. It doesn't matter what you are doing, as long as you are active. The fact is, whether we want to hear it or not, we are on this planet for a very short period of time, and every second we spend being inactive we are taking a bit of that time and throwing it away, so let’s get that time back.

However, getting that time back is far more complex than simply finding the time. There are a multitude of factors that influence one’s ability to not only find the time, but also the resources to make physical fitness an attainable goal. For it is not about an individual prioritizing physical fitness, but rather how the environment that surrounds them supports opportunities to maximize their physical fitness. When “obesity continues to impact greater than 2/3 of the U.S population” it is clearly not an individualistic issue (Gustat et al., 2014). Anything from the amount of sidewalks to the number of functioning street lights can affect rates of physical activity. Essentially, the neighborhoods we live in design the framework in which one can be physically active.

For instance, programs have been implemented to try and mitigate the grand scope of the obesity problem through physical fitness intervention. Although this issue affects almost all social strata, there are those that face more social inequities and therefore experience higher rates. Because this problem is vast, studies have tried to narrow down the grand scale. In a study in South Carolina there was an overview study that provided nutritional information, exercise tips, and discounts at fitness centers to a wide group of people spanning many races, socioeconomic backgrounds, and genders. Even though the results were only slightly better amongst most groups, the more disadvantaged subpopulations seemed to benefit the most (Gay & Trevarthen, 2013). However, this does speak to why generic intervention like this often doesn’t produce stellar results. This study shows who may need more help. On the other hand it doesn’t bear in mind the specific needs of each subpopulation.      

Giving someone the chance to exercise for the recommended 150 minutes is a far better solution than just telling them that they need to increase their exercise regimen. Since about 45% of people live with some sort of chronic disease (type II diabetes, hypertension, heart disease) as a result of being overweight, it’s obvious that physical activity inequities are causing serious problems (Gustat et al., 2014). The best place to find a solution to a problem of this magnitude is to start at the source. In this case, neighborhoods are an ideal platform upon which to launch better access to physical fitness improvements. Although programs should not be implemented without community input. Generally, “targeted and tailored programs can enhance participation and adherence when preferences are taken into account” (Gay & Trevarthen, 2013). Increasing walkability, adding fitness centers, or changing zoning codes should be done with the specific community in mind. These shifts “aim to influence large groups of people, even populations, rather than promoting change only at the individual level” (Gustat et al., 2014). Interventions at the population level are needed so as to enhance the social determinacy of physical fitness for all, not just a privileged few.

So while we do create our own health to some extent by the personal choices that we are able to make, it goes without saying that we only make the choices that we are able to make. If one chooses to live more healthfully but does not have the means to do so, then this decision may not be very useful. If a person has fair health, access to gyms in the workplace or the means to travel to a safe park or jogging trail and then chooses to add physical activity to improve their health, then they may have a different health outcome than someone who lives in an unsafe neighborhood and has no access to gyms and who decides to do sit ups in their living room every day. Again, let us focus on implementing programs and policies to increase physical activity by looking deeper into the source of the social problems preventing this. We all deserve to be healthy, and we all deserve to have access to that which will improve our health.

Bibliography

 (2014, July 14). Retrieved November 19, 2014, from http://www.cdc.gov/physicalactivity/

Gay, J. L., & Trevarthen, G. (2013). Location, Timing, and Social Structure Patterns Related to Physical Activity Participation in Weight Loss Programs. Health Education & Behavior, 40(1), 24-31.

Gustat, J., O'Malley, K., Tian, H., Tabak, R. G., Valentine Goins, K., Valko, C., & ... Eyler, A. (2014). Support for Physical Activity Policies and Perceptions of Work and Neighborhood Environments: Variance by BMI and Activity Status at the County and Individual Levels. American Journal Of Health Promotion, 28S33-S43. doi:10.4278/ajhp.130430-QUAN-216 

WHO | World Health Organization. (n.d.). Retrieved November 20, 2014, from http://www.who.int/en/

World Health Organization. (1986). The Ottawa charter for health promotion. Retrieved from http://www.euro.who.int/__data/assets/pdf_file/0004/129532/Ottawa_Charter.pdf.