Exercise as Preventative Medicine
In many countries outside of the United States, public health focuses on prevention rather than cure. Strict Western medicine tends to favor treating an illness or condition either by offering a medication or a surgical procedure. This poses a significant burden on our country’s resources.Medicare and Medicaid programs alone currently spend $84 billion a year on what have become the five major chronic conditions afflicting today’s population: diabetes, heart disease, depression, cancer, and arthritis. Medicare costs for treating depression mushroomed from $1.3 billion in 1992 to $2.1 billion in 2000.According to Dr. James Dillard, author of the book The Chronic Pain Solution: Your Personal Path To Pain Relief, “People who exercise have less heart disease, diabetes, and cancer….It’s a no-brainer.” He further explains how data now exists illustrating “…all causes of mortality are lowered by exercise”.
As educated fitness professionals, we already pass on to our clients the knowledge that exercise may hold many physical and emotional health conditions at bay. In fact, it has often been said that if “exercise” could be delivered in a pill, it would be the most requested and prescribed medication in the world.
It is incumbent upon our industry to keep step with the medical professionals, encouraging them to explain the effectiveness of exercise when speaking with patients, both healthy individuals and those potentially at risk for developing chronic illnesses.
Tiers of Treatment
The paradigms of preventive and integrative medicines are in their infancy within our society. As defined in 1948 by the World Health Organization (WHO), prevention refers to “the range of measures aimed at preventing or reducing the number and seriousness of diseases, accidents or disabilities”.
3 predominant tiers of prevention currently exist, and each does play a role in today’s public and private health initiatives, albeit not in a very balanced manner.
The first tier encompasses the actions propelling us in the direction of decreasing incidence of disease in a population and aims to reduce the risk of new cases emerging.
The goal of the second tier is to reduce the prevalence of a disease in a population. This takes the form of action when a disease first appears, in an attempt to arrest its development and eradicate potential risk factors.
The third tier is where the majority of Western medicine resides. Its main focus is reducing the recurrence of chronic conditions in a population and to treat/mitigate complications, disabilities, and relapses once such diseases become acquired.
It is evident that a stricter adherence to Tier 1 might be a more prudent lifestyle construct than relying on ending up at Tier 3. The challenge is delivering this message to the entire population, not just preaching to those already engaged in such behavior.
Integrative medicine is an excellent starting point for such endeavors. As the name implies, such a paradigm seeks to blend conventional Western treatments with alternative and complementary approaches, such as lifestyle and fitness behaviors. By starting with a “blurring of lines”, as it were, and striking a balance between palliative and preventive approaches, a greater percentage of our society may be willing to embrace change.
Physician, Heal Thyself… In The Gym
In an ideal world, physicians would employ the psychology-related approach of modeling. Knowing that his doctor practices the habits of regularly exercising, making healthy food choices and adopting a lifestyle geared toward longevity, a patient may be more willing to take the steps necessary to shift his own lifestyle.
While this ought not be a utopian fantasy, doctors and nurses have become programmed to believe that in order to legitimatize their profession and ensure its continuity, they must rely upon unhealthy individuals, being heavily influenced by the giant pharmaceutical industry. After all, if everyone remains healthy, might there no longer be a need for conventional medicine?
An Imperfect Yet Improved System
Our society is far from allowing that to happen. While a majority of chronic health conditions may be prevented and attenuated by incorporating exercise and prudent nutrition into one’s daily regimen, the truth is that there are conditions which we simply cannot prevent in the gym.
We can do our part to strengthen our immune systems, but bacteria and virus particles still exist in the air we breathe, and preservatives are still present in many grocery items. In addition, genetics exerts a powerful pull, regardless of our lifestyles. The best we can do for our population is to reach underserved areas, promote education about lifestyle change, and encourage those in the medical profession to model good practices for their patients.
Joy Prouty, a Reebok Master Trainer and fitness studio owner, weighs in with her ideas on this topic: “To motivate inactive people, health/fitness professionals should think outside the box and outside the walls of the health club. Get out into the community and get people moving.
There are lots of programs going on in community centers, retirement homes, youth centers, malls, parks, and recreation facilities.” For as many of us that are already serving these demographics, there are an equal number of medical professionals who are unaware of such goings-on and their potential to help patients.
Taking steps to inform such individuals can propel fitness well into the next few decades. We can create flyers to leave in doctors’ waiting rooms, conduct lunch-and-learn seminars and exercise programs, and solicit doctors and nurses to actively participate in fitness health fairs.
Carol Kennedy, a faculty member in the Fitness Specialist Curriculum at Indiana University, shares her ideas on the future of fitness in general: “Professionalizing the field of health and fitness is a critical issue. There are many certifications/credentials that health/fitness professionals can acquire.There also are many different curricula in higher education that teach various skills to health and fitness professionals. Until organizations work together for the greater good – certification, credentialing and education will remain inconsistent. Organizations that educate, certify, and credential health/fitness professionals must be willing to work together rather than compete so that one standard can be adopted”.
By integrating our professionals into the medical arena and working alongside such specialists as physical/occupational therapists, orthopedists, and even psychiatrists, we can share knowledge of the role fitness can play in preventive healthcare.
Facilitators of the Future
Do we dare to conceive of a society where the posture of senior adults is upright and pain-free, where asthmatic teens breathe more easily, where Pilates is a prescription for treating depression? It is possible! Fitness professionals, as well as those in the medical field, must find a path they can navigate together, with the same common goal of preventing rather than medicating our population.