More Than Willpower: What's Holding Americans Back in Fitness

Part one of a two-part series. Read part two here.

Did you make an exercise goal for a New Year's resolution? Are you having difficutly meeting it?

If you are, it might not just be you. There may be some external factors at play. In January, the Centers for Disease Control and Prevention (CDC) released data on adult physical inactivity in the United States and several U.S. territories using data collected from 2015 to 2018.

Overall, the report shows that over 15 percent of adults in U.S. states and territories did not participate in any physical activity outside of their job. Most states and territories had 20 percent or more adults reporting no leisure time physical activity in the past month.

Keep in mind that even doing one leisure time physical activity during the last month would have changed the results. Being physically active once a month is a pretty low bar when it comes to evaluating fitness levels. By and large, the report indicates that adults in the United States need to be more physically active.

Since the report measures leisure time physical activity, here's our first question: Does discounting job-related physical activity make this an unfair representation of fitness levels and overall health in the United States?

The CDC also created maps that show hot zones of inactivity by state or territory. There are several maps that show differences in activity levels by region and ethnicity. These differences are striking.

“When you go through the CDC report, there are two main points that stand out. The first is that Southern states and the Northeast states have one of the highest inactivity levels. The second fact is that non-white Hispanics and non-Hispanic black adults got the least amount of exercise,” observes Dr. Dheena Sadik, Consultant Nutritionist and Dietician for Tea Leafed. 

So, the second question: What barriers exist preventing leisure time physical activity?

And, to wrap up this two-part series: What can people do to increase their activity levels regardless of the barriers they may face?

We reached out to health and fitness experts and looked at research studies to learn more about these questions. Read on to get their insight.

Does discounting job-related physical activity make the results an unfair representation of fitness levels and overall health in the United States?

While some experts noted that job-related physical activity contributes to overall health and fitness, others had compelling reasons for it not being an unfair statistic. 

Here’s why:

1. Active day jobs may not affect everyone’s fitness levels the same way.

Kristen Burris, LAc, MSTOM, Acupuncturist and Master Herbalist Eagle Acupuncture
“Oddly, in 20 years of practice, I have not noticed a correlation with active day jobs equating fitness. You would think every housekeeper in America would be underweight and muscular from the demands their job ask of them; however, it is not true. Leisure activity is key.”

2. Job-related activity is different from fitness.

Dr. Dheena Sadik
“A study conducted by Netherland researchers found that individuals who worked in construction and similar jobs were actually at risk for dying earlier. It appears that physically demanding jobs require a different type of physical activity. This, coupled with the fact that these workers don’t get as much rest could be doing their cardiovascular system more harm than good. So, in that way, even people with such jobs may need to work out during their leisure time as well.” 

Jasmine Marcus, PT, DPT, CSCS of McCune and Murphy Physical Therapy
“I'm a physical therapist and strength and conditioning specialist. I do think it's important to overlook the physical aspects of work, because your body becomes used to this level of activity, and to truly benefit from exercise, you usually have to overload the body and do more than what it is used to. 

Additionally, while a job may require heavy lifting, it probably isn't adequately lifting all the muscle groups that need strengthening. Additionally, everyone needs both cardiovascular activity and strength training, and even an active job may not hit both of these goals.”

3. The purpose of physical activity matters.

Samantha Clayton, Vice President of sports performance and fitness for Herbalife Nutrition
“All activity counts in terms of assessing people’s sedentary lifestyle behaviors. However, there is a big difference between doing purposeful exercise with the aim of improving your fitness level with dedicated time, versus simply moving your body doing activities of daily living or work. 

All activity is important, but intentional activities done for the purpose of decompressing or health improvement has a greater impact on our mental health and this, in my opinion, makes the report truly accurate. It’s for this reason that more people are prioritizing self-care wherever possible. Stress relief is needed in our busy lives and physical activity has so many positive health benefits.”

All of this is to say: having a physically active day job doesn’t mean your body is getting what it needs. 

As you evaluate your physical activity level, keep in mind that your activity levels also need to hit recommended levels to get the health benefits.

"An important thing to remember is the recommendation of 150 minutes of moderate-intensity aerobic exercise per week, so although your activity during the day is beneficial you want to make sure it is enough to raise your heart rate to get the benefits of exercise,” says Michael Groesch, PT, DPT Clinical Manager of Menorah Park Center for Senior Living.

What barriers exist preventing leisure time physical activity?

While the study also shows exercise rates across states and ethnic or racial groups, regions and ethnicity may not be the best way to interpret the findings. There are other factors that may have more of an effect.

Sadik remarks: “The one thing that the CDC study didn’t take into account was socioeconomic factors. However, if you were to take a closer look, this could be the missing piece to show why non-whites were getting less activity outside of their jobs.”

Socioeconomic factors likely have more of an impact on physical activity levels than anything else. 

In fact, the states with the highest poverty levels almost exactly match up with the states with the lowest activity levels when you look at the Overall Physical Activity Map from the CDC’s report and compare it to The Percentage of People in Poverty for the United States and Puerto Rico: 2018 map (Figure 2 in Poverty: 2017 and 2018 of the American Community Survey Briefs, issued November 2019).

When you consider that disparity in socioeconomic outcomes and poverty rates in the United States are different across racial and ethnic groups, it’s not surprising to see that these outcomes affect health.

For example, the Kaiser Family Foundation has data from 2018 that shows poverty rate differences across racial groups. The overall U.S. poverty rate for Whites is 9 percent. In contrast, the poverty rates for Blacks (22 percent) and Hispanics (19 percent) are both double the poverty rate for Whites. If you look at the states with the highest poverty rates for each group, they generally match the states that have 25 percent and higher reported inactivity levels in the CDC's report. While there are a few exceptions, these trends are telling.

“Across our nation, we see that the lower economic areas have the highest rate of a sedentary lifestyle. Many of the rural areas lack the simple amenities already mentioned, but have the added barriers of the lack of funds to join a gym, take classes, or buy the perceived necessary equipment. Inner-city areas have plenty of sidewalks but may be unsafe and lack outdoor green space,” says Sandra Crawley, RN, BSN and Mom Loves Best medical consultant.

These differences indicate a relationship between socioeconomic factors and physical health.

While there is evidence suggesting a strong correlation between poverty rates and leisure time physical activity, regardless of race, ethnicity, and region, there are other regional factors to consider. These include geography, weather, and climate.

For example, areas with hiking trails and nicer weather may make it easier for people to get outdoors and be active. Colder weather and storms can make it harder to get outside or even drive to a recreation center.

Experts we talked to also identified other potential barriers. Some of the barriers mentioned below are socioeconomic factors. Each potential barrier listed below may be experienced differently based on identity and location.

Weather

Amber Nash, fitness expert and group exercise instructor of Fit Healthy Best
“I live in Kansas City and getting outside from December through February is very difficult, which is common across the entire Midwest.  

Even on the days when there is no precipitation, you have to really bundle up to get out and be active. This can be harder for people with limited resources to buy warm layers or for parents with very young children.  On top of that, if you have limited financial resources and don't live close to a public rec center, your options for physical activity during these three months are severely limited.  

According to my fitness tracker, even though I aim to be active all winter, my activity levels do plummet during these months.  It's simply so much easier to just walk outside during the spring, summer, and fall in the Midwest and get in some movement than it is during the harsh winter months here.”

Fatigue and expectations around exercise

Alysa Boan, NASM Certified Personal Trainer at MyTennisLessons and RealFitnessMaven
“Physical activity can be daunting. Oftentimes we are not confident in the gym so we avoid it. Or we are so exhausted from our day, exercise gets pushed to the bottom of the priority list. What we must recognize is that exercise and a healthy diet are proven to increase energy levels, decrease stress, and improve sleep. All of which help to battle exhaustion and lack of motivation. Increasing exercise can be a strong indicator for improving overall health and wellness.”

Work-life balance

Michael Groesch
“Other barriers include time constraints and access to exercise equipment.  A lot of people have difficulty with finding a balance between work, responsibilities at home, and physical fitness.”

Samantha Clayton
“The main barrier that I see while traveling is that many people struggle to find a work/life balance. Technology as well as the expectation to be constantly connected to work is preventing people from making their health and activity a priority.

In most major cities around the world, time stuck in traffic or commuting each day also interferes with recreation, family time, and food prep time. People are then reduced to having to pick up takeout or skip the gym. A way to manage this is to try to beat the traffic, get to work early and squeeze in some exercise, use your lunch time to move or workout close to work, or use your time wisely after work to allow the traffic to die down. This way you can reduce your stress while also getting in your fitness activity for the day.”

Pain

Michael Groesch
“A large barrier we see in my profession to physical activity is pain. If pain is limiting your ability to be physically active this can impact your health substantially.  Consulting with a physical therapist is a great way to help you overcome this barrier and get back on track with your exercise.”

Read the second article in the two-part series: "More Than Willpower: Overcoming Barriers to Fitness"