What if there was one prescription that could prevent and treat dozens of diseases, such as diabetes, hypertension and obesity? Would you prescribe it to your patients? Certainly.
- Dr. Bob Sallis, Founding Task Force Chair
Exercise Is Medicine® Canada
I think we can all agree there is overwhelming evidence that physical activity improves population health (Fremont, et al., 2012). As the American College of Sports Medicine (ACSM) states, “there is no other prescription with such pluripotent potential” as exercise. Let’s think about this for a moment. This is a POWERFUL statement. This means there is no single medication that can encompass the broad spectrum of application that exercise prescription can offer. So why is it that we, in a modern society that is rapidly succumbing to the dire health and financial consequences of physical inactivity, are not prioritizing the need for exercise-based prescriptions given by primary caregivers for chronic disease and prevention and intervention?
In an unprecedented era where over half of Canadians have settled into a “culture of convenience” and inactivity, the message that “exercise will improve your health,” is clearly not enough (Statistics Canada, 2016). Physical inactivity costs Canada 6.8 billion dollars annually (Joy, et al., 2012). So, in strictly practical terms, the financial impact of our sedentary behaviour has created an ever-increasing burden on our healthcare system, not to mention more sick days and decreased productivity in the workplace and in schools. More importantly, this has meant our children will likely be at the highest risk for early onset cardio-metabolic disease/disability than any young generation in history (Centers for Disease Control and Prevention, 2015). What kind of legacy does this leave for future generations, and how will this further the burden our healthcare system and economy in the future? How do we systematically work towards instilling the habit of regular exercise at an early age so we can avoid the downward spiral of chronic disease and disability (CDD), or at the very least, delay the onset for as long as possible?
We are faced with a hugely daunting task that will require wholesale changes of attitude towards exercise as medicine at all levels of society. We would have to devise a top-down system (from all levels of government, to healthcare, workplace, schools and households), which will create an environment to support, encourage, and even reward households, - especially those households with children - that participate in exercise programming (organized sports, personal training sessions, gym memberships). This means focused government programming, tax credits and healthcare coverage for fitness activities that will breakdown many of the socio-economic and ecological barriers to exercise that so many of us encounter; it means primary physician care that includes vital sign and health risk assessment and exercise prescription; it means support from the workplace by way of providing fitness facilities and/or regular exercise programs on-site, flexible work hours for participation in physical activity (including their children's), or benefits for those who are in registered fitness activities or use personal trainers; and finally, it means re-introducing physical education curriculum back into schools as a mandatory daily requirement. It will have to be a two-pronged approach that will prioritizes prevention, while also serving as intervention for those that are already suffering from CDD.
Exercise is Medicine® Canada (EIMC) is part of a global initiative that was launched by the American College of Sports Medicine in 2007 to address this very issue (EIMC, 2016). It’s vision, to have physical activity as a central part of the prevention and treatment of chronic disease in the Canadian Health Care System (EIMC, 2016). This is a great start. And since it is clear to anyone who pays attention to anything and everything fitness, especially online and on social media, that FITNESS IS IN, there is no better time to piggyback on this movement. EIMC’s mission and goals are as follows:
To provide national leadership in promoting physical activity as a chronic disease prevention and management strategy to improve the health of Canadians.
Increase the number of health care professionals who are assessing, prescribing and counseling patients in physical activity; and
Facilitate the collaboration between health care and Exercise is Medicine Canada recognized professionals in the prevention and treatment of chronic disease.
According to the British Journal of Sports Medicine, physicians are in a critical position to assist patients in embracing healthy lifestyles through proactive counsel and exercise prescription (Joy, et al., 2012). Sports medicine physicians, in particular, with their expertise in sports and exercise medicine are in a prime position to provide expertise to patients, students and peers. If primary care physicians are not equipped with the clinical tools and processes that aid in exercise counsel and prescription, then perhaps a cross referral system should be implemented.
These are just some examples of how we can effect change, but altering physical activity behaviour remains an enormous challenge. The EIM in Canada and worldwide will need to continue their efforts in partnering with all facets of government, healthcare professionals, education, exercise professionals and community organizations to support this change. How we get all levels to buy in is the million-dollar question. Ultimately, for Canada, it has to start from the top - Justin Trudeau, just doing pushups as a photo op is not enough!
By Sandy Yoo