A Publication of the
Jacobs Institute of Women's Health
June 1996 - Volume 4, Number 2
Any regular physical activity--not just exercise--can help women reduce their risk of chronic disease, according to Wanda Jones, PhD, associate director for the office of women's health at the Centers for Disease Control and Prevention (CDC). "Today it's not who we are but what we do that kills us--and in some cases what we don't do," she told a full house at the Jacobs Institute's breakfast seminar on May 1. "Physical Activity, Exercise, and Women's Health" was the first in this year's seminar series, which is focused on healthy living and living well.
Recently revised recommendations from the CDC and other agencies shift the focus from the intensity of physical activity to the frequency with which it is performed. They stress the importance of accumulating 30 minutes or more of any physical activity on five or more days out of the week. Dr. Jones defined physical activity as any body movement produced by skeletal muscles that results in energy expenditure, distinguishing it from exercise and fitness, which are more specifically targeted to developing certain abilities. What this means for women, she pointed out, is a change in perception, one that should make it easier to lead a less sedentary lifestyle without being co-opted into the "conspiracy of thinness" so prevalent in the media.
The health problems associated with inactivity are widespread. Inactivity is associated with as much as 25% of deaths from chronic disease. Nearly a quarter of the American population leads a completely sedentary lifestyle. During the average lifespan of 76 years, Americans can expect to spend an astonishing 12 years in ill health. Physical activity declines with age--starting at age 14 for geducation levels and socioeconomic status, as well as certain racial and ethnic groups.
But the health benefits of regular physical activity are clear. Dr. Jones cited the known positive effects on women's risk of contracting top killers like heart disease, cancer, and diabetes. Physical activity also reduces the risk of developing hypertension and lipid disorders, and improves other chronic conditions, such as osteoporosis and arthritis. Most studies have shown a clear dose-response to physical activity for both men and women, with the greatest gains seen among those who go from a sedentary lifestyle to an active one.
The evidence shows that more activity is not necessarily better, that any activity is a significant improvement over no activity, and that the duration of activity is not critical--even short bursts are effective. "This accumulation idea is very exciting," said Dr. Jones, "because many women are already doing some activity at this level but may not perceive it as useful as 'exercise.'"
Given all these benefits and the minimal risks of physical activity, Dr. Jones asked "What's stopping us from becoming more active?" Societal and cultural norms that have seen physical activity as harmful, unfeminine, or even self-indulgent and the emphasis on image that comes from the "conspiracy of thinness" are obvious answers. Environmental barriers include income and time, compounded for many women by the need for childcare. Safety concerns are further complicated by lack of transportation.
More important may be misperceptions of what physical activity really is: Dr. Jones pointed out that even with the advent of labor-saving machinery, housework has long required serious physical exertion. "We are biologically designed to be mobile," Jacobs Institute director Martha Romans pointed out in her introduction. Dr. Jones elaborated on that fact, enumerating many ways in which women are physically active simply doing housework: wrestling with a clothes washer that is out of balance, for example, mopping or scrubbing floors, carrying a 20-pound child. Confidence in one's ability to be active and fear of injury are other kinds of perception-based barriers.
The CDC's PACE program offers physicians and other health care providers simple counseling protocols that are short (5 minutes) and include patient education handouts. A recent evaluation showed the benefits of physician counseling in terms of time spent by patients in physical activity, the simplest being walking. A good way to start, Dr. Jones joked, would be to stop cruising for the closest spots in parking lots.
For information on the PACE program, call 404-639-2607.
The 1996 breakfast seminars series is sponsored by The Monsanto Company and G.D. Searle. Audiocassettes are available for $12 plus $3.50 shipping and handling. A resource packet on exercise and women's health is also available for $10 plus $3.50 shipping and handling. For more information, call the Jacobs Institute at 202-863-4990 or mail to: .
With grants from the Commonwealth Fund, the Henry J. Kaiser Family Foundation, and Wyeth-Ayerst Laboratories, the Jacobs Institute is establishing a program to gather and disseminate information about the ways in which managed care may improve or hinder women's ability to obtain timely and appropriate health services.
More than one third of insured, employed households reported being covered by a managed care plan in 1994, according to a Gallup survey for the American Medical Association. Such plans also cover 23% of Medicaid beneficiaries and 9% of Medicare beneficiaries--and these numbers are on the rise.
Through a series of issue papers and a corresponding series of panel discussions, the Institute will provide policy makers, health care providers, plan administrators, employers, and consumers with objective and unbiased information. The objective of the program is to help key players better understand issues, interpret data, identify research needs, and formulate policies about women's health.
A representative advisory committee will identify and prioritize topics , and the Institute will produce papers and convene panels on at least eight topics over the next two years. Examples of possible topics include plan practices such as restrictions on length of hospital stay, access to and choice of providers, and attention to confidentiality issues. Other potential topics include the impact of managed care on the uninsured and on specialized clinics such as those devoted to family planning, abortion, and primary-care-oriented women's health, as well as those serving women with disabilities, adolescents, and racial and ethnic minorities.
The Institute began exploring how managed health care plans can contribute to the deliver of quality health care to women through an invitational meeting convened last July. Plan representatives, health care providers, consumers, researchers, and policy experts met to begin identifying opportunities and challenges presented by the managed care concept. Proceedings from this meeting were published in Women's Health Issues, the Institute's bi-monthly journal. For more information, see Women's Health Issues volume 6, no. 1. To order, click on Order Form.
The Jacobs Institute of Women's Health has established a research grant to support efforts to find new ways to improve health care services for women. The grant is an annual award of $30,000 given to the selected applicant to conduct a research study resulting in a publication-quality manuscript on a topic related to women's health.
Areas of Interest
The research may focus on a number of areas, including:
The award is directed toward the objective of the Institute. It is not intended to support basic laboratory research, nor to evaluate local projects which are not generalizable.
Applications will be evaluated on:
Who is Eligible and Application Procedures
Citizens of the US, Canada, and Mexico who have a health care related degree and who are actively involved in women's health care are eligible. Applications should include background, related research, methodology, analysis of results and evaluation and should not exceed six pages. The project description should include a reason for the topic selection and a timetable for completion of the project.
A budget and a list of other support for the proposed project, either current or pending, should be included. No indirect costs are provided. The initial $25,000 is provided on the effective date of the grant. The final $5,000 is payable on receipt of the final report and manuscript.
Applicants must include a curriculum vitae and two letters of reference, one from a current academic colleague. Three copies of the application should be submitted. The application deadline is October 15, 1996. The selected scholar will be notified by January 15, 1997. Awards will run from July 1 to June 30.
Award recipients should submit one or more manuscripts evolving from their research to Women's Health Issues (the Jacobs Institute's peer-reviewed bi-monthly journal) for possible publication.
Mission Statement of the Jacobs Institute
The Jacobs Institute of Women's Health is an organization committed to excellence in women's health care. It will: