Of the leading modifiable causes of death in the United States today, physical inactivity ranks alongside factors such as high blood pressure, use of tobacco products, high glucose levels, and obesity (CDC, 2014). When looking at the risk factors of premature death, physical activity is one of the easiest to modify, as it is not addiction based and can be maintained without the use of medication. The American College of Sports Medicine recommends that adults participate in at least 150 minutes of physical activity each week, with minimal recommendations of thirty minutes for three days a week (ACSM, 2017). Even minimal amounts of moderate to vigorous physical activity provide health benefits, as shown by the British Journal of Sports Medicine (Hupin, Roche, et. al., 2016). Because physical activity recommendations do not take much time or effort, it would be easy to presume that everyone could easily achieve the recommendations. However, with a variety of reasons as to why individuals are nonadherent to exercise, such as lack of access to safe places of exercise or financial capability, many do not. Special populations, such as low-income and homeless individuals, have a particularly difficult time meeting recommendations for physical activity.
Physical activity plays a vital role in maintaining and improving overall physical health. Those who are physically inactive suffer far greater risk of developing chronic diseases, such as cardiovascular disease, diabetes, cancer, obesity, hypertension, osteoporosis, and depression (Warburton et.al., 2006). Physical activity also helps in maintaining and losing weight. Unfortunately, the Center for Disease Control and Prevention records that only one in five adults in the United States meet the recommended amount of daily physical activity (2014). Of these adults, more non-Hispanic white adults met the recommended daily amounts of aerobic and muscle-training physical activity than other racial groups (CDC, 2014). This trend follows that of low-income communities, being comprised mostly of minorities and suffering a lower physical activity level. While in 2014 non-Hispanic white adults had a 10.1 percent poverty rate in the United States in 2015, the lowest of any racial group, black adults had a poverty rate of 26.2 percent, Asian adults a rate of 12 percent, and Hispanics a rate of 23.6 percent (DeNavas-Walt, Proctor, 2015). These percentages show a positive correlation between income and physical activity. With more leisure time and access to safe places of physical activity, high-income communities are better able to meet recommended amounts of activity and lower risks associated with physical inactivity. Low-income, low-education, and homeless individuals are particularly at risk for high rates of physical inactivity.
Introducing more accessible physical activity methods to low-income communities could greatly improve its members’ health. In the United States, homeless individuals are three times more likely to die than the general population (CDC, 2016). While these issues are in part due to outside factors, improved physical activity greatly reduces these issues and therefore has the potential to decrease mortality. The problem comes in that there are far fewer recreational resources available to low-income and homeless individuals (Moore, Diez Roux, et. al., 2008). Many of the resources that are available in these areas require fees for participation or use of equipment. By creating a safe, accessible, environment to participate in physical activity, free of cost, one of the largest barriers of physical activity is removed. Once the issue of resources is improved, other contributing factors to inactivity may be addressed.
While adults are typically the focus of concern, many children are also being affected by inadequate physical activity. A study done in Bangladesh sampled 240 homeless children, asking them questions about a variety of health questions from the amount of meals they eat each day, to exercise, sicknesses and even hygiene (Rahman, 2016). It was found that over two-thirds of the children were malnourished, and the 6.25% were overweight (Rahman, 2016). While the obesity number is small in comparison to the malnourished, underweight children, both sides of the spectrum could be counteracted by exercising regularly. Childhood obesity has grown to be a vital health problem in the United States. In 2014, the presence of obesity was 14.4% in children that were 2 to 4 years old in low-income families (CDC, 2016). Children that are obese in the early years of childhood are most likely to stay obese throughout their teen years and adult life, which in turn can lead to the factors of obesity (Pan, 2015). The World Health Organization lists physical activity as a leading cause in obesity, which in turn proposes further health risks (2017). In order to help children overcome obesity, physical activity of some sort is required. In low-income communities, it is more difficult to exercise due to insufficient or unsafe resources available for recreation, however, it is necessary for children to understand the benefits of physical activity early on. While it may not seem detrimental now, children are going to grow up and be the leaders of the United States. If they know nothing about physical activity and exercising, along with how important it is in maintaining and improving, the health of America’s population will not improve, but will continue to suffer. Introducing physical activity and health to children, especially those who do not have access to it, will help improve the way that physical and mental health is perceived in the future.
In addition to poor physical health among low-income communities, poor mental health can also be an occurrence while living a sedentary lifestyle. It has been found that physical activity plays an essential role in controlling mental health illnesses, especially depression and anxiety. Increased physical activity or aerobic exercise has reduced symptoms of depression considerably, as it releases endorphins in the brain that improve mood (Paluska, 2012). It has also been found that symptoms of acute and chronic anxiety can improve and dissipate with frequent exercise, as well as with meditation and relaxation (Paluska, 2012). Homeless and low-income individuals are more likely to suffer from chronic illnesses, substance abuse, and poor mental health than non-homeless individuals (CDC, 2016). The connection between homeless or low-income families and mental health issues is very complex, due to the fact that mental health problems can be either a contribution to or a consequence of homelessness (Chambers, et. al., 2015). Homeless and low-income women with children are more likely to suffer from mental health issues than their male counterparts, especially depression, anxiety, humiliation, and guilt (Chambers, et. al., 2015). Things such as material deprivation, financial struggles, and a lack of stable living conditions, may contribute to a feeling of failure and defeat because the women are not able to provide a safe environment for their children (Chambers, et. al., 2015). Providing a safe and secure environment for the low-income families to exercise would allow the women to relax and, at the same time, aid her mental health. Psychological issues and mental health problems could potentially be improved by exercising daily and doing physical activity.
While many people enjoy being physically active, others find it unappealing, unimportant, or simply do not know ways in which they can participate in it. This in turn leads to physical nonadherence and contributes to a sedentary lifestyle. There are many reasons that make it potentially more difficult to engage in physical activity within certain populations, such as the homeless and low-income populations. The factors contributing to physical inactivity and sedentarism can be grouped into three categories: predisposing, reinforcing, and enabling factors. When specifically looking at homeless and low-income individuals, factors such as a lack of resources, unsafe environments, lack of time, social and political factors, and a lack of knowledge on the benefits of physical activity all play an active role in making adequate amounts of exercise difficult to achieve.
One of the main factors contributing to physical inactivity is the lack of places to engage in exercise. Most urban neighborhoods have buildings built very close to each other, and it can be difficult to accommodate everyone in it. A lack of free space could cause low-income neighborhoods to lack parks or even an open yard. Not having parks, courtyards, or open facilities can be very detrimental to the overall health of the communities as they do not have a space to be active. As seen in a census data from Powell, 25.59% of neighborhoods in the United States have only one place to exercise, while the rest do not have a place for recreation at all (Powell, et. al., 2006). With no park or open area to exercise, it can be hard to achieve recommended levels of physical activity. Individuals in low-income communities are less likely to have access to safe areas to exercise and be physically active, such as parks, gyms, and health centers. In 2008, low-income communities were 4.5 times less likely to have accessible facilities than their high-income counterparts (Moore, et. al., 2008). The disparity in access to places to be physically active accounts for a large percentage for the physical inactivity, and furthermore the increased health risks, associated with low-income communities.
In order have access to facilities where people can engage safely in physical activity, individuals must have a mode of transportation, whether it be by car, bus, train or walking. Even when there is access to public transportation, it is often costly, and therefore not readily accessible to low-income and homeless individuals (White, 2015). High costs of bus or train rides combined with overcrowding makes using these resources difficult. Whether due to a lack of access to public transportation or high costs, in low-income urban neighborhoods, walking is often the primary method of transportation (White, 2015). This becomes a problem when there are no exercise facilities within walking distance. Without access to public transportation, inequality of proper exercise and wellness resources between high-income and low-income areas is only heightened, especially for children who rely on their parents for transportation (Kanter, 2015). Inability to utilize public transportation when physical activity facilities are not in walking distance further discourages physical activity in low-income and homeless populations.
Safety plays a huge part in whether people engage in physical activity or not. In low-income neighborhoods, children are often seen playing in the streets because they do not have access to playgrounds and physical activity centers. Urban neighborhoods have a problems with gangs and drugs in the middle of the streets. The same streets that these kids play on are the same streets that harbor fights and drug deals. These urban cities that are not seen as safe and the lack of safety affects children due to the parents being protective. Some parents might not care about the safety, however, other parents would rather their children stay safe and out of the areas that are not safe. Lower-income neighborhoods do not have the same safe spaces that the higher income families do. People living in urban neighborhoods do not have the luxury to take a jog when the sun has gone down or even let their children run free outside without directly watching over them (Day, 2006).
Another notion why the homeless populations do not want to exercise is that it is time consuming. There are much more entertaining things one can do with their time then to spend it exercising. One thing that is prevalent in the homeless community is smoking. According to research, almost 70% of people who are homeless are smokers (Taylor, et. al., 2016). Smoking takes up a lot of time, and to some people is the easier choice than doing thirty minutes of exercise. Participating in an activity that could cause one to have trouble breathing versus taking a smoke break is an easy decision to make within this population. Participating in the unhealthy habit of smoking is often used as a time of socialization. If one person does it, then his friends are likely to join. Because smoking is associated with social interaction, it is seen as fun. Then, not only is the habit time consuming, but it is seen as fun. Because the individuals do not have access to fun and safe exercise environments, as stated earlier, they are not motivated to exercise. If one person took the time to stop and instead of taking a smoke break, engaged in physical activity, it could potentially start a chain reaction and more and more people would join in.
Physical Activity is one of the main components to lead a healthy life; nutrition also plays a vital role. The price of healthy foods are very high and are rising, while the price of unhealthy items are significantly cheaper. It is far easier for someone to go to a fast food restaurant for a meal than to go to the grocery store and pick up ingredients to make a well balanced meal. For the homeless and low-income population, the cheaper option is the better option. Not recieving getting the correct amount of nutrients may lead to obesity. Children are a casualty here as well, for low income families, the obesity rate increases. In Virginia, 20% of the population is considered obese (CDC, 2016). Genetics also play a role in increasing the risk of obesity. For example, differences in the prevalence of obesity are seen in people of similar racial, ethnic, or familial backgrounds (CDC, 2013). In order to lose weight, the American College of Sports Medicine states that individuals would need to exceed the recommended minimum weekly amount of exercise (2017). With obesity comes a nonadherence to physical activity, because people does not feel it will benefit them, as they already struggle to meet recommended activity levels.
The lack of knowledge on how to engage in physical activity leads to the people having a lack of self efficacy. The social cognitive theory model has found that lack of knowledge influences efficacy beliefs by giving them a negative outcome expectation (Anderson, et al,. 2006). In order for someone to have the courage and motivation to work out on their own, they have to be guided and they have to know how to exercise on their own. They are not educated on how to live a healthy lifestyle so that leaves them with nowhere to start. Interventions should not give up on the homeless, some desire to make the change if given the opportunity (Taylor, et. al., 2016). When individuals do not feel confident in themselves leads to them not feeling comfortable with exercise, so they decide to just give up trying and stop exercising.
Organizations involve the social groups that you put yourself into. Social support can be defined as the presence and nature of interpersonal relationships and interactions (Anderson, et. al., 2006). Many people in urban neighborhoods do not have many social groups that can help motivate them to engage in physical activity. Having a support system in place is a big issue in getting people to engage in a consistent exercise, so finding ways to encourage this support in various settings is extremely important. As stated before, adults in these neighborhoods do not have the time needed to emerge themselves in exercise as well as social groups. They focus most of their time on their kids and working that they do not spend time building relationships with people they work with or even people in their communities.
Many believe that their health is only detrimental to themselves and not affecting one’s around them. In many cases, such as among families in low-income communities, the children watch and learn what the parents do to improve their health. Overweight or obese parents can lead to a greater chance that the children will also be overweight or obese (Hotovec, 2014). Parents have a huge impact on children due to the fact that they set rules for television time, when to go out to eat, and how often a child participates in physical activity (Hotovec, 2014). Showing the children that physical activity can help them overcome obesity or reduce the risk of it can improve the way that they learn to take care of themselves. For example, Santa Clara County in California is trying to increase the amount of physical activity in children of their area. They want to add more after school programs that help make sure that kids are staying active and not sitting around after they get home from school. There is a grant being offered that helps with the addition of afterschool programs, called the Healthy Apple Award. If it all works out, over 11,000 children will be more physically active than before. There are almost 140 sites that are offering to help with getting the community more active (CDC, 2013). Santa Clara County is a great example of how to start getting your location more physically active.
Though the average individual desires better health, it often takes hard work to achieve it. Even minimal amounts of physical activity provide physical and mental health benefits (Hupin, Roche, et. al., 2016). Though physical activity seems simple to achieve, many factors influence whether an individual maintains exercise adherence. For the low-income and homeless population of the United States, factors working against encouraging physical activity are even more prevalent than in higher-income areas. These individuals deal with obstacles such as unsafe or lack of spaces designated for physical activity, inaccessible transportation, insufficient funds, lack of social support, and more. For these populations, introducing easy, fun, safe, and accessible methods of exercise would help to improve their overall health.