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-The SPARK Team

Where is Health?

This was not written as a blog entry. It was written as an op-ed piece for a newspaper. However, 4 major newspapers have rejected it, but I would like someone to read it, so I am sharing it with you. I wrote this piece because even before the health reform debate devolved into a depressing spectacle of shouting and fear-mongering, almost noone was talking about how reforms might actually improve health. Use your freedom of speech to make your views known on this critical national issue.

Where is Health?

Where is health in the debate over health care reform? The mass media debate is almost completely about improving health care coverage, reducing health care costs, and paying for the increased coverage. There is a great deal of media attention to the proposed public option for insurance, and we hear a lot from hospital groups, insurance companies, and the pharmaceutical industry about what the proposals would do to their businesses. But people’s health is virtually absent from the mass media debate; an afterthought at best. Every so often there is a passing mention of prevention or enhanced primary care, but no explanation of what that might mean.

Where is health in the Congressional debates? Believe it or not, health is present in discussions of preventing disease to both control health care costs and improve the health of Americans. Did you know that in the Senate three committees are working on health reform and one of those is focused on prevention and public health? I’m guessing you did not know that. I’ve been looking for reports on their work, and I don’t find them in the mass media.

Where is health on the minds of the American people? Surprise, it’s the number one priority for health reform. A May 2009 Trust for America’s Health poll of 1014 US voters identified prevention as the top priority of six health reform proposals that included universal health care coverage and prohibiting insurance companies from denying coverage based on pre-existing conditions. What’s more, 76% of voters supported investing more money in prevention, and that included at least 70% of Republicans, Democrats, and Independents.

Why is the public debate on health care so discrepant from the public’s interest in health improvement? This is a question that needs to be answered by media organizations, but here is my guess. The debate is being driven by money, health care industry money. Hospitals, insurance companies, pharmaceutical companies, medical device makers, medical testing companies, and physician groups are the beneficiaries of the current system that spends $2 trillion annually. They are on the receiving end of the unrelenting rise in health care costs. They have something to lose if Americans become healthier, so I imagine they are sending the most letters and emails to news organizations and lobbyists to Capitol Hill. Their primary concern is the financial health of their companies, so excuse them if they don’t talk much about the health of the American people.

Who is representing the voice of the American people who want a health system that helps them stay healthy and prevent disease? Almost nobody. There are public interest groups and foundations that are trying to make their voices heard and find some scraps for prevention, but they are no match for the lobbying activities of giant health care industries. If you are one of the 76% of American voters who wants health reform to create a health system that invests much more in prevention, you are going to have to speak for yourself. Express your opinion to your representatives and to news outlets.

But as we prepare to speak our minds, let’s be clear about what prevention really is. In the health care debate, prevention usually refers to mammograms, prostate screening, and cholesterol testing. These are worthy but not at the heart of making people healthier. Prevention can summed up by “3four50”. This means that 3 behaviors (smoking, inactivity, poor diet) contribute to four leading diseases (heart disease, cancers, diabetes, and lung disease) that in turn are responsible for 50% of all deaths in the world, more in the U.S. As everyone knows, achieving those behavior changes is difficult. But, if our health system was designed to focus on preventing smoking and helping people be physically active and eat sensible portions of nutritious foods, we could prevent disease, reduce the need for health care, and control health care costs. This is our chance for true health reform. Let’s add the voice of the American people to the debate before it’s too late.

Jim Sallis

www.drjamessallis.sdsu.edu

Honey, Please Pass the Scale?

The next time you and your spouse sit down to dinner together, take a critical look at all the food on your table. You might be sharing a pretty unhealthy meal. According to a recent study, married men and women are twice as likely to become obese as the general population. And the longer they live together, the greater the risk.

By the way, women should not think they’ll be exempt from packing on the pounds if they forgo the marriage license and simply live with the one they love. Women co-habitating with a romantic partner have a 64% greater risk of obesity. However, men co-habitating with a romantic partner have no increased risk at all—proving once again that it's really great to be born male.

The researchers, from the University of North Carolina in Chapel Hill, aren’t sure why marriage might make you fat. They do note that being married does provide other health benefits, including decreased smoking and longer life. “But we also see greater weight gain than in others of the same age, and greater risk of obesity,” said Penny Gordon-Larsen, an associate professor of nutrition at UNC and co-author of the study.

According to Gordon-Larsen, when people are living together – married or not – they tend to share behaviors and activity patterns. They may chose to eat meals together, possibly cooking bigger meals or eating out more often than they did when they were single, and may watch TV together instead of going to the gym or playing a sport. Gordon-Larsen said that in subsequent interviews with both romantic partners, they found that couples who lived together for more than two years (especially those who were married) were most likely to display similar weight/obesity patterns and physical activity behaviors.

The UNC researchers suggest that, just as spouses share unhealthy behaviors, they could learn to share healthy behaviors. Would the couple that runs together be as likely to stay together as the couple who shares a late night venture out for Mexican food and margaritas?

I think there's another factor at play here. Prior to marriage, we watch what we eat, exercise more, take better care of ourselves -- trying to look better and attract a mate. Then, when the romantic chase is over we say our mutual, "I do's," people become complacent and let themselves go. Too bad. It should be about health -- and not being more physically attractive.

Why don't you "weigh in" on this topic? How many of you have noticed a similar pattern -- weight gain after marriage or co-habitating? What do you think contributes to it?

-Paul Rosengard

This article adapted from Cathy Arnst, "Marriage Makes You Fat" in Business Week magazine.

Obesity Dollars and Sense

It's swimsuit season -- that time of year when people assess the way the look with fewer clothes on -- and maybe, resolve to make some changes.

Whatever the motivator to shed fat/lose weight, statistics show there is surely a need for Americans to take a long look in the mirror. A recent USA Today front page article titled, "Obesity is a key link to soaring health tab" said that about 40% of adults -- more than 72 million -- were obese in 2006; up from 23% in 1994. And, 2/3 of everyone in the US is overweight or obese. I can almost hear the Europeans chuckling at us...

While many of us judge our bodies by how they look in a bathing suit at the beach, the article goes beyond skin deep. It reports that the cost of healthcare has doubled to $147 billion in a decade, and obesity accounts for almost 10% of that total.

Eric Finkelstein, a health economist says,

"If you really want to rein in healthcare dollars, you have to get people dieting, exercising and living a healthier lifestyle."

Alright, we get it. The message isn't new -- it's just that the statistics are getting worse and the unfortunate result is obesity is costing us more. People KNOW they are overweight and many want to drop some unhealthy fat and be more active, but it's harder than just shouting from the rooftops, "Eat less and move more!" If changing behavior were that easy, we wouldn't be in this predicament.

Here are a few tips for personal change that are less commonly known:

1. Call in a Substitute. Take one thing you consume every day (e.g., coffee creamer) and go from full fat to no fat. This little change done frequently adds up. Once you've made one small change, add another. Rinse and repeat.

2. Take 10: After dinner or anytime, go for a 5 minute walk (always consult your Doctor before beginning any exercise regimen). Five minutes in one direction, then turn around and head back. These 10 minutes -- most if not all days of the week -- will kick-start your activity program. Build from this foundation by increasing your frequency (how many times a week you walk) and duration (how long you walk). And check out a previous blog spot where I talk about how our dog Scout has helped my wife Wendy become a daily walker -- after work.

3. Tell a Friend: Ask someone you know to be your health coach. Encourage you to eat regular size portions -- and try and eat smaller meals 4-5 times a day, instead of 3 big ones. More frequent eating helps regulate your blood sugar, keeps you from getting hungry, and fires up your metabolism. Use that friend for support (e.g., an exercise buddy). By the way, my wife Wendy does this for an optimal health program called Take Shape for Life (www.spreadyourwings.tsfl.com). It works, people lose weight and keep it off, and I highly recommend it!

While personal responsibility is by far the main factor in weight management -- our communities can play a role -- positive or negative. From the USA Today article, here are 6 steps communities can take to help prevent obesity:

1. Put schools within easy walking distance of residential areas.

2. Improve access to outdoor recreational facilities.

3. REQUIRE PHYSICAL EDUCATION IN SCHOOLS -- YEA!

4. Enhance traffic safety in areas where people could be physically active.

5. Enhance infrastructure supporting walking and biking.

6. Discourage consumption of sugar-sweetened drinks.

So, if you haven't had that long, self-assessment look in the mirror yet this summer, maybe it's time. Ultimately, it's up to each of us to be in control of our own healthy lifestyle. If we don't, healthcare costs will take control of us.

-Paul Rosengard

It's About Professional Growth

This was a great week of the year for all of us at SPARK. We just finished hosting our K-2 and 3-6 physical education Institutes and meeting approximately 100 passionate educators from around the globe. Since 1995, SPARK has been facilitating these professional growth opportunities for individuals whose districts are either too small, too poor, or too poorly prioritized to bring a SPARK trainer to them. Institutes provide the opportunity for people to come to SPARK -- and we love it.

While we do our best to limit each program focus to the first 40 people to register, we usually invite a number of special guests to observe, and they may swell our numbers to 50 or more. This year, we entertained people from India, China, Canada, Australia and myriad cities and towns across the U.S. Personally, I think learning about physical education in other countries is fascinating. For example, in China, children start preschool at age 3 and don't begin at the elementary school until age 6 or 7 -- missing what we call Kindergarten, and beginning in first grade. In India, almost everyone speaks English, and our SPARK books don't have to be translated for teachers there. What we refer to as Standards in the U.S., are known as Outcomes in Canada. And Canadian funding for education comes only from provincial money, not from the federal government, therefore, each province writes their own outcomes. By the way, SPARK has already aligned with Alberta, Ontario and Saskatchewan outcomes and they're posted on our website Here.

In the evenings, we have a place selected for people to meet, eat, and socialize with our SPARK staff. While it's definitely about having fun in the sun in San Diego and meeting new friends, SPARK Institutes are designed so each person receives the best possible physical education workshop -- and learns SPARK's unique content and instructional methodology. Our specially selected, fantastic trainers (this week it was Courtney Sjoerdsma and Ken McFadden for K-2; Julie Green and Joan Gillem for 3-6) inspire and motivate everyone, often taking the skeptical and converting them into our most enthusiastic advocates. And, each person leaves with a thorough understanding of SPARK and all training, materials, and support they need to begin "practicing" the craft with their students right away.

We encourage these newly formed professional families to stay in touch with us and one another, and we facilitate that via email distribution lists, our monthly e-newsletter, and the opportunity to visit SPARK again for another Institute in the future. For the people that attended the Level I K-2 and 3-6 last week, they're ready now for Level II Institute next year, or whenever they're ready to see us again.

If YOU haven't attended a SPARK Institute yet, I highly recommend it. I don't know anyone who didn't think it was a terrific experience and well worth their time and money.

Hope to see YOU in San Diego next year!

-Paul Rosengard

It was 20 years ago today!

In August 1989 the SPARK study began, with funding from the National Heart, Lung, and Blood Institute. Our goal was to create a national model of physical education designed to respond to children’s health needs. We wanted to not only get kids active, but “turn them on” to activity and build the physical and behavior-change competencies they needed to remain active and healthy.

Twenty years later, I can say we succeeded beyond my wildest expectations! The SPARK and M-SPAN studies provided some of the evidence that led The Community Guide to strongly recommend enhanced physical education as an evidence-based intervention. We now have a suite of physical activity and school health programs to help young people remain active. There is a network of talented trainers across the country who provide hundreds of enthusiastically-received trainings every year. We have shown that when teachers learn to use SPARK, they keep using it for years. Most importantly, well over 1 million children benefit from SPARK every day. I often say SPARK is the most fulfilling experience of my career.

Of course, I was just a catalyst for what SPARK has become. Thom McKenzie is the architect who built a fabulous program. Paul Rosengard is the mastermind behind the blossoming of SPARK into a powerful force for improving health throughout the nation (and hopefully, soon, the world). It is a rare combination of skills to go from being an award-winning coach to a PE innovator to directing the phenomenal growth of SPARK, while maintaining quality and our strong reputation the whole time.

Recently, the SPARK staff and the master trainers got together to celebrate SPARK’s 20^th birthday. It was a special occasion for me for many reasons. I really enjoyed paying tribute to Thom, Paul, and all the fabulous staff. It was a special treat to recognize SPARK employee numero uno, Kecia Carrasco. She was number one then, and she is number one now. We are all blessed that she is still devoting her considerable talents to SPARK. And it wouldn’t have been a SPARK party without a lot of fun activities. The master trainers led us in 3 great dances under the California sun, and I hope you get a chance to see some of the video.

With all that the SPARK team has accomplished, it is not nearly enough. While SPARK was growing, so was the obesity epidemic. It is very fortunate that we created some solutions for this problem, because concern about childhood obesity is certainly driving much of the interest in what we can provide. But still most schools do not have evidence-based activity-focused physical education. Most after-school, preschool, and recreation programs are not active enough. We have much more to do. But “with a little help from our friends” we will “come together” and SPARK the “revolution” that is needed to get every child active so they can be healthier and happier.

Jim Sallis

www.drjamessallis.sdsu.edu

This ATM Isn’t About Money

Nope – this ATM is the SPARK Annual Trainers Meeting and it’s one of those special things that sets SPARK apart from other organizations. Each year, SPARK brings its top trainers to San Diego for 2+ days of professional and personal growth. The professional comes from constantly striving to improve SPARK workshop agendas, powerpoints, and facilitation techniques. The personal from the friendships that grow when terrific people gather because of a shared passion for children and teaching.

SPARK is a training organization at heart, because we know from research that the most efficacious of what we refer to as the “essential components” (i.e., curriculum, staff development, follow up support, and equipment) is the teacher training. And, if you can change (for the better) the way a teacher teaches, then you have a chance to impact many children over time. So, SPARK invests to find the best presenters, train them well, and support their ongoing development.

Each SPARK program (Early Childhood, After School, Physical Education K-2, 3-6, Middle and High school, and Coordinated School Health) has a Lead Trainer. The Lead Trainers mentor their flock and gather feedback on how to improve their program’s content, instruction, and equipment lists.

Trainers begin as novices and once they complete an extensive training program, they can advance to Certified, Master, and Elite levels. Today, SPARK is proud to have more than a dozen trainers with over a decade worth of experience conducting SPARK workshops. And in this case, experience matters.

So, the next time you’re ready to deposit or withdraw money from your ATM, think about our ATM. Yours might have a lot of cash stored inside, but ours is priceless.

-Paul Rosengard