Professor in the Department of Health Services and Co-Director of UCLA Kaiser Permanente Center for Health Equity at the School of Public Health at the University of California, Los Angeles, Toni Yancey, MD, MPH, in her inspirational and health transformational book Instant Recess: Building a Fit Nation 10 Minutes at a Time.
Toni Yanceypresents a compelling case that a lack of physical activity is costing employers and the community money, time, and lost production due to the sedentary lifestyle of employees and the general public.
Thanks to Toni Yancey, MD, MPH for her time, and for her tremendous and comprehensive responses to the questions. They are greatly appreciated.
What was the background to writing this book Instant Recess: Building a Fit Nation 10 Minutes at a Time?
Toni Yancey: I've been working on promoting physical activity in a variety of population groups for the past two decades, and have become increasingly frustrated by the lack of progress. The idea of incorporating brief bouts of physical activity into daily routine seems to resonate with people across different sectors and groups, and addresses the major obstacles to regular participation, for example, association with obligation or exertion vs. fun or stress relief, perceived or actual lack of discretionary time or money, no strong biological drive like hunger to prompt being active, concerns about messing up hair and make-up, distaste for gyms or sports, or lack of fitness or movement skills.
I want to catalyze the activity movement most in the field recognize is necessary, and need to extend and expand the dialogue about these issues beyond the public health field. When I began working with professional athletes on this, I came up with the mission of making prolonged sitting as socially unacceptable as smoking, or driving and drinking. For this reason, I targeted the book, stylistically, to sophisticated lay audiences, although the scientific grounding is there for health professionals and scholars.
Many people believe that physical fitness is their own choice, but you write that a fit population benefits the entire community. What do you mean by that?
Toni Yancey: Freedom of choice is illusory, when most of the environment conspires to chain us to our desks or couches. Though most people pay lip service to the importance of regular physical activity--and likely believe that it would be beneficial to them, fewer than 5% of adults actually meet minimum recommendations, especially in communities with little park space, absent or poorly maintained sidewalks, lack of safety, and few appealing vistas like trees, mountains or beaches.
Even in predominantly affluent communities like the West Side of Los Angeles, nearly a third of the population is sedentary--getting less than 10 minutes per week of continuous moderate to vigorous activity. Activity levels have plummeted during the past few decades and it's not because people suddenly value physical activity less--it used to be necessary to meet our basic survival needs. The individual costs of sedentariness are clear cut--diabetes, obesity, heart disease, stroke, depression, back pain--but the larger societal costs are tremendous in terms of lost productivity and high workers' comp and health care costs.
If private business and government spent less on these costs associated with obesity and sedentariness, they would be more competitive globally, in less of a budgetary crisis and have higher longevity and quality of life across the population.
The level of physical fitness in the population has declined, along with lower levels of activity in general. Can this situation be reversed for the benefit of the community?
Toni Yancey: Of course it can be reversed! I argue in the book that we have to stop focusing so much on motivating individuals, and rather, convince leaders already motivated to achieve their organizational objectives that Instant Recess breaks and other "push" or "opt-out" practices and policies that make the active choice the easy or default choice and the inactive choice more difficult or inconvenient (ex: auto-free zones around schools and workplaces, walking meetings, making stairs more convenient and accessible than elevators for the non-disabled).
Toni Yancey (photo left)
One of the central themes of the book is that good physical fitness enhances the bottom line. What do you mean by that?
Toni Yancey: Physical activity not only enhances the health of the individual, but also improves productivity through higher morale, less "presenteeism" (being in your seat but not performing at optimal levels) and absenteeism, less employee attrition (saving recruitment and training costs), and, ultimately, lower health care costs. Brief bouts of structurally integrated activity (on paid time or woven into the regular conduct of business) are easy to implement, with minimal upfront investment and, because they deliver a small amount of activity to a large proportion of people with the most sedentary the most likely to participate and benefit, a high return on investment
Should companies consider adding fitness programs to their daily organizational routines to achieve these benefits?
Toni Yancey: Absolutely! Fitness programs run the gamut from minimal investment (exercise breaks at certain times of day or in long meetings, restricting nearby parking or employee drop-off) to comprehensive wellness initiatives. Obviously the greatest gains are associated with the greatest investments, but that's usually only possible for large companies. Any company can implement Instant Recess breaks, even if they don't have dedicated wellness staff or facilities. Thus, Instant Recess and other "push" or "opt-out" practices and policies deliver a greater return on investment, particularly in the short run, when benefits must be demonstrated to maintain the investment.
Will companies add what you call ‘Instant Recess’ when they discover the financial, personnel, and competitive advantages of doing so?
Toni Yancey: I certainly hope so! It's been my experience that certain leaders ("early adopters") who are always on the lookout for such an advantage are persuaded by the documented benefits and the minimal upfront investment (start-up costs).
Are companies making the move toward more physical activity in the workplace now?
Toni Yancey: The growing awareness of the obesity epidemic and its consequences for employers is creating an opening to get more of them involved. However, my concern is that if they don't adopt the kinds of policies and practices that are most effective, they'll drop them and label the whole approach as unworkable. I recently gave a talk for the National Business Group on Health's obesity initiative, and heard from several people there that the interest is high and growing, but the strategies they've traditionally implemented (ex: fitness facilities on site, lunchtime walking clubs, before- or after-work exercise classes) are not working.
Is the entire concept of workplace fitness based on having the leadership of the organization on board, or must individuals within the company take the initiative themselves?
Toni Yancey: This is a top-down and bottom-up process. Individual employees who are not highly placed in the organizational hierarchy will find it difficult to implement these policies and practices without upper management support. At the same time, if the rank and file aren't included from the beginning to build their investment and ownership, fitness activities will fall by the wayside--they'll be "on the books" but not actually operating, like the poor compliance with state physical education mandates in schools.
What is the first step a company should take toward incorporating ‘Instant Recess’ and better physical fitness into their organizations?
Toni Yancey: Identify one or a few departments or divisions with individuals who'll be likely to be excited by the opportunity and readily get on board. My experience is there are two key types of these program champions--someone who's into fitness, for example, a former athlete, fitness instructor, or dancer, and someone who's entrenched in the company rank and file and who others look to for guidance as a peer (if Mary Lou's doing it, then it must be OK).
If there's an employee wellness advisory committee, solicit their buy-in. Market and promote a launch date for a few weeks before the start, and make sure that the bosses make a visible commitment through their participation--doesn't have to be every day or even every week, but if the boss is conspicuously absent even when s/he is in town, that will clearly communicate a low priority. And, in human capital management terms, Instant Recess participation is a great way for the C-suite to directly connect with the average Joe or Jane in a way that's not artificial, demonstrating themselves to be "regular people," creating camaraderie and engendering loyalty.
What is next for Toni Yancey?
Toni Yancey: I've got my hands full with this mission of increasing fitness population-wide for at least a generation! The First Lady is aiming to get it done within a generation and I'm pulling out all the stops to help her as a member of the Board of Directors of the non-partisan Partnership for a Healthier America, supporting her Let's Move campaign.
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My book review of Instant Recess: Building a Fit Nation 10 Minutes at a Time by Toni Yancey.
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