Code Red & Code Critical

Schools are the primary source determining the direction of the future health trajectories of each student under their tutorship. (1, 2)

They are the cornerstone for establishing the child’s health and well-being journey in that they are the only constant influence that promotes healthy lifestyles, laying the foundation for the student’s health outcomes year in and year out.

Teachers have the capacity to establish and incorporate health and well-being curricula and to build health and well-being cultures that will have lifelong impacts. The teacher and the school are in the unique position through each child to reach, influence, and engage not only the child but also to positively impact the family and the community they live in.

The Inactivity Crisis: Code Red

Before the pandemic, 65-80% of students did not engage in the recommended amount of physical activity to sustain their health and well-being. Most high school graduates live through 12 years of education having learned to live sedentary lifestyles, with no ownership over their health and a poor relationship with being active. (3, 4) The pandemic’s lockdowns and isolation have exacerbated this inactivity crisis to previously unseen proportions.

Longitudinal studies tracking students for decades have identified that the direction their health will travel as adults is dictated by what happens in school. (10) The future-facing those 65-80% of graduates who are inactive is that a significant proportion (40% by Centre for Disease Control estimations) (5) will acquire late-onset diabetes. Most will live lives plagued by premature incapacitation directly attributable to lifestyle-related diseases like cardiac disease (heart attacks, congestive heart disease, etc.), premature cognitive decline and strokes, chronic kidney disease, and other illnesses. Pause here—this may be the first generation that may need to be cared for by their aging parents due to incapacitation and premature failing health. This downward spiral, it started while in school!

The Mental-Health Crisis: Code Critical

The fallout of pandemic lockdown measures has been a significant implosion of the general well-being and mental health of our youth. Needs for mental health services have skyrocketed in this cohort. Experts estimate we now have over 50% of our youth suffering varying degrees of increased mental illness burdens. If this remains unaddressed, the consequence is that most will face life trajectories of varying degrees of permanent psychological incapacitations as adults.

Physical activity levels in youth continue to decline.(6-8) Inactivity results in an increased incidence of serious physical and mental health issues. (3, 9) Of the 65%-80% of the student population not engaging in recommended PA while traveling through the school system, most will face a life trajectory acquiring Lifestyle Modifiable Disease Burdens (LMDB) because of their learned inactivity while in school. The eventual result will be varying degrees of incapacitation, loss of independence, and increased mortality and morbidity. (4-6, 10-12) The impact on overall mental health of regular physical activity is well established.(13-14) For depression, anxiety, sleep disorders, managing stress, and overall perceived well-being, the addition of exercise has a pronounced benefit. (14).

Therefore, the consequence of the high prevalence of low self-efficacy for physical activity and unhealthy lifestyles laid down during the school years not only has immediate impacts on growth, development, behaviour, and academic performance (3,4, 15-17), but will lock most students on a defined trajectory of lifelong inactivity, (9, 10-12, 18, 19 ) with the resultant personal health and economic impact and added burden on healthcare delivery systems. (6, 16, 20, 21, 22)

References

1. Kuzik, N., da Costa, B.G.G., Hwang, Y. et al. School-related sedentary behaviours and indicators of health and well-being among children and youth: a systematic review. Int J Behav Nutr Phys Act 19, 40 (2022). https://doi.org/10.1186/s12966-022-01258-4

2. Langford, Rebecca et al. “The WHO Health Promoting School framework for improving the health and well-being of students and their academic achievement.” The Cochrane database of systematic reviews ,4 CD008958. 16 Apr. 2014, PMID: 24737131 DOI: 10.1002/14651858.CD008958.pub2

3. Health characteristics of children and youth aged 1 to 17 years, Canadian Health Survey on Children and Youth 2019 https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310076301

4. Hills, Andrew P et al. “The contribution of physical activity and sedentary behaviours to the growth and development of children and adolescents: implications for overweight and obesity.” Sports medicine (Auckland, N.Z.) vol. 37,6 (2007): 533-45. doi:10.2165/00007256-200737060-00006

5. https://www.webmd.com/diabetes/news/20140812/40-percent-of-americans-will-develop-diabetes-cdc-projects

6. How Healthy Are Canadians? A Trend Analysis Of The Health Of Canadians From A Healthy Living And Chronic Disease Perspective Public Health Agency of Canada https://www.canada.ca/content/dam/phac-aspc/documents/services/publications/healthy living/how-healthy-canadians/pub1-eng.pdf

7. How Healthy are Canadians? https://health-infobase.canada.ca/datalab/healthy-canadians-interactive.html

8. Myer, Gregory D et al. “Exercise deficit disorder in youth: a paradigm shift toward disease prevention and comprehensive care.” Current sports medicine reports vol. 12,4 (2013): 248-55. doi:10.1249/JSR.0b013e31829a74cd

9. Obesity and overweight reports [Internet]. World Health Organization. 2018 [cited 22 March 2018]. Available from: http://www.who.int/mediacentre/factsheets/fs311/en/

10. Lounassalo, I., Salin, K., Kankaanpää, A. et al. “Distinct trajectories of physical activity and related factors during the life course in the general population: a systematic review.” BMC Public Health 19, 271 (2019). https://doi.org/10.1186/s12889-019-6513-y

11. Telama, Risto. “Tracking of physical activity from childhood to adulthood: a review.” Obesity facts vol. 2,3 (2009): 187-95. doi:10.1159/000222244.

12. Borodulin K, et al. “Leisure time physical activity in a 22-year follow-up among Finnish adults.” Int J Behav Nutr Phys Act. 2012;9:121. https://doi.org/10.1186/1479-5868-9-121.

13. Murphy M.H., Carlin A., Woods C., Nevill A., MacDonncha C., Ferguson K., Murphy N. Active students are healthier and happier than their inactive peers: The results of a large representative cross-sectional study of university students in Ireland. J. Phys. Act. Health. 2018;15:737–746. doi: 10.1123/jpah.2017-0432

14. Penedo, Frank J, and Jason R Dahn. “Exercise and well-being: a review of mental and physical health benefits associated with physical activity.” Current opinion in psychiatry vol. 18,2 (2005): 189-93. doi:10.1097/00001504-200503000-00013

15. Harold W. Kohl, I., Cook, H., Environment, C., Board, F. and Medicine, I. (2018). Physical Activity and Physical Education: Relationship to Growth, Development, and Health. [online] Ncbi.nlm.nih.gov. Available at: https://www.ncbi.nlm.nih.gov/books/NBK201497/\ [Accessed 22 Mar. 2018].

16. ParticipAction Report card Full report https://participaction.cdn.prismic.io/participaction/f6854240-ef7c-448c-ae5c-5634c41a01 70_2020_Report_Card_Children_and_Youth_Full_Report.pdf

17. O’Brien, Wesley et al. “Relationship between Physical Activity, Screen Time and Weight Status among Young Adolescents.” Sports (Basel, Switzerland) vol. 6,3 57. 23 Jun. 2018, doi:10.3390/sports6030057

18. Tammelin, Tuija et al. “Adolescent participation in sports and adult physical activity.” American journal of preventive medicine vol. 24,1 (2003): 22-8. doi:10.1016/s0749-3797(02)00575-5

19. Tsang, Sandra K M et al. “Self-efficacy as a positive youth development construct: a conceptual review.” TheScientificWorldJournal vol. 2012 (2012): 452327. doi:10.1100/2012/452327

20. Vanessa Hrvatin It costs Canada $9B to treat obesity, while barely any money is put into preventative care National Post Nov. 1, 2019

21. Ding D, Lawson KD, Kolbe-Alexander TL, Finkelstein EA, Katzmarzyk PT, van Mechelen W, et al. The economic burden of physical inactivity: a global analysis of major non-communicable diseases. Lancet. 2016;388:1311–24. https://doi.org/10.1016/S0140-6736(16)30383-X.

22. Peter T. Katzmarzyk, Norman Gledhill and Roy J. Shephard. The economic burden of physical inactivity in Canada CMAJ November 28, 2000 163 (11) 1435-1440; https://www.cmaj.ca/content/163/11/1435

23. Nike (2013). Designed to Move: A Physical Activity Action Agenda™. [image] Available at: https://clubs.marathonkids.org/keeping-kids-moving/ [Accessed 17 Mar. 2018]