CDC Telebriefing: Vital Signs – Physical Activity among Adults with Disabilities

OPERATOR: Welcome and thank you for standing by. At this time, all participants are on the listen only mode until the question/answer session of today’s conference. At that time you may press star one on your touch tone phone to ask a question. I would like to inform all parties that the conference is being recorded. If you have any objections, you may disconnect at this time. I would now like to turn the call over to Mr. Llelwyn Grant. Thank you, sir. You may begin.

LLELWYN GRANT: Thank you, Angela. Good afternoon. I wish to thank you all for joining us for today's release of CDC’s vital Signs Report on Physical Activity and Inactivity among Adults with Disabilities. Here to discuss the report are CDC’s Principal Deputy Director, Dr. Ileana Arias. First name is spelled I-L-E-A-N-A. Last name A-R-I-A-S. And Dr. Dianna Carroll, senior health specialist with CDC’s National Center on Birth Defects and Developmental Disabilities. First name is spelled D-I-A-N-N-A, last name C-A-R-R-O-L-L. Following their remarks, we'll take questions. At this time, I would like to turn the call over to Dr. Arias.

ILEANA ARIAS: Thank you, Llelwyn. And thank you all for joining us today to discuss the Vital Signs report. At CDC we work 24 hours a day 7 days a week to make sure that we save lives and protect people and that's why we release Vital Signs reports, which is a monthly morbidity and mortality weekly report publication highlighting a critical public health issue that faces the country and importantly, what can be done about it. At CDC, we have previously communicated often about the significant benefits of physical activity. We know that regular aerobic physical activity increases heart and lung function, it improves daily living activities and independence, it decreases the chances of developing chronic diseases and it also improves mental health. Today, in this month's issue of Vital Signs, we have new science that underscores the importance of physical activity for everybody of every ability. More than 21 million adults 18 to 64 years of age in the U.S. have a disability. They are millions of Americans with serious difficulty walking or climbing stairs, with hearing, with seeing, or concentrating or remembering and making decisions. They are our co-workers, our family members, friends and neighbors with disabilities who are able to participate in physical activity, but don't get the recommended amount of regular aerobic physical activity, which is a key protective factor to avoid heart disease, stroke, diabetes, and some cancers and to improve mental health. Unfortunately, nearly half, or one in two working age adults with disabilities in the U.S. get no aerobic physical activity at all. By contrast, a quarter or one in four working age adults without disabilities get no aerobic physical activity. We're very concerned about this and we're also very motivated to change it, because working age adults with disabilities who get no aerobic physical activity are 50 percent more likely to have cancer, diabetes, stroke or heart disease than those who get the recommended amount of physical activity. Everybody has a role to play to help adults with disabilities get more physical activity. At minimum, doctors, family members and friends should ask adults with disabilities, what are you doing to be active or how are you keeping active? The research report in our Vital Signs report has found if doctors and health professionals recommend physical activity, then adults with disabilities are 82 percent more likely to be physically active. So the components toward a solution are already in place. Adults with disabilities see their doctors at one of their trusted sources of health information. Doctors regularly discuss health issues with their patients. Physical activity guidelines have been established. In 2008 the Department of Health and Human Services developed guidelines for adults of all abilities and now we know through these new data that doctors and other health professionals can help increase aerobic physical activity by discussing and recommending it to their patients with disabilities. At CDC, we're committed to helping doctors and other health professionals discuss and recommend physical activity to their patients with disabilities. We've identified five steps and have included supporting resources on our website that doctors and other health professionals can use to recommend aerobic physical activity for adults with disabilities. Our lead scientists on this report, Dr. Carroll, will discuss this further in a few minutes. But before I turn the telebrief over to her, I do want to reiterate that physical activity is a responsibility of all members of our community. Although our focus in this Vital Signs is on the health professional role, this opportunity does not just reside with the doctor or other health professional. Adults with disabilities should also talk to their doctors about how much and what kind of physical activity is right for them. They can work together with their doctors to increase their aerobic physical activity in ways that match their abilities. Communities can also make sure that physical activity, recreation and sports-based program opportunities are accessible to adults with disabilities. For example, there's some wonderful community programs, such as wheelchair tennis leagues, but we need more options and we need to communicate those options to them as well. Dr. Carroll?

DIANNA CARROLL: Thank you, Dr. Arias. I'm delighted to have the opportunity to talk with all of you about adults with disabilities and the need for aerobic physical activity in this issue of Vital Signs. Increasing physical activity is a public health priority for CDC. It benefits people of all abilities and ages. But too many are not getting enough aerobic physical activity. And now we see that it is also a critical need for adults with disabilities. Although our study shows that inactivity and chronic disease are related for adults with disabilities, we don't know whether disability leads to inactivity and chronic disease or if inactivity leads to disability and chronic disease. But one thing is certain, physical activity is important for everyone. Physical activity has the potential to prevent chronic disease, manage and improve health for someone with a chronic disease and help reduce the risk of additional chronic diseases in someone who already has one. Dr. Arias mentioned that nearly half of all 18 to 64-year-old adults with disabilities in the U.S. get no aerobic physical activity. Our study also shows that regardless of the type of disability, a higher percentage of working-age adults with disabilities get no aerobic physical activity than adults without a disability. So here are some numbers. 57 percent of adults with mobility limitations, 40 percent of adults with cognitive limitations, which means they have difficulty with concentrating, remembering or making decisions, 36 percent of people with a serious difficulty seeing, and 33 percent of people with serious difficulty hearing get no aerobic physical activity. This is in contrast to 26 percent of adults in the study who did not have a disability and did not get any aerobic physical activity. While the benefits of physical activity are known to prevent or manage diabetes, stroke, heart disease and some cancers, only 44 percent of adults with disabilities who visited a doctor in the past 12 months were advised by a doctor to get physical activity. But adults with disabilities were 82 percent more likely to be physically active if their doctor recommended it than those with disabilities who did not get a doctor recommendation. This Vital Signs puts the spotlight on an important but often missed opportunity to get a substantial segment of the country to be physically active. Physical activity guidelines already exist. Guidelines that cover everyone. These guidelines from the Department Of Health And Human Services published in 2008 have a recommendation that all adults, including those with disabilities get at least 150 minutes or 2 1/2 hours of moderate intensity aerobic physical activity each week. If adults with disabilities are not getting or cannot get the recommended amount of aerobic physical activity, they should engage in regular physical activity according to their abilities and avoid inactivity. Some activity is better than none. They should start slowly based on their abilities and fitness level. They should be active for at least ten minutes at a time and slowly increase activity over time with the goal being to reach at least 2 1/2 hours per week of moderate intensity physical activity. Adults with disabilities, communities, doctors and other health professionals all play a role in helping adults with disabilities be more physically active and get that recommended amount of aerobic physical activity. Adults with disabilities should talk to their doctor about how much and what kind of physical activity is right for them. For example, there is a colleague with spina bifida here at CDC who participates in an adapted rock climbing course and he's available to share his story with you if you're interested. Doctors and other health professionals can discuss and recommend aerobic physical activity at every medical visit. Communities can incorporate features such as proper curb cuts on sidewalks, ramps for wheelchair access, and well-maintained trails to improve space access to public places for adults of all abilities to get physical activity. CDC has developed five steps a doctor can take and has provided a website of resources that can help doctors find options for adults with disabilities to get physical activity. These are the five steps: One, know the physical activity guidelines. They are for adults of all shapes, sizes and abilities. The recommended level of aerobic physical activity is at least 2 1/2 hours of moderate intensity physical activity each week. At minimum, an adult needs to be active for at least ten minutes at a time and slowly increase activity over time until they reach the recommended amount. Two, ask about physical activity. Doctors can ask about physical activity levels of their adult patients with disabilities with a few simple questions. Such as how much are you getting each week? What types of physical activities do you enjoy? And how can you add more of it to your life? When having the conversation, doctors can improve the patient experience for an adult with a disability by looking beyond the disability and putting the person first. For example, it's important to use terms such as “person with a disability” instead of “disabled” or “handicapped person.” Three, discuss barriers to physical activity. Adults with disabilities may experience barriers to getting aerobic physical activity that their peers without disabilities may not experience. Talk with them about these barriers. For example, these may include physical barriers in the built or natural environment, such as the ones I mentioned earlier, lack of curb cuts, countertops too high for someone using a wheelchair or local parks and trails that may not be safe and accessible. Another barrier is having limited information about accessible facilities and programs and lacking social support for physical activity from family and friends or feeling self-conscious about using a fitness facility and asking for assistance from fitness center staff. Four, recommend physical activity options. Most aerobic physical activity can be modified or adapted or additional assistance or equipment can help adults with disabilities overcome these barriers and be physically active. Doctors and other health professionals can recommend physical activity options such as using hand crank bicycles or water aerobics that match each person's specific abilities. Five, refer patients to resources and programs. CDC has developed a web page that will help doctors connect their adult patients with disabilities to physical activity resources. The URL is at www.cdc.gov/disabilities/pa. Thank you. Dr. Arias?

ILEANA ARIAS: Thank you. The bottom line is that physical activity is a wonder drug and everyone can benefit from it. Too many working age adults with disabilities, nearly half of them as we said, get no aerobic physical activity and we need to change that. Physical activity is an important health behavior to help avoid and manage chronic diseases like heart disease, stroke, diabetes, some cancers and to improve mental health as well. All of us have a responsibility to help adults with disabilities, including our friends, our family members and neighbors be more physically active. Doctors and health professionals are key in promoting help foyer adult patients with disabilities. We can accomplish this by knowing the guidelines, asking patients with disabilities with their physical activity at every visit. Discussing barriers to physical activity, recommending physical activity options when there are barriers and referring patients to resources and programs that are already available in the community. By including discussions and recommendations for physical activity during all medical visits, professionals can help adults with disabilities be more physically active in ways that work for them. It's critical that none of us underestimate the value of physical activity in our lives or underestimate the capabilities of adults with disabilities. Aerobic physical activity can help all adults, including those with disabilities by preventing chronic diseases or helping manage them if they already exist. Thanks for your attention and now we'll open it up for any questions that you may have.

LLELWYN GRANT: Thank you, Dr. Arias. Dr. Carroll. Operator, we are now ready for questions.

OPERATOR: Thank you. At this time if anyone would like to ask a question, please press star one on your phone, unmute your phone, and record your name when prompted. For questions, please press star 1. For today's conference, you'll be allowed one question and one follow-up.

OPERATOR: Our first question is from Erin Sykes from NBC News.

ERIN SYKES: Good afternoon. Thanks for taking questions. I was wondering if your survey or if the study looked at the role of depression, how many adults with disabilities reported depression and whether that played a role in their ability or desire to exercise?

DIANNA CARROLL: Hi. No. We weren't able to assess if the disability was occurring concurrently with depression in our survey. But it certainly can be. People who were answering the question of having trouble remembering or concentrating or making decisions may be picking up some people who have some mental health issues, but we're not able to determine that with the survey that we had.

ERIN SYKES: Thank you.

LLELWYN GRANT: The response was provided by Dr. Carroll. Next question. Next question, Angela, please?

OPERATOR: Our next question is from Steven Reinberg with Health Day. Go ahead. Your line is open.

STEVEN REINBERG: I have two questions. First is, can you give some examples of the kind of exercise that people with disabilities can do? And are there psychological barriers that some people have to--

ILEANA ARIAS: Sure. Let me-- this is Dr. Arias. I'll start off by address sort of the latter and turn it over to Dr. Carroll for specifics. It is the case that the context in which people with disabilities find themselves is significant in determining also whether they are going to exercise, whether it's in response to a recommendation by a physician or not. We have to make sure that we're creating a context that is supportive of that. Meaning that not only do we have to change our attitudes and make sure that we recognize that physical activity is not outside of the realm of possibility for people with disabilities and then in so doing, also making sure that people with disabilities develop the belief in their ability to engage effectively in aerobic physical activity as a way of contributing positively themselves to their own health. I'll turn it over to Dr. Carroll to give you examples of the specific types of things that folks can do.

DIANNA CARROLL: Thank you. So, for example, people who have mobility limitations and may not be able to walk, walking is one of the main activities that we recommend. It's an easy way to get physical activity. Obviously, some people have difficulty walking. So there are other activities, such as hand crank bicycling or if someone moves around typically in a wheelchair, certainly wheeling one's self in a wheelchair is a way to incorporate physical activity into their day. Just to reiterate, some of this can be discussed with their physician. So physicians can help identify activities and help identify ways that activities can be adapted according to the specific abilities of each patient. There's not a one size fits all, obviously. But the great thing about physical activity is there's a lot of flexibility, a lot of different activities that we can engage in and doctors and other health care professionals, as well as fitness professionals and family and friends can help ensure that we're creating a supportive environment so that people with disabilities engage in physical activity more so and don't miss out on those important health benefits that regular physical activity offers.

LLELWYN GRANT: Next question, please.

OPERATOR: We're showing no additional questions. Reminder, star one if you'd like to ask a question.

LLELWYN GRANT: Since there are no further questions, I want to again thank our speakers, Dr. Arias and Dr. Carroll. CDC has some helpful resources available on our website. That site is www.cdc.gov/disabilities/pa. We also have referrals for organizations, health care providers and individuals willing to share their stories and efforts to address this problem. For more information about today's report, please visit www.cdc.gov/vitalsigns. Don't forget our digital press kit on the main press site developed for this report. I wish to thank you for participating in today's telebriefing. A transcript will be available later this afternoon. For follow-up questions, please contact CDC’s press office at 404-639-3286. This concludes our media telebriefing. Thank you.

OPERATOR: That does conclude today's conference. Thank you for participating. You may disconnect at this time.

###
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES