Schools have played a central role in the provision of physical activity to American children and youth for more than a century. Physical education (PE) has been an institution in American schools since the late 1800s,1 and school sports have been a growing component of the educational enterprise since the early 1900s. Traditionally, students have engaged in physical activity during recess breaks in the school day and by walking or riding bicycles to and from school. However, as we move into the 21st century, alarming health trends are emerging, suggesting that schools need to renew and expand their role in providing and promoting physical activity for our nation’s young people.
Over the past 20 years, obesity rates in US children and youth have skyrocketed. Among children ages 6 to 11, 15.8% are overweight (≥95th percentile body mass index [BMI] for age) and 31.2% are overweight or at risk for overweight (≥85th percentile BMI for age).2 Among adolescents ages 12 to 19, 16.1% are overweight (≥95th percentile BMI for age) and 30.9% are overweight or at risk for overweight (≥85th percentile BMI for age).2 The rapid increase in the prevalence of obesity in American young people has occurred concurrently with other disquieting trends. Between 1991 and 2003, enrollment of high school students in daily PE classes decreased from 41.6% to 28.4%.3 Physically active transport to and from school has declined from previous generations; only one third of trips to school ≤1 mile and <3% of trips ≤2 miles are made by walking or biking.4,5 Even recess has been reduced or eliminated in some elementary schools.6,7
Over the years, many public health, medical, and educational authorities have called on schools to give greater attention to provision of physical activity to students. It has often been recommended that PE programs be expanded, and for several decades professional organizations have indicated that the provision of “quality, daily physical education” should be a standard to which schools aspire.8–11 Unfortunately, few American schools meet that standard, and little evidence indicates that progress has been made toward attaining that goal.3,12
The recent rapid increase in childhood obesity rates suggests that a reconsideration of the role of the schools in addressing this problem is necessary and appropriate. The American Heart Association recently issued a scientific statement on overweight in children and adolescents that drew attention to the severity of the problem and identified the importance of prevention and treatment.13 The Institute of Medicine recently issued a report on prevention of childhood obesity that placed major emphasis on the potential role of schools.14 Other leading organizations have recommended that schools adopt policies that require daily PE, elementary school recess, and physical activity opportunities before, during, and after school.15 Over the past decade, several organizations have recommended that children and youth participate in ≥60 minutes of physical activity each day.16,17 Recently, an expert panel conducted a comprehensive review of the literature on physical activity in school-age youth and recommended that children and youth participate in ≥60 minutes per day of physical activity that is developmentally appropriate, enjoyable, and involves a variety of activities.18 The panel’s report suggested that the ≥60 minutes can be accumulated throughout the day in school, during PE and recess, during intramural sports, and in before-school and after-school programs.18
It appears that the time has come to consider a markedly expanded role for schools in providing physical activity to our children and youth. Schools could become the central element in a community system that ensures that students participate in enough physical activity to develop healthy lifestyles. Although nutrition also clearly plays an important role in the promotion of health and prevention of obesity,13 the present document focuses on physical activity. It describes a renewed and expanded role for schools in the area of physical activity. Furthermore, it addresses the current state of affairs and summarizes the evidence supporting schools’ potential for effectively providing and promoting physical activity. In addition, this statement recommends several key changes in school policy and practice.
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