Legislation on physical activity related to health implications for persons with disabilities.

There are many pieces of legislation that can have implications for persons with disabilities related to physical activity and health promotion. It has been established that regular, moderate physical activity can assist in amelioration and prevention of secondary disabling conditions (Surgeon General's Call to Action, 2006). Through physical activity one derives health benefits for prevention of chronic health conditions (Healthy People 2000, 2010).

There are over 50 million persons with disabilities in the United States and 6.4 million children enrolled in special education services who can benefit from regular physical activity. With this number of constituents in need of physical activity services and supports, there have been legislative initiatives to encourage people to participate in regular physical activity (Surgeon General's Report, 1996, Surgeon General's Call to Action, 2006, and Healthy People 2000, 2010).

Active advocacy for legislative activity involves developing a unified message for Congress that educates House and Senate members to the benefits of physical activity for persons with disabilities and asking for Congressional oversight of this critical issue.

Developing the Message to Legislators

The message we must convey to legislators at both the federal and state levels consists of education and civil rights issues for persons with disabilities with respect to access to regular physical activity. Following 12 years of schooling and enrollment in physical education classes, children enrolled in special education should exit school in good health. However, the health of children with disabilities is poor, and it gets worse at school exit. This is exhibited by increases in overweight and obesity among these children. Obesity is a barrier to good health and is a special problem for children with disabilities. Legislators must understand the barriers to access physical activity and recreation pursuits by children who have disabilities, the secondary condition of obesity, and the hardships it places on families and the community. Obesity can be caused by a lack of access to good, healthy food choices, safe areas to play, and recreation facilities led by highly qualified personnel who understand the unique physical activity needs of children with disabilities.

Persons of all ages who are overweight suffer from greater risks to chronic health conditions. The lack of adequate nutrition and regular physical activity are the consequences of chronic health conditions. Chronic health conditions are associated with 70% of acute health care expenditures heart disease, arthritis, and low back pain. Other chronic conditions such as diabetes can cause blindness, kidney failure, and amputations.

There is a need for evidence-based research and practice to demonstrate effective professional preparation and training for workers who produce similar observable outcomes to facilitate participation in physical activity for children with disabilities. Such documentation will provide legislators with the message needed to initiate legislation supportive to this cause.

Specific Issues

Leisure physical activity. Health benefits from physical activity result from lifelong leisure participation, and leisure is effectively chosen by individuals who self-select their choice of active lifestyle. Persons most in need of physical activity are our most vulnerable populations. There is a decline of physical activity needing to be reversed that begins in puberty and extends into adulthood. This is even more pronounced among individuals with disabilities.

Barriers to participation. Children and adults in disadvantaged communities face greater barriers to participation in physical activity than those in advantaged communities. There are socio-economic disparities to participation in physical activity. Persons from low income families participate less in physical activity; thus, a special need to address obesity and the barriers to physical activities exists in low income communities. Part of the common message must address socioeconomic status for those with disabilities.

Generic physical activities should be available. There are generic school health programs--physical and health education, athletics, and intramurals--commonly not available to school children with disabilities. There are other schoolbased programs including counseling, as well as school health programs to address obesity and other health conditions. Therefore, the common message must also address generic school-based programs often not available or offered to children with disabilities.

Legislative Briefings and Oversight

There are several activities associated with legislation concerning physical activity in Washington, DC. Some of these activities are occurring as briefings and oversight hearings so Congress can share information, learn more. and assess success/failure of existing programs. Briefings inform Congress of the status and significance of issues on physical activity for persons with disabilities. Congressional oversight activities assess whether or not legislation is performing intended purposes.

Legislative briefings. There is a coalition of 25 organizations organized by the American Heart Association advocating for prevention of obesity through physical activity. A Senate briefing was held on the Impact of Obesity on Health by Coalition of Public Health Funding and the Robert Wood Johnson Foundation to look at challenges to school wellness policies. Other organizations instrumental in briefings are the National Association for Sport and Physical Activity, YM/ YWCA, National Parks and Recreation Association, the Center for Science in the Public Interest, the National Consortium for Physical Activity and Recreation for Individuals with Disabilities, and the Adapted Physical Activity Council. All of these organizations have vested interests in physical activity and prevention of secondary conditions for persons with disabilities. These organizations regularly participate in Senate and House briefings.

Legislative oversight. The Education and Labor Healthy Families and Communities sub-committee recently held a hearing on Using School Wellness Plans to Fight Child Obesity. There should be communication with legislative staff who arranges such briefings so that experts can remain active in these hearings and briefings. Staff issues should be inclusion of students with disabilities, consequences of not including children with disabilities, building programs on researched health and quality of life benefits through physical activity.

An example of participation in this process recently occurred in western Pennsylvania. The Speaker of the House of Representatives in Pennsylvania is a wonderful advocate for children with autism and their families. Recently, several Congressmen scheduled a hearing on autism. This took place in western Pennsylvania, and several key persons were invited to describe the life of a child with autism. Parents, teachers, administrators, and an adapted physical education specialist were invited to testify. Bob Arnhold, one editor for Legislative Update, as the adapted physical education specialist, was able to inform and educate the panel of Congressmen present on the critical importance of physical education and recreation for children diagnosed with autism. This hearing resulted in legislators leaving the meeting with much more information, knowledge, and an understanding about the school and community needs children with autism face daily.

Legislation

There are several pieces of legislation relevant to physical activity for persons with disabilities. Legislation emanates from committees in the House of Representatives or the Senate. Legislation needs to be passed in both the House of Representatives and in the Senate and then must be signed by the President before it becomes law.

In the House, committees with jurisdiction are the Education and Workforce and the Energy and Commerce Committees. These are committees which generally address health and physical activity legislation. In the Senate, the Committee of Health, Education, Labor, and Pensions (HELP) has jurisdiction over physical activity legislation. Legislators sitting on one or more of these committees are key persons to contact when legislation is under discussion. Persons who are constituents (living in that legislator's district) have the most power and influence to encourage positive outcomes of these pieces of legislation.

Legislation in the Senate and House of Representatives.

The two primary pieces of legislation that have emanated from the Senate HELP committee and the House Education and Labor committee are as follows:

* Play Every Day Act (S 651, HR 2045) This bill was sponsored by Senator Harkin in the Senate on February 15, 2007, and was introduced in the House by Representative Udall on April 25, 2007. This act calls for community-based recreational assessment of opportunities and stresses daily community-based physical activity for children.

* Kids Fit Act (S.2173 and HR 3257). These are amendments to the No Child Left Behind (NCLB) law (PL 107-110). This act attempts to incorporate a physical activity provision within the NCLB and broaden the curricula to include health as an educational outcome.

House Energy and Commerce and Senate HELP Committees. Legislation focusing on health provision (i.e., physical activity for health) may be within the jurisdiction of the Energy and Commerce Committee in the House and of the HELP Committee in the Senate. The Promoting Wellness for Individuals with Disabilities Act (S. 1050) provides for weight control and increased opportunities for physical activity. The Christopher Reeve Paralysis Act (H.R 1554; S.828) provides for rehabilitation research to improve opportunities for physical activity for persons who are paralyzed.

Agriculture Department. The Agriculture Department will also be responsible for legislation that may impact upon the health and physical activity of persons with disabilities. For example, the School Nutrition and Women, Infants, and Children Act reauthorization of 2004 (PL 108-265) included a school wellness programs. Likewise, committees of jurisdiction usually provide oversight to the legislation in their own committees. However, the House Education and Labor Subcommittee had a hearing that provided oversight to overall school wellness.

Summary

There are many pieces of legislation currently being addressed in one way or another, addressing the physical activity, nutrition, and wellness needs of children and adults with disabilities. While it can be a daunting task to track all of these various Bills, each can provide critical support to programs beneficial to persons with disabilities. It remains critical for advocates to follow these Bills as they progress through the legislative process. A key telephone call or letter from a constituent of legislators sitting on important decision-making committees can make a tremendous difference. Stay tuned!

Legislative Update is a regular feature of PALAESTRA, providing the reader with updates and analyses of current federal and state legislative activities relative to public policy development of interest to professionals and others interested in adapted physical activity. David A. Auxter, Legislative Chairperson of the National Consortium for Physical Education and Recreation for Individuals with Disabilities, 35 E. St. NW, Apt. 607, Washington, DC 20001-1518; [phone]; [e-mail]; and Robert W. Arnhold, Coordinator, Adapted Physical Activity Program & Center on Disability and Health, Room 15 Stoner Educational Complex, Department of Exercise and Rehabilitative Sciences, Slippery Rock State University, Slippery Rock, PA 16057: (724) 7382847, [phone] (FAX); [e-mail] are Department Editors for Legislative Update.