Exercise in United States

United States

Being physically active and reducing sedentary behavior has many health benefits. Regular physical activity (at least 150 minutes a week) is associated with reduced risk of: cardiovascular diseases such as heart disease, stroke and hypertension; Type 2 diabetes; certain cancers including bladder, breast and colon cancer; dementia; anxiety and depression; and mortality from influenza and pneumonia. 

Key physical activity guidelines for adults include:

• At least 150 minutes per week of moderate-intensity (or 75 minutes of vigorous-intensity) aerobic physical activity, such as running, riding a bike, dancing or swimming. 
• Muscle-strengthening activities involving all major muscle groups two or more days a week. 
• Moving more and sitting less throughout the day. 

Getting more exercise is associated with lower health care expenditures. According to a 2021 study, health care expenditures are lower for those who maintain moderate or high physical activity throughout adulthood, as well as for those who increase physical activity in middle age compared with adults who are consistently physically inactive.

According to America’s Health Rankings analysis, the prevalence of exercise (sufficient to meet aerobic and muscle strengthening guidelines) is higher among:

• Men compared with women.
• Adults ages 18-44 compared with adults age 45 and older.
• Adults who identify their race as other compared with Hispanic adults. 
• College graduates compared with adults with lower levels of education.
• Adults with an annual household income of $75,000 or more compared with adults who have lower incomes.

The Centers for Disease Control and Prevention has several recommendations for community efforts to increase physical activity, including built environment approaches to make it easier for people to walk, run, bike, skate or use wheelchairs to get to where they need to go.

County Health Rankings and Roadmaps lists several scientifically supported exercise policies and programs aimed at creating opportunities for active living, including: 

• Promoting active classrooms and walking school buses for children.
• Offering fitness and exercise programs in community centers.
• Expanding mixed-use development and improving neighborhood walkability.

Further, the Community Preventive Services Task Force recommends combining interventions to increase physical activity, finding there to be increased benefit when implementing infrastructure interventions (such as parks, trails and greenways) in tandem with interventions such as community engagement, awareness campaigns, structured classes and expanding hours or means of accessing these spaces. 

Community-wide campaigns to encourage physical activity have shown success in increasing exercise levels and improving fitness among adults and children. These may involve activities like walking clubs held in public spaces and workplaces, community health fairs with activity coaching, or support groups.

Healthy People 2030 has several objectives that focus on increasing the proportion of adults who do enough physical activity.

Coughlan, Diarmuid, Pedro F Saint-Maurice, Susan A Carlson, Janet Fulton, and Charles E Matthews. “Leisure Time Physical Activity throughout Adulthood Is Associated with Lower Medicare Costs: Evidence from the Linked NIH-AARP Diet and Health Study Cohort.” BMJ Open Sport & Exercise Medicine 7, no. 1 (March 5, 2021): e001038. https://doi.org/10.1136/bmjsem-2021-001038.

U.S. Department of Health and Human Services. “Physical Activity Guidelines for Americans, 2nd Edition.” Washington, D.C.: U.S. Department of Health and Human Services, 2018. https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf.

Webber, Bryant J., Heather C. Yun, and Geoffrey P. Whitfield. “Leisure-Time Physical Activity and Mortality from Influenza and Pneumonia: A Cohort Study of 577 909 US Adults.” British Journal of Sports Medicine 57, no. 19 (May 16, 2023): 1231–37. https://doi.org/10.1136/bjsports-2022-106644.