Active Voice: What is Public Health Surveillance and Why is it Important for Physical Activity?

By Janet E. Fulton, Ph.D., FACSM, and Susan A. Carlson, Ph.D.

Janet E. Fulton, Ph.D. Susan A. Carlson, Ph.D.
Viewpoints presented in SMB commentaries reflect opinions of the authors and do not necessarily reflect positions or policies of ACSM.

Janet E. Fulton, Ph.D., FACSM, is an epidemiologist and the chief of the Physical Activity and Health Branch of the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia. In addition to publishing more than 100 scientific articles, she has contributed to many federal documents including the 2008 Physical Activity Guidelines for Americans, The Physical Activity Guidelines for Americans Midcourse Report: Strategies to Increase Physical Activity Among Youth, and Step It Up! The Surgeon General’s Call to Action to Promote Walking and Walkable Communities.

Susan A. Carlson, Ph.D., is lead epidemiologist of the Physical Activity Epidemiology and Surveillance Team at CDC’s Physical Activity and Health Branch. Her research interests include surveillance of physical activity, physical activity and its association with health, economic costs associated with inadequate physical activity and community-level strategies for promoting physical activity. Recently, Dr. Carlson was CDC’s lead scientific writer for Step It Up! The Surgeon General’s Call to Action to Promote Walking and Walkable Communities.

This commentary presents Dr. Fulton’s and Dr. Carlson’s perspectives on the above-captioned topic. Along with a large group of experts in physical activity surveillance, these two SMB co-authors conducted a joint CDC/ACSM roundtable in 2014 to establish strategic priorities for physical activity surveillance in the United States. This resulting paper was published as a special communication under this same title. The paper appears in the October 2016 issue of
Medicine and Science in Sports and Exercise® (MSSE).

Improving physical activity in the United States is a national health priority. Regular participation in physical activity provides substantial health benefits. However, despite these benefits, only about one-half of U.S. adults and about one-quarter of high school youth report enough aerobic physical activity to meet national guidelines. The low level of physical activity among Americans is a contributor to the burden of chronic disease, premature death and high medical care costs.

Surveillance data can be used to monitor trends in physical activity and identify groups and communities where disparities exist. Surveillance is the cornerstone of public health practice and can tell us where we have been and provide the foundation to guide us into the future. When combined with strategic and innovative thinking, surveillance data can empower practitioners and decision makers to support changes at national, state and local levels to effectively promote physical activity.

Traditionally, U.S. surveillance systems have assessed the aerobic physical activity behaviors of individuals. Surveillance systems can also be used to monitor factors that can promote physical activity. For example, surveillance systems can monitor community supports -- features that make it safe and easy for all people to be active, such as having nearby destinations or sidewalks.

Strategic Priorities for Surveillance of Physical Activity

To guide the future of physical activity surveillance, “Strategic Priorities for Physical Activity Surveillance in the United States: Findings from a Centers for Disease Control and Prevention and American College of Sports Medicine Roundtable” was published in the October 2016 MSSE. This work is the result of a partnership between ACSM and CDC. In August 2014, 20 physical activity surveillance experts gathered to review the current state of surveillance related to physical activity behavior, human movement and community supports. Experts recommended one overarching strategy and five strategic priorities for physical activity surveillance. The overarching strategy was to develop and promote a national plan for physical activity surveillance, akin to the National Physical Activity Plan. Such a plan would enhance coordination and collaboration within and among societal sectors to address recommendations from the roundtable experts. The roundtable also identified the need for resources and a defined process to be fully executed. Experts identified five strategic priorities to guide the future of physical activity surveillance:
  1. Identify and prioritize physical activity constructs;
  2. Assess the psychometric properties of instruments for physical activity surveillance;
  3. Provide training and technical assistance for those collecting, analyzing or interpreting surveillance data;
  4. Explore accessing data from alternative sources;
  5. Improve communication, translation and dissemination about estimates of physical activity from surveillance systems.
These five priorities, along with associated potential actions for researchers and practitioners, provide a roadmap that can, in part, guide a national plan for physical activity surveillance. Many individuals and groups are already involved in addressing these strategic priorities, but more engagement is needed to increase the reach, breadth and impact of these efforts. Advancing progress in physical activity surveillance will take a collective effort among many organizations — both federal and nonfederal.