I'll start with two bold statements.
Those are bold claims, and I wholeheartedly believe they are not only true but supported by strong scientific evidence. By the end of this article, I suspect you'll agree with me. But that isn't where I want to start. We need to start with the difference between physical activity and exercise. Then we need to understand the true cost of inactivity in our society.
Physical Activity vs. Exercise
The difference between physical activity and exercise is something most people miss, because they use the two terms interchangeably. Physical activity is any bodily movement that increases energy expenditure above resting levels. Walking your dog, taking the stairs, gardening, carrying groceries, playing with your kids, standing more throughout the day: all of that counts as physical activity. Exercise is a subcategory of physical activity. It is intentional, structured, and specifically designed to improve some aspect of fitness, performance, or health. Going for a walk because you enjoy the weather is physical activity. Following a progressive walking program to improve your cardiovascular fitness is exercise.
That distinction matters more than most people realize. One of the biggest mistakes we've made in public health and healthcare is convincing people that if they aren't "working out," they're failing. In reality, meaningful improvements in health often start well before someone ever joins a gym or follows a formal exercise program. For many sedentary individuals, simply increasing overall daily movement can produce profound improvements in metabolic health, cardiovascular risk, mental health, energy levels, and quality of life. Exercise absolutely matters, especially for optimizing health and physical function over the long term, but physical activity is the foundation. Without it, we miss the far bigger opportunity to simply get people moving more throughout daily life.
A Society That Lacks Physical Literacy
Physical literacy is the ability, confidence, motivation, and understanding to engage in physical activity throughout life. It goes well beyond athletic ability or exercise skill. A physically literate person has the movement competency to be active, along with the confidence, knowledge, and intrinsic motivation to value movement as a normal part of daily living.
The sad reality is that we have become a physically illiterate society. We have engineered physical activity out of life on every possible level, and we are now engineering it back in. Toggle between the two to see how we got here, and where the momentum is heading.
How We Engineered Movement Out, and Back In
Toggle between the systemic forces that created the crisis and the work reversing it.
The Cost of Physical Illiteracy and Inactivity
It would be easy to dismiss physical inactivity as a personal responsibility issue, a matter of individual choice that each person needs to solve on their own. But like most major societal challenges, the consequences extend far beyond the individual. Physical inactivity doesn't just create a personal health burden. It creates a massive societal, healthcare, and economic burden that affects all of us.
Research from the CDC consistently demonstrates that insufficient physical activity is associated with increased risk for cardiovascular disease, type 2 diabetes, obesity, depression, anxiety, multiple cancers, dementia, musculoskeletal decline, and premature mortality. The downstream effects don't stop there. Physical inactivity also contributes to higher healthcare expenditures, lower workplace productivity, increased absenteeism, higher disability rates, and reduced quality of life across populations.
The estimated annual cost of physical inactivity to the United States in healthcare expenditures and lost productivity, according to the CDC
The economic implications are staggering:
- More than 80% of annual healthcare spending is related to chronic disease that can be positively affected by physical activity
- Individuals with chronic disease related to inactivity consume significantly higher healthcare resources over their lifetime
- Employers bear substantial costs through absenteeism, presenteeism, disability claims, and rising insurance premiums
- Physical inactivity contributes to workforce inefficiency, lower energy levels, reduced cognitive performance, and increased burnout
- Healthcare systems are increasingly overwhelmed managing largely preventable chronic diseases strongly linked to sedentary lifestyles
- Communities with lower physical activity levels often experience greater long-term public health and infrastructure costs
- Reduced physical function in older adults increases healthcare utilization, fall risk, long-term care needs, and loss of independence
- Military readiness, workforce readiness, and overall national productivity are all negatively affected by declining physical fitness and movement competency
In other words, physical inactivity is far more than a fitness problem. It is a healthcare problem, an economic problem, a workforce problem, a mental health problem, and increasingly a societal sustainability problem.
Policy and System Changes Required
As outlined above, many systemic barriers prevent our society from being physically active. While a level of personal agency certainly exists when implementing any health behavior, leaning on individual willpower alone is a reductionistic and frankly ineffective way to approach the physical inactivity epidemic our nation is facing.
Physical inactivity has reached crisis levels. Fewer than 25% of US adults meet the federal guidelines for physical activity and muscle strengthening. Even more concerning, we are raising a generation that is less physically active than we are as adults. Only about 24% of children aged 6 to 17 participate in the recommended 60 minutes of physical activity daily. Physical inactivity is on a trajectory to get worse, and it is long overdue for society to address this issue boldly.
Given that systems and policies created our physically inactive culture, it is systems and policies that must be put to work to reverse the trend and "treat" the epidemic. While this might sound daunting, there is positive momentum around policy and system change at the local, state, and federal levels. I have the opportunity to be deeply embedded in all three.
Driving Change at Every Level
All health is local, but lasting change needs every tier. Tap each to explore the work.
The work I am directly involved with is only a small subset of the work that goes on every day to get our society more active. Among the great work happening nationally:
- Expansion of Complete Streets policies and walkable community design initiatives
- Increased investment in parks, trails, green spaces, and active transportation infrastructure
- Exercise is Medicine initiatives integrating physical activity into healthcare delivery
- Growing momentum toward insurance reimbursement for exercise and lifestyle-based interventions
- State and local physical activity plans focused on implementation, not just awareness
- Community-based programs aimed at improving equitable access to movement opportunities
- Workplace wellness and employee wellbeing initiatives that prioritize movement and health promotion
- School systems re-emphasizing physical education, recess, and whole-child wellness models
- Healthcare systems beginning to recognize exercise professionals as part of the preventive health workforce
- Public health campaigns reframing physical activity as essential medicine rather than optional recreation
- Cross-sector collaborations between healthcare, public health, education, parks and recreation, transportation, and community organizations
- Increasing research on the mental health, cognitive, and economic benefits of physical activity
- Technology platforms and wearables helping individuals better monitor and engage with movement behaviors
- Aging and longevity initiatives emphasizing strength, mobility, balance, and functional independence across the lifespan
- Advocacy efforts to improve equitable access to safe, affordable, and culturally meaningful opportunities for movement
- Emerging recognition that physical activity is a systems-level public health imperative, well beyond a matter of personal responsibility
Most Importantly: A Little Goes a Long Way
Let's go back to my bold statements from the beginning. The federal guidelines suggest you need 150 minutes per week of moderate to vigorous physical activity to receive a wide range of health benefits. I challenge you to find any other health behavior you can engage in for only 150 minutes that delivers the same benefit. Sleeping well or eating well for 150 minutes certainly won't come close. Physical activity is the best return on investment for your time from a health perspective, full stop.
What's even more compelling is that the biggest difference in health comes from moving when someone is doing none, or very little, to doing just a bit more. Two studies demonstrate this well. Use the toggle below to see how steeply the benefit curve rises at the very start, then flattens.
The First Steps Matter Most
Mortality risk drops sharply with a little movement, then levels off. Switch between two landmark studies.
The first study, published by Banach and colleagues in 2023, shows that mortality rates drop sharply when going from 0 steps a day to 5,000 steps a day, then begin to flatten quickly. Your mortality rate falls more going from 0 steps per day to 5,000 than it does going from 5,000 to 20,000.
The second study, Blair and colleagues in 1989, finds that going from the lowest level of aerobic fitness to the second-lowest level cuts mortality rates in half or more. Going from really, really, really out of shape to just really, really out of shape cuts your mortality rate in half. That's one less REALLY.
So how do my two bold statements hold up? Scroll back to the top and tap each one to mark it proven, or take my word for it here:
Join the Movement for Movement
After reading this, I hope you're compelled to join the movement.
If nothing else, I hope you understand the difference between physical activity and exercise. I hope you understand that physical activity is the gateway to health through movement, and that while exercise is an accelerant for fitness and function, physical activity is the foundation.
Lastly, I hope you never forget that the biggest improvements in health require just a little more movement than you're already doing. If you're on board with all of that, do two things. First, start to move more in a way that is fun and meaningful for you. There is no right answer here. Just move. Second, please share your movement discoveries with others. What you've just learned needs to be shared, because the power of movement to improve health is real.
I also hope you now recognize the importance of policy and systems in shaping a world where the active choice is the easy choice. Many systemic and policy barriers to leading a physically active life exist today. If we are to reclaim the health of our nation, we need to advocate for policy and systems change that engineers physical activity back into our lives. Advocate to your local, state, and federal politicians about the importance of physical activity in improving physical, mental, economic, and societal health. Support the coalitions and local organizations doing the hard work of making our country more active.
There Is a Movement of Movement Building in America
We need you to join it. Start by moving a little more today, then help shape the systems that make the active choice the easy choice for everyone.
Move With Us →