With recent estimates suggesting that 31.7% of children aged 2 to 19, and 34.2% of adolescents, are overweight or obese, the childhood obesity problem has become one of the defining health and social issues of our time. Attempts to reverse the high levels of obesity have led to hundreds of policies being developed at state and federal levels in order to increase levels of physical activity and improve the nutritional value of food that children consume.

One area that policy-makers and advocates have focused upon is the provision of physical education (PE) in schools. This has widespread support among many groups, including the President's Childhood Obesity Taskforce, Michelle Obama’s Let's Move! campaign, the US Surgeon General, and the Robert Wood Johnson Foundation. Seen as a way in which to enhance all children’s activity levels, irrespective of access to facilities or athletic ability, there have been concerted efforts to improve the quantity and quality of PE across the country. These sentiments have been accompanied by a substantial increase in legislation over recent years with 90% of states now requiring high school PE. However, despite its prevalence, there is compelling evidence that such legislation is having little effect on levels of PE participation, particularly among older students. With this in mind, we looked at the formulation and implementation of legislation designed to increase levels of physical activity and improve the quality of PE in 8 high schools in Mississippi and Tennessee, states with among the highest levels of childhood obesity and obesity-related illnesses in the country.

We carried out 145 interviews with policy-makers, school administrators, teachers and students and spent extensive periods in each school observing what went on, particularly during PE lessons. We also collated information from documents produced by the schools, other education and related institutions, and various media outlets. From these data we uncovered four main findings.

Our findings

Seven schools in our study did not increase the quantity or quality of PE over the three years of our study; the other school initially avoided implementation, but embraced the new policy after a change of heart by the Principal.

Value Changes in Education.
High schools have long been seen as places in which health and social issues can be addressed alongside the pursuit of academic attainment. This has now changed with the traditional holistic approach to education being supplanted by a much more singular focus on academic achievement as measured by students’ performances in standardized tests across a narrow range of subjects. This is pervasive across high schools irrespective of socio-economic, demographic or academic characteristics. Further, administrators, teachers, and students have internalized this value change, leading to widespread avoidance of adherence to the new PE policies at all levels.

PE has become highly marginalized.
PE is not valued within schools. It is largely viewed as expendable by school administrators, classroom teachers, and parents, and is generally seen as detracting from other activities perceived as more worthwhile. Importantly, this opinion has also filtered through to children, most of whom see little value in PE.

PE is heavily subjugated to varsity sport.
With little oversight, those delivering PE and making resource decisions have, almost without exception, prioritized varsity sport over PE. PE teachers often perceive their worth as depending more on team success than their PE curriculum. Therefore, little attention is given to the development of PE, which is often characterized by a narrow range of activities,such as cross-country running, calisthenics, weight training, and basketball depending on the interests of the teacher. These activities may appeal to some, usually those who are already active, but theygenerate little enthusiasm among a large majority of students, particularly girls.

Role of Principals.
The implementation of new PE policy is dependent upon the attitudes and actions of school Principals. They only implement policies for which they will be held directly accountable, or in which they have a personal interest. Issues such as resource constraints, inadequate facilities, overcrowding, and the sheer number of new policies with which principals are confronted (over 50 annually according to one Principal), are woven into a justification as to why new PE policies should be avoided or opposed, or on one occasion in our study, implemented.

What needs to change?

There are four main policy implications that emanate from our work. Without changes such as those described here, it is highly unlikely that PE will play an effective role in strategies intended to reduce levels of childhood obesity.

1. New policies will not be implemented just because they have some intrinsic social value. The new educational value system has led to Principals being overwhelmingly concerned with standardized test performances to the detriment of non-tested subjects.Thus, Principals and other key stakeholders must be educated as to the benefits that PE can provide, both to academic and health outcomes, as laid out recently in reports in the Minnesota StarTribune and by the CDC. Further, Principals must be held accountable for the quality of PE in the same way that they are for those subjects included in standardized tests.
2. The detrimental impact of varsity sport on PE cannot be underestimated. PE teachers must be evaluated based on their delivery of a balanced, broadly appealing PE curriculum, not just the performances of the teams that they coach; their appraisal and incentive systems should reflect this. Further, school administrators must develop a culture in which PE and physical activity are celebrated in a way similar to the successes of varsity sport teams.
3. Legislation that is under-funded and/or runs counter to the new educational value system may be politically expedient but is very unlikely to be implemented. Therefore, PE must be tied to central educational policy at federal and state levels.
4. Policy-makers must not assume that institutional environments are static. They must go beyond arms length consultation with key actors, such as Principals and PE teachers, and actively include them in crafting legislation. In this way, the constraints to action will be more likely to be made apparent, resulting in legislation that is not just well-meaning, but also more likely to lead to desired outcomes.

The findings described here are drawn from the following paper:
Amis, J.M., Wright, P.M., Dyson, B.,Vardaman, J.M.& Ferry, H. (2012). Implementing Childhood Obesity Policy in a New Educational Environment: The Cases of Mississippi and Tennessee. American Journal of Public Health, 102 (7), 1406-1413.

John Amis, PhD
University of Memphis
johnamis@memphis.edu

About the author

John Amis, PhD is Associate Professor in the Department of Management in the Fogelman College of Business & Economics at the University of Memphis. More information on Dr. Amis' Active Living Research grant can be found here.