Fitness: The Solution to the Healthcare Crisis in America

The growing U.S. healthcare crisis can be depleted with simple exercise and prevention methods.

As I shared in my education session at IHRSA 2021 in Dallas last October, fitness is the answer to the healthcare crisis in the U.S. As health club operators and fitness professionals, you live and breathe this mission/purpose. The challenge is to enlighten the public about the healthcare crisis and educate them on the small, realistic steps to improve the quantity and quality of life through fitness.

What is the healthcare crisis in America today?

The rising cost of healthcare in this country affects the functionality of the government and the economy. The U.S. spends almost $4 billion per year on healthcare expenditures but ranks thirty-fourth in longevity. So, where does that money go? Of the $3.6 trillion spent on healthcare, most go to hospitalization. A good portion of American employees’ salaries goes toward healthcare—with an almost punitive effect if someone in that person’s family gets sick, rising from 12% to about 20% in healthcare expenditures.

Chronic disease drives the cost of healthcare, primarily starting with the cause of obesity. The Centers for Disease Control and Prevention show more than one-third of U.S. adults are obese, and more than two-thirds of adults are overweight or obese. Annually, obesity-related preventable chronic diseases cause 7 in 10 deaths, accounting for roughly 75% ($2.7 trillion) of the $3.6 trillion spent on medical care in this country, and 9% of that goes to prescriptions. Decreasing obesity levels means a tremendous gain in dollar savings—a person whose obese spends approximately $1,500 more on healthcare per year.

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We also know obesity leads to diabetes, which is rising in the U.S. Diabetes is correlated to increased risk of:

  • cardiovascular disease,

  • cerebral vascular disease,

  • kidney failure,

  • eye problems, and

  • neuropathy.

We also see these risks with dementia, which affects about 5.2 million people and is forecasted to reach 16 million by 2050. These are costly, dangerous, and horrible diseases that impact the quality of one’s life—something that is our direct purpose here at Cooper Aerobics, improving the quality and quantity of people’s lives. We want people to understand their health is their responsibility, and they can make improvements to impact their lives.

Science-based Solution: Exercise & Prevention

Exercise as prevention started with my father, Dr. Kenneth H. Cooper, publishing his book, Aerobics, in 1968 to prove the physiological benefits of exercise. He started measuring fitness by time on a treadmill stress test to predict VO2—the max amount of oxygen your body uses when exercising. When he left the Air Force in 1970, he established Cooper Clinic in Dallas and measured physical fitness by treadmill stress-testing.

We’ve been doing this for 51 years with the data collected at Cooper Clinic making up the Cooper Center Longitudinal Study (CCLS) at The Cooper Institute—the largest database in the world of its type, measuring more than 326,000 records on 116,000 individuals. Research based on this has changed the world. We always thought more exercise was better. This study showed if you can get out of the bottom category of fitness, it would extend your life by six years and decrease your risk of dying of any cause by 58%.

It’s Never Too Late

The good news is, it’s never too late to get fit, especially for the 80% of people who don’t visit gyms or work out! A 1995 JAMA study notes people who are fit throughout their life will have the lowest risk of mortality. The same study shows those who become fit later in life still benefit from a lower risk of mortality than those who stay unfit their entire lives.

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We also know cancer drops precipitously with your level of fitness, as shown in a study published in the JAMA Oncology in 2015. Lung cancer and colon cancer rates go down as fitness goes up, with the opposite with prostate cancer. Prostate cancer goes up because the rate of this cancer increases later in life, so you’re living long enough to develop cancer.

With diabetes, there is a steep drop in the risk of diabetes relevant to your level of fitness. The most notable decline in the risk of diabetes is getting out of the lowest category of fitness.

Dementia risk related to fitness level is linear. The more fit you are, the less likely you are to have dementia. The key is consistency. For example, at 90-years-old, my father is consistent with his diet, his exercise, his weight, and continues to study. Never stop exercising your mind and learning—it’s one of the most important things you can do, combined with a regular exercise plan.

Decreased Healthcare Costs

Another study conducted by The Cooper Institute compares Medicare spending and fitness levels in midlife to Medicare years. To no surprise, we saw almost half a drop in the amount of Medicare dollars spent concerning their fitness level. In a similar study with our employees, those in the very poor or poor fitness category—or those who don’t participate at all—cost the organization five times more than those in the fair fitness category or better.

“There is an absolute correlation between healthcare expenditures and fitness levels. It doesn’t take much to be fit—that’s the message that needs to be out there.”

Exercise can also impact your quality of life and make you feel better. Fatigue, heartburn, impotence, low back pain, depression, headaches, and difficulty sleeping fizzle out.

If there is a magic pill, it is fitness! We’re working to put fitness testing inside doctor’s offices through a program called CooperFit, to have a basic walk test or run test so doctors around the country can begin to give their patients results of a fitness test—just like they’ve come through Cooper Clinic. We’re excited about this project and hopeful to help solve the healthcare crisis by putting the information in the hands of doctors who can help create change in their patients.

One thing is clear—fitness is a vital sign for our health. We can be agents of change in the healthcare crisis sweeping the nation by encouraging people to make small changes that can have a tremendous impact on their health.

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Tyler Cooper

Tyler C. Cooper, M.D., MPH, is president and chief executive officer of Cooper Aerobics, a preventive medicine physician at Cooper Clinic, and co-author of “Start Strong, Finish Strong.” Dr. Cooper oversees Cooper Aerobics’ seven diverse health and wellness companies, which focus on fulfilling the Cooper mission of improving the quality and quantity of the lives we touch, through preventive medicine, corporate wellness, or fitness and nutrition.