'On the Web' is an internet-based supplement that provides additional web content to supplement the material in Concepts of Fitness and Wellness. Browse through the whole document to explore web content related to this concept. If you know the specific 'On the Web' number or page number of the web icon in the text you can click on the direct link you are looking for below. Click here to access the other Online Learning Center resources available from the McGraw Hill Website (http://www.mhhe.com/corbin7e).

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On the Web - Concept 01

Web01-01: Healthy People 2010

Web01-02:  Public Health Accomplishments in the Past Century

Web01-03: Quackery and Misinformation in the Fitness and Health Industry

Web01-04 Holistic Health

Web01-05 Life Expectancy

Web01-06: The Surgeon General's Call to Action to Improve the Health and Wellness of Persons with Disabilities

Web01-07: Health Care System and Insurance

Web01-08: Healthy Environments

Web01-09: Learn About Your Family Health History

Web01-10: Lifestyle Changes are a Public Health Priority

Web01-11: Leading Causes of Death

Web01-12: Health Risk Appraisals

Web01-13: Web Resources

Web01-14: Supplemental Readings

Web01-01: Healthy People 2010

The United States Public Health Service establishes national health goals each decade to guide public health policy, research and promotion efforts. The current goals (Healthy People 2010) have established a framework to increase their effectiveness. The broad goals will be targeted by seeking to promote changes in 4 different categories of Enabling Goals including Promoting Healthy Behaviors, Protecting Health, Achieving Access to Health Care and Strengthening Community Prevention. A total of 22 Primary Objectives have been established as the primary focus areas for the initiative. The importance of personal lifestyle behaviors toward the public health goals is evident in the fact that the top three objectives are physical activity, nutrition, and tobacco. A conceptual view of this planning model is presented below:

Considerable efforts are made to track progress on these goals. Detailed reports compiled in 2000 summarized the effectiveness of the Healthy People 2000 goals. While many objectives were met, a large number in many of the categories were not met or were actually farther from the target. The revised goals now rely on a series of 10 Leading Health Indicators to monitor overall progress towards the collective goals.

Further information on Healthy People 2010 visit the website at www.health.gov/healthypeople.

Web01-02: Public Health Accomplishments in the Past Century

Since 1900, the average lifespan of persons in the United States has increased by more than 30 years.  The Centers for Disease Control and Prevention (CDC) recently estimated that 25 of these years can be attributed to improvements in public health. They recently compiled a list of the top 10 public health accomplishments in the past century. These were selected based on their overall potential impact but are not ranked in order of importance.

• Vaccination—The development of vaccinations has helped to eradicate smallpox, and control measles, rubella, tetanus, diptheria and other infectious diseases.
• Motor vehicle safety—Engineering efforts to make cars and highways safer and improved measures of personal safety such as seatbelts, helmets and reduced drinking and driving have contributed to large reductions in motor-vehicle related deaths
• Safer workplace—Work-related health problems and injuries have decreased in the past century with the passage of employee protection laws and standardized safety practices.
• Control of infectious diseases—Cleaner water and improved sanitation have reduced spread of infectious diseases.
• Decline in deaths from CHD—Declines in smoking and awareness about hypertension, coupled with improved detection and treatment options ha led to significant declines in CHD deaths.
• Safer and healthier foods—Decreases in microbial contamination and increases in nutritional content have reduced food related illness and almost eliminated the major nutritional illnesses that were common in earlier times (e.g. pellagra, rickets, goiter).
• Healthier mothers and babies—Technological advances in maternal and neonatal medicine as well as improved access to health care and antibiotics have contributed to dramatic decreases (~90%) in rates of infant mortality since 1900.
• Family planning—Family planning and contraceptive services have provided health benefits to families and has altered social and economic roles for women.
• Flouridation of drinking water—Flouridation of drinking water (begun in 1945) has helped to reduce rates of tooth decay in children by 40-70% and tooth loss in adults by 40-60%.
• Recognition of tobacco as a health hazard—The increased awareness about the dangers of tobacco have resulted in altered social norms and increased efforts to prevent initiation of tobacco use and to promote cessation of use.

Source: Click here to read the article in Morbidity and Mortality Weekly Report – a public health publication from the Centers for Disease Control and Prevention.

Web01-03: Quackery and Misinformation in the Fitness and Health Industry

Consumers often become very confused when trying to sift through information about fitness and health. The Internet is a popular way for consumers to learn about health. In fact, the topic of "health" is one of the leading search topics on the internet. Because the Internet is a free domain it is often difficult for consumers to know how to access reliable information. The following links provide information that you can use to learn how to obtain reliable information on the internet.

Internet Healthcare Coalition Tips for Health Consumers; Finding Quality Health Information on the Internet

Published criteria for evaluating health related web sites - BMJ 1999;318:647-649 (6 March) Objective: To review published criteria for specifically evaluating health related information on the world wide web, and to identify areas of consensus

Guidelines for Medical and Health Information Sites on the Internet Principles Governing AMA Web Sites American Medical Association

How to Spot a "Quacky" Web Site, by Stephen Barrett, M.D. provided by Quackwatch Your Guide to Health Fraud, Quackery, and Intelligent Decisions

HONcode Principles; Code of Conduct for medical and health web sites. Health On the Net Foundation

Criteria for Assessing the Quality of Health Information on the Internet - Policy Paper Health Summit Working Group

How To Evaluate Health Information on the Internet – The National Cancer Institute

A number of non-profit consumer organizations have developed websites to better inform the public of various forms of quackery in the health and fitness industry. These are some recommended ones that are worth browsing whenever you have a question about quackery.

Quackwatch.com (http://www.quackwatch.com/)

National Coalition Against Health Fraud (http://www.ncahf.org)

Center for Science in the Public Interest – CSPI (http://www.cspinet.org/)

Web01-04: Holistic Health

Wellness and holistic health are terms that are widely used as well as misused in society today. There are many different dimensions of wellness as shown in the graph below. Many products and services are being marketed to individuals to enhance these dimensions without the scientific documentation to support these claims. There are good products and services that fall into the holistic health category, but care should be taken when choosing these goods and services. The site below provides some good information as well as those sites listed in Web01-03 on Quackery.

The American Holistic Health Association provides resources for people trying to reach a higher level of wellness. Their resources can be found at the following site: http://ahha.org/ Their mission is dedicated to promoting holistic principles: honoring the whole person (mind, body and spirit) and encouraging people to actively participate in their own health and healthcare. WebMD also provides information on alternative medicine.

Web01-05: Life Expectancy

Americans life expectancy has reached an all time high.  The average life expectancy is 77.6 years old.  The average gap in life expectancy between males and females has been reduced to 5.3 years.  These statistics can be found on the following websites:

National Center for Health Statistics through the Center for Disease Control  http://www.cdc.gov/nchs/pressroom/05facts/lifeexpectancy.htm

The World Health Organization also has statistics on life expectancy http://www.who.int/healthinfo/bod/en/index.html

Web01-06: The Surgeon General's Call to Action to Improve the Health and Wellness of Persons with Disabilities

The Surgeon General is the nation's leading health official appointed by the President to lead the nation in health and wellness practices.  When the Surgeon General believes a health and wellness topic needs attention, a Call to Action is issued.  The Surgeon General recently issued this call to action to improve the health and wellness of persons with disabilities.

Below are some facts from the Surgeon General's call to action:

Fast Fact: The chance of having a disability goes up with age, from less than 10% for people 15 years of age or younger, to almost 75% for people 80 or older. With good health habits and access to health care, many disabilities can be delayed or even prevented.

Fast Fact: People with disabilities are twice as likely to be physically inactive as people without disabilities. As a result, they are less likely to stay heart healthy and to maintain strong muscles and bones.

Fast Fact: Among nonelderly people with disabilities, 25% reported they had difficulty finding a health care professional who understood their disability. Many training and continuing education programs for health care professionals are now focusing on training them to understand disabilities.

The Surgeon General's call to action for improving health and wellness of people with disabilities can be found at these two links:  SG 1, SG 2.

Web01-07: Health Care System and Insurance

The Institute of Medicine is a non-profit science-based organization that offers advice health and medicine.  There mission is to serve as an advisor to the nation to improve health.  Many health related topics are easily accessible through the website's homepage (IOM).  In particular, health care and quality is a vital topic that is covered by the IOM.  As stated in the text, a study entitled "Care without Coverage:  Too Little, Too Late" was conducted by the IOM.  The committee found that uninsured people who suffered from major diseases such as cancer, heart disease, HIV, mental illness, and other major chronic diseases were more likely to receive too little medical care and receive it too late in the illness.  These people were more likely to be sicker, receive worse care, and die sooner than those with insurance.

This study found that 1 in 7 working adults were without health insurance.  That is equal to approximately 30 million Americans.  And this number did not include 10 million children who are uninsured as well as the large population of adults over 65 that are covered by Medicare.  The IOM's Committee on the Consequences of Uninsurance came up with the following five guiding principles to help lead the reform on health insurance for all Americans:

1. Health care coverage should be universal.
2. Health care coverage should be continuous.
3. Health care coverage should be affordable to individuals and families.
4. The health insurance strategy should be affordable and sustainable for society.
5. Health care coverage should enhance health and well-being by promoting access to high-quality care the is effective, efficient, safe, timely, patient-centered, and equitable.

Click the Unisurance Checklist to learn more about this initiative by the IOM.

Web01-08: Healthy Environments

Some factors that influence your health are out of your control such as age, heredity, and disabilities.  Other factors that can have a major influence on your health and wellness include environmental factors such as the neighborhood or area of the country in which you choose to live and work.  It is important to consider the environment (such as safety issues or exposure to unsafe toxins) when choosing an environment to live, work, and play.

The National Institute of Environmental Health Sciences (NIEHS) mission is 'to reduce the burden of human illness and disability by understanding how the environment influences the development and progression of human disease'.   Because of studies conducted by the NIEHS, many health-enhancing environmental steps have been taken in the United States.  Some of these steps listed on the website include the following:

• Removed lead from gasoline, and redesigned the gasoline pump to expose you to less benzene, which might increase your risk of cancer.
• Reduced smog, making your breathing easier.
• Removed from the market questionable products, such as a laxative ingredient that tests showed could cause cancer.
• Restricted or removed from commerce many workplace chemicals, food dyes and pesticides because they posed a risk of sterility, cancer or other diseases.
• Recommended healthier food habits - advising pregnant women, for example, to avoid eating certain large ocean fish, like shark and swordfish, in which mercury accumulates.

Web01-09: Learn About Your Family Health History

Because some common diseases such as heart disease, cancer, and diabetes (and even rare diseases - like hemophilia, cystic fibrosis, and sickle cell anemia) can run in families it is important to learn all you can about your family's health history.  A recent survey found that most Americans believe it is important to know their family's history, yet only about one third of those Americans have tried to gather and write down their family's information.

My Family Health Portrait is a website provided by the U.S. Surgeon General to help individuals create a personalized family health history report.  It creates a family tree along with a family health history.  Once you create your family health portrait, it can be shared with other family members as well as with family physicians.  The following is a list of helpful functions provided by My Family Health Portrait:

With My Family Health Portrait, you can:

• Edit or update your health information at anytime.
• Save your health information to a disk and take it with you if you are using a public machine (e.g., at the library).
• Decide with whom you want to share your health information.
• Decide how to share your health information (e.g., mail it to someone).

Web01-10: Lifestyle Changes are a Public Health Priority

Many of the leading causes of death can be linked directly to unhealthy lifestyles. The Centers for Disease Control and Prevention (CDC) publishes a number of documents that provide information for both health educators as well as consumers. In a document called the Burden of Chronic Diseases and their Risk Factors they provide national and state statistics about lifestyles and associated chronic disease risks.

Lifestyle behavior change is a critical public health goal. In a document titled Top 10 Public Health Challenges for the 21rst Century, the CDC highlights those public health problems or issues that are most pressing and also those that may be difficult to address. Incorporating physical activity and healthy eating into daily lives was listed as one of the top public health priorities on this list.

Links to a number of valuable and informative public health documents can be found directly at the CDC website. Direct links to some other sites are provided below:

Setting the Agenda, CDC Research in Chronic Disease Prevention and Health Promotion, September 2000

Unrealized Prevention Opportunities: Reducing the Health and Economic Burden of Chronic Disease, November 2000

The federal government has taken new steps to Healthy Lifestyle campaign known as Smallstep.gov

Web01-11: Leading Causes of Death

The leading causes of death in the past 100 years have undergone dramatic shifts. Infectious diseases accounted for more deaths in the early 1900's but now chronic diseases related to lifestyle behaviors have become the more significant threat.  Risks for these conditions can be greatly reduced by practicing healthy lifestyles. Various public health service agencies in the United States provide documentation of the leading causes of death.

The National Center for Health Statistics (http://www.cdc.gov/nchs/about.htm) has a "Fastats" option that provides updated statistics about various health conditions. Click here to see the Fastats results posted for the leading causes of death.

The National Center for Injury Prevention and Control (http://www.cdc.gov/ncipc/) within the Centers for Disease Control and Prevention (CDC) provides an interactive tool that allows users to examine the leading causes of death for different years, regions, ethnic groups or genders. Click here to access the website.

Web01-12: Health Risk Appraisals

The Healthy Lifestyle Questionnaire included in the book provides a way to assess your lifestyle behaviors and their relationship to your health. This assessment is similar to the Health Risk Appraisals (HRA) that are commonly used by health promotion professionals to assess the health risks and behaviors among participants in their programs. HRA's provide the individual with personalized information about their health and recommendations for improving their health lifestyles. If completed as part of a worksite or community program, HRA's also provide the health promotion professional with valuable information about the collective risks within the population. This information is useful for planning health promotion programs and for documenting any changes in health status or behaviors over time.

There are now a number of HRA's that are available online to individuals interested in tracking and improving their health. These programs allow a person to receive personalized information about their health and to receive tips and guidelines for how to improve their lifestyles. Some HRA's are from for-profit companies that offer their software to companies to track health behaviors of employees. Other HRA's are developed by non-profit agencies that sponsor these sites to promote health in the population. Some Universities may subscribe to some online software that tracks health behaviors across the campus. An example of this type of tool is the TestWell program developed by the National Wellness Institute. Try out the free version of the TestWell program for college students. Links to several other free health risk appraisals are included below:

HealthStatus.com Assessments (requires free login)

American Heart Association Learn and Live Quiz

Web MD (http://www.webmd.com/) offers a service called the WebMD Health Manager that provides a detailed online database to store personal and family health information. The service requires a registration fee.

While many health risk appraisals provide valuable feedback and suggestions for behavior change they are not generally found to be sufficient for promoting behavior change by themselves.

Note:The selection of these sites is only for demonstration purposes. They are not being advocated or recommended over other health related sites on the Internet but are to be used as examples of the types of information that is available. You are encouraged to browse and explore other sites to find one that best fits your needs.

Web01-13: Web Resources

American Medical Association (AMA)—www.ama-assn.org 

Centers for Disease Control and Prevention (CDC)—www.cdc.gov

Health Canada—http://www.healthcanada.ca

Healthfinder—http://www.healthfinder.gov/

Healthier United States—http://www.healthierus.gov/

Healthy People 2010—www.health.gov/healthypeople

Healthy People 2010 Mid Course Review—http://www.healthypeople.gov/Data/midcourse/default.asp

National Center for Chronic Disease Prevention and Health Promotion Publications—www.cdc.gov/nccdphp/publicat.htm

National Center for Health Statistics—www.cdc.gov/nchs 

President's Council on Physical Fitness and Sports—www.fitness.gov

World Health Organization—www.who.int

Web01-14: Supplemental Readings

• Bryant, C. X., Peterson, J. A., & B. A. Franklin. Fountain of Youth. Fitness Management. 14(10)(1998):44.
• Centers for Disease Control and Prevention. Ten Great Public Health Accomplishments—United States 1900-1999. Morbidity and Mortality Weekly Reports. 48(12), 241-243,
• Corbin, C. B., Pangrazi, R. P., & Franks, B. D. Definitions: Health, Fitness and Physical Activity. President's Council for Physical Fitness and Sports Research Digest. 3(9), 1-8, 2000.
• Corbin, C. B. & R. P. Pangrazi. (Editors), Towards a Better Understanding of Physical Fitness and Activity. Scottsdale, AZ: Holcomb-Hathaway, 1998.
• Etnier, J. L. et al. The Influences of Physical Fitness and Exercise upon Cognitive Functioning: A Meta Analysis. The Journal of Sport and Exercise Psychology.. 19(3)(1997):249.
• Jonas, W. B. et al. Alternative Medicine: Learning from the Past, Examining the Present, Advancing to the Future. Journal of the American Medical Association. 280(18)(1998):1616.
• Maddux, J. E. Habit, Health, and Happiness. Journal of Sport & Exercise Psychology. 19(1997):331.
• Morbidity and Mortality Weekly Reports. Published Weekly by the Centers for Disease Control and Prevention, Provides Updated Information on Health
• National Council for Reliable Health Information Newsletter. Published every other month it contains articles that give objective information about health products and food supplement. NCRHI, P. O. Box 1276, Loma Linda, CA 92354.
• National Center for Health Statistics. Health, United States, 1998: With Socioeconomic Statistics and Health Chartbook. Hyattsville, MD: National Center for Health Statistics, 1998.
• Payne, W. A. & D. B. Hahn. Understanding Your Health (5^th ed.) St. Louis: WCB/McGraw-Hill, 1998.
• Smith, A. D. (1998). The Fit Woman in the 21^st Century. The Physician and Sports Medicine, 26(1998):23.
• U. S. Department of Health and Human Services. Physical Activity and Health: A Report of the Surgeon General.Atlanta, GA: U. S. Department of Health and Human Services, 1996.
• U. S. Department of Health and Human Services. Healthy People 2010. (Conference Edition, in Two Volumes). Washington, DC: USDHHS, 2000.
• USA Today/Gallup. American Opinion in the 20^th Century. USA Today. December 31, 1999, 11A and 29A.