There are many reasons why individuals might not meet the Physical Activity Guidelines, but one major factor is the physical environment that surrounds them. When people don't have the option to make the healthy choice regarding their participation in physical activities, there is no possible way they can do it.

Over the past several decades, our society has engineered physical activity out of our lifestyles. For example, 13% of children five to fourteen years old usually walked or biked to school in 2009, compared with 48% of students in 1969. For a long time, neighborhoods were being built without regard for pedestrians, putting the needs of the driver first. Safe biking lanes, walking paths that connected places where people wanted to go, and a variety of safe outdoor play spaces were all but engineered out of most built environments. Schools were being put in a position where they had to eliminate physical education, whether for budget reasons or to meet academic goals. Offices were built without bike racks, employee changing areas, or easy to use staircases, further enhancing less physical activity instead of more.

Fortunately, things are starting to change. A healthier communities movement is building across the nation. The Y, along with other national organizations, is leading the way. Since 2004, with support from the Centers for Disease Control and Prevention and other corporate and foundation donors, the Y has engaged leaders in 200 communities in working together to implement strategies that provide opportunities for physical activity.

YMCAs engaged in our Healthier Communities Initiative (pioneering Healthier Communities, Statewide Pioneering Healthier Communities and ACHIEVE) are helping families by giving parents peace of mind when they let their kids walk to school. The initiative is focused on creating safer routes, making streets safe for all users whether they are on foot or on wheels. The organizations strive to keep a generation of kids healthier by working with schools to increase physical education and physical activity during the school day, and making recess periods more active. The initiative also encourages employers to build environments that support activity among their employees. These examples are just the beginning.

How healthy is your community? What are examples of your community's efforts to change the built environment so more people engage in physical activity to meet the PA guidelines? How are you helping people see that their own built environment supports or inhibits meeting these guidelines? What barriers are there, and how can you work with other leaders in your community to collaboratively remove those barriers?

"If you always put limits on everything you do, physical or anything else, it will spread into your work and into your life. There are no limits. There are only plateaus, and you must not stay there, you must go beyond them." - Bruce Lee

As important as it is for health and fitness professionals to know what limitations an individual may have in terms of creating appropriate activities, especially for safety and medical considerations, it's also important to consider what that individual CAN do, and what they can do in context with their environment. The social model of disability has taught us that systemic barriers, negative attitudes and exclusion by society (whether purposely or not) are the main contributing factors in disabling people, not the disability itself.

The International Classification of Functioning, Disability, and Health, or ICF, is a comprehensive framework used by the World Health Organization (WHO) for describing and measuring health and disability at both the individual and population levels. This framework is used to assess the relationship among an individual's function, activities, and participation while also considering these in the context of the environmental and personal factors that influence an individual's overall health. 

The ICF puts the idea of 'health' and 'disability' in a new light and recognizes that any person can experience peaks and valleys in health, and therefore any person is prone to experiencing some kind of disability. It shifts the focus from what caused a disability to the impact that it has on the person. In addition, ICF considers the social aspects of disability and does not see disability as a medical condition. By including these contextual factors, the ICF helps us to assess the impact of the environment on the person's functioning, and therefore possibly assess potential "limitations" a bit differently.

The health domain and health-related domain contained in the ICF are described fromt he perspective of the body, the individual, and society in two basic categories: (1) Body Functions and Structures (system level); and (2) Activities and Participation (person level and person-environment interaction). The ICF can be used as a tool in exercise physiology to conduct a needs assessment or as an outcome evaluation. It allows the fitness professional to identify the barriers and facilitators that affect the health of the client with the disability and then find or create modifications for the specific individual in order to facilitate participation in an activity. The ICF emphasizes function, NOT the health condition, and categorizes the situation, NOT the person. Here is an example.

Do you see the ICF as having application in your field?

Reference: http://www.who.int/classifications/icf/en