Asian Perspectives on America's"National
明治期日本における武士道の創出
Blueprint:
Increasing
Activity
Among Adults
Age 50 and Older"
筑波大学体育科学系紀要
Bull. Inst.
Health& Sport Sci.,
Univ.Physicalof Tsukuba
25：13―22,
2002.

13

Asian Perspectives on America's "National Blueprint: Increasing
Physical Activity Among Adults Age 50 and Older"
TANAKA Kiyoji #, SHIGEMATSU Ryosuke *#, NAKAGAICHI Masaki **#,HAYASHI Yo-ichi ***, and OHTA Toshiki *#1. Background1996). Despite abundant evidence on the life benefits

The International Year of Older Persons - 1999

associated with physical activity, many people still

focused world attention on the many challenges societychoose not to exercise. It has been estimated that only

faces as a result of the remarkable aging of the

12 to 22% of U.S. adults engage in leisure time physicalpopulation. In Japan, as well as in the United States,

activity at recommended levels, and 24 to 60% havethe realization that the nation is aging rapidly has led

been reported to be very sedentary and unfit (Caspersensome to voice concerns about the implications foret al., 1994). These figures are quite similar to thosesociety as a whole. As a practical matter, thereported by the Ibaraki Health Science Center (2000).

percentage of Japanese adults aged 65 years or overAccording to a Report by the U.S. Surgeon Generalin the total population has been increasing. This

(1996), approximately 38% of the U.S. population aged

percentage was only 5.3% in 1955, 6.3% in 1965, 7.9%

55 and older is sedentary. In Japan, the percentage

in 1975, 10.3% in 1985, and 14.5% in 1995. It is

seems to be similar for people in their 50s andprojected to increase to 19.6%, 25.2%, 27.5%, 29.0%,

somewhat lower for those in their 60s and 70s (Ibaraki

and 32.0% in the years 2005, 2015, 2025, 2035, andHealth Science Center, 2000; Harada et al., 1994).

2045, respectively (Institute of Population Problems,

Another research survey (Ohta et al., 2000) indicates

1997; Ohno et al., 2000). These demographic changes

that at least 50% of senior adults do not exercise

will inevitably result in increases in older adults withregularly and that more than 40% walk only

various types of chronic diseases or disabling

infrequently.

conditions as well as those with a high level of fitness.
In addition, automation and other technologies

2. The Objective of This Article

have contributed to a dramatic decline in physicalWith the lack of physical activity among the U.S.

activity at work and home. Fortunately, however,

population in mind, the Robert Wood Johnson

many older people are able to lead active, healthy,

Foundation (RWJF) hosted the "Technical Experts

productive, and independent lives well into their 80s

Working Group Meeting on Physical Activity and Mid-and 90s. Physical activity and exercise have been

life and Older Adults" on April 4 and 5, 2000.

proposed as a key factor for preserving and enhancing

Representatives of the American Association of Retired

both the quantity and quality of life in old age (Tanaka,

Persons (AARP), the American College of Sports

2000). In other words, physical inactivity has

Medicine, the American Geriatrics Society, the Centers

increasingly been recognized as an important risk

for Disease Control and Prevention, the National

factor associated with morbidity and mortality in adults

Institute on Aging, and the RWJF formed a steering(CDCP, 1994; Healthy Japan 21, Ohta et al., 2000;

committee and developed an agenda for a "Blueprint

U.S. Department of Health and Human Services,

Conference." The conference was held on October

*
**
***
#

National Institute for Longevity Sciences, Chub National Hospital, Obu, Aichi, Japan 474-8511
Foundation for Advancement of International Science (FAIS), Tsukuba, Japan 305-0062
Doctroal Program for Health and Sport Sciences, Univesity of Tsukuba, Tsukuba, Japan 305-8574
Center for Tsukuba Advanced Research Alliance (TARA), University of Tsukuba, Japan 305-8577

Kiyoji Tanaka, Ryosuke Shigematsu, Masaki Nakagaichi, Yo-ichi Hayashi, and Toshiki Ohta

14

30-31, 2000. A document encouraging American

Blueprint wanted to encourage physical activity for the

adults aged 50 and older to increase physical activity

entire aging population. This document outlines three

was developed.

steps for achieving this vision. They are as follows:

However, little is known about individual(1) to provide a background on the issues related tomotivation and determination to adhere to programs

the physical activity and health of Americans aged 50

of physical activity. This article focuses on theand older, (2) to overcome barriers to increasing

mission, goals, and structure of "America's National

physical activity among the aging population, with

Blueprint" for increasing the physical activity of adults

respect to research, home, community, workplace,

aged 50 and older and on the discussion of future

medical systems, public policy, and advocacy, and (3)perspectives on the importance of physical activity.

to look toward and beyond 2010 for actions that canSpecifically, this article presents possibilities forand should be carried out by organizations,

reducing sedentary behavior as a beginning for

associations, and agencies.

increasing physical activity. An objective of this article

The Blueprint outlines the roles of organizations

is that it will help facilitate the development of betteras follows:

health policies for the societies of both the East andOrganizations need to explore new models and avenues

the West.

for the development, integration, and implementationof physical activity initiatives. They might include

3. Summary of America's "National Blueprint"

working with transportation organizations andRegular physical activity and exercise unquestionably

community planners to assure that communities lookpromote dramatic benefits for health and life for people

for solutions that will enable citizens to remain orof almost all ages and abilities. Typically, physicalbecome more physically active. People should be able

activity can provide opportunities for adding years of

to safely walk to stores, banks, post offices, parks,

active independent life. Furthermore, activity canpedestrian malls, fitness centers, and other community

reduce disability and contribute to the quality of life

facilities.

for middle-aged and older individuals. However,

The National Blueprint can be obtained from theequally clear is the fact that most people are free to be

Robert Wood Johnson Foundation, Princeton, NJ, or

sedentary. With this in mind, on May 1, 2001,

other organizations, associations, and agencies that

America's National Blueprint, entitled "Increasing

participated in the development of the document. The

Physical Activity Among Adults Aged 50 and Older,"Journal of Aging and Physical Activity also published

was developed as a guide for organizations,the entire document in a supplement to the Journal

associations, and agencies interested in increasing the(JAPA, May 2001). Selected responses by experts are

physical activity of America's aging population. This

also published in the Journal (Eakin 2001, Atienza

major national planning document was actually

2001, Linnan and Marcus 2001, Stewart 2001).

released by a coalition of national organizations(Chodzko-Zajko, 2001). The entire plan synthesizes

4. Contributing Organizations and Individuals for

input from more than 65 experts, representing 48

the Development of the National Blueprintorganizations with expertise in health, medicine, social

The following individuals and organizations

and behavioral sciences, epidemiology, gerontology/

contributed to the development of the National

geriatrics, clinical science, public policy, marketing,Blueprint.

medical systems, community organizations, andenvironmental issues (JAPA, S3, 2001).

4-1 Acknowledgments

The vision of the National Blueprint developers

The following organizations have provided input

was for a society in which all people aged 50 and older

into the development of this document: the American

enjoy health and a quality of life that is enhanced by

Association of Retired Persons (AARP), the American

regular physical activity. The developers of theCollege of Sports Medicine, the American Geriatrics

Asian Perspectives on America's "National Blueprint: Increasing Physical Activity Among Adults Age 50 and Older"

15

Society, the Centers for Disease Control andto the development of this plan. Furthermore, the many

Prevention, the National Institute on Aging, the Robertindividuals who made presentations at the Blueprint

Wood Johnson Foundation.

Conference: Increasing Physical Activity Among

Other organizations that participated in the

Adults Aged 50 and Older were acknowledged.

Blueprint Conference and/or provided review and input
into the document were as follows: the Alliance of

4-2 Moving toward and beyond 2010: Turning

Community Health Plans, America Walks, thestrategies into action

American Academy of Family Physicians, and the

The following steps will help place this document into

American Academy of Nurse Practitioners, American

action:Cancer Society, American Heart Association, American

1. Organizations should identify the strategies that they

Occupational Therapy Association, American Red

are already addressing or will address and collaborate

Cross, American Society on Aging, Arthritis

with other groups that share an interest in the same

Foundation, Assisted Living Foundation of America,

strategies. Organizations should make efforts to work

Association for Work Site Health Promotion,with existing coalitions and coordinate with other

Barrington & Chappell, Bayer Institute for Health Caregroups and organizations. Participating organizations

Communications, Center for Livable Communities/

should also identify and involve organizations that are

American Institute of Architects, Fifty Plus Fitness

not working on this issue but could play a major sup-Association, Gerontological Society of America,

portive role.

Health Canada, Fitness Active Living Unit, National

2. Organizations, associations, and agencies working

Association for Health and Fitness, National

collaboratively should focus on activities that they can

Association of Area Agencies on Aging, National

reasonably expect to accomplish.

Center for Bicycling and Walking, National Center on

3. Organizations need to undertake detailed tactical

Physical Activity and Disability, National Council onplanning to delineate the specific actions that are

the Aging, National Highway Traffic Safety

needed to achieve the strategies.

Administration, National Hispanic Council on Aging

4. Organizations need to allocate money and people

National Recreation and Parks Association, National

to help support coalition and collaborative efforts.

Senior Games Association, Palo Alto Medical

5. Health organizations and government agencies must

Foundation, Partnership for Prevention, President's

encourage the exchange and dissemination of the best

Council on Physical Fitness and Sports, Research

practices. These groups must establish systems to ac-

America, Sporting Goods Manufacturers Association,complish this.

Stanford University School of Medicine, University

6. Evaluation should be a key tool in all implementa-of California at San Francisco, University of Northtion steps. In some cases, evaluation can be objective

Carolina School of Public Health, US Department ofand based on measurable objectives. In other cases,

Health and Human Services Office on Women's Healthevaluation will be subjective.

and the National Aeronautics and SpaceThis Blueprint is designed to support an increase

Administration, US Department of Veterans Affairs,of physical activity among people aged 50 and above

Visiting Nurse Association of America, Walking

and ultimately to improve the health and well being of

Magazine, YWCA, plus International Health, Racquet

all Americans. The key to success lies in developing

and Sportsclub Association, and finally Americanand channeling resources and working collaboratively

Alliance for Health, Physical Education, Recreation

to distribute the evidence of the benefits of physicaland Dance and the American Association for Active

activity as widely as possible and promote this type ofLifestyles and Fitness.

activity nationwide.

In addition, special thanks were expressed to many
scientists who contributed to the Blueprint by preparing
and/or presenting background papers that contributed

16

Kiyoji Tanaka, Ryosuke Shigematsu, Masaki Nakagaichi, Yo-ichi Hayashi, and Toshiki Ohta

5. Perspectives on the National Blueprint

or diet instruction leader. We have observed that theyFirst of all, it should be acknowledged that thelead older people as appropriately as young but

National Blueprint summarizes well the essential

inexperienced fitness leaders with numerous

points that U.S. society currently has to focus and act

credentials. These leaders have been instructing theon. This is really what middle-aged and older adults

60+ population in the community for one and half

who are living (and will live) in the first quarter of theyears. Only one out of the original 14 leaders has

21st century need. Success in increasing physical

dropped out, due mainly to poor physical condition.

activity at any age stage for successful active aging is

They work well with older adults by teaching andquite difficult, but we must continue facing thereinforcing specific skills that we have trained themchallenge enthusiastically. Implementation of somewith in advance. The skills consist of calisthenics, legEastern ideas may help facilitate further expansion offlexion in a standing position, walking on a balancing

the Blueprint throughout the U.S. and eventually allbar, rotation of shoulder joints, and general stretching.

over the world. Following are our specific comments

At present, the lay leaders have the ability to increaseon the "National Blueprint."

awareness about the importance of physical activity
to improve the health of Japanese people aged 60 and6. Specific Perspectives on the National Blueprint

older with the appropriate aid of a mass-market
communication campaign by the community

6-1 Practical Use of Lay Leaders

government.

It is our strong belief that health plans in each local
community should be promoted among the people

6-2

An Effective Advocacy Strategy

living there. "For the people by the people" is a slogan

An effective advocacy strategy that helps promotethat usually works well. It is not essential for people

health policies within each community is greatly

who are committed to health promotion in a given

needed. University professors, research assistants, andcommunity to have higher academic degrees or

graduate students can act as ambassadors, particularly

qualifications such as M.D. or Ph.D. or be a qualified

during the challenging months of the initial training

nurse, dietitian, or health fitness instructor. In Japan

period. They serve as resources for information andand perhaps in some other countries as well, there areassistance on health and fitness. In order to lead people

many lay leaders who do as well or better than qualified

to sound behavioral modifications, we avoid phrases

instructors in their communities.

such as "enhance your health and quality of life" andIn Aizu Hongo, Fukushima prefecture, Japan, we

focus on objectives such as "recover your health andhave been advocating the increase of the number ofmaintain your quality of life." This is simply because

lay leaders (i.e., health-promotion instructors who doenhancement or improvement seems to be a non-not have any professional credentials) who work

achievable assignment for the majority of older

mainly for older populations. The chronological age

citizens. If health and wellness programs rely on well-of the 14 lay leaders ranges from 53 to 75 (average

trained allied health professionals, then many averageage: 66.2 years), while their functional age averages

citizens may tend to lose their own willpower (strong

62 years. All of them were recruited from thedesire or mental vitality) to achieve an independent,

community where they live. The total population ofself-motivated way of living. An advocacy strategy

the community under examination (i.e., Aizu Hongo-that cooperates with or recruits non-qualified but

machi) is about 6,700, and more than one-fifth is incapable health-fitness leaders should be implemented

the 65+ age range.

in the new initiatives. Whether one has an exercise

According to our recent empirical investigation,

leader's license is not so important for actual leading.

a high percentage of the 65+ population in each

Whether one is competent to help people modify

community seems to feel very positively about working

inadequate health behaviors is much more essential

in the field of community health promotion as a fitness

than having the license. Orientals tend to accept this

Asian Perspectives on America's "National Blueprint: Increasing Physical Activity Among Adults Age 50 and Older"sort of idea more than Westerners do.

17even work well in the U.S. An advantage can be seen

There are large inter-individual differences in thein that such a strategy may allow the employer to pay

motivation to engage in physical activity. Some healthless tax. However, the most important aspect of theprofessionals (physicians, nurses, and other allied

program is to bring the public to an awareness of thehealth professionals) do not exercise at all, even though

value of regular physical activity and how itthey advocate the necessity of exercise or physicalcontributes in terms of pleasure, fun, and satisfaction

activity. We encourage health care trainers as well as

to general health and quality of life. It is of overriding

city officers and company employers who are in charge

importance today that people find life worth living.

of advocating health promotion to be more physically

Older Japanese adults place a high value on pleasure,active in order to serve as role models for patients andhappiness, and self-efficiency, and they recognize thethe general public. This sort of advocacy/policy

contribution that physical fitness makes toward thesestrategy may also be very effective.

ends. The value of money should be separated fromthe idea of successful active aging, particularly among

6-3

Workplace Strategy

Asians, who have values that are different from those

Generally speaking, employers are well motivatedheld by Western people. Many Asians do not value

to address employee health issues. This is simply

money as highly as Westerners because of their

because they pay a large proportion of the health caretraditional and cultural values or the teachings ofcosts when employees or their dependents become ill

Confucius. Consequently, an evidence-based approach(Pelletier, 1996). On the belief that physically activeis theoretically or conceptually fine, but it may not

employees accrue many health and social benefits bywork well. This is simply because many things that

reducing their risk to a wide range of physical andscientists believe as evidence have a shortage as true

mental health conditions, increasing the amount ofevidence. We think this idea of a humanistic approach

physical activity has been encouraged by employers.

rather than scientific one needs to be more expanded

However, the workplace is a complicated setting wherein near future.

employee health is influenced in multidimensional
ways (Linnan and Marcus, 2001). Kapio and Sarna

6-4(1994) investigated occupational disability in former

Mass Media

Promotion of Physical Activity ThroughFinnish athletes and found remarkably decreased

Little is known about the complex factors that help

coronary artery disease and cerebrovascular andmotivate adults to begin and sustain physical activities.

respiratory morbidity in the athletes when compared

Similarly, little is known about the physical,

with control persons. Furthermore, it was found thatpsychological, and socio-environmental barriers thatsustained and vigorous physical activity during early

discourage older adults from adopting and maintaining

adulthood may defer the onset of disability and prevent

physically active lifestyles. Above all, we feel thatpremature death, resulting in extending thepsychological barriers have a relatively high impact

occupationally active life span. It is a general

in almost all industrialized countries, and particularly

understanding that worksite health promotion consistsin Asian countries because of the Confucian idea.

of any planned combination of educational, political,

More controlled and systematic research is needed toregulatory, and organizational efforts to develop andexamine the factors that influence people to participate

have a positive influence on the health of employedin physical activities in well-controlled and systematic

individuals (U.S. Dept. Health and Human Services,manner (Chodzko-Zajko, 2000). Currently, the mass

2000; "Healthy People 2010").

media are doing an effective job of promoting the

A strategy that provides employers with tax

values of physical activity, and they emphasize the

incentives for providing opportunities for physicalbenefits of an active rather than a sedentary lifestyle.

activities to their employees would not work well in

When individuals with chronic illnesses and thosesome countries, and especially, in Japan. It may not

who have experienced acute myocardial infarction,

18

Kiyoji Tanaka, Ryosuke Shigematsu, Masaki Nakagaichi, Yo-ichi Hayashi, and Toshiki Ohta

hemiparetic stroke, or severe injury participate in

exercise. Scientists involved in exercise physiology

regular exercise programs, they are in a position toshould be making an all-out effort to inform the public

inspire others. When the mass media focus on such

about the potential harm of unhealthy lifestyles. The

scenes as the chronically ill walking with theirmass media can be extremely influential in these

grandchildren, other people might be inspired toefforts.

change their habits and become more active. Olderadults participating in strenuous activities, such as

6-5

Target Population

marathons, are also inspirational. Public relation

The National Blueprint reads as follows: "Theefforts touting the value of physical activities have been

population aged 50 and older is extremely diverse.

undertaken by members of the Tsukuba Health Fitness

When organizations develop, implement, and evaluate

Research Group and the physicians at the Higashi

physical activity programs and initiatives for people

Toride Hospital, Toride, Ibaraki, Japan. Manyin mid-life and older, they will need to consider age,newspapers (national and local) and radio stations havegender, income, race, ethnic background, geography,

regularly reported on physical fitness activities overeducation, and marital status. For example, this age

the past decade. Several television stations, such asgroup encompasses everyone, from people who run

NHK Educational, TBS, and TV Tokyo, have

two or three marathons a year to very frail elderly whointerviewed members of our organization and shown

are confined to wheelchairs" (p. 19). Because of this,scenes of older adults with ischemic heart disease

there are limitations to the kinds of programs that can

dancing in a fitness room at a hospital for promotionalbe introduced for the promotion of health.

purposes. Currently, there are a number of commercial

Fifty and older may be a range of age that is too

exercise videos available to the public. They havewide. Most people retire around age 60, and somebecome popular in Japan and the United States. Someretire after age 65. People in the range of 50-59 yearsof the exercise videos or computerized programs,of age or 50 to mid-60s have different interests,

particularly those providing dance instruction,

lifestyles, leisure pursuits, and needs for continuing

illustrate steps which become progressively complex.

education and medical services from people in the 75+

These programs are available for various kinds ofrange. The number of healthy people can be increased

music. Such activities are expected to enhance

remarkably by encouraging those with sedentary habitsmobility, balance, and muscular endurance, which

to become physically active. As mentioned in theultimately helps people maintain their independence.

Blueprint, however, there is a great variance in the

Research currently underway at the University ofgeneral population's rate of decrease in physicalTsukuba is examining the adaptation of this kind offunction and fitness (p.19). In the near future, theexercise for the home with the objective to help

number of older adults who continue working beyond

motivate adults in mid-life or older to become more

the age of 70 will probably increase, depending on

physically active.

their ability to work, functional fitness, and mental

More emphasis should be placed on the combined

vitality. Therefore, it may be better to be address

values of exercise and diet. It is unrealistic for most

motivational strategies in a tier-life system, i.e., by eachindividuals with chronic illnesses to expect

age segment and by each functional fitness level.

significantly large benefits from physical activities.

In Japan, many people in mid-life consider 70 to

Most researchers investigating physical activities wantbe quite old. Messages that target people in mid-lifetheir findings from experiments and epidemiologicalshould vary in content from those that target older

studies to be incorporated into health policies.

adults. It might be better to categorize people

However, it is more important to help people gain aaccording to functional fitness (Shigematsu andreal sense of satisfaction from their participation in

Tanaka, 2000; Tanaka et al., 2000) or body weight thanphysical activities. The public may not need any moreby chronological age (e.g., 65+, 75+, and 85+

laboratory data to convince them of the value ofsegments).

Asian Perspectives on America's "National Blueprint: Increasing Physical Activity Among Adults Age 50 and Older"19

In addition, the recognition that a few people will

infarction, unstable angina pectoris, and abnormal

not benefit from exercise and physical activity should

ECG, might experience the negative effects of exercise

be generally accepted. People in risky categories mightand physical activity with even moderate intensity.

cause themselves more harm than good with exercise,

Appropriate and specific instructions need to beparticularly those with knee disorders, low-back pain,

developed for people in high-risk categories. Thoseor uncontrolled angina. This means such people arewith severe health problems and some older adults arequite likely to experience a negative effect before they

not likely to walk in neighborhoods without sidewalks

achieve life or health benefits from physical activity.

because of the danger entailed. Therefore, the National

It may be necessary to include a specific statement

Blueprint says that, in order to implement sound healthindicating the importance of individual supervision ofpolicies, organizations have to reach beyond theirsuch people by allied health professionals. Inclusion

comfort zone. During the first decade of the 21stof a statement regarding clear recognition of self-

Century, a variety of approaches to health promotion

responsibility in case of sudden death associated withshould be tested, taking into account characteristics

stroke or cardiac episode is greatly encouraged. Thisthat are specific to each home, work site, community,

important social policy will be discussed later.

county, or city. Then, probably at some point between
2010 and 2015, the best or better strategies, policies,

6-6

Need for Consideration of Special Popula-tions

and guidelines should be selected as acceptable
standards.

In almost all countries, attention is being given to
health benefits associated with regular physical

6-7

The Role of Self-responsibility

activity. ACSM (1997) published a textbook titled

The National Blueprint addresses the necessity for

Exercise Management for Persons with Chronic

establishing a strategic direction. To increase physicalDiseases and Disabilities. The authors indicate that

activity among the aging population, strategies should

the following patients may exercise: those withbe established for the following: 1) research, 2) home/metabolic diseases, such as hyperlipidemia, diabetes,

community, 3) workplace, 4) medical systems, and 5)

and obesity, as well as those with cardiovascularpublic policy. Items 1) and 4) may not be important indiseases, including those who have experienced

Japan, at least during the initiation period, which may

myocardial infarction, coronary artery bypass grafting,last 5-6 years. It is very difficult to specify whichangioplasty, angina, silent ischemia, hypertension, andinterventions are most beneficial for some segments

cardiac transplant, and those with pulmonary disease.

of the 50+ population (active older adults, frail elderly,

Patients with orthopedic diseases and disabilities, such

homebound, or disabled) because of the extremely

as arthritis, low-back pain, and osteoporosis, are also

large diversity even within one segment. If theencouraged to exercise. The reason that physicalgovernment participation is too large, then theactivity is encouraged even in special populations is

individual resolve of the communities might bevery clear. Physical activity is associated with many

diminished. People in industrialized countries should

health benefits (Blair et al., 1992) including longevity

take more responsibility for their own health and fitness(Paffenbarger et al., 1986; Pekkanen et al., 1987),

Each country and community should place a greater

decreased risk of coronary heart disease (Powell et al.,emphasis on health management and disease1987), stroke (Wannamethee and Shaper, 1992), type-prevention. Also, a specific statement on individual

2 diabetes (Helmrich et al., 1991; Manson et al., 1992),

supervision of special populations by allied healthand increased physical fitness.

professionals needs to be included.

However, even though the majority of people

Each community would be expected to develop

benefit from exercise, there are some people who doprograms that would encourage individuals to alternot. Some of those who have severe health problems,behavior. Furthermore, each community would needsuch as arthritis, diabetes mellitus, myocardial

to make changes that would support individualKiyoji Tanaka, Ryosuke Shigematsu, Masaki Nakagaichi, Yo-ichi Hayashi, and Toshiki Ohta

20

behaviors (Stewart, 2001). Communities would need

If medical professionals, such as physicians, nurses,

to adopt and disseminate programs that have beennurse practitioners, and other allied healthsuccessful for aging adults. The expense of

professionals, are recruited, the budget increases, anddeveloping, implementing, and sustaining sucha controlled health promotion system develops, which

programs needs to be paid by communities and theiris not necessarily accepted by the majority of Japanese

residents. The concept of an individual being

people (as well as most Americans). Implementation

responsible for his own health and fitness should beof an administrative reform is a prerequisite for healthstressed by national governments down to the local

promotion in each community.

level. The ACSM guidelines for exercise training forthe elderly state: "Because of their low functional status

7. Concluding Remarks

and high incidence of chronic disease, there is no

A growing body of research documents thesegment of the population that can benefit more from

benefits of physical activity. Physical activity extends

exercise than the elderly." (p. 14).

active independent life by years and reduces theoccurrence of disabilities. America's National

6-8

Decentralization of a New Health Policy

Blueprint says that, although the scientific evidence is

In general, most people are less likely to adopt aclear, there is no national action program. We are in

habit of regular physical activity. The fact is that mostnearly total agreement with the goals stated inpeople prefer to be sedentary. However, individuals

America's National Blueprint. Communities shouldfind many reasons specific to them that reinforce theprovide adults aged 50 and above with multiple

value of physical activity (Epstein and Roemmich,opportunities for active aging. A major prerequisite2001). Therefore, each community should focus on

for active aging is the life-long maintenance offinding the best way to increase physical activity

programs of physical activity. To assist in theamong its population from the viewpoint of themaintenance of physically active lifestyles, it isparticular social, cultural, and natural characteristics

essential that policies and exercise programsof the geographic area in question. Older adults inaccommodate the preferences and interests of older

Japan are likely to enjoy activities that are less

adults and that a variety of options be made available.

organized and less strenuous, such as calisthenics

Ideally, such exercise programs should be prepared for(15.2%), walking (13.0%), dancing (10.8%), gateballeach age segment and for each fitness level.

(10.8%), golf (9.4%), hiking (8.1%), swimming

Furthermore, the exercise programs should be widely(6.3%), ground golf (4.5%), mountaineering (2.7%),

incorporated into the existing community structures.

and jogging (2.2%) (Harada et al., 1994).

Worksite health promotion involves any planned

In order to accelerate community health promotion

combination of educational, political, regulatory, andstrategies, the development of decentralized localorganization efforts that positively influence the healthpolicies is indispensable. The education of local

of employed individuals. Employers should provide

officers is also important. Bottom-up planning is much

environments that are conducive to exercise. We

more palatable to the general public than a top-down

assume that community support exists for physicalapproach for the implementation of strategies that

activity initiatives in the workplace. Local

promote good health.

The possibilities ofadministration must be conducted in a manner that

implementing holistic philosophies into the strategy

encourages general citizens to pursue voluntary (self-

should be investigated. For example, some people

imposed) health management. The concept ofmight gain some satisfaction from early morning

individual self-responsibility for fitness and health andphysical activities such as cleaning Shinto shrines,

accompanying health policies should be developed

Buddhist temples, or Christian churches. A better

throughout the nation, particularly when a Japanese

psychological well-being can be brought about toversion similar to America's National Blueprint iscommunity residents through such volunteer activities.

developed.

Asian Perspectives on America's "National Blueprint: Increasing Physical Activity Among Adults Age 50 and Older"21

A strategy that leads to more people exercising

emeritus in the Kinesiology Department, California

regularly needs to be developed. In order to increase

State University, Northridge, U.S.A. He is visiting

long-term adherence to programs of physical activity,

professor at University of Tsukuba and is associatedthe pleasures (fun) of exercise should be publicizedwith the Center for Tsukuba Advanced Researchalong with its importance for the maintenance ofAlliance (TARA). Note that the senior author of thishealth. Expressing the benefits of exercise and fitness

article Kiyoji Tanaka is project leader for the Humanin non-medical terms encourages behavioral change.

Beings in the Ecosystem. The TARA project is named

In Japan, the impact of the mass media is very strong.

"Development of overall QOL (quality of life) index

Many Japanese begin to understand the importance offor older adults." This research was supported byphysical activity as a result of what they see, hear, andTanaka Project of TARA, University of Tsukuba.

read on TV, radio, and magazines. Some interventions
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