Physical Inactivity Linked to Long-Term Health Crisis

At your next doctor’s visit, one simple question could reveal more about your long-term health than a blood pressure check or a temperature reading. It takes less than 30 seconds, but your answer could point to your risk for nearly 20 chronic diseases. That question? How much do you exercise each week?

A new study led by researchers at the University of Iowa has brought fresh attention to something many health care systems overlook—your level of physical activity. Their findings show that not asking this question could mean missing an important chance to spot health problems early.

Physical inactivity has long been known to raise the risk of early death and several chronic diseases, such as diabetes, heart problems, certain cancers, and respiratory illnesses. But many clinics still don’t ask patients how much they move during the week. This study shows that skipping that step might be a big mistake.

Over a five-year period, researchers looked at more than 7,000 patients who visited a major medical center in Iowa for annual wellness exams. As part of their check-ups, these patients were asked to fill out a short survey on a tablet. The questions were simple: How many days a week do you engage in moderate to vigorous activity, like brisk walking? And for how many minutes?

Patients who reported at least 150 minutes of moderate to vigorous exercise per week—the amount recommended by public health experts—were found to have a lower risk for 19 different chronic diseases. These included heart disease, diabetes, certain cancers, and lung issues. In contrast, people who said they exercised very little or not at all were much more likely to suffer from these conditions.

“This two-question survey typically takes fewer than 30 seconds for a patient to complete, so it doesn’t interfere with their visit,” says Lucas Carr, the study’s lead author. “But it can tell us a whole lot about that patient’s overall health.”

The tool used in the study is called the Exercise Vital Sign survey. While its name might sound complex, the idea behind it is easy to grasp. The goal is to treat physical activity as a basic health measure, just like blood pressure or weight.

Even though the benefits of regular activity are well-known, most hospitals in the U.S. don’t ask about it during checkups. In fact, no hospital system in the Midwest had done so before this study. Carr and his team wanted to change that by showing how much value this small step could bring to patient care.

To see how effective the survey was, researchers compared the health records of those who filled out the questionnaire with over 33,000 patients who were not given the survey. Those who completed it were found to be in better overall health and were more likely to engage in healthy habits. They were also younger on average.

“We believe this finding is a result of those patients who take the time to come in for annual wellness exams also are taking more time to engage in healthy behaviors, such as being physically active,” Carr explains.

But the researchers say the survey can do more than just identify people who are already healthy—it can help doctors catch problems early in those who aren’t.

Identifying a problem is only useful if there’s a plan to fix it. That’s why the researchers suggest giving patients who report low levels of activity some extra help. This might include referrals to fitness classes, exercise prescriptions, or meetings with community health specialists who can help people build healthier routines.

“In our health care environment, there’s no easy pathway for a doctor to be reimbursed for helping patients become more physically active,” Carr says. “And so, for these patients, many of whom report insufficient activity, we need options to easily connect them with supportive services.”

This support could be key in turning around health outcomes for thousands of people. By catching inactivity early, doctors can work with patients before diseases like diabetes or heart disease take hold.

In a related study, Carr’s team looked at what happens when doctors bill for giving exercise advice to patients. The results were promising. About 95% of those claims were reimbursed by insurance providers. This shows that not only is physical activity counseling valuable, but it’s also supported financially—something that often influences how services are delivered in clinics.

“Our findings suggest the recommended physical activity billing codes are reimbursed at a high rate,” Carr says. “Which reinforces the idea to make physical activity surveys and counseling services available.”

This adds a strong financial reason for health systems to adopt the survey. With reimbursement likely, clinics can start offering these services without worrying about the cost.

The study took place between November 2017 and December 2022, with patients from a large health care center in Iowa. Carr worked with several partners, including Britt Marcussen, a family medicine physician, and Cole Chapman, a pharmacy professor who helped analyze the data. The study, published in the journal Preventing Chronic Disease, supports the idea that even brief conversations about exercise can lead to meaningful changes in care.

This research is a call to action. If health systems start asking simple questions about exercise, they could prevent serious diseases, save money, and improve the lives of patients. And with tools like the Exercise Vital Sign survey available, there’s no good reason not to start now.

Carr and his team hope their work will lead more hospitals to include physical activity checks in routine visits. “We need to think of physical activity like any other vital sign,” he says. “It gives us a powerful snapshot of someone’s current and future health.”