The public health actions to reduce the spread of COVID-19, including social distancing, wearing masks and temporarily closing public spaces, have been instrumental in flattening the curve of diagnosed cases. Although children, the group with the lowest diagnosis rate, appear less vulnerable to COVID-19, they are more susceptible to the unintended consequences of these precautions. Limited interactions with peers due to school closures and lack of school support services to help children cope with the pandemic have contributed to increased stress and anxiety in this age group. In the United States, COVID-19-related school closures have also resulted in significant declines in child physical activity, which is predicted to result in a two percent nationwide increase in childhood obesity and exacerbate existing obesity disparities among disadvantaged and underserved children. Addressing these unintended consequences of in-person school closures is critical to protect and improve the health and well-being of children during the COVID-19 pandemic.
School environments have traditionally provided many opportunities for children to develop social-emotional skills through comprehensive physical activity programs with physical education (PE) as the cornerstone. These programs offer a pragmatic opportunity to promote inclusive physical activity for all children, irrespective of ability status. Yet the consequences of inequitable school funding, the greatest impact of which is felt in schools serving large numbers of low-income and racial/ethnic minority students, limit the ability of schools to provide quality physical activity programming to students at greatest risk for inactivity and obesity. Schools will undoubtedly look very different this year (2020-2021), as administrators plan to implement diverse instructional models, including virtual, hybrid and in-person learning, with physical distancing. School districts across the country have a unique opportunity to reimagine K-12 physical activity programming, but administrators must first address the existing disparities in physical activity policies and practices that existed before the COVID-19 pandemic.
Existing inequities in school physical activity policies and practices
Recognizing the critical role that schools play in promoting student health, in 2010 the United States Congress passed legislation mandating the establishment of local school wellness policies. In 2015, Congress reauthorized the Elementary and Secondary Education Act of 1965, signing into law the Every Student Succeeds Act, which provided increased funding for health education and physical education programs. Despite these legislative wins, economic disparities in school physical activity policies and practices persist. For examples, schools situated in disadvantaged communities are less likely to offer recess, have a certified PE teacher or provide after-school sports programming compared to schools in more affluent communities. High-resource schools are also more likely to have better gymnasiums, playground facilities and recreational and athletic equipment. When comparing children’s physical activity during school, students in high-resource schools have better recess policies and practices and spend 20% more time engaged in health-enhancing physical activity during physical education classes, compared to students in lower-resource schools. Across all schools, students with disabilities are less likely to receive instructional physical education than their peers without disability. All of these factors contribute to the lower physical activity participation observed among disadvantaged and underserved children. Given the likelihood that physical activity disparities have been magnified during the COVID-19 pandemic, a top priority for K-12 schools should be ensuring that all students are physically active every day.
Call to action to develop an Equitable School Physical Activity Plan
Targeted efforts are needed to ensure students with disabilities, limited resources and those from communities of color have adequate support for regular physical activity, regardless of the school’s operational status. Schools can lead those efforts while engaging and collaborating with other sectors to promote access and equity. Schools should develop an Equitable School Physical Activity Plan with the goal of meeting CDC recommendations that schools provide 30 minutes of physical activity to all students every day. School districts can designate a leader who is responsible for ensuring the Equitable Physical Activity Plan is developed, resourced and implemented at each school. Physical education teachers should take the lead by supporting the plan and providing regular updates on its implementation to the school principal. Schools without a physical education teacher, which is more common in low-resource schools, should designate a specific school staff member to take responsibility for the school physical activity plan.
Call to action to tailor existing physical activity programming to fit diverse instructional models
Whether learning is occurring onsite, remotely or a mix, specific plans are needed in all schools to continue providing multiple physical activity opportunities for all students. Additional resources will be needed for students in disadvantaged and underserved groups. The reciprocal benefits of inclusion, notably the ability to learn about others with differing abilities, suggests that plans should be flexible and adaptive, inclusive of all students regardless of ability level. Options during onsite learning include physical education, recess, classroom activity breaks, after school activities and active travel to school programs. Options for remote learning include online physical activity classes that can be done at home in small spaces with limited equipment, written materials for students and parents and email- or text message-based communication. These resources can help families develop physical activity plans to help children achieve a total of at least 60 minutes of physical activity daily, monitor progress and challenges and respond with tailored guidance based on student needs. Options should emphasize student choice in activities, include family and friends (if appropriate) to complete activities and homework and a sense of social-emotional belonging to improve academic success and student motivation.
Call to action to develop multi-sector partnerships to promote child physical activity
The Centers for Disease Control and Prevention’s Whole School, Whole Community, Whole Child (WSCC) framework outlines a student-centered, collaborative approach to improve learning and health in our nation’s schools. This framework recognizes that community organizations and resources need to be engaged to support student success. The National Physical Activity Plan identifies potential partners in multiple sectors of society that can be engaged to provide physical activity resources and support tailored to the needs of all subgroups of students.
Examples of partnerships include transportation agencies closing selected streets to cars to allow for physically-distanced physical activity, faith-based organizations providing physically-distanced activity classes at no cost in low-resource neighborhoods, health clubs and dance studios offering classes with low or no fees for low-income children and professional sports teams providing resources to support physical activity programs in low-resource schools. Developing community partnerships can help to fill the gap in school physical activity programming and reduce disparities in physical activity participation among disadvantaged children. Organizations like YMCAs, Boys and Girls Clubs and Parks and Recreation Departments are likely to support youth physical activity during the pandemic with a diversity of resources.
Physical activity has numerous, far reaching benefits that last into adulthood if sustained as a lifestyle behavior; hence a commitment to physical activity today is an investment in our children’s future. By working together, we can develop new and innovative models of equitable physical activity that can address the unintended consequences of COVID-19 on children’s physical activity and health. But it is clear that schools, parents and community partners need to make specific plans to ensure youth from disadvantaged and underserved (e.g., those with disabilities) groups have equitable opportunities to be active and healthy during the pandemic. Our national goal for the 2020-2021 school year should be a better and equitable new normal for school physical activity policies and practice.
Sharon E. Taverno Ross, Ph.D.; Rebecca Hasson, Ph.D., FACSM; Marquell Johnson, Ph.D.; Vincenzo Nocera, Ph.D.; Jim Sallis, Ph.D., FACSM; Lauren Simon, M.D., FACSM; Lauren Wheeler, MS; Navin Kaushal, Ph.D., and the ACSM Strategic Health Initiative on Health Equity