Physician Counseling on Physical Activity on the Rise?
Each year, as many as 85% of all Americans visit a physician. This presents a great opportunity to reach a large segment of our society in providing lifestyle modification counseling, including physical activity (PA) promotion. However, studies have shown that a low percent (25-35%) of physicians provide any physical activity counseling with their patients. More recently, a study by Ahmed et al. (2017) took a closer look at changes in physician physical activity counseling and how these rates have changed over time and may vary with different sub-populations within our society.
In conducting this study, Ahmed and his team examined data from the 2000, 2005, and 2010 National Health Interview Surveys - a household interview survey conducted across a nationally representative sample of U.S. civilians. The survey asked participants “During the past 12 months, did a doctor or other health professional recommend that you begin or continue to do any type of physical activity?” Adult respondents were included in the analysis for the current study if they answered this question, were physically able to exercise, and had visited a health care provider within the past 12 months. The authors examined trends in physician PA counseling over time, as well as whether these trends were differed by sociodemographic factors such as age, gender, race/ethnicity, education, insurance coverage status, and the number of physician visits in the previous 12 months.
Based on results from the surveys, physician PA counseling steadily rose from 2000 (22.9%) to 2005 (30.4%) to a high of 33.6% in 2010. Over this time period, there was a decrease in gender disparity, although men were still 23% less likely to receive PA counseling by their physician. Adults between the ages of 45 and 74 continued to be more likely to receive this counseling, as were individuals who had education beyond the high school level. In fact, those with education beyond a college degree were 73% more likely to receive PA counseling than those who did not graduate from high school. Similarly, uninsured patients were 35% less likely to report receiving PA counseling, while overweight and obese adults were 66% and 225% more likely to receive PA counseling than normal weight individuals. One of the most encouraging findings from this study was in regards to differences in PA counseling rates among different race/ethnicities. In 2000, Black adults were 27% less likely to receive PA counseling than White adults; by 2010 there was no significant difference between the groups. In 2000, White and Hispanic adults reported receiving equal levels of PA counseling; by 2010 Hispanics adults were 27% more likely to receive this counseling from their physicians.
This work by Ahmed and colleagues reveals that while still low, levels of PA counseling by physicians are on the rise across the United States. There still remains a large bias towards providing this counseling to women, perhaps because they tend to be more “health conscious” and proactive than their male counterparts. Additionally, there are still troubling disparities in PA counseling that is being provided to adults without health insurance and with lower levels of education that need to be addressed, perhaps because physicians may not think these patients have the knowledge or resources to act upon the counseling being given. However, on a more encouraging note, PA counseling disparity rates among Black and Hispanic adults has either been eliminated or even reversed when compared to White adults. While these finding are encouraging, there is much left to accomplish in providing better support and training to physicians and their healthcare teams to ensure that all patients have their PA levels assessed and receive appropriate counseling every time they visit their physician’s office.
Ahmed et al. Trends and disparities in the prevalence of physicians’ counseling on exercise among the U.S. adult population, 2000-2010. Preventive Medicine. 2017: 99:1-6.