99: West Virginia's Health Revolution

"Far from kids getting bored with the mass arrangement, Ryan says his classmates at Hedgesville Middle School love the game. 'When [the gym teacher] has the mats out, the line's always a mile long,' he says. 'We just got two more mats, so you can get four people playing it now. So, like, it was cool before, but now you actually have a line.'
"If there's a kid who doesn't like DDR, says Bailey, 'we haven't found them yet. Almost all the kids who've played it enjoyed it, and wanted to continue to play it.'"
Lara Crigger reports on West Virgina's revolutionary program to curb childhood obesity - with videogames.

West Virginia's Health Revolution

The Escapist Staff:
So why did the test kids respond so well to DDR, when traditional team-based sports had left them cold?

Let's hope the conclusions of this study reflect Ryan's answers, because I think Murphy has it badly wrong. DDR is more fun for these kids. It's that simple.

Traditional team sports are often extremely badly "designed" (insofar as they're designed at all) for promoting exercise. As a kid I saw most sports as violent and offering little worthwhile gameplay. And most team sports were structured in such a way that the weakest member of the team had little impact when they were playing well but a large impact when they screwed up. Not ideal, psychologically.

I have a kind of rather unlikely dream that progress in video game design may one day feed back into real-world team sports and people will start to design and play games that actually don't suck. That would be nice.

Team sports are often less about individual enjoyment than group achievement. Hence the emphasis on "team". I'm not sure the proponents of or participants in this kind of activity would agree with your desire for a shift in focus.

Dom Camus:

The Escapist Staff:
So why did the test kids respond so well to DDR, when traditional team-based sports had left them cold?

Let's hope the conclusions of this study reflect Ryan's answers, because I think Murphy has it badly wrong. DDR is more fun for these kids. It's that simple.

I don't think Murphy would disagree with you on your assessment of the appeal of traditional team sports at all. Indeed, DDR is more fun for kids who dislike team-based games because it is so individualistic. It levels the playing field: The fat kid can finally be just as good as the captain of the football team, or even better. That's what makes it so appealing.

But DDR also appeals because it's a videogame, and kids love videogames. And you do sort of forget that you're exercising when you're trying to keep up with those arrows. Instead, you simply have fun - which is what you're saying. And that's the whole point - you've got to get these kids hooked on something they'll have fun with, because it doesn't matter how intense or successful your exercise plan is, they're just like adults: if they don't like doing it, they won't do it.

As for DDR sucking, I think you and I and tens of thousands of West Virginian kids will just have to disagree on that point. :)

Dom Camus:

Let's hope the conclusions of this study reflect Ryan's answers, because I think Murphy has it badly wrong. DDR is more fun for these kids. It's that simple.

And most team sports were structured in such a way that the weakest member of the team had little impact when they were playing well but a large impact when they screwed up. Not ideal, psychologically.

I never thought of it this way, and I agree to an extent, but I think there's more to it than that. I always thought of it from the angle that kids who shun all other sports nevertheless embrace DDR because there's much less 'baggage'. In other words, the culture of other sports is one where people who aren't very good are laughed at and made fun of which creates a negative feedback loop for out of shape kids: they can't keep up, so they stop playing, which makes them even less likely to ever be able to keep up. If it was all about the design of the game we'd see more kids trying out for wrestling or gymnastics or other individual sports like track and field. Or we'd see more of those kids playing goalie or keeper positions--I was a goalie in a box lacrosse intramural league, and talk about impact when playing well!

As a kid I saw most sports as violent and *therefore* offering much *worthwhile* gameplay--I like violent, contact sports. Still though, even for me I found a lot of pressure not to "screw up." However, I think it has less to do with the design of the game and is more about the cultural baggage that accompanies the sport. I mean, in DDR the game broadcasts to anyone watching your screen when you screw up, so. In fact, when I think about it I'd say DDR is *more* poorly designed in that area--in other sports you can make up for a mistake with hustling back into position, while in DDR if you miss a step you can never make up for it later. It's just that DDR still is not a sport--it has remained a 'game', and I think that's the key difference.

So I disagree that DDR is a better designed game psychologically. And a lot of team sports are better designed for exercise--DDR is much more anaerobic than rugby or field lacrosse or soccer (I would think; I've only played the latter three all that much). However, I will say that I wish more of the sports I enjoy(ed) would lose the emphasis on 'sport' and be more of a 'game' than they are now. On that count, I agree that I hope the study gets it right and figures out that DDR was just more fun than traditional team-based sports, because the kids didn't think it was a 'sport' in the first place.

+++

As for the obesity angle, I think the whole thing is blown out of proportion. I found such a weird disconnect in the logic of the people in the article--everyone's concerned that Ryan isn't a physically active as people of his parents' and grandparents' generation, AND they're concerned because his maternal grandfather died at 47 of heart disease. Am I the only one who sees the problem with the logic there?

I guess part of it is that I come from the Atari/NES generation. And I remember all the "pundits, politicians and parents" talking about how kids don't play outside anymore. And now *we're* the generation of pundits, with kids of our own (and some of the more ambitious of us are politicians) and well, it just seems like the same arguments have been around for thirty years now. And to me, there's nothing more illogical than making an argument that 'the current generation is headed for disaster because it's so different from the previous generation' for a span of time in which one generation can go from being children all the way to being parents.

The obesity epidemic seems to have a lot more to do with cultural trends of beauty than any actual changes in how sedentary we are. Now lack of physical activity and bad eating habits make us all fat, yet in the 50s they made us '90 pound weaklings' who got 'sand kicked in our faces' because we were 'pencil necked geeks' who needed to *put on* weight. That's why to me, the 'War on Obesity' just seems like another 'EverQuest'.

If anything, I think it's more that there's a widening gap between in shape and obese kids. While on the one hand more kids are obese, more kids are developed physically at a younger age. I mean, college athletes these days look like the pros used to. It's just strange to me that for all the talk of the 'obesity epidemic' among children no one seems to want to talk about how it reflects the division between the haves and the have-nots. I bet West Virgina, one of the poorest states in America, is ranked number one in a lot more categories that no one wants to be number one in than just childhood obesity.

I'm not entirely convinced as to the accuracy of the advertisement on page six, here.... Well, I'm only through one article.

As for obesity, I've always been of the opinion that calling it a "war" or "epidemic" casts a certain urgency on the issue that just isn't there. Children aside (which, I realize, makes this rant less relevant in the context of the article), being obese is something that a person does to him/herself. Your neighbor being fat has nothing to do with you being (or not being) fat, aside from a common influence that you may respond to differently.

Calling it an epidemic just makes me wonder, "Why? Are you afraid of catching it?" Calling it a war just seems like a "merciful" gesture to absolve people of responsibility for their own health problems. Barring crippling injury, being fit is a matter of willpower, period. Genes and circumstances might make it easier or harder, but nothing can make it automatic or impossible.

If they choose to employ their willpower to a different end than their health, why should I care? All it means for me is bigger helpings are available at restaurants and wider seats in the theater.

As for children, my stance is largely the same: parents take responsibility for their kids, up until the point where the kids decide things on their own, the transitional period to which coincidentally tends to occur at the same point that they are physiologically best suited to become fit.

That being said, studies like this are always a good thing, and bully for the kids who're participating in it.

As for obesity, I've always been of the opinion that calling it a "war" or "epidemic" casts a certain urgency on the issue that just isn't there. Children aside (which, I realize, makes this rant less relevant in the context of the article), being obese is something that a person does to him/herself. Your neighbor being fat has nothing to do with you being (or not being) fat, aside from a common influence that you may respond to differently.

Yes, you're correct, barring hormonal problems and crippling injury, obesity is largely self-inflicted. However, there are two reasons that the issue warrants concern on a national scale.

1) Children have limited say in matters that concern their own health. They are subject to forces outside their control, especially younger kids; even if they wanted to be healthier, many overweight children don't have the support they need from their parents and community, for whatever reasons. Ryan Walker is incredibly lucky that his family rallied around his health like they did. But not every child's parents have the knowledge, resources, inclination, or - most importantly - the money to do the same. (It is no coincidence that a quarter of the fifth-graders in West Virginia, one of the poorest states in the nation, are clinically obese). That's one of the reasons why the Games for Health study and this DDR rollout are so important: To help those kids who aren't getting help in other ways.

2) Obesity-related issues drive up your health insurance costs. According to PEIA numbers, diseases and health complications directly linked to obesity (Type II diabetes, cardiovascular problems, hypertension, etc) cost PEIA members $77 million in 2005. Ouch. And that's just for one health insurance company, too, a local, statewide one at that. Lowering obesity on a nationwide scale is clearly in your wallet's best interest.

Bongo Bill:
Calling it an epidemic just makes me wonder, "Why? Are you afraid of catching it?"

Actually, maybe we should be: "Fat Bacteria in Human Guts Tied to Obesity". A similar situation existed in the recent past--doctors were all convinced to the point of orthodoxy that ulcers were caused by stress, diet, anything *but* bacteria, anything but something willpower was, well, 'powerless' against. It wasn't until a researcher was willing to swallow a beaker full of H.pylori bacteria that the medical establishment could accept they were wrong.

From what I'm to understand, a lot of conditions we now think must be genetic because they run in families might actually be bacteria that is hard to pass on unless the two people are living in close conditions--like a family.

Bongo Bill:
Calling it a war just seems like a "merciful" gesture to absolve people of responsibility for their own health problems. Barring crippling injury, being fit is a matter of willpower, period.

So is having good teeth, but we put fluoride in the drinking water even though proper brushing and flossing is a matter of willpower. So is not catching AIDS, but we still make condoms available even though abstinence is a matter of willpower. So is not being anorexic or developing Female Athlete Triad Syndrome, but we try and promote healthy body images in the media even though eating--or not purging--is a matter of willpower.

I mean, it's perfectly valid if you're opposed to public health campaigns for all diseases/conditions/infections that can be avoided by abstaining from certain risky behaviors/adopting preventative measures, but, if you're wondering why people call it an epidemic, it's because that word is now used for any rampant threat to public health, not just for ones where it's all a "matter of willpower." Technically, the definition given on the blog entry you linked to wouldn't capture the outbreaks of SARS in Asia and Toronto--most of these cases resulted from people having direct or close contact with H5N1-infected poultry or H5N1-contaminated surfaces. Lots of people called that an epidemic, even though there were almost no cases of person-to-person transmission.

It's used for any problem where people think that concerted intervention can improve the health of the general populace, in much the same way advertisers make lots of money with what they do even though purchasing decisions are a "matter of willpower." While all of what you say is true on the microlevel of individuals, on the macrolevel that logic does not apply, and instead sciences like sociology--and its wayward cousin marketing--more accurately describe the reality. It's been 110 years since Durkheim published _Suicide_; it's interesting to see over that time where sociology has been accepted and where we still fall back on logical extrapolations from the 'reasonable man' to describe, well, society.

Another interesting wrinkle in the great obesity debate: Bad Health Care, Deficient Welfare Keep Americans Short. It seems Americans are not only getting fatter, but (in relative terms) shorter. Considering Americans stopped growing around mid-century, there has been just as much time--if not more--for the culture to pick up on this metric of health as it has to pick up on obesity. Seems the problem with where Americans are on the height-weight BMI tables isn't just that out weight is going up, but that our height isn't either. Yet do we hear anywhere near the same alarm over the vertical shrinking of America as we do over the horizontal expansion?

Problem is, medicine and public health and social welfare policy are boring, but big fat gross people are sexy--and by 'sexy', I mean that they sell copies: if you can't get something that bleeds, get something that wobbles. So the debate around American public health gets framed in moralistic terms, same as it was in the face of the AIDS epidemic. Abstinence becomes the message whether we're talking about fatty foods or intercourse. Cutting down becomes the message whether we're talking about portion sizes or sexual partners. The buffet is the new bathhouse.

Funny--and not in the 'ha ha' way--that we've chosen to make weight the golden mean of health here in America to the practical exclusion of every other metric.

All I want is to not hear about how other people are fat all the time. Is that so much to ask?

Bongo Bill:
All I want is to not hear about how other people are fat all the time. Is that so much to ask?

In a country where two-thirds of the adult population is overweight, and one-fifth is clinically obese, yes. As long as weight continues to be a problem on such a large scale, we will continue to discuss its causes and effects on our society as well as potential solutions. You might as well get used to it.

Edit: That's a fascinating article, Cheeze. I hadn't heard much about our country's shrinking problem. But I wonder if it's just a factor of the welfare and health insurance: Nutritionally poor food is so prevalent in our society that even relatively wealthy people will eat at least some of it during their childhoods, and if they eat too much, that lack of nutrition would also contribute to stunted growth.

Lara Crigger:

Edit: That's a fascinating article, Cheeze. I hadn't heard much about our country's shrinking problem. But I wonder if it's just a factor of the welfare and health insurance: Nutritionally poor food is so prevalent in our society that even relatively wealthy people will eat at least some of it during their childhoods, and if they eat too much, that lack of nutrition would also contribute to stunted growth.

Don't know how prevalent nutritionally poor food is in the Netherlands, but it seems the Dutch--who are literally head and shoulders above us when it comes to height--are just as alarmed at their own obesity epidemic: Obesity on the increase in the Netherlands. So much so, it seems, that people are demanding their government take action: Cabinet failing to tackle obesity.

Just for comparison, the U.S. vs. The Netherlands using WHO data: it seems the The Netherlands is facing an obesity rate only about 1/3rd lower than the U.S.

It's funny we never hear that almost half of all Dutch persons are overweight, right? Or that Americans are getting relatively shorter? Or that while America may have the biggest problem with an overweight population, the rest of the western democracies aren't far behind.

I think it shows that, no matter how important the discussion of 'why are we so fat' may be, the terms it is currently framed in this country are fatally flawed. My explanation for why we don't hear that Americans are for the first time in our history losing ground height-wise to the rest of the western democracies, or that Americans in relative terms aren't that much fatter than them either?

Simple--most of the people in the debate have agendas other than a concern with fat as a public health issue. I think that explains why you hadn't heard much about our country's shrinking problem. The people raising the alarms and giving us our facts aren't really concerned with this as a health issue, but as a moral one.

Lara Crigger:

2) Obesity-related issues drive up your health insurance costs. According to PEIA numbers, diseases and health complications directly linked to obesity (Type II diabetes, cardiovascular problems, hypertension, etc) cost PEIA members $77 million in 2005. Ouch. And that's just for one health insurance company, too, a local, statewide one at that. Lowering obesity on a nationwide scale is clearly in your wallet's best interest.

I realize this is an old article, but thanks to the handy-dandy posts tab in my profile I was able to find it quickly, and thought it was worth adding in this bit of news that it really isn't our wallets' best interest to reduce the number of obese people in our insurance pools:

If we somehow figured out a way to "cure" obesity-with a pill, an injection, or a law like the one they're proposing in Mississippi-we'd increase the burden on taxpayers. More people would make it to old age, hastening the Social Security crisis and pushing up the costs of Medicaid. Indeed, the analysis in PLoS Medicine revealed that lifetime health expenditures were highest for healthy-living people of optimum weight.

Like I continue to maintain, the obesity debate is really just the AIDS debate all over again, which is itself an old story: "the tendency to view...disease as both a punishment for...misconduct and an index of social decay"

We have to give up this quasi-religious idea that might will somehow always align with right. We have to acknowledge that the moral thing to do is not always the efficient or most profitable or most rewarding thing to do. Frankly, we have to acknowledge that sometimes, just like not using the Slavery civic in _Civilization_, the decent thing to do is also the harder thing to do.

I mean, how shocking is this: Health care costs for smokers at a given age are as much as 40 percent higher than those for nonsmokers, but in a population in which no one smoked the costs would be 7 percent higher among men and 4 percent higher among women than the costs in the current mixed population of smokers and nonsmokers. If all smokers quit, health care costs would be lower at first, but after 15 years they would become higher than at present. In the long term, complete smoking cessation would produce a net increase in health care costs, but it could still be seen as economically favorable under reasonable assumptions of discount rate and evaluation period.

 

Reply to Thread

Your account does not have posting rights. If you feel this is in error, please contact an administrator. (ID# 54106)