The importance of walking to public health

Purpose: There is clear evidence that physical activity, including walking, has substantial benefits for health. This article, prepared as part of the proceedings of a conference on walking and health, discusses the type of walking that produces substantial health benefits, considers several methodological issues pertinent to epidemiologic studies investigating the association of walking and health, and reviews some of the reasons for the large public health importance of walking. Methods: Review of the available literature. Due to space constraints, this is not intended to be a comprehensive review; instead, selected studies are cited to illustrate the points raised. Results: Walking as a healthful form of physical activity began to receive attention in the 1990s due to new recommendations that emphasized moderate-intensity physical activity. The main example of moderate-intensity activity in the 1995 Centers for Disease Control/American College of Sports Medicine recommendation was brisk walking at 3 to 4 mph. Evidence for the health benefits of walking comes largely from epidemiologic studies. When interpreting the data from such studies, it is necessary to consider several methodological issues, including the design of the study, confounding by other lifestyle behaviors, and confounding by other kinds of physical activity. Walking has the potential to have a large public health impact due to its accessibility, its documented health benefits, and the fact that effective programs to promote walking already exist. Conclusions: Walking is a simple health behavior that can reduce rates of chronic disease and ameliorate rising health care costs, with only a modest increase in the number of activity-related injuries.