Taking Steps on the Path to Health

The North Carolina morning is heating up by the time Ms. Young’s second-graders spill from their classroom to gather outdoors. They’ll spend the next 15 minutes looping the East Rockingham Elementary School track — a welcome break that helps them burn calories, re-energize for classwork and develop healthy habits. Called The Daily Mile, the practice aims to improve the physical, emotional and social health of children regardless of age or circumstances.

“It’s such a part of their routine they’ll ask me, ​‘Isn’t it time for The Daily Mile?’” Julie Young says. ​“It’s a great way for them to get a little exercise and take a nice brain break.”

Eight-year-old Natalia agrees. As she sets a steady pace in her pink sneakers, she says this is sometimes her only exercise outside Physical Education classes.

“After school, I sit and watch TV because my mom wants me to stay inside until she gets home,” she says. ​“The Daily Mile gives me a chance to walk and talk to my friends.”

Live, Work, Play

A teacher in England began The Daily Mile in 2012 to encourage her students to run, walk or jog each day during a 15-minute break from class. The concept became popular across the U.K. and Europe — and now some 3,600 elementary schools in 35 countries participate.

The first schools in the U.S. to offer The Daily Mile were in North Carolina’s rural Montgomery and Richmond counties. Funding came through The Duke Endowment’s Healthy People, Healthy Carolinas initiative, which helps communities in the Carolinas address chronic health issues such as obesity, diabetes and heart disease. The idea is to seek improvement at a grassroots level by looking at what affects health locally — including opportunities to exercise in a safe environment.

Launched in 2015, Healthy People, Healthy Carolinas began in five N.C. regions — including Montgomery/​Richmond — and has expanded to 20 coalitions across both North Carolina and South Carolina. The coalitions adopt evidence-based and evidence-informed interventions, many focusing on policy, environment and infrastructure in the places where people live, work and play.

The Duke Endowment expects to spend more than $9.4 million to support the work. Lin Hollowell, director of the Endowment’s Health Care program area, says resources are targeted on communities that have considerable health needs, but also the ability to take on local challenges. The model will help those communities tackle complex social problems to stimulate sustained improvement in population health. 

“Rates of diabetes, heart disease and unhealthy weight are high throughout the Carolinas — and in many communities, those rates are higher than national averages,” Hollowell says. ​“Healthy People, Healthy Carolinas recognizes that health and well-being are created and sustained not through individual and clinical efforts alone, but through the cooperation and support of the extended local community.”

Improving Health Outcomes

The Montgomery/​Richmond coalition is led by FirstHealth of the Carolinas, a private, not-for-profit health care network based in Pinehurst that serves 15 counties in the middle of North Carolina. Partners include health departments, school systems, Cooperative Extension offices, Community Care of the Sandhills, school nurses, school health centers, municipal government, the Housing Authority, and local businesses and residents. Local funders include Montgomery Hospital Foundation, the Richmond Hospital Foundation and the Richmond Community Foundation.

According to a health needs assessment, 24.5 percent of residents in Montgomery County and 28 percent in Richmond County reported being diagnosed with diabetes or pre-diabetes as compared with the state average of 13 percent. The heart disease mortality rate in Richmond is also higher than the state average (238.5 per 100,000 compared with 170 per 100,000).

“Healthy People, Healthy Carolinas grantees were charged with implementing evidence-based and evidence-informed interventions to improve health outcomes,” says Roxanne Elliott, policy director for FirstHealth Community Health Services. ​“Based on our health needs assessment, we wanted to develop obesity prevention efforts that focused on opportunities for physical activity. The Daily Mile fits the bill.”

East Rockingham in Richmond County and the other 12 elementary schools in both counties now have walking paths for their more than 5,400 students. Each trail is open to the public outside school hours. The coalition is also working on promoting healthier vending machine choices and a ​“corner store” initiative focused on heathy food options.

“We’re trying to influence children so they grow up to become healthy adults,” Elliott says.

Making Strides

In the United States, where the percentage of children and adolescents affected by obesity has more than tripled since the 1970s, only one in three children is physically active every day (and less than 5 percent of adults participate in 30 minutes of physical activity each day).

Research led by the universities of Stirling and Edinburgh in Scotland suggests that The Daily Mile could help. As ScienceDaily explains, the research team studied two elementary schools, with 391 students participating. Compared with the control school, the team saw significant improvements at the intervention site: a relative increase of 9.1 minutes per day in physical activity and a decrease of 18.2 minute per day of sedentary behavior. Body composition also improved for participants at the intervention school. The research is published in BMC Medicine.

In the two years after the tracks opened in North Carolina, students walked nearly 409,293 miles, or 16.4 times around the world. Coalition leaders are also collecting data on changes in body mass index, testing scores and absenteeism.

Wendy Jordan, director of student services for Richmond County Schools, says she hears anecdotal success stories all the time. Some students struggle with a single lap at the beginning of school — and they’re soon walking the entire mile. A teacher credits The Daily Mile for helping her shed 32 pounds.

“Everyone has totally bought into this,” Jordan says.

Another Loop

Back at East Rockingham Elementary, wispy morning clouds dot the sky as Natalia and her classmates near the end of another loop. Third graders are already lining up for their turn on the track.

Principal Jamie Greene likes how The Daily Mile gives her 577 students time to socialize and make friends, which she links to fewer disciplinary problems at the school. She also believes that for most, it’s their only chance to walk outside.

“When you take 15 minutes away from instructional time, you have to justify it,” she says. ​“But in rural areas like ours, there are no streetlights, no sidewalks, no YMCAs, no Boys and Girls Club. If you want to take a walk, you might have to do it on the shoulder of a state highway. This is a wonderful way for our children and their families to form a healthy habit.”