A high-level federal agency could direct and coordinate state, local and private efforts to get people more active, said Lynn Jamieson of Indiana University.
"We are in a crisis with a lack of controls," said Jamieson, an associate professor of recreation. "We are lacking a policy."
America needs a physical activity equivalent of the U.S Department of Education, because the Department of Health and Human Services isn't up to the job, Jamieson said. A spokesman for HHS Secretary Tommy Thompson disputed that.
In at least 100 countries, a national agency funds and coordinates activities from walking trails to elite athletics, said Jamieson. who studies how communities organize athletics. America is far less centralized, leaving exercise to varied initiatives by government agencies and private volunteer groups.
Federal statistics say about 60 percent of American adults are not regularly active, and about 25 percent are not active at all.
Current federal initiatives have recommendations but no penalty for failure, so state and local programs are good in some areas but poor in others, Jamieson said.
For instance, programs of the President's Council on Physical Activity and Sports are voluntary. Even the council's best-known program, the school-based President's Challenge fitness tests, must be purchased by schools, "and no one has to do it," Jamieson said.
Initiatives by the Centers for Disease Control and Prevention are implemented through limited amounts of competitive grants, so programs might not get funding even if they meet the initiatives' requirements, Jamieson said.
In contrast, countries such as Australia have a minister of sports and an organizational structure to foster physical activity, said Jamieson, who spent two years studying Australia's system.
Tax dollars fund the Australian Sports Commission, an agency under the minister for sports. The commission encourages Australians to go out and play games, said Shirley Willis, manager of sports programs.
"We try to hit the fun message more than the fat message," Willis said. "What we've discovered is you cannot bludgeon people into feeling guilty. You can't shame people into being active because they are fat."
The commission provides funds for sports big and small, Willis said. Much of the commission's work is to create new customers for sports, including sports that don't get much attention, Willis said.
For instance, the commission provided seed money for Australian football's development of a kid-sized version of the game and helped to set up sports programs for after-school care facilities. It even has people take portable skateboard ramps into the sparsely populated rural areas to teach kids about the sport, Willis said.
The commission also helps to set up in-school programs; in Australia, health and physical education must be taught in every school, Willis said.
In Washington, a spokesman for HHS Secretary Thompson, Tony Jewell, said Thompson is directing an effort to coordinate federal health and fitness programs that historically had worked separately. Thompson is insisting that the agencies work together, Jewell said.
As for Jamieson, "The good professor has not been paying attention to what Secretary Thompson has done in the past two years," Jewell said.
The federal Steps to a Healthier US initiative included $25 million for community-based pilot projects in fiscal 2003, and has a $125 million proposal for the coming budget year, Jewell said.
However, one U.S. expert doubts that a topdown approach would work in the United States.
"That's not our model for anything," said Judy Young, executive director of the National Association for Sport and Physical Education, a physical education professional group. Many Americans would agree that people need to be more physically active but would balk at having Washington give them orders on how to do it, she said.
What America needs is a change of individual attitudes, Young said. Even where Americans have abundant opportunities to exercise, such as walking on sidewalks or trails, they often don't use them, she said.
America's problem is in making exercise as normal a part of life as brushing teeth, Young said. "I just came back from the Netherlands - even on bad days, they are playing field hockey, and when it's 20 degrees, they ride their bikes," she said.
By Ira Dreyfuss