“Public” is an adjective and also a noun. A word that both describes and identifies. A word we see in many places and most of us understand that whatever is labeled as “public” will be something we share with other people. As an adjective, according to Merriam-Webster, there are two definitions. First: “of or concerning the people as a whole.” The second: “ done, perceived or existing in open view.” Public health embraces both of these definitions, caring for the health of “the people as a whole,” and doing so in a way that is transparent and open. As a noun, “public” means “ordinary people in general, the community.” By its very definition, public health does its work in the service of wellbeing as part of a community of ordinary people.
There is another word essential to the work of public health and to its mission to address the preciousness of both the physical health and mental health of ordinary people. That word is “prevention.” Prevention can be a “thing”, a noun, as in “disease prevention,” or it can be a verb, an action word as in “to prevent something from happening or arising”. Even in its noun form, it implies that intentional work is being done to protect the health and wellbeing of our community and beyond. One way public health puts the word “prevention” into action is through our Ten Essential Public Health Services that aim to “inform and educate.” An effective way public health puts prevention in motion is by offering community programming designed to engage, educate and empower people to take ownership of their health. It also reminds people that health is not a single construct. It is complex and rapidly evolving, and good public health programming exists in this complexity.
One such program designed to address the long term health and wellbeing of a community is Marathon Kids. Marathon Kids supports the younger members of our community at a time when learning a healthier way to live has the most potential impact. Born at the University of Texas School of Public Health and facilitated in Nebraska through the University of Nebraska Extension, Marathon Kids combines all the elements of public health programming to make a difference in the lives of children. The mission of Marathon Kids states, “Through running, we show kids they can achieve more than they thought possible and put them on the path to healthier lives.” It is early intervention and prevention in action.
West Central District Health Department and North Platte Public Schools are collaborating to help elementary students in the district’s after-school program, Kids Klub, adopt an active lifestyle and to learn the many ways that being active can improve their entire wellbeing. The research about where we are is sobering. The era we currently live in is increasingly characterized by high levels of sedentary behaviors like screen time and extraordinary levels of stress. Children today expend 400% less energy day to day than children did just 40 years ago and while the energy expenditure has dramatically changed, the design of the bodies they inhabit has not. The bodies our children live in were designed for movement; consistent, vigorous movement followed by regenerative periods of rest. Movement helps grow a healthy body and a mind more resilient to stress.This deficit of movement is directly linked to the approximately 40% of 5-8 year olds who already present with increased risk factors for heart disease such as obesity, hypertension and high total cholesterol, or for diabetes. Without intervention, the sedentary nature of their lifestyles can lead to diseases that can become irreversible. Marathon Kids is the intervention and prevention they need. Like all good public health programs, Marathon Kids also educates and empowers.
Marathon Kids learn that running and vigorous physical activity are good for them. It aligns closely with the Physical Activity Standards set by the Department of Education. Children also develop skills that help them to be more resilient and supportive of others. The heart of the program with Kids Klub is to teach children that they can do hard things using the Marathon Kids platform. They learn ways to accept things like discomfort and struggle without feeling defeated or abandoning their effort. They learn about the six evidence-based pillars for long-term healthy behavior adoption. In lessons that are combined with running, students learn how to set goals in a way that makes them more achievable by taking small steps toward big change. They learn that keeping track of their efforts helps them learn accountability. They are encouraged to model the way for other students and for their community on the value of physical activity and running. They are learning to be leaders. They are asked to see Kids Klub’s seven schools as one team, and to reach their goals, they will have to come together and work cooperatively, each one’s contribution vital to the success of the whole. Those who don’t struggle must encourage and support those who do. Their efforts are celebrated. They learn that their contribution is integral to the success of the entire team, and that their goals rely on the mutuality of their efforts. They run for themselves and for each other and their common goal. Marathon Kids uses rewards that are motivating, but students are taught to discover their own unique intrinsic reward system. Self-satisfaction is the ultimate prize.
Marathon Kids is supported by fourteen years of research from the Michael and Susan Dell Center for Healthy Living at the University of Texas School of Public Health-Austin. Phase I found that students in Marathon Kids schools showed significantly higher outcomes on key measures like increased amounts of physical activity and an increase in athletic self-perception. Kids Klub Marathon Kids starts with the idea that every child is an athlete. Some kids are seeing themselves as athletes for the first time in their lives. This self-perception is so important in the context of research that documents that athletic identity is positively associated with more physical activity in elementary and middle school age children. Kids don’t have to earn the title of “athlete.” There is no fee attached and no particular identifying uniform. The moniker “athlete” is theirs to claim simply by inhabiting a body designed to move and by making a choice to use it the way it was designed to be used.
The Phase II study found that schools that include a Marathon Kids program incorporate more time during the school day for walking and running or other forms of vigorous physical activity. In addition to a coach-led mile done on a rotating schedule, each Kids Klub site adds additional minutes of “heart pumping” physical activity that can be equated into miles of running. The evaluation of strategies found an increase in parental involvement when students shared their accomplishments and their goals at home. Marathon Kids is a public health best-practice, providing a strong foundation for engaging in and co-learning about how running and increased physical activity provide a path for healthy youth development.
The reaction at all seven sites mirrored one another. When students learned about Marathon Kids in the beginning, there was a real reluctance to embrace the idea that running a mile, or many miles could be fun. There was also some hesitancy in accepting that being an athlete, “a marathoner,” was not dependent on speed, talent, equipment, fancy clothing or participation in organized sports. There was almost a disbelief in the idea that with the support of others, grand goals, like a marathon, or as a team, over 100 marathons,could be possible when accomplished in small steps done consistently over time. There was a fleeting glimmer of recognition of their unique place amongst hundreds of thousands of other runners running over a million and a half miles to date in Marathon Kids programs across the country. With each session at each school, reluctance is turning into embrace. Students are beginning to see that without the miles they contribute to the total, the effort and accomplishment is lessened. Marathoners are learning that doing their best is more important than being the best, and that it is steady and consistent progress that creates the most sustainable progress toward the goal of a flourishing life.
Over the first 9 weeks of the program, the students’ attitudes are changing. In the first few weeks, the appearance of their coach elicited moans and groans and a litany of excuses to try to avoid running. As with all change, in small steps, those attitudes are moving from dread to excited anticipation and their coach is met with hugs and high-fives rather than excuses. There is a transformation taking place. Carrie Lienemann has served as the Kids Klub After School and Summer Director for many years. She summarizes the impact of Marathon Kids and the partnership with WCDHD this way, “When an adult like Ms. Trudy comes into a child’s life and proves to them that they genuinely care about their health and wellbeing and will celebrate their success, those children want to perform better to impress that caring adult. When those same children grow up and realize the habits learned in their youth make them happy and proud of themselves, that is when the lessons become a lifestyle. Those are the moments that people like Ms. Trudy and I live for in our work. Marathon Kids combines the right pieces to motivate, encourage and celebrate our students’ healthy minds and bodies with habits that will last a lifetime. We are so grateful to the West Central District Health Department for partnering with us.”
Partnering is an action word too, and when it comes to community-based programming designed to care for the people within a community, partnering with other organizations is crucial to the work of public health. Just as our marathoners in Kids Klub are learning, when everyone gives their best to something, it changes the individual and has the potential to change the world. For our Marathon Kids, it will lead them to the pinnacle in running by completing their marathon. When combined with runners from all seven schools, Kids Klub will cross the marathon finish line a hundred-fold. Better together. If the “public” in public health means something shared, something concerning people as a whole, sharing the work of outreach with partners like North Platte Public School’s Kids Klub creates the possibility of real impact. “Public”, “prevention”, “partnering”, small words that can help define what a lasting impact on a community looks like, especially when that impact starts with our children.