Daily activity affordable, Department of Education says

West Virginia is among the top five on just about every national chronic disease list. The state leads the nation in diabetes and obesity, according to the Gallup Healthways poll.

Surveys show that many West Virginians do not realize obesity is a leading cause of many chronic diseases. Many also feel those diseases are hereditary, and there is nothing a person can do to prevent them.

The state's children raise major red flags for the future. West Virginia University screens thousands of schoolchildren every year. In 2010-11, they found that 24 percent of fifth-graders have high blood pressure, 26 percent have high cholesterol, and 29 percent are obese. Eighteen percent of kindergartners and 23 percent of second-graders are obese.

There has been little public discussion of this problem. "The Shape We're In" project aims to stir up that discussion. Written and photographed by Annenberg fellow Kate Long, it will be divided into three parts in The Charleston Gazette, the state's largest newspaper:

• Children at risk
• Programs that work
• Communities making a difference

Some segments will be accompanied by West Virginia Public Radio pieces.

Part 1: "This is a public health emergency"

Part 2: A growing problem

Part 3: Putting the pieces together

Part 4: Health officials say W.Va. can reverse its chronic disease numbers

Part 5: W.Va. man: diabetes programs work

Part 6: "Get kids moving"

Part 7: Daily activity affordable, Department of Education says

Part 8: Wood researchers: Active kids do better academically

Part 9: Rocking the gym at 7:30 a.m.

Part 10: Nebraska school district lowers obesity rate

Part 11: What happened?

Part 12: 'Everyday heroes' saving own lives

Part 13: W.Va. ranks first in heart attack, diabetes, eight other categories

Part 14: Success from scratch

Part 15: Great Kanawha food fight

Part 16: Better focus

Part 17: W. Va. slammed with sugar

Part 18: Glenda and Jill vs. diabetes

Part 19: This is how bad diabetes can be

Part 20: Recognize diabetes before it's too late

Part 21: Logan hardest hit by diabetes

Part 22: Even if your relatives had diabetes, you don't have to

Part 23: Body and spirit

Part 24: American Diabetes Association is MIA in W.Va.

Part 25: Young people contending with diabetes

CHARLESTON, W.Va. -- In 2007, legislators asked the state Department of Education how much it would cost for every student to have physical education five days a week.

"It seemed like the obvious step to take," said Sen. Erik Wells, D-Kanawha. One in four fifth-graders has high blood pressure and cholesterol. One in four eleven-year-olds is obese, a clear red flag for the future.

They sent the department a resolution that began with "Whereas, seven of 10 West Virginians will die of heart disease, cancer or stroke; and whereas, 28 percent of West Virginia fifth-graders ... have one or more cardiovascular risk factors ..."

"We knew that, if we could get our kids active, we could prevent a lot of type 2 diabetes, obesity and heart disease," said Sen. Dan Foster, D-Kanawha.

But to their dismay, state Department of Education officials told them daily P.E would cost between $13 million and $1.5 billion.

"The legislators got upset at us for that," said Melanie Purkey, director of the state Office of Healthy Schools, "but they asked for the cost of physical education, not the cost of physical activity."

Wells is still upset. "The department knowingly and effectively killed any effort to have physical education five days a week," he said. "At interims, when Melanie said $1.5 billion, you could just see legislators shifting to 'Well, we can forget that.'

"I have learned that when the department doesn't want something, they put a high estimate on it," he said.

"We had to give them a range, so we had to include the worst case scenario," Purkey said. The $1.5 billion included a gym for every school that didn't have one, she said. The low end, $13 million, added classroom space only.

"We don't need all those new gyms and classrooms, just to get kids moving five days a week," Wells said.

Purkey agrees. There are other ways kids can be active every day for a fraction of that cost, she told the Gazette-Mail in January. In the past five years, given the obesity epidemic, there has been a national movement to get kids moving through physical activity, she said.

"If the Legislature had asked us for the cost of daily physical activity, instead of physical education, the numbers would have been much lower," she said.

"As soon as you use the words 'physical education,' you run into code and policy requirements:" teacher certification, facility specifications, scheduling and teacher/pupil ratio," she said. "We had to take all that into account."

"Physical activity" has no such requirements under West Virginia law. It means get kids moving: running, jumping rope, zumba, walking, whatever. Anyone approved by a school can supervise physical activity. It can happen anywhere, anytime it fits.

Physical education involves classroom time, learning about the body and its functions. Physical activity is simply moving the body. "Physical activity costs very little and is very do-able," Purkey said. "You can require all kids to participate."

"Well, why didn't they say that five years ago?" Wells asked. "Why didn't they say then that daily physical education may not be doable, but there's something else we can do?

"We tried to tell them," Purkey said.

She added, "We don't want more bad P.E.," of the type that causes kids to hate exercising or is a classroom, non-movement situation. "We're concentrating on improving the quality of what we have."

What's the difference between education and activity?

State Schools Superintendent Jorea Marple is a strong advocate of daily exercise, any way it can happen. "We've got to look at what's possible," she said.

Cash-strapped West Virginia could get kids moving every day through a combination of physical education and physical activity, she said earlier this month.

In the past five years, many school systems nationwide have adopted the P.E./physical activity combination, Purkey said. At least 12 states require daily physical activity outside of the required amount of physical education, according the National Association of State Boards of Education.

The cost? "I can hire somebody to run good physical activity sessions for half of what I pay a good P.E. teacher," said Don Chapman, assistant director of the Office of Healthy Schools.

"Parent volunteers run those sessions in some school systems," Purkey said.

Teachers' groups don't like that idea. "They're trying to piecemeal it instead of realizing it'll take money to fix the problem," said Dale Lee, president of the West Virginia Education Association. "We lead the nation in obesity. We need to get kids more active, and qualified physical education teachers should be the ones to do it."

"We're not trying to replace P.E. teachers," Chapman said. On days when the children don't have P.E., he said, a trained person can still lead children in physical activity like zumba and races.

Elementary children must have a half hour of P.E. three times a week, by state law. "A child could have physical education three days a week, then do physical activity two days," Purkey said.

And then there's recess

Crowded school schedules can be a roadblock, Purkey said, so, nationwide, many school systems are organizing games and structured activities at recess and after lunch. They have recess coaches. "We'd like to do that, too," she said. The Department of Education has been looking at an elementary-level program called PlayWorks.

A problem: West Virginia law does not require recess, and many schools are skipping it, to give themselves more time to prep kids for standardized tests, she said.

State school board policy strongly recommends recess before lunch for elementary schools, but schools are free to ignore recommendations.

 "The crunch of No Child Left Behind has made teachers nervous about instructional time and time to reteach kids who aren't getting it, so we're seeing recess get taken away," Purkey said.

"And even when a school has recess, some schools use it for discipline and take it away if a child didn't do well academically," she said. "That's backwards from what the research tells us is good for kids.

"The Department of Education has never required recess because we never thought anyone would want to drop it," she said, "but it looks like we need to require it, and we probably need to help schools understand why children need it."

"We obviously need to pick up this conversation and continue it," said Brent Boggs, the House of Delegates majority leader from Braxton County. "Daily exercise seems like the most basic way we could help with childhood obesity and lower type 2 diabetes. We can pay for it now or pay much more later in medical costs and lack of workplace productivity."

The state School Building Authority gives counties money to build new gyms and other school facilities, but it usually wants counties to come up with part of the money first, "and people aren't in the mood to vote for that," Chapman said. That's another reason for looking at physical activity, he said. Levies that included gymnasiums failed recently in Jackson and Marion counties, he noted.

Ginny Ehrlich, CEO of Alliance for a Healthier Generation, sponsored by the American Heart Association, oversees a network of 14,000 schools. "When it's done well, it's not an either/or," she said. "Both physical education and less formal physical activity are part of the overall equation for childhood obesity prevention."

Senator Wells is leery that physical activity might have no structure. "If they just let kids out for recess and call it physical activity, you could end up with half the kids standing around texting," he said.

Trained people should led the sessions, and they should involve all students, Purkey said.

"It may not be something we can fix all at once," Boggs said. "But we could at least start to fix the problem and maybe look at some pilot projects."

Wells is submitting a new resolution, this time requesting that the Joint Committee on Government and Finance conduct "a study of multiple topics, all related to health, nutrition and wellness programs in public schools; including fitness requirements, nutrition in school meals and the inclusion of West Virginia food products in school meals."

"We need to look at the whole problem and make sure we do something effective," he said.

"We'd be glad to have that conversation," Purkey said.