President-elect John F. Kennedy highlighted the importance of a physically fit and healthy America to remain a strong nation in his Sports Illustrated article “The Soft American”. Decades later, the of Americans are far too often neglected, putting our great nations future at risk. An unhealthy population is not only an unproductive population but one that lacks a positive morale and the general well-being that allows us to thrive in our daily lives â at home, at school and at work. We owe it to our children to dedicate the necessary resources and design and implement the appropriate initiatives to address the concerning health trends we are witnessing.
As an orthopaedic surgeon, I see the health benefits of routine exercise firsthand for general well-being and overall quality of life. But we are falling short. Today, greater than one in five , while only about 25% are getting the recommended daily dose of physical activity. In addition, the prevalence of mental and behavioral health conditions among adolescents continues to increase at an alarming rate, up by 35% from 2016 to 2023. This is unacceptable, and we must do better.
Fortunately, efforts to tackle the growing pediatric and adolescent health crisis associated with a sedentary lifestyle and worsening mental health are underway. On July 31, 2025, signed an executive order reinstating the . Since that time, numerous states, including Mississippi and Tennessee, have shown their strong support of the program as the exact design and implementation of a reinvigorated Presidential Fitness Test are ironed out.
The reinstatement of the Presidential Fitness Test is not simply about nostalgia but is necessary for public health, national resilience, and American prosperity; here are design considerations and the lessons this intervention can teach our next generation.
First, we must ensure the updated Presidential Fitness Test is evidence-based using the latest gold standard science. Originating in 1956 by President D. Eisenhower and periodically updated until it fell out of favor, the Presidential Fitness Test can be reimagined today to focus on exercises and related physical benchmarks that better measure key components of health (for example, functional strength and aerobic capacity). Once the components of the test are identified and agreed upon by experts, physical education curriculums can then be adapted to better teach students the importance of staying physically active and how best to prepare and train for the yearly assessment. Resources for physical education teachers to support the educational mission associated with the test will be crucial.
Second, there should be a focus on both personal growth metrics and . These ideas are not mutually exclusive. Critics of the Presidential Fitness Test have argued that the focus is too much on athletic ability over general health and because it is completed in a public environment, the test can damage self-esteem and mental health. However, if we stress both internal and external competition and support all children in finding tangible ways to discover joy in routine physical activity as part of more robust physical education curriculum support, this critique falls apart.
Importantly, alongside a new focus on personal growth metrics, the national competition component must remain. Not only is there great pride in receiving a certificate and patch from the U.S. President if you win an award, but it helps teach grit, resiliency, and an important life lesson: some things are difficult, but perseverance, determination, and dedication can lead to improvement. Effort matters, and there are no shortcuts to circumvent hard work. Even still, participants may come up short of winning an award â learning that it is OK to be knocked down but more important to get back up is a skill in and of itself. Simply removing standards and the spirit of competition helps no one in the long term.
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