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When Cynthia Hasbrook walks into a room full of Milwaukee senior citizens, she sees fit and healthy people in the making. And, for seniors involved in a collaboration between UWM's College of Health Sciences and Milwaukee County's Department on Aging, that is just what they are becoming: fit and healthy.

"We're seeing some remarkable successes," says Hasbrook, the UWM leader of the effort, carried out at five senior centers seeded strategically throughout city neighborhoods that have historically been ignored by sports and fitness services.

The program, known as WellnessWorks, arose in the late 1990s from a collaboration between Hasbrook, a professor in the UWM Department of Human Movement Sciences, and Linda Cieslik, program coordinator for community health for the county's Department on Aging. "There were two overarching goals," Cieslik recalls about the formative years. "The first was to provide learning opportunities for students in the health sciences, specifically in movement science, to work with older adults. Most of those students' previous experiences had been with older adults in nursing homes; we wanted to give the students a more wellrounded experience.

"The other goal was to give local seniors, particularly those who had not been served by fitness programs, a more preventative (sic) perspective on health issues-an eye toward prevention, rather than simply treating a health crisis when it occurs." The solution? A free fitness program for anyone 50 and older. Funded by nearly $1.2 million in grants from the state of Wisconsin's Department of Health and Family Services, and publicized by public-service television spots, door-to-door flyers, and physician referrals, the program was an instant hit when it opened its doors in 1999.

Originally based at the Washington Park Senior Center in the city's ethnically diverse Washington Park neighborhood, WellnessWorks has expanded to serve about 1,200 city seniors, most of them in lower-income or ethnically diverse neighborhoods. While participants are typically in their 70s, Cieslik notes a 94-yearold regular participant and several dozen in their early- to mid-80s.

Gains in physiology - and attitude

At each center, now staffed by UWM graduate and undergraduate kinesiology students, the fitness regimens begin with individual health assessments of each participant, then move on to the creation of personalized training programs composed of cardiovascular workouts (on treadmills, stationary bikes, and senior-oriented NuStep cross-training equipment) as well as both upper- and lower-body weight training. The weightlifting machines, specially designed for seniors, use pneumatic force rather than physical weights to reduce the strain on aging muscles.

The workout circuits were designed by UWM exercise physiologists Steve McCole and Mark Parmenter (and further developed by assistant professors Scott Strath and Ann Swartz) to emphasize improved strength, cardiovascular health, and fall prevention. "Strength and muscle mass are so important for older adults," Hasbrook says. "The more muscle mass you have, the higher a metabolic rate you can maintain, and the better you can burn fat and avoid diabetes."

"These programs are tailored to our clients," Cieslik adds. "After all, there's quite a difference between exercises that are appropriate for 20-, 30-, and 40-somethings and those that are best for 50- or 60-somethings."

A review of physiological data from the first two years of WellnessWorks has revealed impressive results. Participants-who visit the centers an average of three times a week-increased their strength by an average of 25 percent in just their first 15 weeks in the program. During that time they also realized a 17 percent gain in cardiovascular endurance and became slightly (approximately 9 percent) more flexible.

Equally important, the participating seniors' levels of anxiety and depression-as measured by UWM physical activity/sport psychologist Barbara Meyer-dropped approximately 43.5 percent, which Hasbrook and Cieslik attribute to improved physical fitness and increased social contact.

"We have collected some amazing stories," Hasbrook remarks. "One man, for example, lost 80 pounds. Others who suffered paralyzing strokes can now walk with the help of a walker or a cane. We've also had people who are diabetics telling us they are reducing their need for insulin."

Beyond the individual gains, there is also the question of the social benefits of exercise. In 2002, the study team also began collecting detailed personal data on each participant for a longterm study that will address just this issue. In a moment where an aging American populace is poised to strain health care resources and retirement benefits, researchers wonder if improved fitness among Milwaukee seniors might translate into lasting economic benefit for the city and, by extension, society as a whole. Might workouts keep the city's minority and lower-income seniors healthier and living in their homes longer, and out of hospital rooms, emergency rooms, and secondary care facilities?

"We can now say with certainty that the fitness programs have improved the fitness levels and psychological well-being of the participants," Hasbrook says. "And theoretically, for those who keep active or increase their levels of physical activity and receive counseling on nutrition, it should reduce their rates of illness, disease, and hospitalization. But does it actually contribute to the economic well-being of our community by decreasing hospitalization rates and illness? We can't yet say."

A long-term, detailed study begun in 2002 by Hasbrook should soon begin answering this question.

Surprising commitments to fitness

Hasbrook hasn't been satisfied merely with serving as a catalyst for the effort to bring physical fitness programs to the area's lowerincome seniors. As a physical activity/ sport sociologist (and former editor of Sociology of Sport Journal), she's also intrigued by questions of ethnicity, gender, and class as they relate to the new exercise programs.

"I'm interested in how and why older adults become interested in physical activity, pursue it, and remain active," she explains.

To that end, Hasbrook has interviewed a sample of WellnessWorks participants, inquiring in greater detail about their social backgrounds and exercise patterns-and the relationship between the two.

She found some surprising trends that run counter to current understanding of the relationship between social class background and physical activity. For example, both African-American and white men from lower-income socioeconomic backgrounds tended to value physical exercise and conditioning much more highly than Hasbrook expected-despite growing up under conditions that would seem antithetical to an organized exercise program.

"A lot of African-Americans here grew up in the South, in rural areas and in segregated times," Hasbrook explains. "Their schools were too poor to offer sports, and they were forced to walk to school on dirt roads three or four miles and back each day, they tell us. Yet, what they recall is that they learned early on they could walk long distances and were in shape because of it; they grew up thinking of physical activity as a part of life. Being strong and muscular was part of their masculinity, and as seniors they still believe it's important to exercise. They enjoy it."

Similarly, she learned that lower-income white men growing up in Depression-era Milwaukee could not afford cars, and thus exercised regularly simply to commute to and from their factory jobs.

"Years later, when they retired, they were fearful of losing their physical shape," Hasbrook says, "and the exercise program was attractive to them."

Lower-income senior women in the Milwaukee County area also confounded the conventional wisdom. Hasbrook's interviews revealed that there were unusually abundant opportunities for young women to participate in sports during the 1920s and 1930s: church softball and basketball leagues, for example, encouraged rather than discouraged women to become athletic.

"A lot of them grew up proud of their physicality, and they never really lost that," she notes. "It was considered appropriate."

Many of these women continue to value physical fitness today.

"Sociologists typically understand that a higher social class means one is more likely to engage in physical activity than others," Hasbrook says. "However, in examining the life histories of our older adults currently active in WellnessWorks, this was not necessarily true."

Though there's no hard data to prove it yet, Hasbrook adds that it appears the program is bringing in many seniors who lack the discretionary income to join fitness clubs-but wish to participate in a formal exercise program.

The program, then, has been a striking success to date and already has garnered a handful of awards. Yet none of it would have happened if UWM and Milwaukee County hadn't found a way to join forces.

"It is not easy to set up this kind of partnership," notes Hasbrook of the rather unusual collaboration between county department and university department. "A university has its interests, departments on aging have their own interests; normally it takes a great deal of work to ensure that all the parties in a collaboration are satisfied and remain satisfied."

"It is unusual," agrees county Department on Aging official Cieslik, "and I have found that it has been difficult for others to replicate this kind of a government- academic partnership, because we each have to deal with our specific bureaucracies. We both understand each other's worlds, and we're able to be very flexible with each other when necessary. That is special."

Citing still-increasing enrollment numbers and talk of further expansion, Hasbrook lists WellnessWorks as one of the highlights of her nearly 23-year academic career. "This project fulfills all three missions of a university-to teach, conduct research, and do public service-at the same time. It is very rare that you can do all three. That has been very, very gratifying."

Paul Karr is a prize-winning writer and editor based in New York City.

Reader comments and requests for permission to reproduce material can be sent to Peter Hansen