A groundbreaking US medical research project has received a $3.4 million boost to study a simple but powerful idea: how prescribed exercise, woven into healthcare routines, can prevent and treat chronic diseases. The findings from this ambitious study could offer valuable lessons for Thailand, where non-communicable diseases such as diabetes, heart disease, and obesity are major public health challenges with rapidly rising rates.
The National Institutes of Health (NIH) has awarded the University of South Carolina (USC) School of Medicine Greenville a substantial grant to investigate their innovative program—Exercise is Medicine Greenville. The program centers on connecting patients with chronic conditions to accessible, community-based activities like those at local YMCAs, aiming to integrate physical activity referrals directly into primary healthcare settings. The research will focus on evaluating referral rates, analyzing cost-effectiveness, and assessing impact on key health metrics including blood pressure, cholesterol, and body weight. The collaboration includes USC School of Medicine Greenville, Prisma Health, YMCA of Greenville, and Foothills Area YMCA, reflecting a close partnership between medical and community organizations (Greenville News).
This research is timely for many Thai readers, as Thailand faces an increasing burden of chronic, lifestyle-related illnesses. According to the Thai National Statistical Office, over half of Thai adults aged 15 and over are insufficiently active, contributing to a surge in hypertension, diabetes, and other preventable conditions (World Health Organization Thailand). There is growing recognition among Thai medical professionals and policymakers of the need to move beyond medication alone and promote lifestyle medicine, a specialty that uses behavioral and lifestyle interventions—such as exercise, diet, and stress management—as primary treatments for chronic diseases.
At the heart of the US study, led by a professor of biomedical sciences and director of lifestyle medicine programs at USC School of Medicine Greenville, and a professor of public health and co-director of the Wolfson Research Institute for Health and Well-Being at Durham University, is the initiative to increase referrals of eligible patients from 24 Prisma Health primary care clinics to structured exercise programs. The model is unique in its integration of medical, public health, and community resources. The key principle, as summarized by the research leads, is that “consistent physical activity prevents, treats, and even reverses chronic diseases—it literally can be a prescription for health.” The study aims not only to boost the number of patients participating in physical activity but also to provide doctors feedback on their patients’ engagement and progress.
Central to this effort is making exercise accessible to all, regardless of income. Local YMCA partners in South Carolina offer scholarships to ensure that low-income or otherwise disadvantaged patients can join and benefit from these programs. Such an approach aligns closely with Thai values of ensuring broad community inclusion in public health efforts. In Thailand, similar models have emerged in public hospitals offering group exercise classes, and village health volunteers promoting activity in rural areas, but challenges remain in scaling up such efforts and integrating them seamlessly with medical care (Bangkok Post).
The Exercise is Medicine Greenville program builds on a global initiative launched by the American College of Sports Medicine, bringing scientific rigor to the concept of “prescribing” exercise. The Thai Society of Sports Medicine and Exercise Science (TSSMES) and other professional bodies have advocated related strategies, but often face a lack of integration with mainstream healthcare and limited evaluation of long-term patient outcomes (TSSMES).
Key to the US project’s methodology is analysis of several questions highly relevant for Thai policymakers and public health practitioners: How many patients can primary care clinics successfully refer to community exercise programs? Do these referrals translate to measurable improvements in health outcomes, such as better blood pressure or glucose control? Is the model a cost-effective investment for health systems? And what are the barriers—be they financial, logistic, or behavioral—that keep some patients from participating, especially those most in need?
According to a US-based medical director at Prisma Health’s internal medicine clinics, a critical component of the model is support for patients who cannot afford to pay for exercise programs, as well as those with unique health or mobility challenges. The provision of behavioral modification resources, coupled with ongoing feedback to referring doctors on patient outcomes, is designed to keep patients motivated and accountable—a strategy with proven benefits in the literature on chronic disease management (PubMed: Medically Prescribed Exercise and Chronic Disease Outcomes).
For Thailand, where the Ministry of Public Health has declared a national “war on NCDs,” this research offers a practical template for strengthening the referral pathway between hospitals and community exercise resources. Thai experts note that while Thailand boasts a vibrant network of public health volunteers and community fitness initiatives—such as “Fit for Life” aerobics groups and green exercise parks across Bangkok and major provincial cities—the link between physicians and these community programs is often informal and underutilized (Thailand Health Information System). The US model highlights the importance of equipping doctors with tools to prescribe exercise and establishing strong feedback loops to track patient progress.
The historical context helps explain why such innovations are needed. Traditionally, Thai medicine has prioritized pharmaceutical interventions supplemented by advice on healthy living. However, time constraints in busy clinics often leave little room for counseling on exercise and nutrition. Cultural expectations may also play a role—many older Thais associate gyms or organized fitness with youth, and women, in particular, may perceive structured activity as less accessible or relevant. The Exercise is Medicine approach—normalizing physical activity as a standard part of medical treatment—could help shift these perceptions (see analysis by Mahidol University’s Institute for Population and Social Research: mahidol.ac.th).
Thai health experts have warned that, without bold new initiatives, the long-term costs of chronic disease could overwhelm public healthcare budgets. According to the Thai Health Promotion Foundation, direct healthcare spending for diabetes and cardiovascular disease has almost doubled over the past decade (Thai Health Promotion Foundation). Provision of subsidized or free access to safe, culturally appropriate exercise opportunities is seen as a high-return investment, but implementation remains patchy.
Looking ahead, the findings from the US project will shed light on the most effective strategies to motivate both healthcare providers and patients. If proven successful, such models could be adapted for use in Thailand’s urban and rural settings alike, complementing current efforts to nudge Thais toward active lifestyles. Further, the economics of such an approach—whether integrated exercise prescriptions reduce healthcare spending enough to justify their rollout at national scale—will be closely watched by Thai officials and insurance providers. Discussions among Thai public health leaders already emphasize the need for pilot programs in major provincial hospitals, with lessons shared via academic conferences and government workshops.
For ordinary Thais, the implications are clear: exercise is not merely a personal choice but a powerful medicine, worthy of a place alongside conventional treatments for chronic disease. The next step for Thai readers is to ask their family doctors or community hospitals whether similar referral programs exist. Participation in community group exercises, fitness classes offered by local tambon health promotion hospitals, and use of Bangkok’s urban green space programs can help drive better health outcomes while reducing reliance on long-term medication.
In summary, the US research on the Exercise is Medicine Greenville model delivers vital evidence for a global movement to embed exercise in everyday healthcare. For Thailand, embracing such principles could accelerate progress against the country’s steadily rising tide of lifestyle-related illness, supporting a healthier, more productive future for all.