Chris Bain knew he needed to get into better shape.
A U.S. Navy veteran with post-traumatic stress disorder, Bain’s life took a turn for the worse after a layoff and family tragedy. Bain, of Dubuque, was celebrating three years of sobriety in April when he decided to take the next step in his healing journey — joining a gym.
“I have three grandkids,” Bain said. “It’s really important for me to be there for them mentally and physically.”
Bain has gone to Dubuque’s Crescent Community Health Center for dental care for a decade but only recently found out about its wellness center. The center is free to the health care provider’s patients and offers open hours, fitness classes, personalized fitness and nutrition coaching and nicotine cessation counseling.
“When this came up, I thought … I could just give it a try and if I don’t like it, I don’t have to come,” Bain said. “I haven’t missed one day since I started in April.”
Bain suffers from chronic back pain. He said the workout routine developed for him at Crescent, a mix of cardio and lifting, has helped him avoid further aching while maintaining a steady weight, which helps alleviate the back pain. The regular exercise also has helped his mental health.
“If I didn’t have this program, I would probably be suffering a little bit more depression than I do. My anxieties would be higher,” Bain said. “I probably wouldn’t be at the weight I’m at right now, which would cause me pain, which in turn causes more depression, and I wouldn’t be able to get up and do stuff.”
Cassie Foley, health and wellness coordinator at Crescent, said patients such as Bain have found a haven at the wellness center. She said patients who have dealt with addiction or other kinds of trauma need healthy coping mechanisms, one of which could be exercise.
“People find a safe haven in (the gym),” Foley said.
Bain is one of many Iowans who has taken steps to improve their physical and mental health through exercise, bucking data that shows the state’s residents rank poorly in various metrics, such as frequency of exercise and obesity.
Local experts say many barriers to wellness exist in the tri-state area, including financial or transportation issues that prevent some people from accessing workout opportunities and healthy food options. For others, the barriers are related to lifestyle choices or a lack of motivation.
Local leaders and fitness experts are working to increase access and point people to existing opportunities to get in shape — and they say there are plenty of steps residents can take, too.
Running the numbers
A 2017-2020 survey sponsored by U.S. Centers for Disease Control and Prevention shows that 24.5% of Iowa respondents did not exercise at all outside of work within the past month, which the CDC categorizes as “physical inactivity.” This statistic puts Iowa at about the national median.
Illinois’ number was similar, at 24.9%. Wisconsin, at 21.9%, had the 12th-lowest rate of physical inactivity.
In terms of obesity, Iowa fairs worse. At 37.8%, according to 2023 CDC data, the state’s obesity rate is the eighth-highest in the country. Illinois’ obesity rate is 36% and Wisconsin’s is 35.9%
Iowans’ alcohol intake is also higher than the national average. Monthly prevalence of binge drinking among Iowa adults was 20.5% in 2023, above the 15.2% national rate. Illinois and Wisconsin, while still above the national rate, fared better, at 18.1% and 18.4% respectively.
The 2023 Dubuque County Community Health Assessment and Community Health Improvement Plan shows several areas in which the county ranked worse than the state and the nation, including in excessive drinking and in heart attack hospitalizations. Dubuque County’s obesity rate, at 33.7%, was comparable to the national rate, but lower than the state.
The assessment also includes a survey of county residents on their top health priorities for the county. Among the top three was physical activity, nutrition and obesity.
Mary Rose Corrigan, city of Dubuque public health director, said poverty could be a barrier to exercising due to the price tag that comes with many gym memberships and fitness classes.
“A lot of people don’t know how to exercise properly,” she said. “They might not know the proper or safe way to exercise.”
Poverty also can negatively impact other health metrics, such as nutrition, Corrigan said. She said unhealthier, processed foods tend to be more economical and that certain neighborhoods in the city lack access to quality grocery stores.
Dubuque County Public Health Director Allie White said the county developed an action plan in response to the assessment, which includes finding ways to get people moving.
“The community felt we could help provide them opportunities for exercise,” White said.
The county now lists local health and wellness resources on its website. It includes lists of local gyms, parks and trails. Maps of conservation areas are also available on the county website.
White said officials also seek to work on reducing barriers to exercise, though exactly what that looks like has not been finalized.
“We are looking at a partnership with Dubuque County Conservation,” she said. “An idea we had is to have a hike on the trail with a doctor you can chat with. We’re still in the early stages.”
Lifting locally
A bright spot on the assessment was Dubuque County residents having more recreation and fitness facilities per 100,000 residents than the state and the nation.
That includes gyms affiliated with national chains such as Planet Fitness and Anytime Fitness, but also locally owned facilities in the area, such as Volv Fitness in Dubuque.
Kim David, owner of Volv Fitness, said she got involved in the industry to motivate others.
“I realized being part of the fitness industry was a way to help people who feel limited,” David said.
Aside from general fitness, the facility offers classes such as CrossFit; yoga; and Onnit, a program born out of a Texas gym that uses tools such as steel clubs, tires and sandbags in place of more conventional gym equipment.
Three years ago, Volv launched the Survivorship Program, a referral-based exercise program for people undergoing cancer treatment or within three years of remission, which since has branched off into the nonprofit Crocus Foundation.
Iowa has the fastest-growing rate of new cancers in the country and the second-highest rate of new cancers overall for the second year in a row, according to Iowa Cancer Registry’s 2024 Cancer in Iowa report.
David said poor diet and alcohol, as well as environmental factors, can contribute to the cancer rate along with Iowans’ overall poor health metrics.
While some environmental factors are hard to overcome, David said part of her role is encouraging her clients to make healthy choices outside of the gym.
“I’m really big on education of nutrition and making that a component of what we do here,” David said. “Our job as fitness (instructors) is to educate on how to make healthy choices.”
David said her gym’s membership is regional and includes people from Jackson County, Iowa, and Grant County, Wis., who are attracted to opportunities not available to them in smaller towns. However, David said she has few members from western Dubuque County, which she attributes to what she sees as quality fitness centers in that area.
One of these is Bar Raising Fitness. Although it started in Dubuque in 2019, owner Brandon Hogan opened a Dyersville location the following year.
Bar Raising Fitness offers one-on-one training, small group training and classes. He said his clients are mainly, but not exclusively, athletes seeking to optimize their bodies. They come from different parts of northeast Iowa.
“We get people from Manchester, Guttenberg and all the small towns around,” said Hogan, a Farley, Iowa, native. “This area’s continuing to grow.”
For Hogan, coaching his clients on lifestyle choices is important so that they can achieve long-lasting results.
“We talk to them about the lifestyle choices they make,” Hogan said. “We want long-term results even when their athletic career is over.”
Increasing access
Jason Kieler owns Tri-State Fitness in Kieler, Wis., where he seeks to address what he said is a lack of fitness centers in rural Grant County.
CDC data shows that adults in rural areas are less likely to exercise than their urban counterparts, though in neither case do most meet the CDC’s recommendations. Only about 16% of rural adults reach the CDC’s advised 150 minutes of moderate or 75 minutes of vigorous, aerobic physical activity a week, in addition to two days of strength training. In urban areas, 28% of adults meet the guidelines.
Kieler said he has members from around Dickeyville and Cuba City, but also Dubuquers who work in Kieler.
“You didn’t have any opportunities (in Kieler) besides traveling,” Kieler said. “Not everyone has time to travel an extra 15 to 20 minutes.”
Tri-State Fitness offers personal training and classes, including for kids as young as 8. Members have 24/7 key fob access to cardio machines, free weights and weight machines.
Like David, Kieler is mindful of how unhealthy certain aspects of the rural Midwest lifestyle can be.
“Some of the social things around here … (are centered around) going out to the bars,” Kieler said. “I’m big on moderation.”
Kieler also said cold winter months limit outdoor exercise potential.
However, local officials such as White hope to promote the use of Dubuque County outdoor trails as a free alternative for those who cannot afford gym memberships.
“Go out on the trails. … There’s no fees to use them,” White said. “A lot of them are hidden gems.”
White also said there are many free exercise classes and videos online.
“There are so many opportunities to engage in exercise,” she said.
White and Corrigan both praised Crescent’s Wellness Center as an alternative to fee-based gyms.
Foley said the wellness center provides an opportunity for those who would otherwise be unable to use a gym. Crescent, a federally qualified health center, provides medical, dental and brain health care to uninsured and under-insured residents.
“We wanted to offer (the wellness center) for people with transportation issues or financial issues,” Foley said. “I think anyone who lives in poverty … automatically has a disadvantage.”
Corrigan said other options for low-income Dubuquers include borrowing exercise kits from Carnegie-Stout Public Library and using SNAP/EBT cards to purchase tokens at Dubuque Farmers Market to buy vegetables, fruit, meat, seafood, dairy products, breads, seeds and plants.
College cardio
Exercise habits tend to decline among young people as they transition from high school to college. A 2016 CDC study of 233 students shows that while 65% reported regular vigorous physical activity in high school, only 38% did so in college.
In Dubuque, colleges provide students with opportunities to stay active while in school.
Clarke University’s Robert and Ruth Kehl Center houses a physical activity center, three regulation playing floors, a gymnasium, weight rooms, walking/running track and a cardio room, according to Athletic Director Curt Long. There is also a wellness center in Mary Josita residence hall with a cardio room, fitness/dance studio and a meditation space.
Lillis Athletic and Wellness Center at Loras College has cardio and weight machines and free weight exercise space. Director of Athletics Denise Udelhofen said it is well used by student athletes and students who are not athletes alike, though the college does not collect usage data.
Udelhofen said the school’s athletic staff educates athletes not just about exercising, but also about nutrition, proper sleep and caffeine intake.
University of Dubuque’s Chlapaty Recreation and Wellness Center provides students and staff with basketball, volleyball, tennis, badminton and pickleball courts, as well as a 200-meter track, according to Assistant Director of Recreation Jose Reinoso. There are also two weight rooms with cardio and weight machines and racks.
A focus on wellness expands beyond the student body. Loras and UD both offer classes in which students interested in the personal training field can train faculty.
“Everyone’s always looking for an outlet to improve their health and wellness,” said James Romagna, associate professor of health, wellness and sport at UD. “This is a free program for them.”
Romagna teaches the Theory and Principles of Personal Training course, which prepares students for the national personal training exam. The class has seven students for the fall semester, each paired with a university employee seeking to improve their physical health. Students plan workouts, and Romagna reviews them.
Romagna said the class is so popular that not all interested faculty can be accommodated.
“Everyone’s always looking for an outlet to improve their health and wellness,” Romagna said. “We usually put something out in the faculty newsletter, and we typically get more than we can accommodate. There’s a need for it.”
Senior Abbie Bailey, a UD basketball player, became interested in the field after recovering from several injuries over her athletic career. Bailey, who hopes to own a training facility one day, said most of the clients in the UD class simply are looking to get into better shape.
“They want to get more toned or get stronger, just for that overall health benefit,” Bailey said. “Most of them want longevity. They have kids, so their lives are busy. They just want to feel healthier.”
Carrie Preston, patient services administrator at UD’s student health center, is one of the faculty members participating in the personal training class this year. She said she hopes to get into good shape as she ages.
“I signed up … to prevent any types of falls, to decrease osteoporosis as I continue to age and just get my body more limber so if I do have any injuries I’m able to recover quicker,” Preston said. “As we age, falls can really debilitate you.”
Aside from the in-person sessions, students also plan at-home workouts for their clients, said senior Brandon Coppola, Preston’s trainer.
Preston said she already feels a difference in her body.
“I’ve learned skills that … help me move better,” Preston said. “It’s just a healthier lifestyle.”
Community fosters good habits
Bailey said the trainer-client relationship can be “symbiotic.”
“We’re kind of going through it together,” Bailey said. “We talk about life. We talk about our days. It’s almost like a friendship as well as a client.”
At Crescent, Bain has found a community at the wellness center, which offers some small group classes.
“Not only are you getting a stretch or workout in, it’s kind of a little camaraderie,” Bain said.
Bailey said UD clients are generally eager to work out but are sometimes unmotivated on bad days, which she helps them work through.
“There are some days …. (clients) feel a little bit unmotivated,” Bailey said. “It’s life. If I just push them, they’re eager to do whatever I ask them to do.”
Bain said the camaraderie at Crescent and guidance from Foley helps keep him motivated. He said his therapists are “very happy” that he has access to the wellness center.
“On occasion, I’ll try to talk myself out of coming, but I haven’t missed one day since I started,” Bain said. “It’s just part of my day now.”
Like Preston, Bain is feeling a difference in his body just a few months into his routine.
“It’s nice to have a good habit,” Bain said. “It’s very important to have some kind of an exercise routine. Working out is good for mental health, and it’s good for physical health.”