© vaga associates the value of leisure and culture to enfield our bodies were made to move! nikki...

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The value of leisure and culture to Enfield

Our bodies were made to move!

Nikki Enoch and Mike Collins

Health Improvement Partnership

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Project Brief

Commissioned October 2003 to: Summarise available national research Apply research locally Identify priorities for the ESP thematic groups

Funded by Neighbourhood Renewal

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Presentation

Summary of national research Priorities of the Leisure and Cultural Partnership Focus on health:

• National evidence• Enfield picture• Benefits of leisure and cultural services• Potential achievements in Enfield

Information sources Your views

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The value of leisure & culture to Enfield

Summary

Personal Health - halves CHD risk

- reduces BP

- controls body weight,diabetes

- reduces risk of falls, back pain

- reduces risk of colon cancer

- reduces anxiety/depression

- enhances mood, self-esteem

- promotes imagination and vision

Socialisation, tolerance, team working

Social cohesion Leadership & organising skills

Communal/social increases family/local links reduces NHS costs reduces crime and disorder costs community identity thro’ history/culture increased participation of poor, disabled,

ethnic minorities increased social networks/active citizens

creates jobs improves environment

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Leisure & Culture Partnership

Emerging Priorities

Agreed on 10th November 2003: Addressing health issues Capacity building and organisational development Activities for young people

(divert from crime and anti-social behaviour)

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The value of leisure & culture for healthThe evidence

1. Strong trends with physical health

2. Close association with mental health

3. Strong correlation with deprivation

4. Payback

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The value of leisure & culture for healthThe evidence

Education profession (e.g National Curriculum)

Leisure profession (e.g LGA 2001)

Sports profession (e.g Balyi 2002)

Medical profession (e.g BMA 2002)

BHF National Centre for Physical Activity & Health (www.bhfactive.org.uk)

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The EvidenceIncreasing prevalence of Obesity

0

5

10

15

20

25

30

1980 1985 1990 1995 2000 2005 2010

Year

% o

bese

(BM

I >30

) men

women

N.A.O. 2001

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The Evidence Inactivity Indicators

0

100

200

Year

% Obese

Cars (perhouse)

TV viewing(hrs/wk)

Prentice & Jebb ‘95

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The Evidence Inactivity levels

0102030405060708090

%

16-24y

25-34y

35-44y

45-54y

55-64y

65-74y

Age

Men

Women

HSE ‘98

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The EvidenceEvidence of health risks

Source: Britton & McPherson

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The EvidencePrevalence of CHD Risk factors

0

20

40

60

80

% o

f P

op

ula

tio

n

men

women

Source: Joint Healthy Survey Study 1999

Economic Cost of CHD

£7.06b annually

Source: Liu, Maniadakis, Gray & Raynor 2002

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The Evidence Relative risk of diabetes

with increasing weight

0

20

40

60

80

100>

22.0 23 24 25 26 28 30 32 34

>35

.0

Body Mass Index (kg/m2)

Inci

dent

ris

k o

f dia

bete

s in

mid

dle

age Men

Women

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The EvidenceInequalities in Health

Poor health and high inactivity in deprived areas• Conceiving earlier• Born smaller• Lower access rates• More ill health• Dying younger

Mortality rates are 3 times higher for those in social class V than those in I

BHF National Centre for Physical Activity + Health

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The EvidenceYoung People’s Trends

Aged 5-18 Years

20% overweightChinn, S. & Rona, R.J. (2001)

10% have one or more mental disordersOffice for National Statistics (2000)

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The Evidence Prevalence of Mental Disorders

Growing sharply Young women twice as likely to suffer Children with lone parents Lower socio economic groups 20,000 suicide attempts annually by young people

Office for National Statistics (2000)

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The Evidence Conclusions

“There is an obvious relationship between physical activity and good health. Conversely, inactivity is related to poor health. Therefore

there are considerable public health benefits to be had by increasing the proportion of the

public that is physically active”.

BMA Priorities for Health Briefing Note

Scottish Parliament Dec. 2002

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The EvidenceEnfield Picture

Neighbourhood Renewal Assessment (Feb 02) Poor health link with highest levels of deprivation

Pro-rata national estimates to Enfield residents: 37% are sedentary = 101,200 22.5% are obese = 61,500Savings from a 10% increase in activity 10% = 17,200 residents 311 lives £10.5m

• £1.8m NHS• £4.3m loss of earnings• £4.3m premature mortality

Source: DCMS: 2002 Game Plan Implementing the Government’s Strategy for Sport

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Our UnderstandingBest Start in Life

Young People

u4-15 yrs

Physical

•Heart size

•Muscle strength

•Ligamentous structures

•Motor patterns & balance

•Co-ordination

Mental/Cognitive

•Attention span short

•Imagination blossoming

Emotional

•Self concepts & self importance

•Peer influence

•Understands rules & structures

Physical

•Bone - fat - muscle tissue

•Growth spurts (girls earlier)

•Puberty

•Increase in red blood cells

•Central nervous system

Mental/Cognitive

•Abstract thinking

•Egocentric thought/self identity

Emotional

•Heightened peer influence

•Accepting responsibility

•Different maturity rates

Multiple

Learning

Styles

“Drama, dance, movement,words,images and music – all stimulate

the brain to learn”

University of the First Age

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Our Understanding Dropping Out

Young People

12-18 yrs

Girls and Young Women

•42% active for health benefits

•Negative peer pressure

•10% 12-13 yr olds inactive

•20% 13-14 yr old inactive

•Drop out - earlier and higher numbers


•Positive peer pressure

•Drop out – later and lower numbers

Boys and Young Men

50% not receiving 2 hours of PE

Media use = approx. 5 hours a day

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Our UnderstandingFinding time

Adults

16-55 yrs

All


•33% ‘inactive’

Bangladeshi


•65% ‘inactive’

Age Decline

•Aerobic capacity: 25 yrs onwards 8-10% per decade

•Strength: 5-10% per decade

•Muscle mass: 40% loss between 20-70 yrs

All


•25% “inactive”

Bangladeshi


•59% ‘inactive

Women Men80% perceive themselves

physically active

Sources: ADNFS 1992; BFH National Centre for Physical Activity + Health

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Our UnderstandingKeeping fit for life

Adults

50+ yrs

All


•50% sedentary

•25% unable to climb stairs unaided

Bangladeshi

•92% sedentary

Importance of Physical Activity

•Maintains functional ability

•Prevents disability, immobility and isolation

All


•40% sedentary

•7% unable to climb stairs unaided

Bangladeshi

•85% sedentary

Women Men

Source: BFH National Centre for Physical Activity + Health

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Our UnderstandingGetting the message across

Reach deep into older, DE markets

Components of the participation market (Rowe,2003)

• sporty 20% - keen -sustain interest, safeguard provision• mildly enthusiastic 16% - could do more – reduce drop-

out, better access, foster enthusiasm• on the bench 44% - persuadable (busy,non-sporty) –

remove barriers,incentives, take sport to them• couch potatoes 20% -ingrained scepticism – raise

awareness, promote benefits, teach children

Trends are reversible – pay back within months

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The value of leisure and culture for healthA Multi Dimensional Strategy

East and South, poor, single parents, C2DE women, Pakistani/Bangladeshi, older

Focus on the highest risk (highest savings)

Best start for young people

Reducing drop out

Reaching out for older

adults

Making it easier for

those at work

Strategic and social marketing

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The value of leisure and culture for healthCurrent and proposed activities

Healthy Living Centre ; Garden Gym

Exercise referral

•SS coordinators

•Specialist colleges

•YP gyms

•Children’s centres

•Healthy schools

•Mind how you go

•Fit for life

•Sure start

•children’s centres

•Play schemes

?

Leisure Discount Schemes

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The value of leisure & culture for healthFilling Gaps

Suggestions for new areas: Walking to Health with Countryside Agency, Sport England Cheaper public fitness suites (12% cited cost)

eg SIV Sheffield, build/fit/lease packages, eg Pulse Fitness HIP promotion and action strategy Integration within existing services (4YP)

For maximum benefits …. Time barrier - 2.5 hours a week

Cognitive gap – most people are less active than they know they should be

Safety out of doors Increased priority and funding

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The value of leisure & culture for health

Continuing the research

LEAP pilots Nottingham increase 50+moderate by 5%, reduce sedentary in

deprived areas by 10% Dudley use open space Ashton/Wigan marketing;chair-based in homes; falls prevention

NHS good practice Birmingham ‘Walk tall,don’t fall’, ’Next step’ from classes, tai chi

Baselines and Monitoring For evidence based assessment

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References (1)

Armstrong, J., Reilly, J.J. & Child Health Information Team – Information Statistics Division, Edinburgh. (2001). Assessment of the National Child Health Surveillance System as a tool for obesity surveillance at national and health board level. www.show.scot.nhs.uk

Arts Council for England (2002) Arts in health London:ACEBritton, A. and McPherson, K. (In Press). Monitoring the progress of the 2010 target for coronary heart disease

mortality London: National Heart ForumBMA (2002) Priorities for Health Background Briefing Paper, Scottish Parliament Central Council of Physical Recreation (2002A) Saving lives, saving money: physical activity - the best buy in

public health London: The CCPRChinn, S. & Rona, R.J. (2001). Prevalence and trends in overweight and obesity in three cross sectional studies

of British Children, 1974-1994. British Medical Journal. 322: 24-26.Coalter, F. (2001a) Realising the potential of cultural services: the case for sport; (2001b) the case for the arts;

( 2001c) The case for libraries; (2001d); The case for museums; (2001e) The case for tourism; (2001f); The case for urban parks, spaces,and the countryside; (2001g) The case for children’s play London: Local Government Association

Coalter, F. (2002) Sport and Community Development a manual Research Report 86 Edinburgh: sportscotlandCoalter, F. (2003) Measuring the impact of sport (unpublished lecture) University of StirlingCoalter, F., Allison, M.. and Taylor, J . (2000) The role of sport in regenerating deprived urban areas Edinburgh:

Scottish Executive Central Research UnitCollins, M. F. (2003) Sport and social capital London: RoutledgeCollins, M.F. et al (1999) Sport and the arts paper for Policy Action Team 10 London: DCMSCountryside Agency (2001a) Walking for Health –the first randomised trial CR Note 18 Cheltenham: CACountryside Agency et al (2003) The use of public parks in England Cheltenham: CA

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References (2)

DCMS (1999) Sport and Arts: Policy Action Team 10 report London: DCMS

DCMS (1999) Libraries for All London:DCMS

DCMS (2002a) Game Plan: implementing the government’s strategy for sport London: DCMS

DCMS (2002b) Social impact of museums: centres for social change London:DCMS

Department of Health (2002) Tackling health inequalities: consultation on a plan for delivery London: DoH

Enfield Council (2001) Sports strategy for Enfield 2001-2005 Enfield: LB Enfield

Enfield Council ( 2002a) Enfield’s future, draft Community strategy Enfield:LB Enfield

Enfield Council (2002b) Leisure strategy Enfield:LBE

Enfield Council (2002c) Neighbourhood Renewal Strategy: Residerts in priority neighbourhoods Enfield:LB Enfield

Enfield Council (2002d) Toward neighbourhood renewal : a draft strategy Enfield: LB Enfield

Enfield Council (2003a) Enfield residents 2003 Enfield:LB Enfield

Enfield Council (2003b) Voluntary and community sector funding paper Cabinet meeting 25.6.03

Gorard, S. and Taylor, C. (2001) The composition of Specialist Schools: track record and future prospect School Leadership and Management 21,4 365-81

Health Development Agency (1999) Social capital and health London:HDA

Health Education Authority (1999) Physical activity and inequalities London: HEA

Health Education Authority (1999) Art for health: Social capital for health summary London: HEA

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References (3)

Joint Health Survey’s Unit (1999). Health Survey for England: Cardiovascular Disease 1998. London: The Stationery Office.

Joint Health Surveys Unit. (2000). The Scottish Health Survey, 1998. London: Joint Health Surveys UnitJackson, A. (2003) Doing it ourselves: Learning to challenge social exclusion through the voluntary arts

London: Department for Education and SkillsLadd, J. and Davis, L. (2003) Guide to best practice in sport and urban regeneration London: British Urban

Regeneration AssociationLong, J.et al (2002) Count me in! London:DCMSOffice for National Statistics. (2000). The mental health of children and adolescents in Great Britain:

Summary Report. London: NSO.Reeves, M. (2002) Measuring the social and economic impact of the arts: A review London: Arts Council of

EnglandRiddoch,C., Puig-Ribera,A. and Cooper,A. (1998) Effectiveness of physical activity promotion schemes in

primary car: A review London: Health Education AuthorityPrentice, A. M. and Jebb, S. A. (1995) Obesity in Britain: gluttony or sloth? BMJ 333, 437-39Splash National Support Team (2003) Splash 2002 Final Report London: Youth Justice Board/Cap Gemini

Ernst Young www.homeoffice.gov.uk accessed 14.7.03Sport England et al (2002) Positive Futures: a review of impact and good practice Summary report London:

SE

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ConclusionsPhysical activity = Better healthPhysical activity = Better health The proof exists and is nationally accepted There are high personal, financial and community benefits Trends can be reversed but require:

• Priority from both thematic Groups• Focus on the highest risk areas• Continue investment in projects• Work towards a multi-dimensional strategy• Measure impact

Fundamentally what’s the most important:• Best start?• Keeping well?• Living longer?• All of them?

Inactivity = Poor HealthInactivity = Poor Health

Its costly and its increasingIts costly and its increasing

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Leisure and Cultural Partnership Group

Any further thoughts, evidence or contributions please

contact us:

Tel: 07989 351047

[email protected]

Thank youThank you

© vaga associates the value of leisure and culture to enfield our bodies were made to move! nikki...

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