10 September 2010
From The Roots to the Shoots
From the Roots to the Shoots
Dr Charlie Foster - Kids, Adults, Cycling and Health
IMBA UK Conference 2010
Kids, Adults, Cycling and Health
Dr. Charlie Foster University Research LecturerBHF Health Promotion Research Group
University of Oxford
Presentation Objectives
To briefly describe the relationship between physical activity and health
To examine how best to promote cycling for kids and adults
To examine the economic case for promoting cycling and physical activity
Presentation Objectives
To briefly describe the relationship between physical activity and health
To examine how best to promote cycling for kids and adults
To examine the economic case for promoting cycling and physical activity
Physical activity
Physical activity
Physical activity
Physical activity
Physical activity
Work
Leisure & Play
Exercise & Sport
HouseholdActive Travel
% active
Age
61% of men and 71% of women do not meet the Chief Medical Officer’s minimum recommendations for physical activity in adults
Men
Women
% active
Age
% active
Age
% active
Age
% active
Age
% active
Age
% active
Age
International consensus on health benefits of physical activity
Physical activity can reduce the risk of:
» Cardiovascular disease» Hypertension» Obesity» Some forms of cancers» Non insulin-dependent
diabetes mellitus» Strokes » Osteoarthritis, by
maintaining normal muscle strength, joint structure and joint function
» Osteoporosis
» Cognitive function» Crime reduction and community
safety» Economic impact and
regeneration of communities» Education and lifelong learning» Psychological well-being» Self esteem» Management of anxiety and
depression» Social capital and community
cohesion» Drug misuse» Carbon use
(US Dept Health & Human Sciences, 1996; CMO, 2004; Sport England, 2009)
A c t iv it yfo r h e a lt h
E x e r c is e fo r fi t n e s sA c t iv e
l iv in g
L ig h t , m o d e r a t eD a ilyT e n s o f m in u t e s , e v e n h o u r s
M o d e r a t eA b o u t d a i lyA t le a s t 3 0 m in
M o d e r a t e , v igo r o u s3 t im e s a w e e kA t le a s t 2 0 m in
S t r e n u o u sS e v e r a l t im e s a w e e kV a r ia b le
T r a in in gfo r s p o r t
T y p e a n d a m o u n t o f a c t iv it y
H e a lt h ,fi t n e s sb e n e fi t s
V u o r i / U K K I n s t i t u t e 1 9 9 7
A c t iv it yfo r h e a lt h
E x e r c is e fo r fi t n e s sA c t iv e
l iv in g
L ig h t , m o d e r a t eD a ilyT e n s o f m in u t e s , e v e n h o u r s
M o d e r a t eA b o u t d a i lyA t le a s t 3 0 m in
M o d e r a t e , v igo r o u s3 t im e s a w e e kA t le a s t 2 0 m in
S t r e n u o u sS e v e r a l t im e s a w e e kV a r ia b le
T r a in in gfo r s p o r t
T y p e a n d a m o u n t o f a c t iv it y
H e a lt h ,fi t n e s sb e n e fi t s
V u o r i / U K K I n s t i t u t e 1 9 9 7
Risk reduction all cause mortality
28% risk reduction all cause mortality
(Anderson et al, 2000)
Pressure on transportsystems
Sedentary behaviourCarbon emissions
Presentation Objectives
To briefly describe the relationship between physical activity and health
To examine how best to promote cycling for kids and adults
To examine the economic case for promoting cycling and physical activity
Bruno Taylor's Playful Spaces
The effectiveness of environmental change interventions to promote
physical activity
NICE review – physical activity and environment
Systematic reviews have also found some evidence to support the impact of large scale environmental changes on physical activity
A combination of changes to working practices, policies and the physical environment encouraged adults to maintain their vigorous physical activity and fitness
Active travel interventions must contain environmental supports to sustain individual choice (i.e. public transport)
Active travel interventions must contain environmental supports to
sustain individual choice (i.e. public transport)
Policies
Places
People
Right-hand turn lanes
Right of way over motorists
Linked traffic light system
Priority of bicycle lanes
The Cycling Demonstration Towns
programme First phase: October 2005 –
October 2008 All towns funded at approx £5
per head per year, matched by the local authority
Comprehensive evaluation
CityAnnual
increase in cycling flows
Darlington +14.2%
Exeter +9.9%
Brighton & Hove +9.0%Strasbourg +7.0%
Lanc w Morecambe +6.2%Vienna +6.4%
Graz +5.9%
Munich +5.5%
Hanover +5.4%
Annual growth rates: European cities and CDTs
Adapted from: Transport for London (2004) ‘Creating a chain reaction. The London Cycling Action Plan. February 2004. (http://www.croydon-lcc.org.uk/downloads/2004_TfL_LondonCyclingActionPlan.pdf)
CityAnnual
increase in cycling flows
Nottingham +4.8%
Freiburg +4.4%
Munster +3.6%
Aylesbury +3.6%Berlin +3.2%
Derby +2.5%Zurich +2.3%
Delft +1.2%
» Continue to encourage physically active modes of travel (such as walking or cycling)
» Continue working with schools on travel plans, focusing on physical activity
» Ensure local transport plans take account of children and young people’s need to be physically active
Physically active travel
Presentation Objectives
To briefly describe the relationship between physical activity and health
To examine how best to promote cycling for kids and adults
To examine the economic case for promoting cycling and physical activity
Economic value
•Burden of disease
•Cost benefit
•Cost utility
Burden of disease
£14.85
£14.01
£17.20
£12.95
£14.85
£14.63
£13.94
£15.96
£18.71
£15.27
Cost of physical inactivity (£/population) related disease by SHA
Foster et al, 2009
£14.85
£14.01
£17.20
£12.95
£14.85
£14.63
£13.94
£15.96
£18.71
£15.27
Cost of physical inactivity (£/population) related disease by SHA
Spend in London is 85p per head
Foster et al, 2009
Scotland has a higher mortality of CHD compared to England
Cost of physical inactivity related disease in Scotland - Method
Attribute the proportion of morbidity and mortality to diseases related to physical inactivity» Cardiovascular disease» Cancer (Lower GI & breast)» Diabetes mellitus
Spend within disease areas
Allender et al, 2007; DH, 2009; Foster et al, 2009
Burden of physical inactivity related mortality in Scotland in 2007-2008
There were just under 18,000 deaths per year in physical inactivity disease categories
Physical inactivity contributes to 2,640 deaths
Source http://www.isdscotland.org/isd/
The direct costs of physical inactivity related disease to the NHSS is…..
£141 million per year
Health costs for alcohol £400 million per year
Cost of physical inactivity related disease in Scotland - Results
What’s still to be added?
Other disease areas direct health service costs» Mental health, obesity, falls
Indirect costs» Lost productivity» Premature mortality
Others?
The direct costs of physical inactivity related disease to the NHSS is…..
£141 million per year
This is an underestimate of the real costs
Cost of physical inactivity related disease in Scotland - Results
It’s fantastic value…
NICE established that brief interventions for physical activity cost between £20 and £440 per QALY (when compared with no intervention), which is significantly below the £30,000 threshold and represents exceptional value for money
NICE: comparing interventions
Presentation Objectives
To briefly describe the relationship between physical activity and health
To examine how best to promote cycling for kids and adults
To examine the economic case for promoting cycling and physical activity
Conclusion
High level strategic commitment Targeted investment Consistent implementation of best
practice
Cycling is related to health and saves £
We can change our environments and promote cycling successfully
Capture and promote the broadest sense of value
Things to think about…
ThanksNick Cavill – Cycle England
IMBA UK Conference 2010
Kids, Adults, Cycling and Health