Green Spaces to Healthy Places

The Dudley Healthy Towns Story

• Better health overall positively related to greenspace, regardless of

socio-economic status

• Levels of physical activity positively related to greenspace

• Greenspaces most valuable for physical activity when high volume

use

• Greenspaces need to be accessible, connected and safe

• Consistent negative relationship between levels of stress and

access to greenspace

The Evidence Base - 1

• Primary value placed by people is ‘destressing’; physical activity

second

• Frequently noted as places of attachment

• Populations exposed to the greenest environments have lowest

levels of health inequality.

• Causal pathways not well understood

• Dose/response relationships not well understood

Croucher et al (2007); Mithcell and Popham (2008)

The Evidence Base - 2

What is the Healthy Towns Programme?

• National Pilot Fund available for the prevention of obesity

(£30 million) through environmental change.

• Dudley PCT/Council Joint Bid

• One of 9 successful bids nationwide

• £4.5m awarded for ‘Lets Go Outside’

• Dudley’s Programme

– Healthy Hubs

– Active Travel Corridors

– Service Reform

Why was obesity prevention receiving

funding?

• 2/3 of the population of England are overweight or obese.

• Obesity has grown by 400% over the past 25 years.

• Obesity will surpass smoking as the greatest cause of premature death.

• The costs of treating the conditions attributed to poor diet, low activity levels and obesity run into £billons

• The UK has the fastest accelerating rates of childhood obesity in the world

• Today’s generation of children will be the first for over a century for whom life expectancy falls

What is the “environment” and why was it a focus?

• The environment refers to all of the objective structural factors, external to the individual, that both positively and negatively influence a person’s behaviour

(Baranowski et al. 1997)

• Environmental Interventions contribute to behaviour change by advocating and implementing measures that will make it easier for people to engage in health enhancing activities, whether they are aware of it or not, while making it more difficult to engage in competing and less desirable behaviours

Environment tiers

• Healthy hubs (specific local)

• Active Corridors (wider general)

• Service reform

(Borough wide and sustainable)

Healthy Towns

What is a Healthy Hub?

• 5 Parks (one in each Select Committee area)

• New building

• Staff

• Outdoor gym

• Pathway improvements

• Play areas and MUGAs

• Programmes and events

Why did we take this approach in Dudley?

Issue Approach Rationale outcome

The evidence base for

the prevention of

weight gain is to

increase physical

activity (PA) with

dietary support.

Increase PA opportunities Low levels of physical

activity (PA) within the

Borough

Increased PA levels

within the parks and

via active corridors

(see evaluation

findings)

People felt unsafe in

parks, and generally

felt that safety was a

barrier to be physically

active.

Get committed police

involvement from the

start. Recruit on site

rangers, increase

footfall.

Dudley Lifestyle

survey 2004 showed

that 66% of people

could be more active if

safety issues were

addressed.

Police are committed

partners, with formal

protocols signed off by

the Chief inspector.

Rangers appointed 2x

per site. Footfall

massively increased

Barriers to PA (next slide)

Not enough facilities

and services locally

Provide new buildings

with toilets, kitchens

new paths, play areas

MUGAs walking and

cycling infrastructure

Previous park work,

Livability,

Transforming your

space (TYS) National

LEAP pilot, Steps to

Health and the Play

Pathfinder

consultations.

See Hub slides

The need for Supportive

Environments to enable

and support behaviour

change

Hubs , corridors and

service reform

National and local evidence

and guidance

Five Hubs, 30km of active

corridors, service reform

and policy development

Why parks, existing and potential?

Barriers to activity • Cost

• Lack of time

• Not the sporty type

• Access

• Transport

• Personal safety

• Lack of welcoming facilities

Potential of Parks • Free

• Local, can be accessed quickly

• People don’t have to be sporty

• Within 15mins of home/work

• On site staff

• Welcoming facility

Typical Hub Building

New Build

Unisex and disabled toilets with baby change facility

Covered outside space

Outdoor Gyms

Active Travel Corridors

• Improve access to and from hub

• Linkage with wider borough travel infrastructure

• Cycle and footpath infrastructure

• Traffic calming

• Signage

Active Corridors (On road)

Active Corridors (Off road)

Service Reform

• Physical Activity on all agendas

• Transformation of Parks Service

• Safety considered at all levels

• Partner impact on health recognised

• Planning guidance in place to tackle the obeseogenic environment

Make it Sustainable

Service Reform

Transformation of the Parks Service

Park Keeper - Scale 2 - 3 Park Ranger - Scale 3 - 4

Experience

Relevant practical experience of working with the public in a front line position

Relevant practical experience of working with the public in a front line position

Must be able to demonstrate a basic knowledge of Health & Safety requirements including some experience in preparing risk assessments

Some experience of risk assessment and knowledge of health & safety

Some experience of working with community groups

Some experience of working in a park, sport or community environment

Some experience of supervising staff, trainees or volunteers

Some practical experience of working with a range of age groups

Qualification/training

NVQ level 1 in amenity horticulture or equivalent A minimum of NVQ level 2 in; play work, sports coaching/gym instruction, customer services, amenity/environmental subject

Willingness to undertake any training in relation to the job requirements

Willingness to undertake any training in relation to the job requirements

Advertised

Horticultural Week Leisure Opportunities

Successes and opportunities

• High profile of the health agenda at senior Council and Elected

Member level

• High profile and support at regional level

• Strong police commitment

• Joint Core Strategy

• Changes to departmental structures

• Alcohol strategy, Clean air plan, HPS

• Recruitment, maintenance, adherence and exit for supportive

services

• Umbrella term

Evaluation

• Relevant Targets (RT):

• More children and families more active over initial base line.

• An Increase in Parks/ Hub usage over baseline

• Increased perceptions of safety in and around the Hubs.

• An increase over baseline of numbers of children and families walking and cycling.

• An increased awareness and understanding of the Change 4 Life messages.

Is it working?

Final evaluation report – October 2011

Some interim findings:-

- 11,000 structured attendances September 2010 – July 2011

- 65% gym users use it > 1 week

- 54% male, 68% female gym users

‘think about other ways to be more active’

as a result of outdoor gym use

Is it working? Findings so far User comments:

• ‘I feel healthier because I am outdoors and I am physically more active’. (male aged 46).

• ‘Nice to be able to be active with the whole family’ (male aged 41)

• ‘It has inspired me to generally lose weight and spend more time with my kids’( female aged 34)

• ‘I go with my husband and daughter. She sees mum and dad being active and it encourages her also to be active. She goes on to the park and also socialise with other children which is great. We can all keep fit now and it doesn’t cost a penny’ (female aged 27)

• ‘Single person can getting out more, mixing with other people of all ages in a friendly environment’ (female aged 55).

• ‘I can use this now for free instead of paying for the gym’ Paul says, ‘I think it’s great, I only came over with the baby and now I’ve done a workout, really think its brilliant’.

• ‘I use it because it keeps me healthy, it’s free and I can’t afford to use other gyms. It’s really good because I think people of all ages will now be able to get fit outdoors and people can also strengthen their muscles’

• ‘Having the gym equipment installed and the introduction of the park rangers has been a marvellous concept. This has led to more people using the facilities on the park, so of course leading to residents of the area being healthier as a whole. I look forward to see what changes will be happening on the park in the future, if the events over the last few months are anything to go by in this exciting embryonic stage’.

Is it working?

Healthy Towns “Health is Everyone’s Business”

Increased

Activity in

Parks

Reduction in ASB

Weight

Management LAA

N18 56 NI57

Social Cohesion

Recruitment

Retention and exit

for Services

WEA Tandrusti

Phases

Local Area

Action Plans PPG 17

JCS

Green Space

Strategy

Links to external

partners

Inequalities

Strategy

Improved Mental

Health No 1 PCT Strategic

Plan

Increased Budget

Children’s

Services

Youth

Services

Increased

Activity in

Parks

Reduction in

ASB

Clean Air Act

Weight

Management

LAA

N18 56 NI57

Increased

Activity

Cardiac

Rehab GP Referral

Reduction in

Crime

Social Inclusion

Social Cohesion

DACHS

Recruitment

Retention and

exit for Services

WEA

Tandrusti

Age

Concern

Phases

Local Area

Action Plans

PPG 17

JCS

Community

Regeneration

Green Space

Strategy

Links to external

partners

PA Strategy

Inequalities

Strategy

Five hour offer

Improved Mental

Health Obesity Strategy

No 1 PCT

Strategic Plan

Weight Watchers

Support and exit Increased

Budget

National Profile Children’s

Services

Youth

Services

Police

Political Buy In

Healthy Towns Embedded ?

Next Steps

• Full evaluation report due October 2011.

• Local and national dissemination.

• Use report recommendations to plan the next three

years of service delivery.

• Embed the programme into core business.