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© Vaga Associates
The value of leisure and culture to Enfield
Our bodies were made to move!
Nikki Enoch and Mike Collins
Health Improvement Partnership
© Vaga Associates
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 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
•61% active for health benefits
•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
•31% active for health benefits
•33% ‘inactive’
Bangladeshi
•7% active for health benefits
•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
•46% active for health benefits
•25% “inactive”
Bangladeshi
•18% active for health benefits
•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
•17% active for health benefits
•50% sedentary
•25% unable to climb stairs unaided
Bangladeshi
•92% sedentary
Importance of Physical Activity
•Maintains functional ability
•Prevents disability, immobility and isolation
All
•25% active for health benefits
•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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The value of leisure & culture to Enfield
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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The value of leisure & culture to Enfield
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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The value of leisure & culture to Enfield
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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The value of leisure & culture for health
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
Thank youThank you