Potential impact of physical activity on public health
Dr Steven Mann, research director, ukactive
Steven began his presentation by outlining the role of ukactive – aiming to improve the health of the nation through getting more people, more active, more often. They’re working with over 4,000 members and stakeholders across the UK – public, private and third sector – who all want to get the UK moving.
The audience were challenged to identify the top 5 causes of death in 1850 and 2000, and scored well with their answers.
- 1850: tuberculosis, dysentery/diarrhoea, cholera, malaria and typhoid fever.
- 2000: heart disease, cancer, stroke, lung disease and accidents.
So, 1850 it was all about the spread of killer diseases; in 2000 it’s all about an inactive lifestyle.
Major illnesses are down to inactivity e.g. constipation in children and young people, irritable bowel syndrome in adults and chronic obstructive pulmonary disease. So, how do we get more people more active more often?
As Steven pointed out, we have a natural desire to be inactive. We all know that we should be more physically active but doing this is a conscious decision taking into account:
- Time, priority, support, environment, availability, knowledge
All too hard! Steven describes this as “the science of laziness” – the interference of everyday life disrupts our good intentions.
Public Health England’s “cradle to grave” evidence based framework ‘Everybody active every day’ identifies the opportunities for action using four domains:
- Active society – creating a social movement.
- Moving professionals – activating networks of expertise.
- Active environments – creating the right environments.
- Moving at scale – scaling up activities that make us more active.
The clearest opportunity for our sector to work within public health is in the area of exercise referral.
Unfortunately, there is a discrepancy between what PHE want and what is actually delivered. Whilst most fitness and athletic clubs offer fitness and weight loss programmes, there is little evidence of the outcomes. If evidence is gathered it isn’t publicly acknowledged, and in many cases the means to gather this evidence isn’t available.
Steven argues that evidence isn’t everything – rather it is the potential impact of physical activity on public health. This is based on objectives, outcomes and outputs, outcomes – some of which are harder than others: When looking at local authority tendering, a combination of partnerships, programmes and pathways make this a complicated business.
- Objectives: the methods or the activities by which you plan to achieve your aims.
- Outcomes: the changes, benefits, learning or other effects that happen as a result of your work. They can be wanted or unwanted, expected or unexpected. They are often hard to count or prove, and normally rely on an understanding of the initial situation or problem for comparison. For example, the outcomes for users of a refugee centre might include improved English language skills, improved confidence in accessing services and reduced isolation.
- Outputs: tangible products, services or facilities created by your work, and are usually quantifiable. They don’t rely on any knowledge of your ‘starting point’ and instead focus on what happens once you have finished your work. For example, a youth employment programme might get 20 young people into work, provide 600 hours of accredited training, and run 5 careers fairs.
Local authorities want a total solution which is unlikely to come from a single source. There will be a“lead bidder” who will act as the single point of access (SPA) and then work together with weight management, health checking, signposting, workplace and exercise referral partners.
- What exactly is it that you offer? For whom? Where?
- When? What will be the benefit?
- Can you condense this into an offer for GP surgeries or primary care providers?
- Routes in – routes out?
- How does your service integrate with those around you?
Circling back to activity
So, back to activity as a conscious decision. As a sector we need to assist this decision making as follows:
- Time – staff skillset.
- Priority – make every contact count.
- Support – ability to engage with the inactive.
- Environment – creating a supportive environment.
- Availability – evidence-based programming.
- Knowledge – accessible delivery times.
- ukactive are here to help – facilitating big impact partnerships.
- ukactive Research Institute – engages with partner organisations to secure large grants to further investigate real world physical activity interventions.
- Non-communicable diseases and prevention is a key focus.
- Physical activity is good for you!
- Opportunities exist to integrate our sector within public health and primary care.
- Small adaptations can create huge impact.