Everybodyactive,everydayThecasefortakingactionnowOctober2014Thisdocumentprovidesabriefingon:theurgentneedtoincreasephysicalactivitylevelsintheUKtheuniquepositionMPshaveinhelpingconvincetheirconstituentstochangelifestyleandbemoreactiveexamplesofpromisinglocalinterventionsandinitiativesAresourceforMPs2AboutPublicHealthEnglandPublicHealthEnglandexiststoprotectandimprovethenation'shealthandwellbeing,andreducehealthinequalities.
Itdoesthisthroughadvocacy,partnerships,world-classscience,knowledgeandintelligence,andthedeliveryofspecialistpublichealthservices.
PHEisanoperationallyautonomousexecutiveagencyoftheDepartmentofHealth.
PublicHealthEnglandWellingtonHouse133-155WaterlooRoadLondonSE18UGTel:02076548000www.
gov.
uk/pheTwitter:@PHEukFacebook:www.
facebook.
com/PublicHealthEnglandPreparedby:DrJustinVarney,DrMikeBrannan,GaynorAaltonenSupportedby:DrNickCavill,StuartKing,LuisGuerraDevelopedwithover1,000healthprofessionals,localauthorities,researchspecialists,educationalists,charitiesandfitnessexpertsatnationalandlocallevelsthroughaprocessofdiscussionandengagement.
Crowncopyright2014Youmayre-usethisinformation(excludinglogos)freeofchargeinanyformatormedium,underthetermsoftheOpenGovernmentLicencev2.
0.
Toviewthislicence,visitOGLoremailpsi@nationalarchives.
gsi.
gov.
uk.
Wherewehaveidentifiedanythirdpartycopyrightinformationyouwillneedtoobtainpermissionfromthecopyrightholdersconcerned.
Anyenquiriesregardingthispublicationshouldbesenttophysicalactivity@phe.
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uk.
PublishedOctober2014PHEpublicationsgatewaynumber:20144323InactivityThetollitistakingonourhealthSincethe1960speopleintheUKhavebecomelessandlessactive.
Wearearound20%lessactivetoday,andestimatessuggestthatby2030wewillbe35%lessactive.
1HalfofwomenandathirdofmeninEnglandtodayarenotactiveenoughtostayhealthy.
AsPublicHealthEngland's(PHE)newreportmakesclear,thoseofuswhoaren'tactiveenoughriskdevelopingaseriesofconditions–depression,dementia,obesity,heartdisease,cancerandmore.
YetaroundoneinfourpeopleintheUKarecurrentlyclassedas'inactive':theydolessthan30minutesactivityaweek.
2Thisisoneofthecountry'smosturgentchallenges.
Withoutaction,theburdenonhealthandsocialcarewilldestabiliseservicesandreducethequalityoflifeforindividuals,theirfamiliesandcommunities.
Negatives:1.
Health–inactivityisthefourthgreatestcauseofourill-healthburden3andresponsibleforoneinsixdeaths4(equaltosmoking)52.
Internationalcompetitiveness–theUKismoreinactivethancomparativecountries,worsethantheUSA,AustraliaorFrancePositives–fixinactivityandwewill:1.
Economics–savetheestimated7.
4bnayearincoststotheNHSandwidersociety6,72.
Social–reducethefrailtyandassociatedrelianceonhealthandservicesthatisaconsequenceofinactivityratherthananinevitablepartofageing3.
Employment–activeworkplacesreducesicknessabsenceandincreaseproductivityandstaffwellbeing4.
Environment–morewalkingandcyclingwouldreducetheeffectsofthe265,000life-yearslosteachyeartoairpollutionaloneThereisasolution:everybodyactive,everyday.
Weneedaculturalturnaroundinattitudestophysicalactivity,whichiswhyweareappealingtoMPstousetheirinfluence,wherevertheypossiblycan,tohelpturnthetideofinactivity.
Thisisoneofthecountry'smosturgentchallenges.
Withoutaction,theburdenonhealthandsocialcarewilldestabiliseservicesanddiminishthequalityoflife"4TacklingtheproblemneedscriticalmassThegoodnewsisthatwecanchangethissitutation.
Oncetheworldrecordholderforheartdisease,Finlandbeganamasscampaign40yearsagotogetwhatwasthentheworld'smostinactivenationbackonitsfeet.
Today,itisacountrytransformedandhasmoveditselfuptomid-pointinachartofsimilarnations'levelsofinactivity.
8Increasingphysicalactivityisoneofthemosteffectivewaystoimproveindividualandcommunityhealthandwellbeing.
Momentumforactionisalreadybuildingacrosstheboard:nationalgovernment–thecross-government'Movingmore,livingmore'commitmenttoaphysicalactivitylegacyofthe2012games,anddepartmental-specificpoliciesandarangeofinitiatives(eg,thePublicHealthResponsibilityDeal'sphysicalactivitynetwork,thePrimarySchoolsSportsPremium,SchoolGamesandChange4lifeclubs,etc)acrossthepartypolitics–theAll-PartyCommissiononPhysicalActivity's'Tacklingphysicalactivity'isacoordinatedapproachlocalgovernment–haveprioritisedtheagendaacrosstheirfunctions(includingculture,leisureandpublichealth)privatesector–NikehasdriventheDesignedtoMovecoalitionthatinstigatedandsupportedtheAll-PartyCommission,andCoca-Colaisproviding20mtolocalauthoritiesthroughitsParklivesprogrammevoluntarysector–theRichmondGroupofleadinghealthcharities,ledbyBreakthroughBreastCancerandMacmillan,hasprioritisedphysicalactivityasafocusforpreventingandmanagingconditionsAtalocallevel,keypartnersinclude:localauthoritydepartments–eg,publichealth,sportsandleisureservices,planning,etclocalenterprisepartnerships–throughtheirkeyroleintransportandinfrastructuredecision-makinghealthandwellbeingboards–theyhavestrategicinfluenceovercommissioningdecisionsacrosshealth,publichealthandsocialcarecountysportspartnerships–networksoflocalagenciesworkingtogethertoincreaseparticipationinphysicalactivityNHSclinicalcommissioninggroups–decisionmakersonhealthservicesRespondingtothechallengePHEhasspent2014workingwithover1,000individualsandorganisationstoco-produce'Everybodyactive,everyday–anevidence-basedapproachtophysicalactivity'.
Thereportbuildsoninternationalandnationalevidenceofwhatworksatnational,localandcommunitylevels.
Thisvisionof'Everybodyactiveeveryday'isunderpinnedbyfourkeyareasfornationalandlocalaction:activesociety;movingprofessionals;activelives;andmovingatscale.
Thedocumentissupportedbyapractical'whatworks'guide,whichdetailspromisinglocalpracticeinitiativesthathavealreadyhavestrongevidenceofsuccessinincreasingactivityinlocalareas.
95Activesociety:creatingasocialmovementPhysicalactivityhasbeendesignedoutofpeople'slives.
TheinternationalexperienceinFinlandandelsewhereshowsthatthereisnoquickfix:weneedalong-termpromotionofphysicalactivity.
Themessageisthatphysicalactivityisnotjustfulfillingandfun,butcanalsobeaneasychoice.
Itneedstobewovenintothepolicies,commissioningandplanningdecisionsthatweallmakeeverydayacrossthecountry.
Asharedvisionistogeteverybodyactiveeveryday,leadingtoaradicalshiftinthetake-upofphysicalactivityonanationalscale.
UniqueopportunitiesforMPs1.
Bearolemodel–beseenwalking,cyclingandsupportingandparticipatingincommunityphysicalactivity.
2.
Keeptheissuecurrent–encouragedebateandkeyawarenessofphysicalactivitywithintheHouseandwithnationalandlocalpartners.
Examplesofpromisinglocalpractice1.
ProjectACE(active,connected,engagedneighbourhoods).
Inthesouthwestretiredvolunteerspromotephysicalactivityamongolderadultsbyhelpingthemtogetoutandaboutintheircommunities.
Ithashelpedparticipantsfeelmoreautonomous,positiveandconnectedtotheirlocalcommunities,andhasincreasingtheirlevelsofphysicalactivitytothepointofimprovingtheirfunctionalability.
2.
Girlsareworryinglessactivethanboys–aprocessthatbeginsinpuberty.
Anationwideprogramme,GirlsActiveusesleadershipandinnovativemarketingtodeveloppositiverolemodelsto'sell'physicalactivityandschoolsporttogirls.
ResultsshowedimprovedattitudesanddoublethenumberofgirlswholookedforwardtoPE.
Movingprofessionals:usingnetworksWeencourageMPstothinkaboutpromotingthe'everybodyactive'messageacrossalltheprofessionalandbusinessgroupstheydealwith.
Allworkplacescanplayarole–allworkerscanhelpbringaboutthisradicalchange.
Professionalsinspatialplanning,socialcare,psychology,sportandleisure,themedia,tradeunions,educationandbusinesscanhelpusbringaboutradicalchange.
Wealreadyhavetheidealinformationnetwork:thehundredsofthousandsofprofessionalsandvolunteerswhoworkdirectlywiththepubliceverydayandpushto'makeeverycontactcount'.
10Theirunderstandingofpeople'sneedtobecomeactiveeverydayiskeytogettingthenationmoving.
UniqueopportunitiesforMPs1.
Useyourinfluencetalktolocalbusinesses,organisationsandeducationprovidersaboutcreatinglong-termlocalinitiativesspeaktothelocalclinicalcommissioninggroupandacutetrusttoseehowtheyareincludingphysicalactivityintopost-graduateteachingPhysicalactivityisnotjustfulfillingandfun,butcanalsobeaneasychoice.
Itneedstobewovenintothepolicies,commissioningandplanningdecisionsthatweallmakeeveryday"6anddevelopmentforhealthcareprofessionalsdiscusshowlocalauthorityandsportsandleisureprovidersareusingapprenticeshipsandotheropportunitiestocreatebetter,longer-termcareersinphysicalactivity,encouragingthegoodpractitionerstostayputtalktolocalcarehomesabouthowtheyaresupportingcareassistantsandsocialcarestafftohelpolderpeopleremainactiveExamplesofpromisinglocalpractice1.
LiveWellSuffolk'GetIntoSport'programme.
Thisishelpingpeopleindeprivedcommunitiestoincreasetheirphysicalactivity–over50%ofpeoplebecomemoreactiveaftersixmonths.
2.
Well@Workisanationalprogrammetohelpworkplacesencouragestafftoincreasephysicalactivity,eathealthilyandstopsmoking.
Interventionshaveresultedinsignificantimprovements,includinghigherlevelsofactivetravel.
Additionalbenefitsincludeweightlossamongemployees,improvedstaffmorale,betterworkingenvironmentsandmoreinteractionbetweenemployeesandmanagers.
Activelives:creatingtherightenvironmentsAclearlinkexistsbetweenwhereweliveandpublichealth.
Awealthofevidencepointstopeople'sneedforgreenspaceandmakesanoverwhelmingargumentforthebenefitsofincidentalactivity,suchascyclingorwalkingtowork.
Newpartnerships–forexample,architectsandurbanplannersworkingdirectlywithprofessionalsinhealthandleisure–canhelpusfindnewwaystoreversethedownwardtrendsinactivitylevels.
Weneedtoturnexistingspacesbackintoactiveenvironments.
Evidenceshowsthathavingtherightaccesstogreenspacematters;manysurveysalsosayit'sthequality,notjustthenumber,ofparksandpublicspacesthatmakewalking,cyclingorplayingoutdoorsattractive.
UniqueopportunitiesforMPs1.
Campaignforinnovativelocalpracticeasklocalauthorityandlocaleconomicpartnershipstoprioritiseactivetravel(cycling,walkingandpublictransport)whenitcomestoinfrastructureandcapitaldevelopmentplanstalktolocaldevelopersaboutcreatingmore'active'buildingsandspacespromotehealthyworkplacestolocalbusinesses,enablingstafftocommutetoworkbyfoot,bicycleorpublictransportratherthancarsExamplesofpromisinglocalpractice1.
Cyclingcitiesandtowns–DfT,CyclingEnglandandDHinvestedinonecyclingcityandelevencyclingtowns.
Alongsidematchedfundingfromtheparticipatinglocalauthorities,theinvestmentlookedtodeliverastepchangeincyclingfacilitiesfortravelandleisure.
Thescheme'swiderimpactscameinareassuchashealth,decongestionandaccessibility.
2.
Sustranspersonalisedtravelplanning.
Sustranshasworkedacrossthesouthwest,northeast,eastandLondonwithcommunities,policy7makersandpartnerorganisationstohelppeoplechoosesustainabletraveljourneysandenjoybetter,saferspaceswheretheylive.
Projectshavedemonstrateda7.
6:1cost-benefitratio,an11%reductionincartrips,a15%increaseinwalking,anda33%increaseincyclingamongvariousenvironmentalbenefits.
3.
Workplacewellbeingcharter.
Whendelivered,orcommissioned,bylocalauthoritiesthisprovidesemployersofallsizesandsectorswithaneasywayofimprovingworkplacehealth.
Thecharterincludesaspecificfocusonphysicalactivityintheworkplaceandthishelpsorganisationstoconsidertheirspecificsettingsanddrawonbestpracticeandresources.
Movingatscale:makingusactiveeverydayWeneedarevolutioninphysicalactivityandhealth.
Professionalsinschools,thehealthsector,transportation,thesports,leisureandvoluntarysectorscanallbeenergisedtoachievethiscommongoalbyworkinginpartnershipwithlocalandnationalgovernment.
Weneedtolightthetouchpaper.
UniqueopportunitiesforMPs1.
Makewavesateverylevelandinallpolicy-makingtalktopeopleacrossyourconstituencytoidentifypromisinglocalpracticesandencourageitatalocalandnationallevelensureactivelivingisthe'easychoice'andembeddedwithinpolicymakingacrosssectors(eg,education,health,etc)Examplesofpromisinglocalpractice'Loseweight,feelgreat',Wigan.
Thisprogrammeistailoredtopeopleaccordingtotheirdifferinghealth,fitnessandbodymassindex(BMI)levels.
SinceJanuary2009therehavebeenover20,000startersand35,000callstotheaccesshub.
Thecommunityweightmanagementservicealonehasseenover19,000peoplelosemorethan84,000kgs'Starttomove',Bupa.
Thisisateachertrainingprogrammegearedtowardsdevelopingtheconfidenceandcompetenceofchildrentobephysicallyactiveforlife.
Theprogrammehashad92,000participantsandshowspromiseofworkingonalargescaleUnderstandingyourlocalsituationTherearesignificantvariationsacrossthecountry,includingatwo-folddifferenceinlevelsofinactivitybetweentheleastandmostprosperousareas.
11Datasourcesthatprovidethecontextinyourconstituencyinclude:localjointstrategicneedsassessment(JSNA)–alocalauthority-producedsummaryoftheneedsandassetsofthelocalcommunitypublichealthoutcomesframework(PHOF)–aPHE-publishedsummaryofkeylocaloutcomes(includingcomparisonswithnationalandotherareas),includingthepercentageofphysicallyactiveandinactivepeople(outcomes2.
13iand2.
13ii)localsportprofiles–SportEnglandproducesannuallocalprofilesofsportsparticipation,facilities,health,economicanddemographicsWeneedarevolutioninphysicalactivityandhealth.
Weneedtolightthetouchpaper"8SummaryTherearemanyotherreasonstopromotephysicalactivitytoyourconstituentsandtothoseyoumeetandinfluenceeveryday.
Beingactiveplaysakeyroleinbraindevelopmentinearlychildhood.
Itremainsimportanttocardiovascularhealththroughoutourlives,andhelpstokeepusdementia-freeandindependentintooldage.
Itisalsocrucialformuscleandbonestrength.
MPsarekeyinfluences,andareabletotalktopeopleinallwalksoflife.
Theinternationalevidenceshowsthatpositivechangeneedstohappenateverylevel,whichiswhyweareaskingforyourhelp.
Ithastobemeasurableandconsistent,andneedstobethought-throughoverthelong-term.
Beingactiveneedshardwiringintoournationalcultureandconsciousness.
Muchofthisisnotaboutnewinvestment:it'saboutmaximizingouruseofthemanyassetswealreadyhave–ourparks,leisurefacilities,communityhalls,andworkspaces–andaboutthinkingdifferently,sothatbeingactiveisatthecoreofeverydayintheUK.
9Forearlyyears(underfives)1.
Physicalactivityshouldbeencouragedfrombirth,particularlythroughfloor-basedplayandwater-basedactivitiesinsafeenvironments.
2.
Childrenofpre-schoolagewhoarecapableofwalkingunaidedshouldbephysicallyactivedailyforatleast180minutes(threehours),spreadthroughouttheday.
3.
Allunderfivesshouldminimisetheamountoftimespentbeingsedentary(beingrestrainedorsitting)forextendedperiods(excepttimespentsleeping).
Theseguidelinesarerelevanttoallchildrenunderfive,irrespectiveofgender,raceorsocio-economicstatus,butshouldbeinterpretedwithconsiderationforindividualphysicalandmentalcapabilities.
Forchildrenandyoungpeople(fiveto18years):1.
Allchildrenandyoungpeopleshouldengageinmoderatetovigorousintensityphysicalactivityforatleast60minutesanduptoseveralhourseveryday.
2.
Vigorousintensityactivities,includingthosethatstrengthenmuscleandbone,shouldbeincorporatedatleastthreedaysaweek.
3.
Allchildrenandyoungpeopleshouldminimisetheamountoftimespentbeingsedentary(sitting)forextendedperiods.
Basedontheevidence,theguidelinescanbeappliedtodisabledchildrenandyoungpeople,emphasisingthattheyneedtobeadjustedforeachindividualbasedonthatperson'sexercisecapacityandanyspecialhealthissuesorrisks.
Foradults:1.
Adultsshouldaimtobeactivedaily.
Overaweek,activityshouldadduptoatleast150minutes(2hours)ofmoderateintensityactivityinboutsoftenminutesormore–onewaytoapproachthisistodo30minutesonatleastfivedaysaweek.
2.
Alternatively,comparablebenefitscanbeachievedthrough75minutesofvigorousintensityactivityspreadacrosstheweekoracombinationofmoderateandvigorousintensityactivity.
3.
Adultsshouldalsoundertakephysicalactivitytoimprovemusclestrengthonatleasttwodaysaweek.
4.
Alladultsshouldminimisetheamountoftimespentbeingsedentary(sitting)forextendedperiods.
Basedontheevidence,theguidelinescanbeappliedtodisabledadults,emphasisingthattheyneedtobeadjustedforeachindividual,basedonthatperson'sexercisecapacityandanyspecialhealthorriskissues.
AnnexThechiefmedicalofficer'sguidelinesonphysicalactivity10Forolderadults(65-plusyears):1.
Olderadultswhoparticipateinanyamountofphysicalactivitygainsomehealthbenefits,includingmaintenanceofgoodphysicalandcognitivefunction.
Somephysicalactivityisbetterthannone,andmorephysicalactivityprovidesgreaterhealthbenefits.
2.
Olderadultsshouldaimtobeactivedaily.
Overaweek,activityshouldadduptoatleast150minutes(2hours)ofmoderateintensityactivityinboutsoftenminutesormore–onewaytoapproachthisistodo30minutesonatleastfivedaysaweek.
3.
Forthosewhoarealreadyregularlyactiveatmoderateintensity,comparablebenefitscanbeachievedthrough75minutesofvigorousintensityactivityspreadacrosstheweekoracombinationofmoderateandvigorousactivity.
4.
Olderadultsshouldalsoundertakephysicalactivitytoimprovemusclestrengthonatleasttwodaysaweek.
5.
Olderadultsatriskoffallsshouldincorporatephysicalactivitytoimprovebalanceandcoordinationonatleasttwodaysaweek.
6.
Allolderadultsshouldminimisetheamountoftimespentbeingsedentary(sitting)forextendedperiods.
Basedontheevidence,theguidelinescanbeappliedtodisabledolderadultsemphasisingthattheyneedtobeadjustedforeachindividualbasedonthatperson'sexercisecapacityandanyspecialhealthorriskissues.
111.
NgSW,PopkinB(2012)TimeUseandPhysicalActivity:ashiftawayfrommovementacrosstheglobe.
ObesityReview13(8):659-802.
HealthSurveyforEngland,20123.
Murrayetal.
(2013)UKhealthperformance:findingsoftheGlobalBurdenofDiseaseStudy2010.
TheLancet381:997-10204.
LeeI-M,etal.
(2012)Effectofphysicalinactivityonmajornon-communicablediseasesworldwide:ananalysisofburdenofdiseaseandlifeexpectancy.
TheLancet380:219–295.
Murrayetal.
(2013)UKhealthperformance:findingsoftheGlobalBurdenofDiseaseStudy2010.
TheLancet381:997-10206.
ScarboroughP,BhatnagarP,WickramasingheKK,AllenderS,FosterC,RaynerM(2011)Theeconomicburdenofillhealthduetodiet,physicalinactivity,smoking,alcoholandobesityintheUK:anupdateto2006–07NHScosts.
JournalofPublicHealth33(4):527-5357.
OssaDandHuttonJ(2002)TheeconomicburdenofphysicalinactivityinEngland.
London:MEDTAPInternational8.
HallalPC,AndersenLB,BullFC,GutholdR,HaskellW,EkelundU,fortheLancetPhysicalActivitySeriesWorkingGroup(2012)Globalphysicalactivitylevels:surveillanceprogress,pitfalls,andprospects.
TheLancet;publishedonlineJuly189.
PublicHealthEngland(2014)PhysicalActivityPromisingPracticeCollation10.
NHSEngland(2014)AnImplementationGuideandToolkitforMakingEveryContactCount:Usingeveryopportunitytoachievehealthandwellbeing.
London:NHSEngland11.
ActivePeopleSurvey8,April2013-April2014References
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