A healthy mix: sports sector

engagement with the public

health agenda

Dr Justin VarneyConsultant in Public Health MedicineJustin.varney@phe.gov.uk

Public Health

2 Dahlgren & Whitehead (1991)

Public Health EnglandMission is to protect and improve the nation’s health and to address

inequalities

Established 1 April 2013 to unite specialists from >70 organisations into

single public health service with 4 regional offices & 15 centres

Reputation for credibility and expertise is the foundation for PHE to help

the new system to drive transformation

Local government leadership for public health supported by PHE as

expert national body.

Funding and delivery of services by local government, NHS, etc.

3

The Public Health System: an

integrated whole system approach

4

Government

• DH responsible to parliament, with clear line

of sight through system

• Cross-government senior officials group to

improve health outcomes and use Cabinet

Committee structure as required

• CMO to continue to provide independent

advice to Government

Local authorities

• Public health functions integrated into their wider role, helping to

tackle the wider social and economic determinants of health.

• Leading for improving health and coordinating locally for

protecting health

• Promoting population health and wellbeing – role of Directors of

Public Health

Public Health England

• Integrated national body

• Strengthened health protection systems

• Supporting the whole system through expertise, evidence

and intelligence

NHS

• Delivering health care and

tackling inequalities

• Five year Forward Plan

• Making every contact count

• Specific public health

interventions, such as cancer

screening

5http://www.healthmetricsandevaluation.org;

The Lancet, Early Online Publication, 5 March 2013doi:10.1016/S0140-6736(13)60355-4

.

Where do we focus our efforts?

Inactivity is killing us

Decreasing activity levels since 1960s:

• UK adults are 20% less active now than in

the 1960s and activity is predicted to fall a

further 15% by 2030.

Physical inactivity is responsible for:

• 1 in 6 UK deaths

• Up to 40% of many long-term conditions

Estimated £7.4 billion annual cost

6Ng SW, Popkin B (2012); Lee I-M, et al. (2012); Wen CP, Wu X (2012); WHO (2010); Ossa D & Hutton J (2002);

Murray et al. (2013)

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Physical activity: Our greatest defence

against ill health and disease

Adapted from Department of Health and Human Services (2008).

Physical Activity contribution to reduction in risk of mortality and long term conditions

Disease Risk reduction Strength of evidence

Death 20-35% Strong

CHD and Stroke 20-35% Strong

Type 2 Diabetes 35-40% Strong

Colon Cancer 30-50% Strong

Breast Cancer 20% Strong

Hip Fracture 36-68% Moderate

Depression 20-30% Strong

Hypertension 33% Strong

Alzheimer’s Disease 20-30% Moderate

Functional limitation, elderly 30% Strong

Prevention of falls 30% Strong

Osteoarthritis disability 22-80% Moderate

The global picture

8 Hallal PC, et al. (2012)

International comparison of physical inactivity (at ages 15 and over)

Note: Comparator = Not meeting any of the following per week: (a) 5 x 30 mins moderate-intensity activity; (b) 3 x 20 minsvigorous-intensity activity; (c) equivalent combination achieving 600 metabolic equivalent-min.

UK, 63.3%

USA, 40.5%

Australia, 37.9%

Finland, 37.8%

France, 32.5%

Germany, 28.0%

Holland, 18.2%

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0%

% Inactive

9

Trends in physical activity

PHE Adult Physical Activity Fact Sheet (Jan 2015)

Data Source: Health Survey for England 2012.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

16-24 25-34 35-44 45-54 55-64 65-74 75-84 85+

0%

20%

40%

60%

80%

100%

16-24 25-34 35-44 45-54 55-64 65-74 75-84 85+

Inactive

Low activity

Some activity

Meets recommendation

Men

Women

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Inequalities in physical activity in England

GENDER: Women are more inactive than men in virtually every age group.

AGE: Physical activity declines with age and decline starts young, 1 in 4 5-7yrs

girls are active enough for health, by 13-15yrs this falls to only 1 in 10.

ETHNICITY: Only 11% of Bangladeshi women are reaching recommended levels

of activity compared to 25% of the general population of women.

DISABILITY: Disabled adults are half as likely to be physically active as non-

disabled adults.

SEXUALITY/GENDER IDENTITY/FAITH: very limited evidence although some

evidence that discrimination may be a barrier to being active.

SOCIOECONOMIC: Greater levels of inactivity in areas of greater deprivation.

GEOGRAPHY: South East of England has the highest proportion of adults

meeting recommended levels, with the lowest level in the North West.

Everybody Active Every Day Framework Documents (2014)

Everybody needs to be more active

every day

11Health Survey for England 2012 (HSE); Active People Survey 8, April 2103-April 2014 (APS); National Travel Survey

July 2014 (NTS)

Physical activity and health & wellbeing

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Individual Becoming

More Active

Fun

Personal development

Travel

Social inclusion

Health

13

Everybody Active, Every Day:

A model for action

Public Health England (2014-1)

Active Society

Moving Professionals

Moving at scale

Active environments

Active society – Creating a social movement

• Changing general attitudes to make physical activity the expectation or social norm

• Working across sectors in the places we live and work

• Developing a common vision for “Everybody Active, Every Day”

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Active society & Sport

• Target and engage inactive people

• Engage users in design of locally-

embedded physical activity

programmes

• Deliver services that support

inclusive opportunities for physical

activity (eg, inclusion fitness

initiative-accredited gyms, equity

statements)

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Moving professionals – Activating networks

• Utilising existing network of influencers on the public, the public & voluntary sector workforce

• ‘Making every contact count’ across sectors and disciplines

• Starting with expertise & leadership in key sectors:o Educationo Sports & leisureo Health & social careo Planning, design, transport

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Moving Sports professionals

• Support project managers, coaches and

volunteers with training and guidance on

integration of behaviour change.

• Ensure volunteering opportunities and

jobs provide skills development and

career prospects.

• Develop a making every contact count

approach that integrates active living into

all aspects of business.

17 Presentation title - edit in Header and Footer

Active environments: Creating the

right spaces

• Developing ‘healthy’ cities,

villages, towns and

communities

• Linking across disciplines

through planning and policy

• ‘Active’ infrastructure planning

• “Active by Design” campaigns

• Capital funding investments

• Embedding activity for all

• Age-friendly

• Disability-friendly

• Inclusive access

• Fun!

The Design Council (2014)

Active Sport Environments

• Implement active travel

plans for all staff,

participants and fans

• Identify and address

barriers that prohibit

equality groups from

accessing services (eg,

geographic, physical,

economic)

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Moving at scale

• Positive change must

happen at every level and

must be measurable,

permanent and consistent

• Implement ‘what works’ at

scale

• Maximise existing assets

o Human

o Physical

o Make being active the easiest,

efficient choice!

Moving at Scale in Sport

• Establish robust

systems to evaluate

projects that assess

pre and post-project

physical activity as well

as participation and

wider outcomes (using

the standard evaluation

framework).

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Evidence for implementation

• Synthesis of existing evidence base (e.g. NICE)

• Evidence-based actions across public health system:oSettings

oLife-course

• Includes five key steps for local action:

1. Every child to enjoy & have skills to be active

2. Safe, attractive & inclusive active living environments

3. Make every contact count in public & voluntary sectors

4. Lead by example in public sector workspace

5. Evaluate and share ‘what works’

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But……

• Sport’s role in public health is more than

physical activity or obesity

• The unique relationship between coaches and

players and clubs and fans could be pivotal in

enabling people to achieve their potential.

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Other Opportunities

• Musculoskeletal

disease prevention

• Workplace health

• Domestic violence

awareness

• Mental health &

wellbeing

• Dementia awareness

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Let’s get

Everybody Active

Every Day!

Justin.varney@phe.gov.uk