10 September 2010

From The Roots to the Shoots

From the Roots to the Shoots

Dr Charlie Foster - Kids, Adults, Cycling and Health

charlie.foster@dphpc.ox.ac.uk

IMBA UK Conference 2010

Kids, Adults, Cycling and Health

Dr. Charlie Foster University Research LecturerBHF Health Promotion Research Group

University of Oxford

Presentation Objectives

To briefly describe the relationship between physical activity and health

To examine how best to promote cycling for kids and adults

To examine the economic case for promoting cycling and physical activity

Presentation Objectives

To briefly describe the relationship between physical activity and health

To examine how best to promote cycling for kids and adults

To examine the economic case for promoting cycling and physical activity

Physical activity

Physical activity

Physical activity

Physical activity

Physical activity

Work

Leisure & Play

Exercise & Sport

HouseholdActive Travel

% active

Age

61% of men and 71% of women do not meet the Chief Medical Officer’s minimum recommendations for physical activity in adults

Men

Women

% active

Age

% active

Age

% active

Age

% active

Age

% active

Age

% active

Age

International consensus on health benefits of physical activity

Physical activity can reduce the risk of:

» Cardiovascular disease» Hypertension» Obesity» Some forms of cancers» Non insulin-dependent

diabetes mellitus» Strokes » Osteoarthritis, by

maintaining normal muscle strength, joint structure and joint function

» Osteoporosis

» Cognitive function» Crime reduction and community

safety» Economic impact and

regeneration of communities» Education and lifelong learning» Psychological well-being» Self esteem» Management of anxiety and

depression» Social capital and community

cohesion» Drug misuse» Carbon use

(US Dept Health & Human Sciences, 1996; CMO, 2004; Sport England, 2009)

A c t iv it yfo r h e a lt h

E x e r c is e fo r fi t n e s sA c t iv e

l iv in g

L ig h t , m o d e r a t eD a ilyT e n s o f m in u t e s , e v e n h o u r s

M o d e r a t eA b o u t d a i lyA t le a s t 3 0 m in

M o d e r a t e , v igo r o u s3 t im e s a w e e kA t le a s t 2 0 m in

S t r e n u o u sS e v e r a l t im e s a w e e kV a r ia b le

T r a in in gfo r s p o r t

T y p e a n d a m o u n t o f a c t iv it y

H e a lt h ,fi t n e s sb e n e fi t s

V u o r i / U K K I n s t i t u t e 1 9 9 7

A c t iv it yfo r h e a lt h

E x e r c is e fo r fi t n e s sA c t iv e

l iv in g

L ig h t , m o d e r a t eD a ilyT e n s o f m in u t e s , e v e n h o u r s

M o d e r a t eA b o u t d a i lyA t le a s t 3 0 m in

M o d e r a t e , v igo r o u s3 t im e s a w e e kA t le a s t 2 0 m in

S t r e n u o u sS e v e r a l t im e s a w e e kV a r ia b le

T r a in in gfo r s p o r t

T y p e a n d a m o u n t o f a c t iv it y

H e a lt h ,fi t n e s sb e n e fi t s

V u o r i / U K K I n s t i t u t e 1 9 9 7

Risk reduction all cause mortality

28% risk reduction all cause mortality

(Anderson et al, 2000)

Pressure on transportsystems

Sedentary behaviourCarbon emissions

Presentation Objectives

To briefly describe the relationship between physical activity and health

To examine how best to promote cycling for kids and adults

To examine the economic case for promoting cycling and physical activity

Bruno Taylor's Playful Spaces

The effectiveness of environmental change interventions to promote

physical activity

NICE review – physical activity and environment

Systematic reviews have also found some evidence to support the impact of large scale environmental changes on physical activity

A combination of changes to working practices, policies and the physical environment encouraged adults to maintain their vigorous physical activity and fitness

Active travel interventions must contain environmental supports to sustain individual choice (i.e. public transport)

Active travel interventions must contain environmental supports to

sustain individual choice (i.e. public transport)

Policies

Places

People

Right-hand turn lanes

Right of way over motorists

Linked traffic light system

Priority of bicycle lanes

The Cycling Demonstration Towns

programme First phase: October 2005 –

October 2008 All towns funded at approx £5

per head per year, matched by the local authority

Comprehensive evaluation

CityAnnual

increase in cycling flows

Darlington +14.2%

Exeter +9.9%

Brighton & Hove +9.0%Strasbourg +7.0%

Lanc w Morecambe +6.2%Vienna +6.4%

Graz +5.9%

Munich +5.5%

Hanover +5.4%

Annual growth rates: European cities and CDTs

Adapted from: Transport for London (2004) ‘Creating a chain reaction. The London Cycling Action Plan. February 2004. (http://www.croydon-lcc.org.uk/downloads/2004_TfL_LondonCyclingActionPlan.pdf)

CityAnnual

increase in cycling flows

Nottingham +4.8%

Freiburg +4.4%

Munster +3.6%

Aylesbury +3.6%Berlin +3.2%

Derby +2.5%Zurich +2.3%

Delft +1.2%

» Continue to encourage physically active modes of travel (such as walking or cycling)

» Continue working with schools on travel plans, focusing on physical activity

» Ensure local transport plans take account of children and young people’s need to be physically active

Physically active travel

Presentation Objectives

To briefly describe the relationship between physical activity and health

To examine how best to promote cycling for kids and adults

To examine the economic case for promoting cycling and physical activity

Economic value

•Burden of disease

•Cost benefit

•Cost utility

Burden of disease

£14.85

£14.01

£17.20

£12.95

£14.85

£14.63

£13.94

£15.96

£18.71

£15.27

Cost of physical inactivity (£/population) related disease by SHA

Foster et al, 2009

£14.85

£14.01

£17.20

£12.95

£14.85

£14.63

£13.94

£15.96

£18.71

£15.27

Cost of physical inactivity (£/population) related disease by SHA

Spend in London is 85p per head

Foster et al, 2009

Scotland has a higher mortality of CHD compared to England

Cost of physical inactivity related disease in Scotland - Method

Attribute the proportion of morbidity and mortality to diseases related to physical inactivity» Cardiovascular disease» Cancer (Lower GI & breast)» Diabetes mellitus

Spend within disease areas

Allender et al, 2007; DH, 2009; Foster et al, 2009

Burden of physical inactivity related mortality in Scotland in 2007-2008

There were just under 18,000 deaths per year in physical inactivity disease categories

Physical inactivity contributes to 2,640 deaths

Source http://www.isdscotland.org/isd/

The direct costs of physical inactivity related disease to the NHSS is…..

£141 million per year

Health costs for alcohol £400 million per year

Cost of physical inactivity related disease in Scotland - Results

What’s still to be added?

Other disease areas direct health service costs» Mental health, obesity, falls

Indirect costs» Lost productivity» Premature mortality

Others?

The direct costs of physical inactivity related disease to the NHSS is…..

£141 million per year

This is an underestimate of the real costs

Cost of physical inactivity related disease in Scotland - Results

It’s fantastic value…

NICE established that brief interventions for physical activity cost between £20 and £440 per QALY (when compared with no intervention), which is significantly below the £30,000 threshold and represents exceptional value for money

NICE: comparing interventions

Presentation Objectives

To briefly describe the relationship between physical activity and health

To examine how best to promote cycling for kids and adults

To examine the economic case for promoting cycling and physical activity

Conclusion

High level strategic commitment Targeted investment Consistent implementation of best

practice

Cycling is related to health and saves £

We can change our environments and promote cycling successfully

Capture and promote the broadest sense of value

Things to think about…

ThanksNick Cavill – Cycle England

IMBA UK Conference 2010

Kids, Adults, Cycling and Health