The value of leisure and culture to Enfield Our bodies were made to move!

1. Health Improvement Partnership The value of leisure and culture to EnfieldOur bodies were made to move! Nikki Enoch and Mike Collins

2. Project Brief Commissioned October 2003 to: • Summarise available national research • Apply research locally • Identify priorities for the ESP thematic groups Funded by Neighbourhood Renewal

3. 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

4. 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/activecitizens creates jobs improves environment The value of leisure & culture to EnfieldSummary

5. Leisure & Culture PartnershipEmergingPriorities Agreed on 10th November 2003: • Addressing health issues • Capacity building and organisational development • Activities for young people (divert from crime and anti-social behaviour)

6. The value of leisure & culture for healthThe evidence • Strong trends with physical health • Close association with mental health • Strong correlation with deprivation • Payback

7. The value of leisure & culture for healthThe evidence Medical profession (e.g BMA 2002) Sports profession (e.g Balyi 2002) Leisure profession (e.g LGA 2001) Education profession (e.g National Curriculum) BHF National Centre for Physical Activity & Health (www.bhfactive.org.uk)

8. The EvidenceIncreasing prevalence of Obesity N.A.O. 2001

9. The EvidenceInactivity Indicators Prentice & Jebb ‘95

10. The EvidenceInactivity levels HSE ‘98

11. The EvidenceEvidence of health risks Source: Britton & McPherson

12. The EvidencePrevalence of CHD Risk factors Economic Cost of CHD £7.06b annually Source: Liu, Maniadakis, Gray & Raynor 2002 Source: Joint Healthy Survey Study 1999

13. The EvidenceRelative risk of diabetes with increasing weight

14. 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

15. The EvidenceYoung People’s TrendsAged 5-18 Years • 20% overweight Chinn, S. & Rona, R.J. (2001) • 10% have one or more mental disorders Office for National Statistics (2000)

16. The EvidencePrevalence 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)

17. The EvidenceConclusions “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

18. 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 = 61,500 Savings 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

19. Our UnderstandingBest Start in Life • Physical • Bone - fat - muscle tissue • Growth spurts (girls earlier) • Puberty • Increase in red blood cells • Central nervous system • Physical • Heart size • Muscle strength • Ligamentous structures • Motor patterns & balance • Co-ordination Multiple Learning Styles Young People u4-15 yrs • Mental/Cognitive • Abstract thinking • Egocentric thought/self identity • Mental/Cognitive • Attention span short • Imagination blossoming • Emotional • Heightened peer influence • Accepting responsibility • Different maturity rates • Emotional • Self concepts & self importance • Peer influence • Understands rules & structures “Drama, dance, movement,words,images and music – all stimulate the brain to learn” University of the First Age

20. Our Understanding Dropping Out Girls and Young Women Boys and Young Men • 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 Young People 12-18 yrs 50% not receiving 2 hours of PE Media use = approx. 5 hours a day

21. Our UnderstandingFinding time 80% perceive themselves physically active Women Men • All • 31% active for health benefits • 33% ‘inactive’ • Bangladeshi • 7% active for health benefits • 65% ‘inactive’ • All • 46% active for health benefits • 25% “inactive” • Bangladeshi • 18% active for health benefits • 59% ‘inactive Adults 16-55 yrs • Age Decline • Aerobic capacity: 25 yrs onwards 8-10% per decade • Strength: 5-10% per decade • Muscle mass: 40% loss between 20-70 yrs Sources: ADNFS 1992;BFH National Centre for Physical Activity + Health

22. Our UnderstandingKeeping fit for life Women Men • All • 17% active for health benefits • 50% sedentary • 25% unable to climb stairs unaided • Bangladeshi • 92% sedentary • All • 25% active for health benefits • 40% sedentary • 7% unable to climb stairs unaided • Bangladeshi • 85% sedentary Adults 50+ yrs • Importance of Physical Activity • Maintains functional ability • Prevents disability, immobility and isolation Source: BFH National Centre for Physical Activity + Health

23. 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

24. The value of leisure and culture for healthA Multi Dimensional Strategy Focus on the highest risk (highest savings) East and South, poor, single parents, C2DE women, Pakistani/Bangladeshi, older Best start for young people Reducing drop out Making it easier for those at work Reaching out for older adults Strategic and social marketing

25. The value of leisure and culture for healthCurrent and proposed activities Exercise referral Healthy Living Centre ; Garden Gym • Sure start • children’s centres • Play schemes • SS coordinators • Specialist colleges • YP gyms • Children’s centres • Healthy schools ? • Mind how you go • Fit for life Leisure Discount Schemes

26. 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

27. The value of leisure & culture for healthContinuing 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

28. 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:ACE Britton, A. and McPherson, K. (In Press). Monitoring the progress of the 2010 target for coronary heart disease mortality London: National Heart Forum BMA (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 CCPR Chinn, 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: sportscotland Coalter, F. (2003) Measuring the impact of sport (unpublished lecture) University of Stirling Coalter, F., Allison, M.. and Taylor, J . (2000) The role of sport in regenerating deprived urban areas Edinburgh: Scottish Executive Central Research Unit Collins, M. F. (2003) Sport and social capital London: Routledge Collins, M.F. et al (1999) Sport and the arts paper for Policy Action Team 10 London: DCMS Countryside Agency (2001a) Walking for Health –the first randomised trial CR Note 18 Cheltenham: CA Countryside Agency et al (2003) The use of public parks in England Cheltenham: CA

29. The value of leisure & culture to EnfieldReferences (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 strategyEnfield: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

30. The value of leisure & culture to EnfieldReferences (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 Unit Jackson, A. (2003) Doing it ourselves: Learning to challenge social exclusion through the voluntary arts London: Department for Education and Skills Ladd, J. and Davis, L. (2003) Guide to best practice in sport and urban regeneration London: British Urban Regeneration Association Long, J.et al (2002) Count me in! London:DCMS Office 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 England Riddoch,C., Puig-Ribera,A. and Cooper,A. (1998) Effectiveness of physical activity promotion schemes in primary car: A review London: Health Education Authority Prentice, A. M. and Jebb, S. A. (1995) Obesity in Britain: gluttony or sloth? BMJ 333, 437-39 Splash National Support Team (2003) Splash 2002 Final Report London: Youth Justice Board/Cap Gemini Ernst Young www.homeoffice.gov.uk accessed 14.7.03 Sport England et al (2002) Positive Futures: a review of impact and good practice Summary report London: SE

31. The value of leisure & culture for healthConclusions Physical 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 Health Its costly and its increasing

32. The value of leisure & culture for health Your views

33. Leisure and Cultural Partnership Group Any further thoughts, evidence or contributions please contact us: Tel: 07989 351047 nikki@vagaassociates.com Thank you