1. Greenspace and Health Hazel Ainsworth Delivery Lead, Health & Environment

2. Greenspace and Health The scale of the problem Preventative public health care Evidence Case study

3. The Economic Burden of Obesity Estimates of indirect costs (those arising from the impact of obesity on the wider economy such as loss of productivity) from the studies ranged between £2.6 billion and £15.8 billion Modelled projections suggest that indirect costs could be as much as £27 billion by 2015 (National Obesity Observatory (NOO), October 2010)

4. The Cost of Physical Inactivity Physical inactivity costs the NHS between £1 billion - £1.8 billion each year. The costs of lost productivity to the wider economy have been estimated to be £5.5 billion from sickness absence and £1 billion from premature death of people of working age. Taken together, these costs may total £8.3 billion Be Active, Be Healthy, A Plan for getting the Nation moving, February 2009

5. Changes to the NHS

6. Equity & Excellence: Liberating the NHS (12 th July 2010) LAs to promote the joining up of local NHS services, social care and health improvement” PCT responsibilities for local health improvement will transfer to LAs DoH via Public Health Service “will set local authorities national objectives for improving population health outcomes”

7. Health Lives, Healthy People (30 th Nov 2011) New PH system with dedicated budget Recognition that our environment has an effect on our health LAs best placed to influence wider determinants of health

8. New NHS Structure

9. Transition timetable

10. Development of health and wellbeing boards Joint Strategic Needs Assessment Joint Health & Wellbeing Strategy Commissioning Strategies 132 early implementers announced 16/03/11 http://healthandcare.dh.gov.uk/early-implementers-of-health-and- wellbeing-boards-announced/

11. Physical Activity

12. Reducing Health Inequalities Marmot Review 2010: “Create and develop healthy and sustainable places and communities” People living closer to green space have lower death rates and less heart disease. Amongst lower income groups, 1,300 extra deaths occurred each year in areas where the provision of green space was poor. (University of Glasgow, 2008)

13. Social Cohesion Robert Taylor Homes, Chicago 28 identical high-rise homes along a 3-mile corridor Some with nearby vegetation, others without Residents randomly assigned to apartments

14. Tackling Obesity People living closer to green spaces were more physically active and were less likely to be overweight or obese These trends were apparently independent of peoples’ income or social group The most significant findings showed that people who lived furthest from public parks were 27% more likely to be overweight or obese (Original research by Melvyn Hillsdon 1, Andy Jones 2 and Emma Coombes 2 for Natural England, 2009) 1 Department Exercise and Health Sciences, University of Bristol 2 School of Environmental Sciences, University of East Anglia

15. Health Benefits of Physical Activity Physical activity positively contributes to the prevention and management of over 20 chronic diseases and conditions including coronary heart disease (CHD), diabetes, cancer, and obesity.

16. Increased physical activity Being within access to greenspace can increase levels of physical activity (Am. J. Public Health, 2003) Greater opportunities for exercise provided by close proximity to a park reduces weight gain in teenagers by five kilograms over a two year period. (Am. J. Public Health, 2008)

17. Ecotherapy: The Green Agenda for Mental Health The role the environment plays on the effectiveness of exercise for mental wellbeing

18. Greenspace and Health Costs If every household in England were provided with good access to quality green space it could save an estimated £2.1 billion in healthcare costs Our Natural Health Service – The role of the natural environment in maintaining healthy lives Natural England (2009)

19. Benefits of Green Infrastructure Good quality, accessible green space and infrastructure can provide many potential health and wellbeing benefits. The most significant of these can be grouped into three broad categories: increased life expectancy and reduced health inequality improvements in levels of physical activity and health promotion of psychological health and mental well-being ( Forest Research, 2010)

20. Overview of Evidence Indirect benefitsDirect benefits Reducing health inequalitiesModerating impact from extreme weather Improving mental healthShelter from UV, noise, wind Improving physical activityCarbon sequestration Reducing obesityImproved water and air quality Enhancing social cohesionFood The natural environment can help with the major health problems facing society

21. Case Study Mansfield District Council Using greenspace to deliver health benefits