1. © Vaga Associates The value of leisure and culture to Enfield Our bodies were made to move! Nikki Enoch and Mike Collins Health Improvement Partnership

2. © Vaga Associates 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. © Vaga Associates 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. © Vaga Associates The value of leisure & culture to Enfield Summary 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/active citizens  creates jobs  improves environment

5. © Vaga Associates Leisure & Culture Partnership Emerging Priorities Agreed on 10 th November 2003:  Addressing health issues  Capacity building and organisational development  Activities for young people (divert from crime and anti-social behaviour)

6. © Vaga Associates The value of leisure & culture for health The evidence 1.Strong trends with physical health 2.Close association with mental health 3.Strong correlation with deprivation 4.Payback

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

8. © Vaga Associates The Evidence Increasing prevalence of Obesity N.A.O. 2001

9. © Vaga Associates The Evidence Inactivity Indicators Prentice & Jebb ‘95

10. © Vaga Associates The Evidence Inactivity levels HSE ‘98

11. © Vaga Associates The Evidence Evidence of health risks Source: Britton & McPherson

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

13. © Vaga Associates The Evidence Relative risk of diabetes with increasing weight

14. © Vaga Associates The Evidence Inequalities 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. © Vaga Associates The Evidence Young People ’ s Trends Aged 5-18 Years  20% overweight Chinn, S. & Rona, R.J. (2001)  10% have one or more mental disorders Office for National Statistics (2000)

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

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

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

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

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

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

26. © Vaga Associates The value of leisure & culture for health Filling 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. © Vaga Associates The value of leisure & culture for health Continuing 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. © Vaga Associates 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.ukwww.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. © Vaga Associates The value of leisure & culture to Enfield References (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 strategy Enfield: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. © Vaga Associates The value of leisure & culture to Enfield References (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 14.7.03www.homeoffice.gov.uk Sport England et al (2002) Positive Futures: a review of impact and good practice Summary report London: SE

31. © Vaga Associates The value of leisure & culture for health Conclusions 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. © Vaga Associates The value of leisure & culture for health Your views

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