Active Scotland
Policy in to Practice
Emma Broadhurst
Local Authority and Legacy Manager
ACTIVE SCOTLAND
• Background – what do we mean by physical
activity?
• What does the evidence say?
• How do we translate that to policy?
• What is the current national picture?
• Where does Aberdeenshire fit?
Stand Up – Sit Down
Physical Activity - What is it?
Physical activity is any active movement of the
body that is produced by muscular contractions
and that results in the expenditure of energy
Ie
Any movement of the body that uses energy
Dimensions and Domains
Dimensions of physical activity
Domains of physical activity
• Intensity: effort required
(low, moderate, vigorous)
• Leisure time (eg sports,
recreational walking )
• Duration: length of time
activity carried out
• Household activities (eg
cleaning, gardening)
• Frequency: number of
sessions over a fixed period
(usually per week)
• Occupational/school (activity
at work or school eg PE)
• Active transport ( walking,
cycling as transport)
The Active Scotland spectrum…
VISION – A MORE ACTIVE SCOTLAND
Physical activity is about getting people moving. Daily walking, playing in a park, going to
a gym, training with a team or aspiring to win a gold medal- it doesn’t really matter how
people get active, it just matters that we do.
Being physically active contributes to our personal, community and national wellbeing.
Our vision is of a Scotland where more people are more active more often.
Why the Fuss?
Seminal studies linking PA to health
Contribution to health
Costs of inactivity – Global, UK, Scotland
• Seminal studies – CVD/cardiorespiratory fitness (late 1950s) links PA to
health
• Worldwide, estimate that physical inactivity causes
– 6% (ranging from 3·2% in southeast Asia to 7·8% in the eastern Mediterranean region)
of the burden of disease from coronary heart disease
– 7% (3·9–9·6) of type 2 diabetes,
– 10% (5·6–14·1) of breast cancer
– 10% (5·7–13·8) of colon cancer
[(Lee et al 2012) ]
Leading causes of attributable global mortality, WHO 2004
1.
2.
3.
High blood pressure
Tobacco use
High blood glucose
%
12.8
8.7
5.8
4.
Physical inactivity
5.5
5.
6.
7.
8.
9.
10.
Overweight and obesity
High cholesterol
Unsafe sex
Alcohol use
Childhood underweight
Indoor smoke from solid fuels
4.8
4.5
4.0
3.8
3.8
3.3
59 million total global deaths in 2004
UK – 2006/7
• Comparative level of importance varies depending of figures used –
message is the same – physical inactivity is a major issue
– In 2006–07, costs to NHS in UK for behaviour related ill health:
•
•
•
•
•
poor diet £5.8 billion
Smoking £3.3 billion
alcohol £3.3 billion
overweight and obesity cost £5.1 billion
physical inactivity was £0.9 billion
[Scarborough et al 2011,
http://www.ias.org.uk/uploads/pdf/Economic%20impacts%20docs/pubmed.f
dr033.full.pdf ]
• 2002 study commissioned by the UK Department for Culture, Media and
Sport which summed direct and indirect costs to the NHS, including loss of
earnings due to inability to work and premature death. This produced a
total estimated cost of physical inactivity of £8.2 billion
• Unhelpful always to compare - Lifestyle behaviours usually co-exist so all
co-related
Government
Roots of guidelines
Current guidelines
Government and Physical Activity Guidelines
(PAGs)
• American College of Sports Medicine (ACSM)
and American Heart Association – first
guidelines
• Others followed suit including WHO
• New UK-wide 2011, based on latest evidence
UK Guidelines 2011
https://www.gov.uk/government/
publications/uk-physical-activityguidelines
• 150 minutes of moderate intensity or 75 minutes of vigorous physical activity per
week (or a combination)
• At least 2 sessions per week of muscle strengthening exercises
• Minimise time spent being inactive (sitting)
Policy Landscape
Recent research trend leading to
widening of responsibility and gain
across multiple policy areas
Current policy landscape in Scotland
Not just about Health – Impacts and Influence
• IMPACT - Research widened into costs and
benefits of PA beyond health – environment,
education, economy etc
• INFLUENCE - socio-ecological perspective and
role of environment - move away from focus
on the individual and realisation of role for
other policy areas to promote PA
Everyone’s responsibility - All stand to gain
Transport &
environment
Social cohesion,
social capital
Communities
Attainment, social
skills
Education
congestion, carbon emissions,
air/noise pollution, road safety
Economy
Health and
Social Care
absenteeism,
productivity
burden of disease
(mental and physical)
Policy Landscape - Scotland
• Let’s Make Scotland More Active (LMSMA) 2003
• Review of LMSMA 2008
• Obesity Route Map 2010
• Physical Activity Implementation Plan (PAIP) 2014
• Active Scotland Outcomes Framework (ASOF) 2014
So what about Scotland?
PAIP and ASOF
• PAIP is about physical activity settings for
intervention and recognising the need for
action across a range
• ASOF are the high level outcomes that PAIP
seeks to address – draws together policy
landscape
Vision: A More Active Scotland
Physical activity is about getting people moving. Daily walking, playing in a park, going to a gym, training with a team or aspiring to win a
gold medal- it doesn’t really matter how people get active, it just matters that we do.
Being physically active contributes to our personal, community and national wellbeing.
Our vision is of a Scotland where more people are more active, more often.
National Outcomes
Active Scotland Outcomes
We encourage and enable the
inactive to be more active
We improve our active
infrastructure – people and
places
We encourage and enable the
active to stay active throughout
life
We support wellbeing and
resilience in communities through
physical activity and sport
Equality – Our commitment to equality underpins everything we do
We develop physical
confidence and competence
from the earliest age
We improve opportunities to
participate, progress and
achieve in sport
Vision
Active Framework Outcomes
PAIP 5 Year Milestones
The NWS, CAPS and Designing Streets will be implemented
OUTCOME 1
We encourage and enaable the
inactive to be more active
20mph zones will be widely introduced in residential and shopping areas
More active and inactive people will know about and use local opportunities to be active
Urban and rural environements will be designed to increase physical activity
There will be an Increased use of Scotland's outdoors
OUTCOME 2
We encourage and enable the
active to stay active throughout
life
More children and students use active travel to get to their places of learning
More people use active travel for work
More people use active travel for leisure
OUTCOME 3
We develop physical confidence
and competence from the earliest
age
Work place Active Travel Plans
Employee support programmes and activities for both less and more active staff.
The national physical activity pathway will be embedded within clinical settings across the healthcare system
A MORE ACTIVE
SCOTLAND
Hospitals routinely support patients to be more physically active
MORE PEOPLE MORE ACTIVE
MORE OFTEN
OUTCOME 4
We improve our active
infrastructure - people and places
New links exisit between healthcare and the community to signpost patients to phusical actiivty opportunities
Integrated care services routinely take account of physical activity
Education staff have the appropriate knowledge and skills to promote increased physical activity
All places of learning can demonstrate the use of their estate and greenspace for physical activity
Delivery Theme 1
Environment
Delivery Theme 2
Workplace
OUTCOME 5
We support wellbeing and
resilience in communities through
physical activity and sport.
More children will have opportunities for active and outdoor play
Delivery Theme 3
Health & Social Care
Delivery Theme 4
Education
Delivery Theme 5
Sport & Active
Recreation
All places of learning can demonstrate that pupils, students and staff have increased levels of physical activity
The coach and volunteer workforce will have the knowledge and skills to promote increased physical activity
OUTCOME 6
We improve opportunities to
participate, progress and achieve
in sport.
All Community Sports Hubs will be in place (signposting both inactive and active people on how to be more active)
with at least 50% in schools
There will be an increase in grass-roots participation in sport by all
The way ahead
Current PA situation and trends in Scotland
Positives – PA, walking, freq of sport
Challenges – inactive, more into sport, inequalities
Where stand to gain the most (doesresponse/numbers)
Picture in Scotland?
•
Tentative increase in physical activity, recreational walking,
frequency of sports participation
•
No change inactive and proportion participating in sport
•
Indication that active getting more active
•
Increase in physical activity is those doing some moving into
meeting the guidelines
Scotland 2013 – Adults (16+)
Physical Activity
Recreational Walking
64% met the recommended
amount of 150 mins of
moderate or vigorous activity
per week.
65% walked for at least 30
minutes for recreational
purposes in the last four weeks.
A small increase since 2012
Year on year increase since 2010
Scotland 2013 – Adults (16+)
Sports participation
Frequency of
sports participation
52% reported participating in
sport in the last four weeks.
48% of participants took part in
sport and exercise regularly (15 or
more days) in the four weeks prior
to interview.
Relatively stable 2010 to 2013
Increased yearly since 2010
Adult Physical Activity Levels - Scotland, 2012 - 2013
None
2013
Some
21
Enough
15
64
Inactive
Some activity
Meets MVPA
2012
21
0
10
17
20
30
62
40
50
60
70
80
90
100
Reasons for optimism

Rise in interest in recreational sport

International recognition of Scotland's work on PA
The progress made, particularly at high levels of
government and leadership – support and recognition has
increased since my last visit a couple of years ago. There
is clear intent to address this problem.

Professor Fiona Bull, PA
expert, March 2013
Renewed policy push across multiple fronts: Physical Activity Champions;
Physical Activity Implementation Plan; Brief Interventions; National
Walking Strategy; Active Schools; ...and Commonwealth Games!
What do the figures all mean
• Sporty getting sportier
• Moved those doing something to doing more
• Inactive remains a challenge
Percentage of adults meeting recommended levels of
physical activity by age, 2011
Source: Scottish Health Survey
Participation in sport last four weeks
Participation in sport and exercise in last four weeks
Participation in sport and exercise in last four weeks by
age
Includes walking
Excludes walking
Walking distance to nearest
greenspace
Frequency of visits made outdoors
How often uses nearest useable
greenspace
Who are the inactive - AGE
(% who are younger than 45(blue), 45-64(red) and 65+(green))
Inactive (2012)
25
Scotland (2014)
35
45
0
20
40
33
40
60
22
80
100
Who are the inactive - DISABILITY
(% who are healthy (blue) or who have a long-term illness (red))
Inactive (2012)
28
72
Scotland (2013)
56
0
20
44
40
60
80
100
Key characteristics of those who are inactive
Health, long-term illness and disability
Economic activity status especially inability to work and to a lesser extent
those who are retired
Age – activity declines with age from
about age 45
Income and sex were not influential
Dose response activity vs relative risk of all cause death
Relative risk
risk reduces as activity increases
Mins per week of moderate activity
[Adapted from Brown et al (2012)]
•
Shaded area
indicates
optimal range
for health
benefits.
•
Equates to 150
- 300 mins per
week MVPA.
Numbers of inactive in high risk groups
800000
700000
670771
600000
500000
391283
372651
400000
300000
167693
200000
100000
0
Inactive LLI +LI
Inactive 65+
Unable to work
inactive retired
NB - number of adults 16+ in inactive group based on 2014 mid term estimate - 931627
Contribution of different domains of PA to the activity of the
inactive group, 2012
% of mean hours per week
• The main activity making up total
of any PA per week in the
inactive group is heavy
housework.
Occupation
al Work
22%
• Negligible contribution of sport.
Walking
14%
DIY/Garden
ing
7%
Heavy
Housework
57%
Contribution of different domains of PA to the activity of all
adults in Scotland, 2012
% of mean hours per week
• Sport & exercise major
difference.
Occupation
al Work
15%
Heavy
Housework
14%
DIY/Garden
ing
7%
• Relatively larger contribution of
walking.
Sport &
exercise,
39
Walking
25%
Risk reduction associated with physical
activity
Chronic condition
Risk reduction
All cause mortality
CVD, stroke
Diabetes
Hip fractures
30% risk reduction
20-35% reduction
30-40% reduction
36-68% reduction
Colon cancer
Breast cancer
Loss of function
30% reduction
20% reduction
30% reduction
Depression/dementia
20-30% reduction
Next Steps - nationally
• Driving policy across SG
• Delivery of PAIP
• Gathering LA /CPP information
Next steps locally Current SOA
outcome
Physical activity increased across the population
including those who are vulnerable through
shifts in culture, improvements in infrastructure,
opportunities and community empowerment
My questions to you
• Who are your inactive?
• What are the priorities?
• How will you get them active? How will you
keep people active?
• How will you deliver this to help make that
step change in an environment of shrinking
resources?