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Topic on a Page - Physical Activity

Data Sources:

NHS Digitial:

Statistics on Obesity, Physical Activity and Diet

Public Health England (PHE):

Public Health England: Physical Activity Profile

Association for Young People's Health:

Key data on Young People 2017

World Cancer Research Fund:

Interactive infographic summarising risk factors for certain cancers

Further data sources:

Scroll to the bottom of the page to view and compare further datasets

Supporting
Information:

Department of Health (DoH):

Physical Activity guidelines Published: July 2011

National Institute For Care And Health Excellence (NICE):

Guideline: Physical activity for children and young people [PH17] 2009

Guideline: Physical activity: walking and cycling [PH41] 2012

Guideline: Physical activity in the workplace [PH13] 2008

Guideline: Physical activity: brief advice for adults in primary care [PH44] 2013

Local Government Briefing: Physical Activity [LGB3] 2013

Physical Activity and the environment [NG90] 2018

Public Health England (PHE):

What works in schools and colleges to increase physical activity Published: October 2015

Physical activity: applying All Our Health

Everybody active, every day: An evidence-based approach to physical activity

Sport England:

Resources: Partnering local government

Evaluation Framework

NHS Evidence

Physical Activity

Miscellaneous:

UK Active

Linked Topics

Topic last reviewed: Jul-18

JSNA Topic: Physical Activity

Background

According to Public Health England (PHE), physical inactivity "is one of the country’s most urgent challenges". Without action the burden upon health and social care will destabilise services and have a major impact on people's physical and mental health.

  • There is evidence that achieving recommended physical activity levels cuts the risk of type 2 diabetes, colon cancer, CHD, stroke, falls and hypertension by at least 30%
  • There is evidence that physical activity reduces the risk of Alzheimer's, osteoarthritis, hip fractures and depression by between 20% and 80%. (Source: Start Active Stay Active 2011)
  • Physical inactivity is estimated to cost the NHS and wider society £7.4 billion annually (Source: Public Health England 2014)
  • Physical inactivity is one of the top ten risk factors for premature mortality (Source: World Health Organisation, 2013). It is responsible for one in six deaths in the UK
  • There is a strong, well established association between physical inactivity and obesity. (Source: Everybody active, every day)

Chief Medical Officer Guidance recommends; adults should do at least 150 minutes of moderate activity per week; under- fives should be active daily for at least three hours; children and young people should engage in at least one hour of moderate to vigorous activity each day. Everyone should minimise the time spent sitting or lying down (sedentary behaviour):

  • 37% of the adult population in Lincolnshire fail to meet this target
  • By age 15 only 8% of girls reach the recommended level
  • Physical activity declines with age; by age 75 only one in ten men and one in twenty women are active enough for good health (Source: Everybody active, every day)

An increasing reliance on technology and reduced daily activity in paid and domestic work has resulted in an increase in the number of people having relatively sedentary lifestyles.

Context

National Strategies, Policies & Guidance

The Royal College of GPs: physical activity named as a clinical priority for 2016 – 2019. To support this, PHE are delivering a GP training programme around physical activity.

NHS Five Year Forward View 2014: calls for a 'radical upgrade in prevention' to avoid a 'sharply rising burden of avoidable illness' through preventative lifestyle initiatives such as those that promote physical activity.

The NICE Pathway: Physical Activity advises on promotion of physical activity and its role in preventing long term conditions. NICE Guideline: Physical activity and the environment [NG90] covers how to improve the physical environment to encourage and support physical activity. The aim is to increase the general population’s physical activity levels. NICE Guideline: Physical Activity: brief advice for adults in primary care [PH44] promotes the use of brief advice as an effective means of increasing people's physical activity levels. NICE Guideline: Physical activity: walking and cycling [PH41] encourages the implementation of local policies and planning measures to encourage the use of walking and cycling as a means of everyday travel as well as recreation.

In 2011 the four UK Chief Medical Officers produced UK physical activity guidelines for all age-groups in Start Active, Stay Active. The guidance provides recommendations on the amount of activity that is needed in order to benefit health as well as the type of activities that are defined as being of light, moderate or vigorous intensity. The report provides evidence for the effects of physical activity being dose-responsive, in particular with respect to CHD and type-2 diabetes.

There is an increasing emphasis in the literature on sedentary behaviour as an independent risk factor for a number of long term conditions including type-2 diabetes and metabolic syndrome. (Source: British Heart Foundation)

'Everybody active, every day' (PHE 2014) proposes long-term solutions to the problem of inactivity. It details the impact of inactivity on health as well as its costs to the NHS and the UK economy.

The Foresight report: Tackling obesities: future choices-project report (2nd edn.) (2007) locate physical activity as a key component of the obesity problem in the UK.

Sporting Future: A new strategy for an active nation (Department for Culture, Media and Sport (DCMS) 2015) outlines future strategy for sport and activity, including the role of central and local government. Focus will move towards engaging inactive groups including, women, older people, disabled people and those in lower socioeconomic groups. Outcomes have been prioritised as supporting five core themes; physical wellbeing, mental wellbeing, individual development, social and community development and economic development.

In response to Sporting Future, Sport England published its new strategy; 'Towards an Active Nation' 2016-2021. This strategy places a greater emphasis on: tackling inactivity and inclusivity; children and young people; the financial sustainability of the sector; digital opportunities; collaborative working; and promoting behaviour change techniques. It also brought about a change to the role of county sport partnerships. They were challenged to help Sport England deliver its strategy, placing a greater emphasis on physical activity and its wider benefits, and to move away from their traditional role of helping people to get involved in sport.

Children and Young People's physical activity is generally promoted in school settings, through measures such as the PE Premium which is paid to all (non-independent) schools with primary–aged pupils. The Youth Sport Trust, a national charity, works with schools to improve the quality of sport in schools and to maximise the impact of sport and physical activity on children's health and wellbeing.

One You - Is a national PHE campaign aimed primarily at people aged 40 – 60. It encourages people to make small changes to a range of behaviours, including their physical activity levels, which can have a major impact on their health in later life. It links to apps such as the ‘Couch to 5k’ that help support people to be more active.

Change for Life is a national PHE campaign that supports families and children to be more active through programmes such as the 10 Minute Shake Up.

Local Strategies & Plans

In the new Joint Health and Wellbeing Strategy for Lincolnshire (2018), physical activity is, for the first time, one of the seven priority areas. Active Lincolnshire is leading on the creation of a physical activity ‘taskforce’ and will be the accountable body to deliver on this. They have produced a strategic plan for physical activity that will be the starting point for the production of a ‘Blueprint for a more active Lincolnshire.’ The Blueprint will be based on insight and will be the overarching strategic plan for physical activity.

The Director of Public Health’s Annual Report for 2014 recommended measures to increase physical activity levels as a means of addressing the main cause of premature mortality in the county.

The Director of Public Health's Annual Report for 2017 recognises that behavioural interventions that meet the recommended level of physical activity for adults can have a major preventative effect on a number of conditions that contribute towards frailty and ill-health in older age.

The Lincolnshire STP Prevention Plan (2016) values the role of addressing lifestyle risk factors including smoking, alcohol, excess weight, diet and physical activity to improving health and tackling health inequalities.

What is the picture in Lincolnshire?

What the data is telling us

The PHE PA Data Tool contains detailed information on physical activity down to district level including rates of walking, cycling and the utilisation of green space.

63.1% of adults in Lincolnshire in 2016/17 (19 years and older) reach the minimum activity levels that are recommended by the four UK Chief Medical Officers; that is, for at least 150 minutes of moderate, or 75 minutes of vigorous, activity per week (in bouts of 10 minutes or more), plus some activity to improve muscle strength and balance on at least two days per week. Lincolnshire's level is significantly lower than England (66.0%) but similar to the East Midlands rate (65.0%).

In terms of inactivity, Lincolnshire has a similar proportion of inactive adults (24.5%) compared with the East Midlands (23.1%), but significantly worse than England (22.2%) (Source: Public Health Outcomes Framework). 'Inactivity' is defined in the Active People Survey as: the proportion of the population doing less than 30 minutes equivalent (in bouts of 10 minutes or more) of at least moderate activity at least once a week.

This leaves 12.6% of the population considered as 'fairly active'.

There is considerable variation across the county. The most active district is North Kesteven with 67.9% of the population considered active and the lowest active population is in South Holland with 57.5%. Inactivity rates are highest in South Holland at 31.9% and lowest in South Kesteven at 20.2%) in 2016/17 (Source: Public Health Outcomes Framework).

Public Health Outcomes Framework enables comparison data for England, regions, counties and districts to be calculated. The Department of Transport publishes county level data on walking and cycling.

Evidence suggests that adequate access to green space has a positive impact on physical and mental wellbeing and cognitive function through encouraging higher levels of physical activity. 19% of people in Lincolnshire report using green space in order to benefit their health in 2015/16; this is broadly in line with levels in the East Midlands (18.5%) and England (17.9%). In addition, 48,104 had access to woodland within 500 metres of their home in Lincolnshire for 2015. (Source: Public Health Outcomes Framework)

Sports participation depends upon volunteers to administer officiate and regulate sports. Lincolnshire has a lower rate of sports volunteering (13.3%) than other East Midlands counties (range 13.2- 15.9%), (Source: Active Lives 2016/17).

Trend

Physical activity, as recorded by the Active Lives survey has been measured by the current method since 2015/16 so the trend data is minimal. However, Lincolnshire was 3.2% less active in 2016/17 compared with 2015/16. Lincolnshire saw a corresponding rise in more people being inactive, rising by 2.1% from 2015/16 to 2016/17.

The utilisation of Lincolnshire's green space for exercise/health reasons has increased in the past 5 years from 10.1% in 2011/12 to 19.0% in 2015/16, and now on a similar level to the national average.
(Source: Public Health Outcomes Framework)

Key Inequalities

There are a number of inequalities in the activity levels of different population groups; for example; disabled people are less than half as likely to take part in sports as non-disabled; people with learning difficulties are less than half as likely to take part in physical activity than the population as a whole; women are more likely to be inactive than men (26% compared to 19%), similarly girls tend to be less active than boys – the difference is particularly marked after the age of 10; people living in the least prosperous areas are twice as likely to be inactive as those living in the most prosperous areas; physical activity declines with age, most significantly from the age of 75 (Source: Everybody Active Every Day 2014).

At a district level there appears to be some association between activity levels and deprivation: for example North and South Kesteven are the two least deprived areas and tend to have the best activity and lowest inactivity rates. However, the relationship is not straightforward, as exemplified by South Holland which consistently displays the worst activity and inactivity levels but is not the most disadvantaged district (5th out of 7) in terms of Index of Multiple Deprivation (IMD) score.

Current Activity & Services

District Councils provide discretionary leisure, culture and recreation services, subsidising fee-income to provide leisure services, parks and open spaces:

Boston Borough Council
City of Lincoln Council
East Lindsey District Council
North Kesteven District Council
South Holland District Council
South Kesteven District Council
West Lindsey District Council

Most district councils in Lincolnshire have contracted provision of leisure services to external operators. Some of these provide specific health improvement offers to their local communities, over and above the general benefit provided by use of their facilities.

In addition to this, local clubs utilise and may manage their own facilities for dedicated sports throughout the county.

There are a number of physical activity schemes, in particular walking, active travel and cycling projects, taking place in local communities.

Access Lincoln is a Department for Transport supported project seeking to effect behaviour change in people's travel choices. The project is planned to run through to March 2020 and will engage with over 10,000 people in the Access Lincoln area of Lincoln City, Hykeham, Waddington, Skellingthorpe, Bracebridge Heath and Nettleham with personalised travel planning, walking and cycling events, community engagement sessions and other initiatives. The anticipated outcomes will be to help ease congestion, contribute to the carbon management agenda, and improve health and wellbeing outcomes for local residents.

Lincolnshire Co-operative co-ordinates the county's Health Walk's programme, in partnership with district and city local authorities and their leisure providers. There are more than 60 regular, volunteer-run health walks across Lincolnshire. They come under the national Walking for Health scheme which is run in partnership by the Ramblers and Macmillan Cancer Support. Local health walks can be found via the Walking for Health website.

Vitality is a Lincolnshire based programme of exercise classes through movement and music for the over 60’s. Vitality run over 40 weekly classes throughout Lincolnshire in a variety of different town and rural settings – village and church halls, sheltered housing complexes and leisure centres.

Sport England offers grants to local clubs and communities to develop and upgrade facilities. Active Lincolnshire promotes sports and physical activity and supports local clubs and the workforce to access grants and training.

Active Lincolnshire has developed an app, called Go Explore Lincolnshire. It promotes walking, cycling & exploring and aims to help people to discover routes and activities on their doorstep. The app gives greater insight on how people interact with technology to become more active.

Lincolnshire County Council is responsible for maintenance of public rights of way and public health interventions. Public rights of way are recorded on Definitive Maps and are described in accompanying statements. Lincolnshire County Council, like all surveying authorities, is required to maintain the maps and statements and make them available for public inspection. Since 1 April 2013 through The Health & Social Care Act, local authorities have been responsible for improving the health of their local population and for public health services including most sexual health services and services aimed at reducing drug and alcohol misuse.

Lincolnshire's 2500 miles of public rights of way (footpaths, bridleways and byways), managed by LCC's Countryside Service Team, offer a great opportunity to be active and explore the county's countryside and coast. More information can be found on the LCC website.

Lincolnshire County Council (LCC) Public Health continues to promote physical activity through population-level initiatives such as Making Every Contact Count (MECC) and through the One You Lincolnshire network that includes partners from a range of sectors including local authorities, voluntary organisations, Active Lincolnshire and leisure providers.

The Youth Sport Trust sponsors the roles of Schools Games Organiser and School Games through the local School Sport Network (The One Network). Active Lincolnshire monitors the use of the Primary PE and Sport Premium across the county. Analysis has identified extensive use of the grant for the benefit of pupil's physical activity, exercise and competition:

  • 100% of primary schools utilising the premium
  • 97% of primary schools publishing their offer to parents and others
  • Key activities committed towards:
    • Extra curriculum clubs – 100%
    • Coaching – 97%
    • Inclusion activities – 94%
    • Professional learning – 91%
    • Swimming – 78%
    • Equipment- 69%
    • Transport -59%
    • Health /Physical Activity – 41%
    • Facilities – 13%

In addition, Inspire Plus, a school sports charity, provides a range of services to member schools across Lincolnshire including training and supporting staff to deliver higher quality PE and the provision of specialist coaches.

Unmet Needs & Gaps

Activity levels tend to decline steeply with age and Lincolnshire has a greater population of older people compared to the rest of England. Although Sport England data suggests that activity levels are rising amongst older people, rates are still significantly lower than for younger age groups; however, no local strategy or coordinated services are in place to mitigate the effects of this in relation to conditions such as osteoarthritis or type-2 diabetes, for which both age and inactivity are major risk factors.

The Public Health Outcome Frameworks currently only report activity levels for adults and children aged 15; however from this year Sport England will begin to measure the activity of children (outside the school environment) aged 5 – 14 in the Active Lives survey.

Local Views & Insights

The development of the new Joint Health & Wellbeing Strategy for Lincolnshire engaged with numerous stakeholders to define the future priorities for Lincolnshire. Among the new priorities is the theme of Physical Activity.

Risks of not doing something

Physical inactivity currently costs the NHS and wider society £7.4 billion. These costs will be proportionately higher in Lincolnshire as the local population is less active than that of the country as a whole. Inactivity and hence costs are likely to increase as the county ages.

Prevalence of type-2 diabetes, for which inactivity is a major risk factor, is higher in Lincolnshire than it is nationally (7.7% compared to 6.7%). The cost to the NHS of type 2 diabetes is currently £8.8 billion per year and it is estimated that the wider economic costs add a further £13 billion (Source: PHE 2014 Obesity and Type-2 Diabetes).

As a lack of physical activity is strongly associated with a number of chronic conditions including colon cancer, breast cancer, CHD, stroke, falls and hypertension, such inactivity will have a significant impact on the population's health.

What is coming on the horizon?

The five year Sustainability and Transformation Plan (STP) for local health service funding requires health providers to deliver services that meet the needs of local populations as well as supporting the Five Year Forward View vision, which includes a ‘radical upgrade’ in prevention. This provides the opportunity to invest resources in physical activity programmes that will result in financial savings to the NHS through contributing to primary and secondary prevention outcomes. The STP Prevention Plan has prioritised the need for a number of lifestyle services that includes a physical activity component.

Lincolnshire County Council's Wellbeing Commissioning Strategy outlines the authority's intentions and influences relating to health and wellbeing. As part of the strategy there is an intention for a collaborative approach in addressing risky lifestyle behaviours, self- care and social prescribing between the Council and the NHS.

The World Health Organisation (WHO) will be producing a global action plan on physical activity 2018-2030 (More active people for a healthier world). The action plan will seek to promote the benefits of physical activity for people across communities, economies, environments and systems. It will seek a paradigm shift for a whole-of-society response for supporting and valuing all people to be regularly active.

What should we be doing next?

  • Working collaboratively with Active Lincolnshire to set up the countywide Taskforce for physical activity and aligning strategies to work on a ‘Whole System Approach’ and create an agreed Blueprint;
  • As a result, building partnerships that can bring together and maximise the impact of local assets, experience and expertise to attract greater funding;
  • Gathering robust data around the impact of physical inactivity as well as the effects of physical activity interventions in Lincolnshire. Using economic modelling to accurately identify the value of increasing activity levels to health and social care services as well as to the wider local economy. Using this information to develop an accurate analysis of future need and solutions that will inform the priorities of the Blueprint;
  • Increasing knowledge and evidence around the potential impact of physical inactivity on the county's ageing population on which to build an effective strategy and interventions.

 

If you need to contact us about this topic, please email JSNA@lincolnshire.gov.uk

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