Tackling Obesity Locally

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Tackling Obesity Locally

• The Role of Local Government
• Paul Billington
• Sheffield City Council

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Overview

• trends
• local government
• contribution to tackling
• obesity
• progress in Sheffield

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Trends

• participation rates amongst lowest in Europe and
  only the Greeks walk less!
• since 1976 walking decreased by 25 and cycling
  by 33
• highest occupational group has sports
  participation rate double that of unemployed
• sports participation by 20 year olds is almost 5
  x higher than 75 years
• womens sports participation is falling
• competitive sports participation is falling and
  gym, recreational walking and cycling are
  increasing

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Trends

• local government spend on sport has fallen by 30
  since 1990s
• indoor sports facilities require around 550M to
  be spent immediately
• major focus of sports policy on clubs and sports
  governing bodies and no national lead on physical
  activity
• only 10 of population are members of gyms and
  50 leave in first year - plus 90 of members are
  between 16 and 35 and few are from social class
  DE

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Physical activity focus on preventing weight
gain

• people who have been obese and who have lost
  weight may need to do 60-90 minutes of activity
  a day in order to maintain their weight loss
  (CMO)
• for weight loss, we recommend that you aim for up
  to 45 - 60 minutes activity per day and to
  maintain weight lost, aim for at least 60 minutes
  per day. This is equivalent to building up to
  15000 steps every day (National Obesity Forum) -
  thats over 7 miles a day!

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Physical activity and obesity potential
pitfalls

• physical inactivity contributes to up to 20
  chronic diseases or disorders
• in promoting physical activity we must avoid
  medicalising the message
• better to be overweight and active than the
  right weight and inactive Im thin so I dont
  need to exercise!
• obesity debate dominated by diet more
  controllable in public policy terms and we have
  to eat but dont have to exercise
• however obesity debate is giving unprecedented
  profile to exercise we must capitalise on this

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Physical activity interventions

• no studies before 1980
• 2000 studies between 1980 and 1990
• 4000 studies between 1990 and 2002 following
  ground breaking studies on impact of exercise on
  death and disease in 1987
• however, vast majority of research has focused on
  the individual and behaviour change
• little focus on environmental and social policies
  and recognition that society has increasingly
  engineered activity out of our daily lives

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Local government leadership

• 60 of variation in health is due to
• socio-economic differences and environment
• key influence on wider determinants of health
  environment, education, housing, transport,
  access to exercise, urban design, social cohesion
  
• power to promote and improve well being
• lead role in LSPs and LAAs where health is
  central
• still spend more than 50 of total sport spend

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Get strategic

• upstream population wide measures e.g. land
  use, urban design, social marketing
• midstream community/neighbourhood measures e.g.
  facilities, outreach work
• downstream tailored measures aimed at
  individuals or small groups e.g. exercise
  referral
• work across all three simultaneously
• healthy choices must be easy choices

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Go upstream

• policies focusing on individual choice/lifestyle
  are effective for only around 20-25 of
  population
• environmental quality found to be the greatest
  predictor of youth activity levels in 80 Chicago
  neighbourhoods
• individuals living in walkable neighbourhoods
  were 2.4 times more likely to meet activity
  targets than those in low-walkable areas
• US study showed incidence of obesity decreased
  directly with increase in mixed land use i.e.
  shops, amenities and schools close to home

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Sheffield strategy

• focus on young people and their family
• programmes in both school and community settings
• working across the target markets
• more and better places to be active
• a city promotional campaign
• improved environment and walk/cycle
  infrastructure
• partnership underpinning everything

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Active Sheffield?
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Young people

• 1.2M investment in play spaces
• developing pre-school strategy based on
  international best practice
• major investment in school facilities and
  programmes with links to community programmes and
  clubs
• school programmes shifting from team games focus
  to reflect what adults do
• unprecedented 3M investment in positive
  activities for 8-13s

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Target markets

• inactive or nearly active?
• NHS wants to focus on the inactive and especially
  older people
• LAA will push local government towards the active
  and nearly active
• focusing largely on those doing some activity but
  need to do more - with specific programmes for
  the inactive

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Places to be active

• first new swimming pool in 15 years
• 3M city centre pay and play gym
• 15 new sports halls in last 10 years
• 0.3M investment in Victorian pool
• 3M partnership investment in new sports centre
• first ever capital grants scheme for young
  peoples facilities
• unprecedented re-investment in parks

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Social marketing

• motivational messages, information, mobilise
  (participation events) and advocate/lobby
• based on best practice from Finland, Canada and
  NZ
• sustained, non-medicalised campaign with strong
  local flavour
• consistent message 5 X 30 moderate activity

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Walking

• single most important activity
• nearest activity to perfect exercise
  (Morris/Harman 1997)
• since bus de-regulation, bus fares in Sheffield
  have risen by 86 in real terms and passenger
  numbers have halved
• nationally, independent shops reduced by 40
  between 1986 and 1996, while the number of
  superstores more than doubled each generating
  90,000 car kilometres every day
• national Ramblers city walking project in the
  city and walking festival and walkit.com

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Re-engineer the environment

• improving streetscape
• invest in public realm
• removing barriers / bridges / underpasses
• improved bus priorities
• re-modelling seating, signage, traffic calming,
  crossings, revised space allocation, traffic
  enforcement and maintenance

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London 2012

• Sydney Games no increase in participation and
  for some reinforced the couch potato syndrome
• many Olympic sports are minority sports
• no evidence of mega-event impact on participation
• active nation not just sporting nation
• Legacy Now in Sheffield

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News nearly 5M for Sheffield for preventing
obesity!
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Conclusions

• central role for local government
• go beyond service delivery and be strategic
• integrated whole system approach Ottawa Charter
  (1986)
• easy and attractive choices
• active living way beyond sport
• in for the long term!

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Thank you for listening