Physical inactivity Schools as part of a community wide solution Kelly Kennington August 2006

Physical activity Re-frame physical activity Social, sustainability, health & economic benefits Why is it important and urgent? (for us all) In what things do we need to invest? 10 point plan for schools

Why is it urgent that we invest?

Physical activity is decreasing (per cent), 1997 and (WA Adult data, 2002, 57% men, 52% women, 54% overall)

Obesity Trends* Among U.S. Adults BRFSS, 1985 No Data <10% 10%–14% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Obesity Trends* Among U.S. Adults BRFSS, 1986 No Data <10% 10%–14% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Obesity Trends* Among U.S. Adults BRFSS, 1987 No Data <10% 10%–14% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Obesity Trends* Among U.S. Adults BRFSS, 1988 No Data <10% 10%–14% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Obesity Trends* Among U.S. Adults BRFSS, 1989 No Data <10% 10%–14% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Obesity Trends* Among U.S. Adults BRFSS, 1990 No Data <10% 10%–14% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Prevalence of Obesity* among U.S. Adults BRFSS, 1991 (*Approximately 30 pounds overweight) Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16. 15%

Prevalence of Obesity* among U.S. Adults BRFSS, 1992 (*Approximately 30 pounds overweight) 15% Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.

Prevalence of Obesity* among U.S. Adults BRFSS, 1993 (*Approximately 30 pounds overweight) 15% Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.

Prevalence of Obesity* among U.S. Adults BRFSS, 1994 (*Approximately 30 pounds overweight) 15% Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.

Prevalence of Obesity* among U.S. Adults BRFSS, 1995 (*Approximately 30 pounds overweight) 15% Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.

Prevalence of Obesity* among U.S. Adults BRFSS, 1996 (*Approximately 30 pounds overweight) 15% Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.

Obesity Trends* Among U.S. Adults BRFSS, 1997 No Data <10% 10%–14% 15%–19% ≥20 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Obesity Trends* Among U.S. Adults BRFSS, 1998 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman) % No Data <10% 10%–14% 15%–19% ≥20

Obesity Trends* Among U.S. Adults BRFSS, 1999 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman) No Data <10% 10%–14% 15%–19% ≥20

Obesity Trends* Among U.S. Adults BRFSS, 2000 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman) No Data <10% 10%–14% 15%–19% ≥20

Obesity Trends* Among U.S. Adults BRFSS, 2001 No Data <10% 10%–14%15%–19% 20%–24% ≥25% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Source: Behavioral Risk Factor Surveillance System, CDC (*BMI  30, or ~ 30 lbs overweight for 5’4” person) No Data <10% 10%–14%15–19% 20%–24% ≥25% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman) Obesity Trends* Among U.S. Adults BRFSS, 2002

An Australian problem too Two thirds of men overweight or obese A half of women overweight or obese A quarter of children overweight or obese Half our adults not active at a level that would improve their health

A problem with Australian children too Proportion (7-15 yrs) above healthy weight 1985 and 2003 (CAPANS; 2003)

Without concerted action A disturbing outlook If trends continue to worsen in Australia, we may see for the first time, a generation of Australian children who will not live as long as their parents

Wins across the triple bottom line “Re-frame” physical activity in community wide terms Environment and sustainability Economy Social policy And health

Physical activity delivers environment and sustainability benefits

Important nexus between sustainability and health agendas Western Australians –240,000 car trips per day less than 1km –750,000 trips per day of less than 3km What impact on health if we switch 25% of these trips to active modes (walking or cycling)?

What about health? Physical activity delivers significant health benefits across chronic diseases

Chronic diseases have common risk factors and these remain very prevalent in Australia Adult prevalence of selected CVD risk factors

Health benefits Modest increases in physical activity produce major health gains If all Australians were sufficiently active the following would be prevented: One third of coronary heart disease deaths One quarter of diabetes deaths One fifth of colon cancer deaths Up to 12% of breast cancer risk About 15% of ischaemic stroke risk 10-16% of the risk of hip fractures

Economic Benefits Costello on prevention “Singling out obesity as a particular problem, Mr Costello said Australia's health system needed to shift its focus from treating diseases to preventing them if it was to stop soaring costs swamping government coffers”. Citing ageing population and the rising cost of medical technology, Mr Costello said: "You put the two of them together and you have an exponential cost coming down the tunnel in 20 and 30 and 40 years' time." (The Age, Sep 13, 2005)

Why should child and adolescent physical activity a priority? Commencing primary prevention at an early age is important, and effective Very strong evidence for the population health benefits of physical activity in childhood Strong evidence for targeting schools as a setting

Why a priority? Health benefits of childhood Physical Activity? Health outcomes associated with PA in childhood Improved aerobic fitness Increased HDL cholesterol Decreased body fat Increased bone mineral density Improved mental and social health

A community-wide problem requires community wide solutions

Solutions recommended……. Individuals –Build knowledge, skills, self-efficacy, through social marketing and education The built environment –Provide a supportive built environment. –Neighborhood planning –Active transport, walking, cycling Social supports –Fund programs that provide and support social connection –Opportunities to be active in the places where people live, work and are educated (schools, workplaces and local government) Culture -Physical activity becomes the cultural norm

Where should we place the emphasis in schools?

10 point plan (1) Build strong school-community partnerships

Build partnerships with those who plan and build the community Provide more school community linked physical activity programs (that meet the needs and interests of girls as well as boys). Promote more programs and resources for family participation (and school community partnership) Resource and support schools to engage with sectors outside education clubs and associations planners After school service providers local government Transport Non-government agencies Build strong school-community partnerships

10 point plan (2) Support and educate parents

Parents are a central part of the solution Parent targeted education (media, P&C, other) To enable them to: Model active behaviour Support and encourage active play, recreation and sports Be active with their children Encourage walking and cycling to school When they hear “I’m bored”, make active suggestions, provide active alternatives Restrict sedentary down-time (TV, computer games etc) Plan active family outings Advocate with their school and council

10 point plan (3) Fund and prioritise best practice physical education curriculum

Implement policy to ensure: –Minimum time allocations for physical education ( mins) –Accompanied by standards to be achieved in physical education –Accompanied by re-prioritised in-service training for teachers (especially middle-primary level) –TIME + STANDARDS + TRAINING = QUALITY Fund and re-prioritise best practice physical education curriculum

10 point plan (4) Re-prioritise physical education teacher training

Increased training opportunities for all primary teachers pre-service Emphasise training of all current primary teachers in teaching mastery of fundamental movement skills Ongoing professional development opportunities for secondary physical educators Re-prioritise physical education teacher training, especially at pre-service primary level

10 point plan (5) Prioritise walking and cycling initiatives in schools and Local Government and Transport

Prioritise walking and cycling initiatives in schools and local Government and Transport (Child and Adolescent PA and Nutrition Survey, PATF, WA, 2003) Active Transport More than half of students typically do not walk or cycle to school –25% Year 3’s walked or cycled –36% Years 3-5 –46% boys in year 8, 10, 11 and 37% girls

10 point plan (6) Implement campaigns and programs to address sedentary behaviour

Sedentary behaviour: Implement programs and introduce measures to limit television watching and small-screen recreation. (Child and Adolescent PA and Nutrition Survey, PATF, WA, 2003) Primary students Screen time on weekdays was 2.2 hours for primary school males and 2.1 hours for females Secondary students Girls spend 4.3 hours watching Tv and boys 3.9 hours on week nights. Programs? –Turn off the TV challenge –Take home components

10 point plan (7) Provide structured and unstructured opportunities for children and youth to be active at lunch and recess breaks.

Provide opportunities (structured and unstructured) for children and youth to be active at lunch and recess breaks. Ran and played hard most of the time at recess and lunchtime (CAPANS 2003) %

10 point plan (8) Target activities that are in keeping with the interests and developmental needs of children and youth

Target activities that are in keeping with the interests and needs of children and youth Secondary ‘Ask them’ about their needs and interests Give priority to adolescent girls Connect them (at secondary level) with community opportunities (to enhance school-community transition) Primary Focus on fundamental movement skill development with younger children Focus on games skills in upper primary

10 point plan (9) Plan school environments that support physical activity

Emphasise physical activity in –School design –Playground and facility design and provision –Physical activity and sport facilities –Access to community facilities (and the community to the school’s) –Transport planning (walking, cycling, public transport and parking) –Shaded play areas Plan school environments that support physical activity

10 point plan (10) Establish school policies that promote physical activity

A school physical activity policy to ensure previous recommendations are institutionalised: –Policy guiding time allocation, standards and training in physical education –Space, equipment and supervision is provided for before and after school, lunch and recess periods –Incorporate physical activity (as appropriate) in other learning areas and in extra-curricular activities (carnivals, fetes, camps, fundraisers). Establish school policies that promote physical activity

Schools role? 1.Develop community partnerships including with those who plan and build the community 2.Support and educate parents 3.Fund and prioritise best practice curriculum 4.Re-prioritise teacher training in physical education 5.Prioritise walking and cycling initiatives 6.Implement campaigns and programs to address television and small screen recreation 7.Provide physical activity opportunities at lunch and recess breaks 8.Target activities in keeping with student needs and interests 9.Establish school policies that promote physical activity 10.Plan school environments that support physical activity And: Fund, expand and institutionalise programs that work

Closing thoughts The evidence is compelling for adults and children The need to act is urgent It is a community-wide responsibility, but There is a special role for schools

Thank you Kelly Kennington Senior Manager – Physical Activity and Healthy Weight National Heart Foundation of Australia (08)