APPG on Cycling 26th February 2019 Promotion of cycling to improve health and wellbeing Dr Mike Brannan National Lead for Physical Activity, PHE APPG on Cycling 26th February 2019

Inactivity is killing us Image © Shutterstock Inactivity is killing us 1 in 3 (34%) men and almost 1 in 2 (42% women not active enough for good health 20% less active since 1960s (35% by 2030) Physical inactivity is responsible for: 1 in 6 UK deaths Up to 40% of many long-term conditions Around 30% of later life functional limitation and falls Estimated £7.4 billion annual cost Physical inactivity is not a new issue. Over the last few decades trends such as increased car ownership and use, reduced manual element of jobs and increased home-based entertainment has designed physical activity out of people’s lives and we are the first generation that needs to make a proactive choice to be physically active. We know that since the 1960s we are: Over 20% less active, By 2030 we are projected to be 35% less active An estimated £7.4 billion annual cost to UK. This is likely to be an underestimate and is based on calculations of: 1 in 6 UK deaths can be attributed to insufficient levels of physical activity - This makes it as dangerous as smoking Up to 40% of many common conditions such as diabetes could be prevented if people were more physically active Estimated £7.4 billion annual cost to UK, based on estimates of: £0.9bn in costs to the NHS £6.5bn in non-NHS costs - £5.5 billion from sickness absence and £1 billion from premature death of people of working age Health Survey for England 2016; Ng SW , Popkin B (2012); Lee I-M, et al. (2012); Wen CP, Wu X (2012); WHO (2010); Ossa D & Hutton J (2002); Murray et al. (2013)

Prioritising cycling & walking One of seven “best investments” to increase population level physical activity Prioritised for increasing physical activity & health UK CMOs’ guidance National physical activity framework National Sport Strategy WHO Global Action Plan Key intervention in Richmond Group of Charities’ PROMISE study to achieve WHO ‘25 by 25’ goal

Health benefits of active travel Modal benefits of cycling & walking for individuals, communities and health and care system Benefits include: Improved metabolic health and a reduced risk of premature mortality Reduction in the risk factors for many LTCs (e.g. cardiovascular disease, respiratory disease, some cancers, type II diabetes) Positive effects on mental health and general well-being Reduction in pollution & road congestion (due to reduced car use) Health benefits outweigh health risks and harms (e.g. from injury or pollution) PHE (2019) Cycling and walking for individual and population health benefits.

Everybody Active, Every Day: The national framework for action Active Society Moving Professionals Moving at scale Active environments As the statutory leader of the public health system at national and local level, PHE has worked with over 1,000 national and local stakeholders to coproduce the Everybody Active Every Day framework. It consolidates international evidence on ‘what works’ into a single cohesive framework across sectors and levels for increasing physical activity in England. It supports local leaders (e.g. Health and Wellbeing Boards, local authorities, NHS clinical commissioning groups, voluntary sector, private sector) to reframe, refocus and provide leadership on physical activity on: Cross-sector partnership Industrial scale action across the whole system Focus on addressing inactivity as well as increasing physical activity to health enhancing levels – as we now that the greatest gains are in getting people who are ‘inactive’ – doing less than 30 minutes per week of exercise – just to become active irrespective of whether they achieve 150 minutes per week. The overarching vision of ‘Everybody Active Every Day’ summarises the guidance of the UK Chief Medical Officer: The most effective way to achieve the recommended levels of physical activity for good health is by embedding physical activity in daily life; and Physical activity is needed by and should be the expectation for everyone. Irrespective of age, disability economic or any other factor we all need to be supported to be active and have a healthy, happy life. The vision is supported by four domains for national and local actions which are set out in the following slides with actions that NHS providers should take as part of this whole system approach. Public Health England (2014) Everybody Active Every Day.

Support for healthcare system Infographics on UK CMOs guidance Include cycling as recommendation Preventative interventions guidance for STPs Physical activity and active travel promoted as a cost effective intervention (e.g. active travel plans with local activation, workplace support) Moving Healthcare Professionals programme Increasing knowledge, skills and changing practice of HCPs to embedding physical activity in clinical care Evidence review on cycling and walking for individual, community and health and social care systems

Resources for planners Transport Infrastructure for walking and cycling Encourage use public transp. Promote sustainable transport infrastructure Prioritise pedestrians and cyclists Traffic calming measures Prioritise active travel and road safety Active travel to work and school Access to recreational space Enable mobility for all ages

Whole systems approaches to obesity Aim = Produce national guidance on how to set up and implement a local whole systems approach to tackling obesity Multi-phase process led by Leeds Beckett University: 4 Pilot LAs - co-production phase 7 Test LAs – testing phase 80+ LAs – reviewing phase Guidance for Publication – early summer 2019 Sharing findings to support Obesity Trailblazers and Sport England Local Delivery Pilots ______ Original Pilots Additional LAs

Summary Cycling are walking are the easiest ways to embed physical activity in daily life and achieve recommended activity levels for health and wellbeing benefits PHE is supporting action on: Active society (e.g. Change4Life, One You) Moving professionals (e.g. healthcare, education) Active environments (e.g. resources for planners) Evidence-based approaches (e.g. data, reviews)