Mary Allison Co-ordinator Physical Activity Strategy for Scotland

Outline Scotland’s health: the challenge Scotland’s policy responses Scotland’s physical activity strategy Implementing the physical activity strategy

Scotland’s health: the challenge (i) Tackle inequalities WHO World Health Report 1997

Scotland in context of maximum, minimum, and mean rates for 17 Western European countries Source: WHOSIS (May 2002) Year of death Rate per population per year Maximum Mean Minimum ICD6/7: A000 ICD8: A000 ICD9: B00 ICD10: AAA Scotland's rank: All cause mortality age standardised rates among women aged years

Scotland’s health: the challenge (i) Tackle inequalities (ii) Promote healthy ageing WHO World Health Report 1997

Scotland’s health: the challenge (i)Tackle inequalities (ii)Promote healthy ageing (iii) Improve health WHO World Health Report 1997

The big 3 and growing 2 Coronary heart disease Stroke Cancers Mental Health Type II Diabetes

Heart Disease in Scotland Source: British Heart Foundation, 2000 Scottish Health Survey, 1998

Obesity* Trends Among U.S. Adults BRFSS, 1985 (*BMI  30, or ~ 30 lbs overweight for 5’4” person) No Data <10% 10%-14% 15-19%  20% Source: BRFSS, CDC.

Obesity* Trends Among U.S. Adults BRFSS, 1990 (*BMI  30, or ~ 30 lbs overweight for 5’4” person) No Data <10% 10%-14% 15-19%  20% Source: BRFSS, CDC.

Obesity* Trends Among U.S. Adults BRFSS, 1995 (*BMI  30, or ~ 30 lbs overweight for 5’4” person) 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” person) Source: Mokdad A H, et al. JAMA 2001;286:10 No Data <10% 10%-14% 15-19%  20%

Mental Health in Scotland  30% of GP consultations are for mental health problems  NHS in Scotland spends 40% more per head on antidepressant prescriptions than England  Suicide leading cause of death among young men in Scotland - over twice the rate found in England  Around 1,400 young people (under 18 years) treated in hospital each year for deliberate self-harm

Policy Context

Health Department only one partner in health Community Planning Partnerships are critical Focus on early years, teenage transition, workplace health, community-led health improvement Evidence based developments Health Improvement Policy

Scottish Executive's Physical Activity Strategy

June 2001 Task Force set up formed subgroups reviewed evidence identified targets briefed Ministers consulted with experts commissioned research considered effective interventions formulated recommendations June 2002 Consultation Report Feb 2003 Final Report - Policy

Active population 1, by age and sex Source: Scottish Health Survey, children: 60mins on 5 days, adults: moderate or vigorous target

The importance of everyday activities

The importance of individual activities

Recommendations Vision People in Scotland will enjoy the benefits of physical activity Goals By 2022: –50% adults –80% children will meet the minimum recommended levels

Recommendations: National infrastructure Structure & accountability national cross departmental co-ordinator steering and review group Responsibilities: advocacy cross-cutting policy development integrated action plans monitoring and evaluation identifying resources

Recommendations: Strategic objectives Quality environments for activity Dissemination of evidence Training Research and evaluation

Stimulate demand –national communications plan (Healthy Living) Improve supply –four cross-departmental implementation plans Active Schools Active Communities Active Workplaces Active Homes Implementation of physical activity strategy

Pre-school, Primary and Secondary –Getting to/from school –active travel –Breaks –play –Formal curriculum –PE, health ed, environmental ed –Extended curriculum –sports, dance, adventure activity –After school/out of school care Curriculum, schools policies and ethos and school/community linkages Active schools: framework

Getting to and from work –active commuting … green travel planning In and around work –stair use At/in work –occupational health and referral for rehabillitation –flexi-credit Before/After but linked to work (SHAW) –range of regular activity options (buddying) –corporate challenges & events Active Workplaces

Babies –physical activity for parents/carers & babies –parenting development –health visiting Frail elderly –provision and support for exercises for strength and balance –health visiting –joint futures teams –gerontology nursing Active Homes

Active Communities Space planning –housing, recreational land, open space Travel planning –walking and cycling Building design –stairs, active routes Service provision –recreational activities –primary health care

SE Depts Education Rural Affairs Development Justice Health Enterprise and lifelong learning Stronger national policy Community planning Education Land use and planning Transport Social services Health Leisure and cultural services Stronger local policy More consistency across the board through communications plan and the use of the brand Stronger generic support for delivery National Agencies LTS SNH Forestry Comm Communities Scotland sportscsotland Scot Arts Council Health Scotland SHAW HSE More effective local delivery Schools Communities Workplaces Homes