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Mary Allison Co-ordinator Physical Activity Strategy for Scotland
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Outline Scotland’s health: the challenge Scotland’s policy responses Scotland’s physical activity strategy Implementing the physical activity strategy
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Scotland’s health: the challenge (i) Tackle inequalities WHO World Health Report 1997
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Scotland in context of maximum, minimum, and mean rates for 17 Western European countries Source: WHOSIS (May 2002) 200 400 600 800 1000 19501955196019651970197519801985199019952000 Year of death Rate per 100.000 population per year Maximum Mean Minimum ICD6/7: A000 ICD8: A000 ICD9: B00 ICD10: AAA Scotland's rank: 1 1 1 1 1 1 1 1 All cause mortality age standardised rates among women aged 15-74 years
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Scotland’s health: the challenge (i) Tackle inequalities (ii) Promote healthy ageing WHO World Health Report 1997
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Scotland’s health: the challenge (i)Tackle inequalities (ii)Promote healthy ageing (iii) Improve health WHO World Health Report 1997
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The big 3 and growing 2 Coronary heart disease Stroke Cancers Mental Health Type II Diabetes
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Heart Disease in Scotland Source: British Heart Foundation, 2000 Scottish Health Survey, 1998
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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.
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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.
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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%
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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%
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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
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Policy Context
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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
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Scottish Executive's Physical Activity Strategy
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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
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Active population 1, by age and sex Source: Scottish Health Survey, 1998 1 children: 60mins on 5 days, adults: moderate or vigorous target
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The importance of everyday activities
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The importance of individual activities
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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
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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
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Recommendations: Strategic objectives Quality environments for activity Dissemination of evidence Training Research and evaluation
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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
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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
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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
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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
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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
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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
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