Naturally Better – Howbery Park, Wallingford – 26 th March 2009
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Naturally Better – Howbery Park, Wallingford – 26th March 2009
Green space, physical activity and public health
Dr. Charlie Foster – Senior ResearcherBHF Health Promotion Research GroupUniversity of Oxford
Presentation Objectives
To briefly describe the relationship between green space, public health and physical activity
Describe the evidence base for this relationship
Offer possible directions for developing this evidence base
Presentation Objectives
To briefly describe the relationship between green space, public health and physical activity
Describe the evidence base for this Describe the evidence base for this relationshiprelationship
Offer possible directions for developing Offer possible directions for developing this evidence basethis evidence base
Consensus on health benefits of green space
Green space can reduce the risk of:» Promotes good health and prevents ill health
– Stress– Anxiety– Depression
» A place for physical activity
(Bedimo-Rung et al, 2005; Hartig, 2007; Moore & Cosco, 2007; Ottoson, 2007)
Public health importance of physical activity in the UK
Adults who are physically active have a 20-30% reduced mortality risk compared to inactive adults.
Estimates put the total direct costs to England of physical inactivity to the NHS as £1.06 billion
Conservatively, this represents about 54,000 lives lost prematurely per annum.
A 10% increase in adult activity would benefit England by at least £500m a year (saving about 6,000 lives).
(Game Plan, Strategy Unit 2002; Allender et al, 2006)
Cost of physical inactivity related disease in London
The cost of illness for physical activity related disease is nearly £14 per Londoner
The PCT spend on physical activity promotion is 85p per Londoner
(Foster et al, 2009)
Presentation Objectives
To briefly describe the relationship To briefly describe the relationship between green space, public health between green space, public health and physical activity and physical activity
Describe the evidence base for this relationship
Offer possible directions for developing Offer possible directions for developing this evidence basethis evidence base
Mitchell and Popham (2008)
Access to green space is associated with better health for the poorer half of the population
Incidence rate ratios for deaths from circulatory disease in income deprivation quartiles 2–4, relative to income deprivation quartile 1 (least deprived), stratified by exposure to green space
Mitchell and Popham. Lancet, 372, 2008, p 1658
A social-ecological model of physical activity behaviour
Foster et al (2005). Understanding why adults and children participate in physical activity and sport. London, Sport England.
Law & Regulations
Fiscal
Built environment
Natural environment
Health care systems
National policies & programmes
A social-ecological model of physical activity behaviour
Foster et al (2005). Understanding why adults and children participate in physical activity and sport. London, Sport England.
Law & Regulations
Fiscal
Built environment
Natural environment
Health care systems
National policies & programmes
Obesity
A social-ecological model of physical activity behaviour
Foster et al (2005). Understanding why adults and children participate in physical activity and sport. London, Sport England.
Law & Regulations
Fiscal
Built environment
Natural environment
Health care systems
National policies & programmes
Obesity
Proximity to recreation facilities, convenienceDestination factors, micro-scale design, footpaths, trailsMixed land use, shops and services nearbyAesthetics (perceived)Population density/sprawlArea based Coastal residence Area based Urban/age of suburbCulture, social environment as most importantConnectivity
WalkabilityRoute related factors, hills, traffic
Perceived safetyHigh crime rate Unattended dogsLighting/streetlights
Green spaces, environmental correlates and physical activity
Proximity to recreation facilities, convenienceDestination factors, micro-scale design, footpaths, trailsMixed land use, shops and services nearbyAesthetics (perceived)Population density/sprawlArea based Coastal residence Area based Urban/age of suburbCulture, social environment as most importantConnectivity
WalkabilityRoute related factors, hills, traffic
Perceived safetyHigh crime rate Unattended dogsLighting/streetlights
Green spaces, environmental correlates and physical activity
Proximity to recreation facilities, convenienceDestination factors, micro-scale design, footpaths, trailsMixed land use, shops and services nearbyAesthetics (perceived)Population density/sprawlArea based Coastal residence Area based Urban/age of suburbCulture, social environment as most importantConnectivity
WalkabilityWalkabilityRoute related factors, hills, trafficRoute related factors, hills, traffic
Perceived safetyPerceived safetyHigh crime rate High crime rate Unattended dogsUnattended dogsLighting/streetlightsLighting/streetlights
Green spaces, environmental correlates and physical activity
+More
often assoc
iated
Proximity to recreation facilities, convenienceProximity to recreation facilities, convenienceDestination factors, micro-scale design, footpaths, trailsDestination factors, micro-scale design, footpaths, trailsMixed land use, shops and services nearbyMixed land use, shops and services nearbyAesthetics (perceived)Aesthetics (perceived)Population density/sprawlPopulation density/sprawlArea based Coastal residence Area based Coastal residence Area based Urban/age of suburbArea based Urban/age of suburbCulture, social environment as most importantCulture, social environment as most importantConnectivityConnectivity
WalkabilityRoute related factors, hills, traffic
Perceived safetyPerceived safetyHigh crime rate High crime rate Unattended dogsUnattended dogsLighting/streetlightsLighting/streetlights
Green spaces, environmental correlates and physical activity
++More More
often often assocassoc
iatediated
+/0Equivocal
association
Proximity to recreation facilities, convenienceProximity to recreation facilities, convenienceDestination factors, micro-scale design, footpaths, trailsDestination factors, micro-scale design, footpaths, trailsMixed land use, shops and services nearbyMixed land use, shops and services nearbyAesthetics (perceived)Aesthetics (perceived)Population density/sprawlPopulation density/sprawlArea based Coastal residence Area based Coastal residence Area based Urban/age of suburbArea based Urban/age of suburbCulture, social environment as most importantCulture, social environment as most importantConnectivityConnectivity
WalkabilityWalkabilityRoute related factors, hills, trafficRoute related factors, hills, traffic
Perceived safetyHigh crime rate Unattended dogsLighting/streetlights
Green spaces, environmental correlates and physical activity
+/0+/0EquivocalEquivocal
associationassociation
0Not associated
++More often More often associatedassociated
The contribution ofenvironmental variables in explaining variation of physical activity or walking issmall and less important than sociodemographic variables.
PerceptionsSafetyQuality of public space
ObjectivePlaces to go locallyDeprivationPoverty
Using green space to promote physical activity – NICE evidence
Only found 2 grey studies WHY?
» Different views on what is evidence?
But some evidence does exist…..
Using green space to promote physical activity via play– NICE evidence
Real v perceived risk
Using green space to promote physical activity via play– NICE evidence
Real v perceived riskReal v perceived risk Parks mean independence leading to
more physical activity (Mackett, 2007)
Using green space to promote physical activity via play– NICE evidence
Real v perceived riskReal v perceived risk Parks mean independence leading to more Parks mean independence leading to more
physical activity (Mackett, 2007)physical activity (Mackett, 2007) Parks are places for all to play (Moore, 2003)
Source: news.yahoo.com Friday 7 January 2005
Men’s Fitness CriteriaOutcomeOverweight & obesity rates
Exposure junk food outlets gyms/sporting goods retailers fruit and vegetable consumption participation in exercise/sports
alcohol use smoking TV viewing air quality water quality climate index geography commute time parks/open spaces recreation facilities health care access
Inverse Leisure Law Study
Leisure-time physical activity patterns are low and socially patterned
Is there a relationship between neighbourhood deprivation and the density of physical activity facilities in England?
Inverse Leisure Law Study - Method
A database of all indoor exercise facilities in England was obtained, and facilities were linked to administrative areas and assigned a deprivation score
Census data were used to calculate the density of physical activity facilities per 1000 people per quintile of deprivation
The density of exercise facilities by quintile ofdeprivation for the county of Kent in Southeast
England
The density of access to green space by quintile of
deprivation for the county of Kent in Southeast England
Let’s look at green space access now!
Presentation Objectives
To briefly describe the relationship To briefly describe the relationship between green space, public health between green space, public health and physical activity and physical activity
Describe the evidence base for this Describe the evidence base for this relationshiprelationship
Offer possible directions for developing this evidence base
Other missing evidence…?
Does access and actual use of green space relate to health status» Related to quality or characteristics of
green space?» Change in one lead to improvements?
The economic value of green space» Contribution to economy, health costs and
Quality of life
Green space, public health and physical
activity - Conclusions
Green space is related to health Physical activity is related to health Our environment and how we use it does
impact on our health» People, place and policy
Green space, public health and physical
activity - Conclusions
Green space is related to health Physical activity is related to health Our environment and how we use it does
impact on our health» People, place and policy
Put green space and activity into our environments
Naturally Better – Howbery Park, Wallingford – 26th March 2009
Green space, physical activity and public health
Thanks toNick CavillDr Melvyn HillsdonDr Andy Jones
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