Regular physical activity can reduce the risk of many chronic conditions including coronary heart disease, stroke, type 2 diabetes, cancer, obesity, mental health problems and musculoskeletal conditions. Even relatively small increases in physical activity are associated with some protection against chronic diseases and an improved quality of life (Department of Health, 2011).
Evidence shows that inactivity significantly heightens the risk of developing chronic illnesses. A study into the effects of physical inactivity (Lee et al, 2012) highlighted how inactivity is responsible for 17 per cent of premature deaths in the UK every year and shortens the lifespan by three to five years.
In a recent 2014 UK Active report titled Turning The Tide of Inactivity, it is identified that 12.5 million people in England are currently failing to raise their heart level for more than half an hour per week over a 28-day period. It also identifies that the most significant health and clinical benefits are gained by an inactive person currently doing no physical activity starting to do even a little.
UKactive has investigated the biggest causes of inactivity and the interventions which are being effective in 'turning the tide of inactivity'. The report reveals:
- In the most deprived areas in England, one in three people fail to raise their heartbeat for 30 minutes per week across a month, even in separate ten-minute bursts. This number decreases to one in four in the least deprived areas.
- The impact of this inactivity pandemic: where inactivity levels are the highest, premature mortality rates are also the highest. In the 15 most inactive local authorities, there is an average of 342 premature deaths per 100,000 people per year, compared with 242 in the least inactive.
- Green spaces, often touted as the holy grail of increasing activity by lobbyists, actually showed no significant correlation with levels of inactivity in the analysis. For instance, Islington has the least green space of any local authority but is amongst the most physically active areas in England, suggesting that it is the programming, promotion and utilisation of green space that is key, rather than the volume that is available to local people.
- Areas with the highest levels of inactivity have a third fewer leisure facilities per person compared with areas of low inactivity. However, the report also shows that numbers aren't always necessarily the answer - in some cases fewer, high quality, well designed leisure facilities have been effective in driving down inactivity levels.
The report also reveals that English local authorities spent on average just two per cent of public health budgets on physical activity promotion and investment in 2012.
To help turn the tide of inactivity and save lives, ukactive is calling for a national ambition - implemented locally by local authorities - to reduce levels of physical inactivity by one per cent a year over the next five years. This could save the UK economy £1.2 billion.
The report also calls on national and local government to take concerted action.
- Government should develop and deliver a cross party national strategy to turn the tide of inactivity.
- Local authorities should invest in targeted inactivity interventions in line with other top tier health concerns, such as alcohol misuse and smoking.
- Collective adoption of a national ambition to reduce inactivity by one per cent year-on-year by local authorities.
The risk of developing a range of chronic conditions and the associated financial costs are cut even when this new activity falls short of the Chief Medical Officer’s guidelines for recommended levels of physical activity (UK Active, 2014).
Taking part in regular sport can save between £1,750 and £6,900 in healthcare costs per person. It also has positive impacts upon psychological wellbeing, having a positive impact upon depression, anxiety, emotional disturbance and psychological distress. Research also shows that taking part in or spectating at sport has a positive impact on the wellbeing and happiness of individuals. Sport also has positive effects on educational attainment, helps to lower absenteeism and increase progression to higher education. Sport participation programmes targeted on youths at risk of criminal behaviour can help to reduce re-offending rates. Sport also has the potential to strengthen social networks and community identity (Sport England, 2013).
The 2012 Olympic Games has shown how high profile national, regional and local campaigns can have a direct effect on the number of people taking part in both structured and un-structured activities. Proactive community sports clubs benefitted greatly from the 2012 games. For example, the city’s rowing club had an increase of 100 new members following the games, and volleyball and cycling both identified an increase in interest. Support in highlighting similar opportunities for other organisations could help participants and volunteers to experience the range of benefits that sport can bring to both individuals and communities by improving community cohesion.
In 2010, sport and sport-related activity generated a Gross Value Added figure of £20.3 billion – equivalent to 1.9% of the England total. Sport and active leisure is within the top 15 industry sectors in England and is estimated to support over 400,000 full-time equivalent jobs in England (Sport England, 2013).
The Economic Value of Sport in England. 2013.
Source: Economic Value of Sport in England 2013. http://www.sportengland.org/
The Active People Survey (APS) provides detail on participation in sport and recreation in England. The survey samples a small proportion of York residents so caution should be taken when applying these results to the entire city. There is currently a consultation underway into how data for the Active People Survey is collected. The most recent survey covers the period April 2012 – April 2013 and identifies that:
15.3 million people played sport at least once per week between April 2012 – April 2013. This is an increase of 1.4 million people compared to 2005-2006 data and follows a broad general upward trend in the number of people taking part in sport.
Compared to the period just before the 2012 Olympic year, there are now 530,000 more people playing sport regularly.
Level of once a week sport participation in England
Source: Sport England. Active People Survey April 2012 – April 2013.
A more detailed analysis of this information shows that:
- Socio-economic status strongly influences participation in sport. 26.6% of people from lower supervisory; technical; routine; semi-routine; never worked; or long-term unemployed status regularly participate in sport compared to 41.3% of the population from managerial or professional socio-economic status.
- Only 18.2% of the population who have a limiting disability regularly participate in sport compared to 38.7% of the population who do not have a limiting disability.
- A higher proportion of 16 – 25 year olds regularly participate in sport than the over 26 population (54.7% compared to 31.4%) but participation rates of 16 – 25 year olds has decreased from the previous 12 months.
- As a proportion of the population by gender, fewer females than males regularly participate in sport (30.5% of females compared to 40.1% of males).
Regular participation in sporting activity by ethnicity is relatively equal with 34.9% of the White British population compared to 36.7% of the population from other ethnic backgrounds regularly participating (Sport England. Active People Survey, 2013)
In York a significantly higher proportion of the population are physically active, 61.5% of the population compared to the England average of 56% (York Health Profile, 2013).
The UK Active report titled Turning The Tide of Inactivity provides a summary of key data in relation to physical activity across Yorkshire & the Humber. This is given below and shows that York is ranked as one of the top 20 local authorities for physical activity. Even still, in York, there are over 23.5% of the population who are physically inactive and the cost of inactivity is estimated to be over £15 Million.
Source: UKactive (2014)
Department of Transport figures show that York has the third highest cycling prevalence rates in England – 25% of adults cycling at least once per week (an increase of 2% on 2010/11 numbers) and 10% cycling at least five times per week.
This high uptake of cycling is supported by 107km of off-road and 83km of on road cycle routes, 2,450 state school cycle parking spaces and over 2,000 publicly accessible cycle parking spaces within the city.
Public Health Outcome Framework data shows that a higher proportion (17.8%) of people in York use outdoor space for exercise / health reasons than the England average (15.3%).
Whilst York has the second lowest proportion of people in Yorkshire & the Humber recorded as taking part in no physical activity, this group of people still represents 23.7% of the York population. This equates to 47,404 people not taking part in any physical activity.
Almost a quarter of the population in York are inactive. National figures show women, people from lower socio-economic backgrounds and those with a limiting disability are less likely to participate in sports. This gives an indication of which groups of people are more likely to be inactive in York.
Because of the small local sample sizes and the way local data is calculated, direct comparison between local and national trends is not possible. Local data is an amalgamation of 2008-2010 data whereas the national data covers April 2011 – April 2012. Comparison of local and national data by age is not possible at all because national and local data are collected against different age-band categories.
However, local information indicates that the same groups of people who participate in less sport nationally also participate in less sport at a York level: women, people with a limiting disability, and people from a lower socio-economic group.
A Public Health England report about social and economic inequalities in diet and physical activity shows a clear difference in participation levels by gender and by socio-economic group status.
The figure below shows physical activity participation at recommended levels by lowest to highest income groups. The terms lowest and highest across the bottom of the graph refer to levels of income. People with lower incomes generally participate in less physical activity than those in higher income groups. Men participate in more physical activity than women.
Proportion of Health Survey for England participants reporting meeting recommended physical activity levels by gender and socioeconomic status
The difference between sports participation according to ethnicity is more pronounced than the national picture with less white people participating in sport than non-white people, although the categorisation of ethnicity as either white or non-white is a crude measure and does not give a full picture around any differences which might be associated with ethnicity.
Adult participation in moderate intensity sport: Nationally vs York. 2008 to 2010
Young People and Physical Activity
What are the guidelines?
NICE PH17 guidance on physical activity for children and young people advises that children and young people should undertake a range of moderate to vigorous level activities for at least 60 minutes over the course of a day. At least twice a week this should include weight-bearing activities that produce high physical stresses to improve bone health, muscle strength and flexibility. This amount of physical activity can be achieved in a number of short, 10-minute (minimum) bouts. Moderate-intensity activity increases breathing and heart rates to a level where the pulse can be felt and the person feels warmer. It might make someone sweat on a hot or humid day (or when indoors). Vigorous activity results in being out of breath or sweating.
Opportunities for moderate to vigorous physical activity include everything from competitive sport and formal exercise to active play and other physically demanding activities (such as dancing, swimming or skateboarding). They also include some of the actions that can be involved in daily life (such as walking, cycling or using other modes of travel involving physical activity).
How much physical activity are young people doing in York?
The local 2013 citywide primary school survey ‘Stand Up For Us’ identified that:
- Only 43.7% of pupils reported taking the recommended 60 minutes of exercise every day.
- More males than females reported taking 60 minutes of exercise every day.
- A higher proportion of pupils in year 6 reported taking 60 minutes of exercise every day, in comparison to the other primary year groups.
How much are young people doing nationally?
The ‘Stand Up for Us’ survey was conducted locally and there is no national survey data to compare these results to. However, the local trends identified do seem to be in line with national data found in the 'Health survey for England 2007' (The Information Centre 2008a). This survey found:
- 63% of girls (compared with 72% of boys) reported being physically active for 60 minutes or more on 7 days a week.
- Once they reached aged 10, girls' activity declined with age.
- At age 15, 47% of girls achieved the recommended amount – compared to 66% of boys of the same age.
Health Survey for England results identify higher achievement rates but around one third of children are not achieving the recommended amounts of physical activity. This means that, potentially, a large proportion of our young people are not learning to incorporate physical activity into their lifestyles. This might contribute to developing future health problems linked to inactivity.
How can we increase physical activity for young people?
NICE PH17 guidelines recommend that long term (minimum 5 years) local and national campaigns should be developed that are both consistent and sustained. Campaigns should convey that physical activity:
- is healthy, fun and enjoyable, makes you feel good and can be sociable (that is, it can be undertaken with existing friends or can help develop new ones)
- promotes children and young people's independence
- helps develop children's movement skills
- can involve a wide variety of formal and informal activities such as play, dance, swimming, the gym, sport (including street sport and games) and physically active travel (such as walking, cycling and wheelchair travel)
- can (and should) become a regular part of daily life and that small lifestyle changes can be worthwhile (for example, active travel to school, the shops or the park, using the stairs and ramps instead of lifts and helping with housework)
- can be maintained by trying new and challenging activities to keep children and young people interested and motivated
- is something that adults, especially parents and carers, should incorporate into their lives to set an example.
Although sports participation in York is high, the voluntary active leisure sector is facing a number of challenges in maintaining its strong vibrant position. The changes in population and social lifestyle, the reduction in available leisure spend and longer non traditional working hours have all seen an impact in the ability to recruit and retain both participants and volunteers. However many organisations have already started to address this by offering more flexible memberships, more casual sessions and participation opportunities as well as working harder to increase the overall number of participants and volunteers within their structures.
Physical Activity and Older Adults
City of York Council provides a range of active leisure activities for older adults through their Older People’s Activity Service. This service currently provides a range of co-ordinated physical activities in a number of care homes and sheltered housing schemes in York which include activities such as Boccia, New Age Kurling, Chair Based Exercises, Table Tennis, and Parachute Games. Sessions are tailored to individual needs and are adapted around the needs of those who have for example, long term conditions. A Sporting Memories Pilot Scheme began during the summer of 2014 which aimed to engage older adults, in particular those with dementia into talking about their sporting achievements. This project was designed to help combat isolation in older adults and to engage these people into leisure activities.
The Older People’s Atlas provides several measures about hip replacement. This is a procedure undertaken due to a musculoskeletal problem and provides some indication about the levels of hospital based surgical interventions for musculoskeletal problems. Locally, the number of hip replacements that require a revision to them and the number of people who are able to return home after a hip replacement procedure is worse than the England rate (Older People’s Health & Wellbeing Atlas). A focus on preventing the development of musculoskeletal problems which require surgery as well as increasing the musculoskeletal health of our population could help to reduce the number of surgical procedures required and to increase the resilience of those who do undergo surgery so that more people can maintain independence. Physical activity can have a big influence on the health and future health of adults and older adults by helping to build up physical strength, muscle and joint strength and preventing obesity
The City of York Council HEAL exercise referral programme provides physical activity based interventions for people with a range of conditions. People can be referred into this service by GP’s and healthcare professionals. One of the condition specific interventions offereed is to support people with arthritis and musculoskeletal conditions and has helped 46 people aged over 60 years old between November 2013 – October 2014. A total of 21 men and 25 women were seen by the service.
The largest age group of people supported through the HEAL service were those aged between 65-69 where 17 were seen. The age group where fewer people were supported was for people aged between 80-94 years of age with a total of 5 people supported.
Physical activity can be used to help people with dementia remain active and stay socially in touch with people, following diagnosis. It is anticipated that by 2015 over 2,700 people in York will be living with dementia this is due to rise to 4000 by 2030 (documents attached to email. Also available on line)
Health and Social Care partners in the city have begun working on a physical activity package which will contribute towards: Reducing social isolation; reducing barriers to dementia within Sports Clubs and community facilities; helping towards the creation of a dementia friendly city; helping people remain independent in the early stages of diagnosis; keeping people with dementia generally in good health.
The need to broaden the range of activities offered through medical practitioners in the form of a social prescribing package was identified in the City’s Health & Wellbeing plan. York now has a GP referral scheme which offers supported access to condition specific physical activities. Sessions include activity for those with a Cancer diagnosis, those with musculo- skeletal or neurological conditions and there is a growing programme to support those with a mental health condition.
York has received 3 year funding from Sport England to extend the provision of Sport and Physical Activity for people with a long-term limiting disability and those with long term health conditions. This funding has been used to employ staff from 2013 to 2016 to build on the city’s existing programmes and to address the identified under-representation in sports participation of people with a limiting disability.
The city has received 3 year funding from Sport England to increase participation in sport and physical activity within the general population. This project will target young people and adults aged 50+. It will make use of opportunities to raise participation through mass participation events, capitalising on 2012 and other recent national and regional sporting successes. This funding has been used to employ staff from 2013 to 2016 to build on the city’s existing programmes.
York has a strong community and voluntary sector which is a key deliverer of physical activity opportunities in the city. This includes walking and cycling groups, voluntary sector sports clubs, condition specific support groups who run activities and the vast number of volunteers who coach, lead, enable and support participants.A local healthy child participation programme is being developed to target school children who are overweight and obese into physical activity. This will have potential positive impacts on the long-term health of children who are at greater risk of continuing to become more overweight as they get older.
- Expand our social marketing to ensure that people know the health benefits of participation in physical activity.
- Gather more information about Children and Young people’s participation in Sport & Physical Activity. There has been no national or local research to measure this in the last 4 years.
- Improve information to young people about the long term health benefits of physical activity.
- Run a programme of health, nutrition and physical activity for young people who are inactive or obese or at risk of it, and their parents.
- Carry out detailed benefit analysis of the people who participate in the HEAL programme to establish the range of benefits they experience and also to detail the cost reductions in primary and secondary care for these participants.
- The current GP referral and recommendation programmes are operating on a cost recovery basis where participants cover the cost of the activities they participate in. With additional funding the programme could be expanded to offer additional activities and to include those for whom cost is currently a barrier to participation, as these are often the people who are currently least likely to be physically active.
- Increase the engagement of those who commission social and care services and the commissioned services themselves with physical activity to ensure that the residents who benefit from these services are engaged and informed about the benefits and opportunities available.
- Create more outdoor gym/ informal recreation opportunities in publicly accessible open space and community locations.
Public Health England (2013) Social and economic inequalities in diet and physical activity
Social and economic inequalities in diet and physical activity
UK Active (2014) Turning the Tide of Inactivity
Turning the Tide of Inactivity
Public Health England (2013) Health Profile 2013
Health Profile 2013
Office for National Statistics (2013) Method of Travel
Method of Travel
Government (2012) How Often People Cycle
How Often People Cycle
Government (2013) Local Area Walking and Cycling
Local Area Walking and Cycling
Sport England (2012) How the Active People Survey works
How the Active People Survey works
City of York Council (2013) Active York Action Plan
Active York Action Plan
City of York Council (2013) Active York Built Facilities Strategy
Active York Built Facilities Strategy
City of York Council (2013) Active York Pitch Strategy
Active York Pitch Strategy
City of York Council (2013) Big York Survey
Big York Survey
City of York Council (2014) Taking Play Forward
Taking Play Forward
YorOk (2013) Dream Again