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Health Improvement Partnership. The value of leisure and culture to Enfield Our bodies were made to move!. Nikki Enoch and Mike Collins. Project Brief. Commissioned October 2003 to: Summarise available national research Apply research locally Identify priorities for the ESP thematic groups

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The value of leisure and culture to enfield our bodies were made to move

Health Improvement Partnership

The value of leisure and culture to EnfieldOur bodies were made to move!

Nikki Enoch and Mike Collins

Project brief
Project Brief

Commissioned October 2003 to:

  • Summarise available national research

  • Apply research locally

  • Identify priorities for the ESP thematic groups

    Funded by Neighbourhood Renewal


  • Summary of national research

  • Priorities of the Leisure and Cultural Partnership

  • Focus on health:

    • National evidence

    • Enfield picture

    • Benefits of leisure and cultural services

    • Potential achievements in Enfield

  • Information sources

  • Your views

The value of leisure culture to enfield summary



- halves CHD risk

- reduces BP

- controls body weight,diabetes

- reduces risk of falls, back pain

- reduces risk of colon cancer

- reduces anxiety/depression

- enhances mood, self-esteem

- promotes imagination and vision

Socialisation, tolerance, team working

Social cohesion

Leadership & organising skills


increases family/local links

reduces NHS costs

reduces crime and disorder costs

community identity thro’ history/culture

increased participation of poor, disabled, ethnic minorities

increased social networks/activecitizens

creates jobs

improves environment

The value of leisure & culture to EnfieldSummary

Leisure culture partnership emerging priorities
Leisure & Culture PartnershipEmergingPriorities

Agreed on 10th November 2003:

  • Addressing health issues

  • Capacity building and organisational development

  • Activities for young people

    (divert from crime and anti-social behaviour)

The value of leisure culture for health the evidence
The value of leisure & culture for healthThe evidence

  • Strong trends with physical health

  • Close association with mental health

  • Strong correlation with deprivation

  • Payback

The value of leisure culture for health the evidence1
The value of leisure & culture for healthThe evidence

Medical profession (e.g BMA 2002)

Sports profession (e.g Balyi 2002)

Leisure profession (e.g LGA 2001)

Education profession (e.g National Curriculum)

BHF National Centre for Physical Activity & Health (

The evidence increasing prevalence of obesity
The EvidenceIncreasing prevalence of Obesity

N.A.O. 2001

The evidence inactivity indicators
The EvidenceInactivity Indicators

Prentice & Jebb ‘95

The evidence inactivity levels
The EvidenceInactivity levels

HSE ‘98

The evidence evidence of health risks
The EvidenceEvidence of health risks

Source: Britton & McPherson

The evidence prevalence of chd risk factors
The EvidencePrevalence of CHD Risk factors

Economic Cost of CHD

£7.06b annually

Source: Liu, Maniadakis, Gray & Raynor 2002

Source: Joint Healthy Survey Study 1999

The evidence relative risk of diabetes with increasing weight
The EvidenceRelative risk of diabetes with increasing weight

The evidence inequalities in health
The EvidenceInequalities in Health

  • Poor health and high inactivity in deprived areas

    • Conceiving earlier

    • Born smaller

    • Lower access rates

    • More ill health

    • Dying younger

  • Mortality rates are 3 times higher for those in social class V than those in I

BHF National Centre for Physical Activity + Health

The evidence young people s trends aged 5 18 years
The EvidenceYoung People’s TrendsAged 5-18 Years

  • 20% overweight

    Chinn, S. & Rona, R.J. (2001)

  • 10% have one or more mental disorders

    Office for National Statistics (2000)

The evidence prevalence of mental disorders
The EvidencePrevalence of Mental Disorders

Growing sharply

  • Young women twice as likely to suffer

  • Children with lone parents

  • Lower socio economic groups

  • 20,000 suicide attempts annually by young people

    Office for National Statistics (2000)

The evidence conclusions
The EvidenceConclusions

“There is an obvious relationship between physical activity and good health. Conversely, inactivity is related to poor health. Therefore there are considerable public health benefits to be had by increasing the proportion of the public that is physically active”.

BMA Priorities for Health Briefing Note

Scottish Parliament Dec. 2002

The evidence enfield picture
The EvidenceEnfield Picture

Neighbourhood Renewal Assessment (Feb 02)

  • Poor health link with highest levels of deprivation

    Pro-rata national estimates to Enfield residents:

  • 37% are sedentary = 101,200

  • 22.5% are obese = 61,500

    Savings from a 10% increase in activity

  • 10% = 17,200 residents

  • 311 lives

  • £10.5m

    • £1.8m NHS

    • £4.3m loss of earnings

    • £4.3m premature mortality

      Source: DCMS: 2002 Game Plan Implementing the Government’s Strategy for Sport

Our understanding best start in life
Our UnderstandingBest Start in Life

  • Physical

  • Bone - fat - muscle tissue

  • Growth spurts (girls earlier)

  • Puberty

  • Increase in red blood cells

  • Central nervous system

  • Physical

  • Heart size

  • Muscle strength

  • Ligamentous structures

  • Motor patterns & balance

  • Co-ordination




Young People

u4-15 yrs

  • Mental/Cognitive

  • Abstract thinking

  • Egocentric thought/self identity

  • Mental/Cognitive

  • Attention span short

  • Imagination blossoming

  • Emotional

  • Heightened peer influence

  • Accepting responsibility

  • Different maturity rates

  • Emotional

  • Self concepts & self importance

  • Peer influence

  • Understands rules & structures

“Drama, dance, movement,words,images and music – all stimulate the brain to learn”

University of the First Age

Our understanding dropping out
Our Understanding Dropping Out

Girls and Young Women

Boys and Young Men

  • 42% active for health benefits

  • Negative peer pressure

  • 10% 12-13 yr olds inactive

  • 20% 13-14 yr old inactive

  • Drop out - earlier and higher numbers

  • 61% active for health benefits

  • Positive peer pressure

  • Drop out – later and lower numbers

Young People

12-18 yrs

50% not receiving 2 hours of PE

Media use = approx. 5 hours a day

Our understanding finding time
Our UnderstandingFinding time

80% perceive themselves physically active



  • All

  • 31% active for health benefits

  • 33% ‘inactive’

  • Bangladeshi

  • 7% active for health benefits

  • 65% ‘inactive’

  • All

  • 46% active for health benefits

  • 25% “inactive”

  • Bangladeshi

  • 18% active for health benefits

  • 59% ‘inactive


16-55 yrs

  • Age Decline

  • Aerobic capacity: 25 yrs onwards 8-10% per decade

  • Strength: 5-10% per decade

  • Muscle mass: 40% loss between 20-70 yrs

Sources: ADNFS 1992;BFH National Centre for Physical Activity + Health

Our understanding keeping fit for life
Our UnderstandingKeeping fit for life



  • All

  • 17% active for health benefits

  • 50% sedentary

  • 25% unable to climb stairs unaided

  • Bangladeshi

  • 92% sedentary

  • All

  • 25% active for health benefits

  • 40% sedentary

  • 7% unable to climb stairs unaided

  • Bangladeshi

  • 85% sedentary


50+ yrs

  • Importance of Physical Activity

  • Maintains functional ability

  • Prevents disability, immobility and isolation

Source: BFH National Centre for Physical Activity + Health

Our understanding getting the message across
Our UnderstandingGetting the message across

  • Reach deep into older, DE markets

  • Components of the participation market(Rowe,2003)

    • sporty 20% - keen -sustain interest, safeguard provision

    • mildly enthusiastic 16% - could do more – reduce drop-out, better access, foster enthusiasm

    • on the bench 44% - persuadable (busy,non-sporty) – remove barriers,incentives, take sport to them

    • couch potatoes 20% -ingrained scepticism – raise awareness, promote benefits, teach children

  • Trends are reversible – pay back within months

The value of leisure and culture for health a multi dimensional strategy
The value of leisure and culture for healthA Multi Dimensional Strategy

Focus on the highest risk (highest savings)

East and South, poor, single parents, C2DE women, Pakistani/Bangladeshi, older

Best start for young people

Reducing drop out

Making it easier for

those at work

Reaching out for older


Strategic and social marketing

The value of leisure and culture for health current and proposed activities
The value of leisure and culture for healthCurrent and proposed activities

Exercise referral

Healthy Living Centre ; Garden Gym

  • Sure start

  • children’s centres

  • Play schemes

  • SS coordinators

  • Specialist colleges

  • YP gyms

  • Children’s centres

  • Healthy schools


  • Mind how you go

  • Fit for life

Leisure Discount Schemes

The value of leisure culture for health filling gaps
The value of leisure & culture for healthFilling Gaps

Suggestions for new areas:

  • Walking to Health with Countryside Agency, Sport England

  • Cheaper public fitness suites (12% cited cost)

    eg SIV Sheffield, build/fit/lease packages, eg Pulse Fitness

  • HIP promotion and action strategy

  • Integration within existing services (4YP)

    For maximum benefits ….

  • Time barrier - 2.5 hours a week

  • Cognitive gap – most people are less active than they know they should be

  • Safety out of doors

  • Increased priority and funding

The value of leisure culture for health continuing the research
The value of leisure & culture for healthContinuing the research

LEAP pilots

  • Nottingham increase 50+moderate by 5%, reduce sedentary in deprived areas by 10%

  • Dudley use open space

  • Ashton/Wigan marketing;chair-based in homes; falls prevention

    NHS good practice

  • Birmingham ‘Walk tall,don’t fall’, ’Next step’ from classes, tai chi

    Baselines and Monitoring

  • For evidence based assessment

The value of leisure culture to enfield references 1
The value of leisure & culture to Enfield References (1)

Armstrong, J., Reilly, J.J. & Child Health Information Team – Information Statistics Division, Edinburgh. (2001). Assessment of the National Child Health Surveillance System as a tool for obesity surveillance at national and health board level.

Arts Council for England (2002) Arts in health London:ACE

Britton, A. and McPherson, K. (In Press). Monitoring the progress of the 2010 target for coronary heart disease mortality London: National Heart Forum

BMA (2002) Priorities for Health Background Briefing Paper, Scottish Parliament

Central Council of Physical Recreation (2002A) Saving lives, saving money: physical activity - the best buy in public health London: The CCPR

Chinn, S. & Rona, R.J. (2001). Prevalence and trends in overweight and obesity in three cross sectional studies of British Children, 1974-1994. British Medical Journal. 322: 24-26.

Coalter, F. (2001a) Realising the potential of cultural services: the case for sport; (2001b) the case for the arts; ( 2001c) The case for libraries; (2001d); The case for museums; (2001e) The case for tourism; (2001f); The case for urban parks, spaces,and the countryside; (2001g) The case for children’s play London: Local Government Association

Coalter, F. (2002) Sport and Community Development a manual Research Report 86 Edinburgh: sportscotland

Coalter, F. (2003) Measuring the impact of sport (unpublished lecture) University of Stirling

Coalter, F., Allison, M.. and Taylor, J . (2000) The role of sport in regenerating deprived urban areas Edinburgh: Scottish Executive Central Research Unit

Collins, M. F. (2003) Sport and social capital London: Routledge

Collins, M.F. et al (1999) Sport and the arts paper for Policy Action Team 10 London: DCMS

Countryside Agency (2001a) Walking for Health –the first randomised trial CR Note 18 Cheltenham: CA

Countryside Agency et al (2003) The use of public parks in England Cheltenham: CA

The value of leisure culture to enfield references 2
The value of leisure & culture to EnfieldReferences (2)

DCMS (1999) Sport and Arts: Policy Action Team 10 report London: DCMS

DCMS (1999) Libraries for All London:DCMS

DCMS (2002a) Game Plan: implementing the government’s strategy for sport London: DCMS

DCMS (2002b) Social impact of museums: centres for social change London:DCMS

Department of Health (2002) Tackling health inequalities: consultation on a plan for delivery London: DoH

Enfield Council (2001) Sports strategy for Enfield 2001-2005 Enfield: LB Enfield

Enfield Council ( 2002a) Enfield’s future, draft Community strategyEnfield:LB Enfield

Enfield Council (2002b) Leisure strategy Enfield:LBE

Enfield Council (2002c) Neighbourhood Renewal Strategy: Residerts in priority neighbourhoods Enfield:LB Enfield

Enfield Council (2002d) Toward neighbourhood renewal : a draft strategy Enfield: LB Enfield

Enfield Council (2003a) Enfield residents 2003 Enfield:LB Enfield

Enfield Council (2003b) Voluntary and community sector funding paper Cabinet meeting 25.6.03

Gorard, S. and Taylor, C. (2001) The composition of Specialist Schools: track record and future prospect School Leadership and Management 21,4 365-81

Health Development Agency (1999) Social capital and health London:HDA

Health Education Authority (1999) Physical activity and inequalities London: HEA

Health Education Authority (1999) Art for health: Social capital for health summary London: HEA

The value of leisure culture to enfield references 3
The value of leisure & culture to EnfieldReferences (3)

Joint Health Survey’s Unit (1999). Health Survey for England: Cardiovascular Disease 1998. London: The Stationery Office.

Joint Health Surveys Unit. (2000). The Scottish Health Survey, 1998. London: Joint Health Surveys Unit

Jackson, A. (2003) Doing it ourselves: Learning to challenge social exclusion through the voluntary arts London: Department for Education and Skills

Ladd, J. and Davis, L. (2003) Guide to best practice in sport and urban regeneration London: British Urban Regeneration Association

Long, al (2002) Count me in! London:DCMS

Office for National Statistics. (2000). The mental health of children and adolescents in Great Britain: Summary Report. London: NSO.

Reeves, M. (2002) Measuring the social and economic impact of the arts: A review London: Arts Council of England

Riddoch,C., Puig-Ribera,A. and Cooper,A. (1998) Effectiveness of physical activity promotion schemes in primary car: A review London: Health Education Authority

Prentice, A. M. and Jebb, S. A. (1995) Obesity in Britain: gluttony or sloth? BMJ 333, 437-39

Splash National Support Team (2003) Splash 2002 Final Report London: Youth Justice Board/Cap Gemini Ernst Young accessed 14.7.03

Sport England et al (2002) Positive Futures: a review of impact and good practice Summary report London: SE

The value of leisure culture for health conclusions
The value of leisure & culture for healthConclusions

Physical activity = Better health

  • The proof exists and is nationally accepted

  • There are high personal, financial and community benefits

  • Trends can be reversed but require:

    • Priority from both thematic Groups

    • Focus on the highest risk areas

    • Continue investment in projects

    • Work towards a multi-dimensional strategy

    • Measure impact

  • Fundamentally what’s the most important:

    • Best start?

    • Keeping well?

    • Living longer?

    • All of them?

Inactivity = Poor Health

Its costly and its increasing

Leisure and cultural partnership group
Leisure and Cultural Partnership Group

Any further thoughts, evidence or contributions please

contact us:

Tel: 07989 351047

Thank you