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Naturally Better – Howbery Park, Wallingford – 26 th March 2009. Green space, physical activity and public health. Dr. Charlie Foster – Senior Researcher BHF Health Promotion Research Group University of Oxford.

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naturally better howbery park wallingford 26 th march 2009

Naturally Better – Howbery Park, Wallingford – 26th March 2009

Green space, physical activity and public health

Dr. Charlie Foster – Senior Researcher

BHF Health Promotion Research Group

University 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
presentation objectives1
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
consensus on health benefits of green space
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
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
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 objectives2
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
mitchell and popham 2008
Mitchell and Popham (2008)
  • Access to green space is associated with better health for the poorer half of the population
slide9

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

slide10

National policies

& programmes

Law & Regulations

Fiscal

Built environment

Natural environment

Health care systems

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.

slide11

National policies

& programmes

Law & Regulations

Fiscal

Built environment

Natural environment

Health care systems

A social-ecological model of physical activity behaviour

Obesity

Foster et al (2005). Understanding why adults and children participate in physical activity and sport. London, Sport England.

slide12

National policies

& programmes

Law & Regulations

Fiscal

Built environment

Natural environment

Health care systems

A social-ecological model of physical activity behaviour

Obesity

Foster et al (2005). Understanding why adults and children participate in physical activity and sport. London, Sport England.

green spaces environmental correlates and physical activity
Green spaces, environmental correlates and physical activity

Proximity to recreation facilities, convenience

Destination factors, micro-scale design, footpaths, trails

Mixed land use, shops and services nearby

Aesthetics (perceived)

Population density/sprawl

Area based Coastal residence

Area based Urban/age of suburb

Culture, social environment as most important

Connectivity

Walkability

Route related factors, hills, traffic

Perceived safety

High crime rate

Unattended dogs

Lighting/streetlights

green spaces environmental correlates and physical activity1
Green spaces, environmental correlates and physical activity

Proximity to recreation facilities, convenience

Destination factors, micro-scale design, footpaths, trails

Mixed land use, shops and services nearby

Aesthetics (perceived)

Population density/sprawl

Area based Coastal residence

Area based Urban/age of suburb

Culture, social environment as most important

Connectivity

Walkability

Route related factors, hills, traffic

Perceived safety

High crime rate

Unattended dogs

Lighting/streetlights

green spaces environmental correlates and physical activity2
Green spaces, environmental correlates and physical activity

Proximity to recreation facilities, convenience

Destination factors, micro-scale design, footpaths, trails

Mixed land use, shops and services nearby

Aesthetics (perceived)

Population density/sprawl

Area based Coastal residence

Area based Urban/age of suburb

Culture, social environment as most important

Connectivity

Walkability

Route related factors, hills, traffic

Perceived safety

High crime rate

Unattended dogs

Lighting/streetlights

  • +
      • More often
      • associated
green spaces environmental correlates and physical activity3
Green spaces, environmental correlates and physical activity
  • +
      • More often
      • associated

Proximity to recreation facilities, convenience

Destination factors, micro-scale design, footpaths, trails

Mixed land use, shops and services nearby

Aesthetics (perceived)

Population density/sprawl

Area based Coastal residence

Area based Urban/age of suburb

Culture, social environment as most important

Connectivity

Walkability

Route related factors, hills, traffic

Perceived safety

High crime rate

Unattended dogs

Lighting/streetlights

+/0

Equivocal

association

green spaces environmental correlates and physical activity4
Green spaces, environmental correlates and physical activity

Proximity to recreation facilities, convenience

Destination factors, micro-scale design, footpaths, trails

Mixed land use, shops and services nearby

Aesthetics (perceived)

Population density/sprawl

Area based Coastal residence

Area based Urban/age of suburb

Culture, social environment as most important

Connectivity

Walkability

Route related factors, hills, traffic

Perceived safety

High crime rate

Unattended dogs

Lighting/streetlights

+

More often

associated

+/0

Equivocal

association

0

Not associated

slide18

The contribution of

environmental variables in explaining variation of physical activity or walking is

small and less important than sociodemographic variables.

Perceptions

Safety

Quality of public space

Objective

Places to go locally

Deprivation

Poverty

using green space to promote physical activity nice evidence
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 evidence1
Using green space to promote physical activity via play– NICE evidence
  • Real v perceived risk
  • Parks mean independence leading to more physical activity (Mackett, 2007)
using green space to promote physical activity via play nice evidence2
Using green space to promote physical activity via play– NICE evidence
  • Real v perceived risk
  • Parks mean independence leading to more physical activity (Mackett, 2007)
  • Parks are places for all to play (Moore, 2003)
men s fitness criteria
Outcome

Overweight & 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

Men’s Fitness Criteria
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
inverse leisure law study method
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
slide31
The density of exercise facilities by quintile ofdeprivation for the county of Kent in Southeast England
slide32
The density of access to green space by quintile ofdeprivation for the county of Kent in Southeast England

Let’s look at green space access now!

presentation objectives3
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
other missing evidence
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, 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 conclusions1
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
slide40

Naturally Better – Howbery Park, Wallingford – 26th March 2009

Green space, physical activity and public health

Thanks to

Nick Cavill

Dr Melvyn Hillsdon

Dr Andy Jones