04 / 11 / 2014
From evidence into action: opportunities to protect and improve the nation’s health
Everybody active, every day: an evidence-based approach to physical activity
Public Health England, 23 October 2014
‘From evidence into action’ sets out Public Health England’s seven key priorities for the next five to ten years to help people live as well as possible, for as long as possible. ‘Everybody active’ is a corollary to this, setting out ambitions to make physical activity an everyday part of people’s lives – tackling inactivity is an important part of delivering on many of those priorities.
The seven priorities are:
- Tackling obesity, particularly among children
- Reducing smoking and stopping children starting
- Reducing harmful drinking and alcohol-related hospital admissions
- Ensuring every child has the best start in life
- Reducing the risk of dementia, its incidence and prevalence in 65-75 year olds
- Tackling the growth in antimicrobial resistance
- Achieving a year-on-year decline in the incidence of tuberculosis
These are important factors for determining health, and also share many of the same risk factors. For each of the priorities they set out the outcome they are aiming for, the rationale for focusing on that area, an assessment of where we are now and what PHE will do over the next 18 months. Much of the work across the priorities will be around setting out the evidence base and advising government, working with local authorities and running public health campaigns. They will also publicise evidence on ‘what works’ and spread best practice.
One of their commitments is to use alcohol as a ‘trailblazer’ for a new whole-system approach. This will establish what works and be clear about the return on investment to enable government, local authorities and the NHS to be confident investing in evidence-based policies, prevention and treatment.
Underpinning all this, say PHE, are three principles:
- They are concerned with population health and with the impact on individuals; mental and physical health are equally important to our wellbeing
- They will act in a way that reduces health inequality
- They recognise the importance of place and building on all of a community’s assets.
PHE highlight that healthcare itself has a relatively limited impact on our health, which is shaped by where and how we live. They will therefore work closely with local and national government, NHS, the voluntary and community sector, industry and academia. “Above all, we need an active partnership with people so they take greater charge of improving their own health”.
The report also indicates PHE’s ambition to develop its ability to forecast the future direction of health trends, providing an authoritative analysis of the public’s health in the long term. PHE points to six ‘game-changers’ it believes offer real opportunities for faster progress:
- Behavioural science in the digital age, allowing us to reach people we haven’t been able to reach before and providing personalised support on a mass scale.
- Place-based approaches, developing local solutions that draw on all the assets of an area, integrate public services and build resilience in communities.
- NHS preventative services implemented at scale, working with NHS England.
- Transparency, so that everyone can access information on performance or need and evidence on what works, to make better decisions. This will include a partnership with the Chartered Institute of Public Finance and Accountancy to focus on the return on investment from public health interventions.
- The contribution of employers to improving mental and physical health.
- Using the concept of wellness (and developing measures of wellness) to give a broader view of health.
Separately, ‘Everybody active’ is a framework setting out the challenge and the steps PHE plans to take to increase physical activity. Getting the nation active will only happen if all sectors are involved and if physical activity is embedded in the fabric of daily life, a ‘normal’ choice for people to make.
Physical inactivity directly contributes to one in six deaths in the UK (the same number as smoking) and in some communities, only one in ten adults are active enough to stay healthy. The Government’s aim is to increase the number of adults taking at least 150 minutes of physical activity a week, and to reduce the number taking less than 30 minutes. Progress has been made, but it is slow. PHE highlight the physical, mental, social and economic benefits of greater physical activity and argue we should focus efforts on the most inactive, where there is the most to gain. There is also an equalities dimension to this issue, with levels of activity varying depending on income and other factors.
Many studies have already made the case for increasing physical activity. “If we want everyone to be active every day, physical activity needs to be made easy, fun and affordable,” and available to all.
PHE highlights four areas where action is required:
- Society: creating a social movement – the message needs to be woven through policy, commissioning and planning decisions at every level, particularly in communities with significant inequalities. Good marketing and communications strategies can help.
- Professionals: activating networks of expertise – the push to ‘make every contact count’ needs to come from all sectors and disciplines, not just health. Education, sport and leisure, planning, design, development and transport professionals are particularly well placed to show leadership and help bring about change.
- Environment: creating the right spaces – ease of access to open space makes a crucial difference, and has the biggest impact among the least well off. Building more physical activity into daily routines involves creating the kinds of environments that support that, and simple measures (such as providing benches and toilets in public spaces or linking and improving existing resources) can make a difference.
- Scale: scaling up interventions that make us active – positive change needs to be long-term and large-scale, based on community needs. It is not necessarily about new investment, but about maximising the potential of the assets we already have and thinking differently about planning public services.
The report also includes a list of the tools and resources PHE are working on to support local and national action, including a promising practice report and BMJ e-learning resources.