Transcript Slide 1

The Natural Environment:
Our Natural Health
Service.
James Marshall
Senior Specialist – Health &
Environment
Summary
• The main health problem areas for England are
– Heart disease
– Stroke
– Obesity
– Long term conditions (e.g diabetes and osteoarthritis)
– Mental Health
• The Natural environment can help with all these conditions.
More people enjoying, understanding
and
acting
improve,
the natural
• To
unlock
the true to
health
value of he Natural
Environment
Natural England can generate support from central
environment,
moreindustry
often.
government,
NHS, Local authorities,
and above all
the volunteering public.
Natural England: Who are we?
• Rural Development Service
– Support for landowners/managers
– Distribute Agri-environment grant aid
• English Nature
– Biodiversity champions
– Manage National Nature Reserves
• Countryside Agency
– Access & recreation remit
– Landscape scale activity
• Approximately 225 staff in the region based in Shrewsbury,
Wolverhampton, Birmingham, Ledbury and Worcester.
Who needs the natural environment
for health?
• Public
– Personal targets
• Department of Health
– Public Service Agreements
• Primary Care Trusts
– Local Development Plans and
– “Choosing Health”
• Local Authorities
– Local Area Agreements,
– Local Delivery Frameworks
• Industry
– Workforce benefits
The Natural Environment: what is
available?
Woodland:
1 Million Hectares
29% open for access
333 million leisure trips, of which
• 61% for walking
• 11% for sport
• 6% for cycling
Footpaths and Bridleways:
• There are 91,300 miles of
footpath,
• 19,900 miles of bridleway and
3,700 miles of roads used as
public paths/restricted byways
in England
The Natural Environment: what is
available?
Rivers and Canals:
• 40,000km of Rivers
• 2,800km of Canals
• 1,600 Lakes
• 180 million day visits
each year
Nature Reserves:
• 213 National nature reserves
• 600 local nature reserves
• covering over 30,700
hectares
• 35% are urban
• 33% lie within 1km of an
urban area
Physical inactivity is a big problem
Inactive people have higher healthcare costs
Cost of additional healthcare
due to inactivity
inactive
active
Years of life: 20
40
60
Source: CDC / National Centre for Chronic Disease Prevention
80
Sport participation: % of people participating for at
least 30 mins once every 4 weeks. Sport England Active
People Survey Dec 2006
20
18
16
14
12
10
8
6
4
2
0
Walking
Swimming
Gym
Cycling
Football
Running
Golf
Can Green Space increase levels of physical
activity?
90
80
70
60
50
40
30
20
10
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Strongly agree
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% Respondants
What motivates people to continue to participate in
Health Walks.
Slightly/strongly
disagree
Can Green Space benefit the Health of
the Population?
• Senior citizens lived longer with more
space to walk and with nearby parks
and tree lined streets near to where
they live.
Tanaka A, Takano T,Nakamura K, et al. Health levels influence
by urban residential conditions in a megacity — Tokyo.Urban
Stud 1996; 33: 879–945.
• For every 10% increase in green space
there was a reduction in health
complaints equivalent to a reduction of
five years of age.
De Vries, S.Nature and health; the importance of green space
in the urban living environment. Proceedings of the symposium ‘Open space
functions under urban pressure’. Ghent: 19–21 September 2001.
• Being within access to Green space can
increase levels of physical activity
Giles-Corti B,Donovan RJ. Relative influence of individual, social
environmental, and physical environmental correlates of walking. Am J
Public Health 2003; 93(9): 1583–1589.
PSA Targets
Heart Disease and Stroke
• Cardiovascular disease
mortality and inequalities:
– reduce mortality rates by 2010
from heart disease, stroke and
related diseases by at least 40%
in people under 75,
– 40% reduction in the
inequalities gap
Cardiovascular Disease: How can a Natural
Environment help with prevention.
• Natural green space can
increase physical activity levels.
Regular activity halves the risk
of heart disease
• Natural green space can reduce
blood pressure and pulse rate.
Being stressed is a proven risk
factor for heart disease.
• To provide a natural diet rich in
antioxidants
PSA Target
Long Term Conditions
• To improve health outcomes for people with
long-term conditions by offering.
– to reduce overall emergency bed days by 5%
by 2008, through improved care in primary
care and community settings for people with
long-term conditions.
Diabetes
• About 1.3 million people in the UK have diagnosed
diabetes and a further 1 million have undiagnosed
diabetes.
• one in 20 people
over the age of 65
For those at high risk
regular exercise reduces
their chances of
developing diabetes by
up to 64%.
At least five a week. CMO
report 2004 DH.
Osteoarthritis
• Osteoarthritis affects
45% of people over 65
year olds.
• 36 million working days
lost costing £3.2 billion
in lost earnings.
• Risk factors are being
overweight and
inactive. This reduces
the muscle strength.
“Walking is as good as
special strengthening
exercises in reducing pain
and increasing mobility”.
Roddy et al. Aerobic walking or
strengthening exercise for
osteoarthritis of the knee? A systematic
review. Ann Rheum Dis, April 1 2005;
64(4): 544-548
Chronic Obstructive Pulmonary
Disease (COPD)
• There are 1.5 million people with
COPD
• COPD costs the NHS £1 billion a year
mainly due to emergency admissions
which can make up 12% of all
emergency medical admissions.
• Regular walking in patients halves
the risk of an emergency admission
irrespective of the FEV1. REF: Garcia-
Aymerich J, Farrero E, Felez MA, et al. Risk Factors of
readmission to hospital for COPD exacerbation: A
prospective study. Thorax 2003;58:100-5
PSA Target 1.1b Cancer
• Cancer mortality and
inequalities:
• Substantially reduce mortality
rates by 2010 from cancer by at
least 20% in people under 75.
• Reduction in the inequalities gap
of at least 6% between the fifth
of areas with the worst health
and deprivation indicators and the
population as a whole.
Cancer
• 2,500 colon cancer
deaths per year
attributable to
inactivity.
Cabinet Office Strategy Unit (2002)
Health economics model for Game
Plan, Dec 2002.
• Breast cancer claims
12,000 lives and is
reduced by lifelong
exercise At least five a week.
CMO report 2004 DH.
PSA Target 1.3: Obesity
Obesity: by halting the
year-on-year rise in
obesity among children
under 11 by 2010 in
the context of a
broader strategy to
tackle obesity in the
population as a whole.
(DH, DfES, DCMS)
Obesity
• Costs of obesity is £3.3 - £3.7 billion per
year and of obesity plus overweight at
£6.6 - £7.4 Billion.
The World Health
Organisation suggests
that increased risk is
present when the waist
measurement exceeds
94cm (37 inches) for
men or 80cm (32
inches) for women.
Green Space increasing children’s levels of
activity and play
Children’s physical activity
levels are strongly related to
the amount of time spent
outdoors
Average number of Children
Children Participating in Play in high rise flats with
different surroundings
1
0.9
0.8
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0
p<0.05
High Vegetation
Low Vegetation
Play
Non Play
Physical activity
reduces stress and
increases self
esteem in children
Mental Health
• around 300 people out of 1,000 will experience mental
health problems every year in Britain;
• 230 of these will visit a GP;
• 102 of these will be diagnosed as having a mental health
problem;
• 24 of these will be referred
to a specialist psychiatric
service;
• 6 will become inpatients
in psychiatric hospitals.
Mental Health: How can the Natural
Environment Help?
• Physical activity is as
effective a treatment for
depression as
antidepressants
•CMO Report at least 5 a week 2004
•Green space can help
reduce aggression and
antisocial behaviour
particularly amongst those
with more severe mental
illness
• Natural Green space can
immediately reduce stress
and improve coping.
Reduction in Blood Pressure following a
stress event
transit time (ms) Increased time
relates to lower blood pressure
Time after stress
0
0.5
1
1.5
Traffic
Pedestrian Mall
Nature
2
2.5
3
3.5
4
4.5
0mins
3mins
6mins
9mins
Concentration of elderly people following 1
hour rest in a garden vs remaining in own
room
Attention Deficit disorder.
Relationship between ADHD symptoms and playing
indoors, the built environment or in green space
Our Foundation: Walking the way to Health
Initiative
• National Health Walk
Scheme to promote
walking in the Community.
1 million people benefited
• Over 350 schemes now
active throughout UK, 60+
in West Midlands
• Free training for over
20,000 volunteer leaders.
• All areas eligible but
deprived areas have
greater priority.
• People prefer walking
where there is biodiversity.
Role of Natural England
• Research
– Bring together solid evidence platform to create informed
decisions.
• Campaign
– To provide accessible green space within 300 metres of every
home in England for exercise, relation and wellbeing.
– To realise the full health potential of the natural environment.
• Health and Environment Network
– To link all those using the natural environment to promote
health.
• Working with partners to help deliver programmes.
– All Green Exercise, Health walks, Green Gym etc
Summary
• The main health problem areas for England are
– Heart disease
– Stroke
– Obesity
– Long
term conditions
(e.g diabetes
osteoarthritis)
and
acting
to improve,
theand
natural
– Mental Health
More people enjoying, understanding
environment, more often.
• The Natural environment can help with all these conditions.
• To unlock the true health value of he Natural Environment
Natural England can generate support from central
government, NHS, Local authorities, industry and above all
the volunteering public.