An evidence review by Public Health England (PHE) hit the headlines last week, after the government agency found that a large chunk of middle aged adults are doing little to no exercise on a regular basis. According to PHE, 41 per cent of middle aged adults in England (defined as those aged 40-60) walk less than ten minutes at a brisk pace in an average month.
The coverage of this report is all focused on individual behaviour. Headlines covering the study proclaimed that “Millions of English adults failing to go on a brisk 10-minute walk every month”, and “Six million middle-aged people take no exercise”. As a nation, it seems we’ve forgotten the basics of leading a healthy lifestyle. We commute to work, we sit at our desks – and we find little time for exercise against the competing demands of work and family. As a result, our physical and mental health worsen. We need to get moving, and walking is a pretty simple way to start.
In light of the findings, PHE are trying to encourage us all to walk more frequently. The organisation has launched a campaign to get people to take up the challenge of walking briskly for 10 minutes a day, accompanied by an app to help us keep track.
The report acknowledges that previous official advice of doing two and a half hours of intensive activity a week doesn’t seem like a realistic goal for many people. On the other hand, walking is, in theory, an easy choice to make. It doesn’t require any specific equipment, you don’t need to be young and fit to walk, and you don’t need to go to a special place or pay any money.
But reasons why we do or don’t go for a walk are not just about personal choice or inclination. Structural factors influence whether we walk at all, how frequently and how far. Our activity levels are influenced by our social networks, whether we feel safe in our communities, our proximity to green space, and by the design of our cities, towns and neighbourhoods.
There is good evidence on this latter point – Including from PHE themselves. For example, the design and planning of an area can encourage or discourage walking and cycling. A spatial planning review from PHE highlighted the importance of neighbourhood ‘walkability’ in increasing physical activity. Elsewhere, our evidence review on urban design shows that providing safe and convenient footpaths encourages people to walk and cycle more.
How active we are is also influenced by our socioeconomic status. Barriers to physical activity affect some groups more than others and social deprivation affects our capacity to go for a swim, walk or run. Children in deprived areas are nine times less likely to have access to green space or somewhere to play.
To reduce health inequalities, we need to recognise and reduce the barriers to participation. Some of these barriers are the cost of childcare, the cost of transport, and social isolation. London is the third greenest city in the world – but a single mum who has no-one to go for a walk with and no easy transport route to a park faces bigger barriers than others.
Directors of public health are based in local government. As a result there’s an opportunity to do something about this: councils have a major role in influencing some of these factors. Planning, housing, transport, leisure and parks are all core local government responsibilities. We’ve found in our current public health research project that directors of public health across England work with a range of council departments and voluntary sector agencies to improve population health.
There is nevertheless an opportunity to do more, to join up work with the organisations and people that can help tackle the barriers to improving health across all groups. Recognising that the problem is about more than just individual behaviour will be a good place to start.