Green Spaces to Healthy Places The Dudley Healthy Towns Story
The Evidence Base - 1• Better health overall positively related to greenspace, regardless of socio-economic status• Levels of physical activity positively related to greenspace• Greenspaces most valuable for physical activity when high volume use• Greenspaces need to be accessible, connected and safe• Consistent negative relationship between levels of stress and access to greenspace
The Evidence Base - 2• Primary value placed by people is ‘destressing’; physical activity second• Frequently noted as places of attachment• Populations exposed to the greenest environments have lowest levels of health inequality.• Causal pathways not well understood• Dose/response relationships not well understood Croucher et al (2007); Mithcell and Popham (2008)
What is the Healthy Towns Programme?• National Pilot Fund available for the prevention of obesity (£30 million) through environmental change.• Dudley PCT/Council Joint Bid• One of 9 successful bids nationwide• £4.5m awarded for ‘Lets Go Outside’• Dudley’s Programme – Healthy Hubs – Active Travel Corridors – Service Reform
Why was obesity prevention receiving funding?• 2/3 of the population of England are overweight or obese.• Obesity has grown by 400% over the past 25 years.• Obesity will surpass smoking as the greatest cause of premature death.• The costs of treating the conditions attributed to poor diet, low activity levels and obesity run into £billons• The UK has the fastest accelerating rates of childhood obesity in the world• Today’s generation of children will be the first for over a century for whom life expectancy falls
What is the “environment” and why was it a focus?• The environment refers to all of the objective structural factors, external to the individual, that both positively and negatively influence a person’s behaviour (Baranowski et al. 1997)• Environmental Interventions contribute to behaviour change by advocating and implementing measures that will make it easier for people to engage in health enhancing activities, whether they are aware of it or not, while making it more difficult to engage in competing and less desirable behaviours
Environment tiers• Healthy hubs (specific local)• Active Corridors (wider general)• Service reform (Borough wide and sustainable) Healthy Towns
What is a Healthy Hub?• 5 Parks (one in each Select Committee area)• New building• Staff• Outdoor gym• Pathway improvements• Play areas and MUGAs• Programmes and events
Why did we take this approach in Dudley?Issue Approach Rationale outcome The evidence base for Increase PA opportunities Low levels of physical Increased PA levels the prevention of activity (PA) within the within the parks and weight gain is to Borough via active corridors increase physical (see evaluation activity (PA) with findings) dietary support. People felt unsafe in Get committed police Dudley Lifestyle Police are committed parks, and generally involvement from the survey 2004 showed partners, with formal felt that safety was a start. Recruit on site that 66% of people protocols signed off by barrier to be physically rangers, increase could be more active if the Chief inspector. active. footfall. safety issues were Rangers appointed 2x addressed. per site. Footfall massively increasedBarriers to PA (next slide) Not enough facilities Provide new buildings Previous park work, See Hub slides and services locally with toilets, kitchens Livability, new paths, play areas Transforming your MUGAs walking and space (TYS) National cycling infrastructure LEAP pilot, Steps to Health and the Play Pathfinder consultations.The need for Supportive Hubs , corridors and National and local evidence Five Hubs, 30km of activeEnvironments to enable service reform and guidance corridors, service reformand support behaviour and policy developmentchange
Why parks, existing and potential?Barriers to activity Potential of Parks• Cost • Free• Lack of time • Local, can be accessed• Not the sporty type quickly• Access • People don’t have to be sporty• Transport • Within 15mins of home/work• Personal safety • On site staff• Lack of welcoming facilities • Welcoming facility
Service Reform• Physical Activity on all agendas• Transformation of Parks Service• Safety considered at all levels• Partner impact on health recognised• Planning guidance in place to tackle the obeseogenic environment Make it Sustainable
Service Reform Transformation of the Parks Service Park Keeper - Scale 2 - 3 Park Ranger - Scale 3 - 4 ExperienceRelevant practical experience of working with Relevant practical experience of working withthe public in a front line position the public in a front line positionMust be able to demonstrate a basic knowledge Some experience of risk assessment andof Health & Safety requirements including some knowledge of health & safetyexperience in preparing risk assessmentsSome experience of working with community Some experience of working in a park, sport orgroups community environmentSome experience of supervising staff, trainees Some practical experience of working with aor volunteers range of age groups Qualification/trainingNVQ level 1 in amenity horticulture or equivalent A minimum of NVQ level 2 in; play work, sports coaching/gym instruction, customer services, amenity/environmental subjectWillingness to undertake any training in relation Willingness to undertake any training in relationto the job requirements to the job requirements AdvertisedHorticultural Week Leisure Opportunities
Successes and opportunities• High profile of the health agenda at senior Council and Elected Member level• High profile and support at regional level• Strong police commitment• Joint Core Strategy• Changes to departmental structures• Alcohol strategy, Clean air plan, HPS• Recruitment, maintenance, adherence and exit for supportive services• Umbrella term
Evaluation• Relevant Targets (RT):• More children and families more active over initial base line.• An Increase in Parks/ Hub usage over baseline• Increased perceptions of safety in and around the Hubs.• An increase over baseline of numbers of children and families walking and cycling.• An increased awareness and understanding of the Change 4 Life messages.
Is it working?Final evaluation report – October 2011Some interim findings:- - 11,000 structured attendances September 2010 – July 2011 - 65% gym users use it > 1 week - 54% male, 68% female gym users ‘think about other ways to be more active’ as a result of outdoor gym use
Is it working? Findings so farUser comments:• ‘I feel healthier because I am outdoors and I am physically more active’. (male aged 46).• ‘Nice to be able to be active with the whole family’ (male aged 41)• ‘It has inspired me to generally lose weight and spend more time with my kids’( female aged 34)• ‘I go with my husband and daughter. She sees mum and dad being active and it encourages her also to be active. She goes on to the park and also socialise with other children which is great. We can all keep fit now and it doesn’t cost a penny’ (female aged 27)• ‘Single person can getting out more, mixing with other people of all ages in a friendly environment’ (female aged 55).• ‘I can use this now for free instead of paying for the gym’ Paul says, ‘I think it’s great, I only came over with the baby and now I’ve done a workout, really think its brilliant’.• ‘I use it because it keeps me healthy, it’s free and I can’t afford to use other gyms. It’s really good because I think people of all ages will now be able to get fit outdoors and people can also strengthen their muscles’• ‘Having the gym equipment installed and the introduction of the park rangers has been a marvellous concept. This has led to more people using the facilities on the park, so of course leading to residents of the area being healthier as a whole. I look forward to see what changes will be happening on the park in the future, if the events over the last few months are anything to go by in this exciting embryonic stage’.
Healthy Towns “Health is Everyone’s Business” Increased Budget Youth Services Improved Mental Health No 1 PCT Strategic Plan Children’s Services Weight Management LAA Phases N18 56 NI57 Green Space StrategyLocal Area IncreasedPPG 17 Action Plans Activity in JCS Parks Recruitment Retention and exit WEA Tandrusti Reduction in ASB Social Cohesion Links to external for Services partners Inequalities Strategy
Healthy Towns Embedded ? Police Political Buy In Youth Increased Weight Watchers Services Budget Support and exit National Profile Improved Mental No 1 PCTChildren’s Obesity Strategy Services Health Strategic Plan Five hour offer Clean Air Act Weight Management Phases PPG 17 Local Area Increased LAA Cardiac GP Referral JCS Action Plans N18 56 NI57 Rehab Activity in Parks IncreasedGreen Space Community Recruitment WEA Strategy Regeneration Activity Retention and Tandrusti Reduction in exit for Services ASB Social CohesionPA Strategy Links to external Age partners Concern Reduction in Crime Inequalities DACHS Strategy Social Inclusion
Next Steps• Full evaluation report due October 2011.• Local and national dissemination.• Use report recommendations to plan the next three years of service delivery.• Embed the programme into core business.