In public health terms, evidence has shown that loneliness has an effect on mortality that is similar in size to cigarette smoking. It is also associated with poor mental, physical and emotional health, including increased rates of cardiovascular disease, hypertension, cognitive decline and dementia. Socially isolated and lonely adults are more likely to undergo early admission into hospital or residential care, and are at higher risk of the onset of disability. By raising awareness of the issues – and encouraging commissioners to invest in services that reduce levels of social isolation could significantly improve public health and safety. Current action To focus on the outcome of social participation and improve on social isolation among older people, the Department is seeking to collect data around social participation through an indicator within the 2011/12 Adult Social Care Outcomes Framework. This indicator focuses on enhancing the quality of life for people with care and support needs. This will measure and evaluate the levels of loneliness in older people.
How the DH is working toimprove the health andwellbeing of people in later lifePaul Stonebrook, Head of Physical Activity, Department of Health
The Department of Health is committed to healthy ageing • Better integration of public health with social care, transport, leisure, planning and housing • Strong partnerships between communities, business and the voluntary sector, for example Green Deal developed by DECC to improve energy efficiency and warmth of homes • DH carer’s strategy • Directors of Public Health and Directors of Adult Social Care Services working together to commission specific services for older people and those who care for them • Continued funding of national clinical audits on falls and bone healthPhysical Activity and the national hip fracture database, via Health Quality Improvement Partnerships • Social participation indicator within the 2011/12 Adult Social Care Outcomes Framework.
Responsibility for active ageing sits within different parts of DH SOCIAL CARE; LOCAL GOVERNMENT & CARE HEALTH IMPROVEMENT DIRECTORATE PARTNERSHIPS DIRECTORATE SOCIAL CARE POLICY PHYSICAL ACTIVITY TEAM – OLDER PEOPLE AND DEMENTIA •Healthy active ageing •2012 Physical activity legacy •Falls prevention and bone health •Responsibility Deal Physical Activity Network •Early intervention and prevention for older •Let’s Get Moving People •CMOs’ Guidelines •National Dementia Strategy Implementation •Physical activity surveysPhysical Activity Age Action Alliance Older adults Task Force DWP Responsibility Deal PA Network
Physical activity for older adultsPhysical Activity
UK Physical Activity Guidelines • Whole life-course – Early Years – Children and Young People – Adults – Older Adults • ‘Sedentary’ guidelines • Joint UK CMO ReportPhysical Activity • Change4Life
Older adults 1. Older adults who participate in any amount of physical activity gain some health benefits including maintaining good physical & cognitive function. Some physical activity is better than none, and more physical activity provides greater health benefits. 3. Older adults should aim to be active daily. Over a week activity should add up to at least 150 minutes (2 1/2hrs) of moderate intensity activity in bouts of 10 minutes or more - one way to approach this is to do 30 minutes on at least 5 days a week. 5. For those who are already regularly active at moderate intensity comparable benefits can be achieved through 75 minutes of vigorous intensity activity spread across the week or combinations of moderate and vigorous activity. 7. Older adults should also undertake physical activity to improve muscle strength on at least two days a week.Physical Activity 9. Older adults at risk of falls should incorporate physical activity to improve balance and co-ordination on at least two days a week. 11. All Older adults should minimise the amount of time spent being sedentary (sitting) for extended periods.
Physical activity brings a range of benefits for older adults • Helps maintain cognitive function • Reduces cardiovascular risk • Helps maintain ability to carry out daily living activities • Improves mood and can improve self-esteem • Reduces the risk of falls • “Preventive effects arising from regular physical activity in older age are at least as strong as those found in middle age for all-cause mortality, cardiovascular disease and type 2 diabetes”Physical Activity • “People can gain benefits from becoming more active, even if they have previously been inactive until middle age or beyond” • (DH. At least five a week – Evidence on the impact of physical activity and its relationship to health 2004)
A range of different activities contribute to meeting the guidelines • Moderate intensity physical activity • Brisk walking • Ballroom dancing • Vigorous intensity physical activity • Climbing stairs • Running • Physical activities that strengthen muscles • Using body weight or working against resistance • Involves all the major muscle groups • Carrying or moving heavy loads such as groceriesPhysical Activity • Activities that involve stepping and jumping, such s dancing • Chair aerobics • Activities to improve balance and co-ordination • Tai chi • Yoga
Pieces coming together…. National Ambition UK CMO Guidelines Public health Active People Outcomes Survey FrameworkPhysical Activity
National Ambition for Physical Activity • “A year on year increase in adult physical activity, measured by the proportion of those achieving at least 150 minutes of physical activity per week (with the aim of being active every day) and a year on year decrease in the proportion of those classed as ‘inactive’.”Physical Activity
Physical activity indicator: Participation • Domain 2: Health Improvement • Outcome Indicator: • 2.13i Proportion of adults achieving at least 150 minutes of physical activity per week in accordance with UK CMO recommended guidelines on physical activity • 2.13ii Proportion of adults classified as ‘inactive’ • Rationale/Description: Physical inactivity costs the NHS approximately £1.0bn per annum - £6.5bn per year to the wider economy and WHO reports that it is one of the 10 leading causes of death in developedPhysical Activity countries • Data Source: Sport England’s Active People Survey
Let’s Get Moving • Targeted ‘brief intervention’ • Inactive adults aged 16 – 74 • Mainstream PA advice and recommendations • Delivered in primary care or other settings • Health care practitioners • Evidence base (NICE PublicPhysical Activity Health Intervention Guidance no. 2) • Re-launch: March 2012
Walking for Health • Volunteer-led walking scheme established by the Countryside Agency in 2000 • Hosted by Natural England • DH funding under previous government doubled regular walkers from 35,000 to 75,000 • 650 schemes • 2.5 million walker attendances per year • July 2010 – decision to transfer the scheme out of Government • 9th March 2012Physical Activity • Macmillan Cancer Services – Funder • Ramblers Association - Host
The Public Health Responsibility Deal offers important partnership opportunities • Five Responsibility Deal Networks: Nutrition, Alcohol, Physical Activity, Workplace Health and Behaviour Change • 350 organisations have signed up to the Responsibility Deal • 180 have signed up to one or more of the Physical Activity pledges – highest of any network • Collective and individual pledges • Task Forces: – Children and Young People – Older adultsPhysical Activity – Inclusion – Cycling
We are keen to establish an Older Adults ‘Task Force’ • Remit: To raise activity levels in older adults • Membership: Open to any organisation willing and able to support the delivery of one or more ‘collaborative’ pledges • Output: One or more practical projects or interventions, to be captured in a business plan and framed in terms of Responsibility Deal pledges • Scope of work: Shape, develop and ‘project manage’ the pledges and ensure delivery of the business plan. • Relationship with Age Action Alliance?Physical Activity ‘Dancing in the aisles’? Off peak gyms and Sports facilities?
Questions • Paul Stonebrook • Responsibility Deal: http://www.dh.gov.uk/en/Publichealth/Publichealthresponsibilitydeal/index.htmPhysical Activity