Dr Justin Varney, National Lead for Adult Health and Wellbeing at Public Health England. Dr Varney will be discussing the relationship between sport and the public health agenda.

1. A healthy mix: sports sector
engagement with the public
health agenda
Dr Justin Varney
Consultant in Public Health Medicine
Justin.varney@phe.gov.uk

2. Public Health
2 Dahlgren & Whitehead (1991)

3. Public Health England
Mission is to protect and improve the nation’s health and to address
inequalities
Established 1 April 2013 to unite specialists from >70 organisations into
single public health service with 4 regional offices & 15 centres
Reputation for credibility and expertise is the foundation for PHE to help
the new system to drive transformation
Local government leadership for public health supported by PHE as
expert national body.
Funding and delivery of services by local government, NHS, etc.
3

4. The Public Health System: an
integrated whole system approach
4
Government
• DH responsible to parliament, with clear line
of sight through system
• Cross-government senior officials group to
improve health outcomes and use Cabinet
Committee structure as required
• CMO to continue to provide independent
advice to Government
Local authorities
• Public health functions integrated into their wider role, helping to
tackle the wider social and economic determinants of health.
• Leading for improving health and coordinating locally for
protecting health
• Promoting population health and wellbeing – role of Directors of
Public Health
Public Health England
• Integrated national body
• Strengthened health protection systems
• Supporting the whole system through expertise, evidence
and intelligence
NHS
• Delivering health care and
tackling inequalities
• Five year Forward Plan
• Making every contact count
• Specific public health
interventions, such as cancer
screening

5. 5
http://www.healthmetricsandevaluation.org;
The Lancet, Early Online Publication, 5 March 2013doi:10.1016/S0140-6736(13)60355-4
.
Where do we focus our efforts?

6. Inactivity is killing us
Decreasing activity levels since 1960s:
• UK adults are 20% less active now than in
the 1960s and activity is predicted to fall a
further 15% by 2030.
Physical inactivity is responsible for:
• 1 in 6 UK deaths
• Up to 40% of many long-term conditions
Estimated £7.4 billion annual cost
6
Ng SW, Popkin B (2012); Lee I-M, et al. (2012); Wen CP, Wu X (2012); WHO (2010); Ossa D & Hutton J (2002);
Murray et al. (2013)

7. 7
Physical activity: Our greatest defence
against ill health and disease
Adapted from Department of Health and Human Services (2008).
Physical Activity contribution to reduction in risk of mortality and long term conditions
Disease Risk reduction Strength of evidence
Death 20-35% Strong
CHD and Stroke 20-35% Strong
Type 2 Diabetes 35-40% Strong
Colon Cancer 30-50% Strong
Breast Cancer 20% Strong
Hip Fracture 36-68% Moderate
Depression 20-30% Strong
Hypertension 33% Strong
Alzheimer’s Disease 20-30% Moderate
Functional limitation, elderly 30% Strong
Prevention of falls 30% Strong
Osteoarthritis disability 22-80% Moderate

8. The global picture
8 Hallal PC, et al. (2012)
International comparison of physical inactivity (at ages 15 and over)
Note: Comparator = Not meeting any of the following per week: (a) 5 x 30 mins moderate-intensity activity; (b) 3 x 20 mins
vigorous-intensity activity; (c) equivalent combination achieving 600 metabolic equivalent-min.
UK, 63.3%
USA, 40.5%
Australia, 37.9%
Finland, 37.8%
France, 32.5%
Germany, 28.0%
Holland, 18.2%
0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0%
% Inactive

9. 9
Trends in physical activity
PHE Adult Physical Activity Fact Sheet (Jan 2015)
Data Source: Health Survey for England 2012.
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
16-24 25-34 35-44 45-54 55-64 65-74 75-84 85+
0%
20%
40%
60%
80%
100%
16-24 25-34 35-44 45-54 55-64 65-74 75-84 85+
Inactive
Low activity
Some activity
Meets recommendation
Men
Women

10. 10
Inequalities in physical activity in England
GENDER: Women are more inactive than men in virtually every age group.
AGE: Physical activity declines with age and decline starts young, 1 in 4 5-7yrs
girls are active enough for health, by 13-15yrs this falls to only 1 in 10.
ETHNICITY: Only 11% of Bangladeshi women are reaching recommended levels
of activity compared to 25% of the general population of women.
DISABILITY: Disabled adults are half as likely to be physically active as non-
disabled adults.
SEXUALITY/GENDER IDENTITY/FAITH: very limited evidence although some
evidence that discrimination may be a barrier to being active.
SOCIOECONOMIC: Greater levels of inactivity in areas of greater deprivation.
GEOGRAPHY: South East of England has the highest proportion of adults
meeting recommended levels, with the lowest level in the North West.
Everybody Active Every Day Framework Documents (2014)

11. Everybody needs to be more active
every day
11
Health Survey for England 2012 (HSE); Active People Survey 8, April 2103-April 2014 (APS); National Travel Survey
July 2014 (NTS)

12. Physical activity and health & wellbeing
12
Individual
Becoming
More
Active
Fun
Personal
development
Travel
Social
inclusion
Health

13. 13
Everybody Active, Every Day:
Amodel for action
Public Health England (2014-1)
Active Society
Moving
Professionals
Moving at scale
Active
environments

14. Active society – Creating a social movement
• Changing general attitudes
to make physical activity
the expectation or social
norm
• Working across sectors in
the places we live and
work
• Developing a common
vision for “Everybody
Active, Every Day”
14

15. Active society & Sport
• Target and engage inactive people
• Engage users in design of locally-
embedded physical activity
programmes
• Deliver services that support
inclusive opportunities for physical
activity (eg, inclusion fitness
initiative-accredited gyms, equity
statements)
15 Presentation title - edit in Header and Footer

16. Moving professionals –Activating networks
• Utilising existing network of influencers
on the public, the public & voluntary sector
workforce
• ‘Making every contact count’ across
sectors and disciplines
• Starting with expertise &
leadership in key sectors:
o Education
o Sports & leisure
o Health & social care
o Planning, design, transport
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17. Moving Sports professionals
• Support project managers, coaches and
volunteers with training and guidance on
integration of behaviour change.
• Ensure volunteering opportunities and
jobs provide skills development and
career prospects.
• Develop a making every contact count
approach that integrates active living into
all aspects of business.
17 Presentation title - edit in Header and Footer

18. Active environments: Creating the
right spaces
• Developing ‘healthy’ cities,
villages, towns and
communities
• Linking across disciplines
through planning and policy
• ‘Active’ infrastructure planning
• “Active by Design” campaigns
• Capital funding investments
• Embedding activity for all
• Age-friendly
• Disability-friendly
• Inclusive access
• Fun!
The Design Council (2014)

19. Active Sport Environments
• Implement active travel
plans for all staff,
participants and fans
• Identify and address
barriers that prohibit
equality groups from
accessing services (eg,
geographic, physical,
economic)
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21. Moving at scale
• Positive change must
happen at every level and
must be measurable,
permanent and consistent
• Implement ‘what works’ at
scale
• Maximise existing assets
o Human
o Physical
o Make being active the easiest,
efficient choice!

22. Moving at Scale in Sport
• Establish robust
systems to evaluate
projects that assess
pre and post-project
physical activity as well
as participation and
wider outcomes (using
the standard evaluation
framework).
22

23. Evidence for implementation
• Synthesis of existing evidence base (e.g. NICE)
• Evidence-based actions across public health system:
oSettings
oLife-course
• Includes five key steps for local action:
1. Every child to enjoy & have skills to be active
2. Safe, attractive & inclusive active living environments
3. Make every contact count in public & voluntary sectors
4. Lead by example in public sector workspace
5. Evaluate and share ‘what works’
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24. But……
• Sport’s role in public health is more than
physical activity or obesity
• The unique relationship between coaches and
players and clubs and fans could be pivotal in
enabling people to achieve their potential.
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25. Other Opportunities
• Musculoskeletal
disease prevention
• Workplace health
• Domestic violence
awareness
• Mental health &
wellbeing
• Dementia awareness
25

26. Let’s get
Everybody Active
Every Day!
Justin.varney@phe.gov.uk