Physical Activity and Sport Framework Appendix 2 - Hertfordshire

Transcription

1 Physical Activity and Sport Framework Appendix 2 - Hertfordshire 1

2 CONTENTS This appendix provides a wealth of information and data to give the reader an understanding of the demographics, health information and sport and physical activity participation levels for Hertfordshire. The contents table below gives details of information contained within this document. HERTFORDSHIRE DEMOGRAPHICS Figure 1: Hertfordshire population age, gender and disability percentage Page 3 Figure 2: Hertfordshire projected population age and gender Page 4 Figure 3: A map of deprivation in Hertfordshire Page 5 HERTFORDSHIRE HEALTH REVIEW Figure 4: Life expectancy inequalities in Hertfordshire Page 7 Figure 5: Child obesity and excess weight in Hertfordshire Page 7 Figure 6: Adult obesity and excess weight in Hertfordshire Page 7 Figure 7: Adult obesity rates mapped in Hertfordshire Page 8 Figure 8: Healthcare costs of physical inactivity in Hertfordshire Page 8 Figure 9: Estimate number of preventable deaths by increasing physical activity Page 9 levels among year olds Figure 10: Effects of physical activity on reducing the risk of certain diseases Page 10 Figure 11: Effects of exercise in the treatment of chronic disease Page 10 HERTFORDSHIRE PHYSICAL ACTIVITY AND SPORTS PARTICIPATION Figure 12: Percentage of adults (16+) in Hertfordshire achieving at least 150 minutes of moderate intensity physical activity per week in comparison to Hertfordshire and England Figure 13: Percentage of adults (16+) in Hertfordshire classified as inactive (physically active for less than 30minutes per week) Figure 14: Percentage of adults (16+) in Hertfordshire participating in sport for 1x30 minutes per week Figure 15: Percentage of adults (16+) in Hertfordshire participating in sport for 1x30 minutes per week compared to ONS neighbours. Figure 16: Percentage of adults (16+) who currently play sport 1x30 compared to ONS neighbours Figure 17: Percentage of adults (16+) in Hertfordshire participating in sport for 3x30 minutes per week Figure 18: Percentage of adults (16+) in Hertfordshire participating in sport for 3x30 minutes per week compared to ONS neighbours Figure 19: Percentage of adults (16+) who currently play sport 3x30 compared to ONS neighbours Figure 20: Percentage of adults (16+) in Hertfordshire who do not take part in any sport (zero participation) Figure 21: Percentage of adults (16+) in Hertfordshire who do not take part in any sport (zero participation) compared to ONS neighbours Figure 22: Percentage of latent demand for sport and active recreation for adults (16+) living in Hertfordshire who are currently inactive Figure 23: The Hertfordshire adult population broken down into market segments Page 13 Page 13 Page 14 Page 14 Page 15 Page 15 Page 16 Page 16 Page 17 Page 17 Page 18 Page 19 BIBLIOGRAPHY Bibliography Page 20 2

3 HERTFORDSHIRE DEMOGRAPHICS It is firstly important to understand the demographics of Hertfordshire so that effective physical activity and sport initiatives can be coordinated to target the local population. Sport England local profile (2014) shows us that over 895,400 people currently live in Hertfordshire, and the proportions of people in each age bracket are similar to the national average (Figure 1 and Figure 2) 2. Hertfordshire has a significantly lower percentage of young people in comparison to the national average. Hertfordshire has 25.7% and 6.9% 20 to 24 year olds in comparison to 5.8% and 8.4% year olds in England 2. In addition Hertfordshire has a higher number of males in comparison to males. 51.1% female and 48.9% male 2. Figure 1: Hertfordshire population age, gender and disability percentage The table below shows the population demographics in Hertfordshire in You can see from the table below that the population in Hertfordshire is ageing 2. 3

4 Figure 2: Hertfordshire population age and gender numbers The table below shows the number of people living in Hertfordshire by age bracket, and the number of people living in the East of England and England. The values are presented in 000s 2. Hertfordshire has a lower Index of Multiple Deprivation (IMD) than the national average. In 2010, Hertfordshire had an IMD of and ranked 138 th out of 149 county areas 2. However this low county wide IMD masks the high deprivation in smaller areas within the districts. The Office of National Statistics shows that there are Super Output Areas (SOAs) with significant deprivation in Hertfordshire. There are a number of areas that fit into the most deprived quintile for England. Here are three examples of these deprived SOAs in Hertfordshire 1. Hertfordshire (Waltham Cross) has an IMD of which is well above the national average of In addition 33.77% of children within Waltham Cross are living in poverty Stevenage (Bedwell) has an IMD of which is well above the national average of In addition 31.04% of children within Bedwell are living in poverty Welwyn Hatfield (Peartree) has an IMD of which is well above the national average of In addition 26.22% of children in Peartree are living in poverty 4. These SOAs with high deprivation are across the whole of Hertfordshire in all 10 districts, and they suffer from health and social inequalities. This could be an area for targeted initiatives for raising sport and physical activity. 4

5 Figure 3: A map of the deprivation in Hertfordshire. The map below shows differences in deprivation levels in Hertfordshire based on national quintiles (fifths) of the IMD and SOA. The darkest coloured areas are the most deprived areas in Hertfordshire The chart on the right shows the percentage of residents living in that deprivation quintile. The key finding is the inequality between economic and social deprivation in Hertfordshire, with areas of very high deprivation and very low deprivation. You can find a more detailed version of this map for each district within the district fact sheets if you would like to view the deprived SOAs in your areas. The high level of deprivation in the above SOAs is important when understanding sport and physical activity in the county. The Sport England Local Sport Profile (2014) shows that the areas above highlighted as most deprived have the lowest level of participation in sport and active recreation. In addition it is noted in the Public Health Profile of Hertfordshire (2014) that there are health inequalities within these most deprived SOAs, which means that adults within these deprived areas are more likely to suffer from diseases related to inactivity and die younger. Therefore it is appropriate that sport and physical activity initiatives target the residents in these deprived SOAs in order to reduce these health and social inequalities, and improve access to affordable and appropriate sporting activities. 5

6 HERTFORDSHIRE HEALTH REVIEW This section will provide a range of health data for Hertfordshire. It includes: the health costs of inactivity, life expectancy inequalities in the district, obesity levels in adults and children, the estimated number of preventable deaths amongst year olds, and the effects of physical activity to reduce the risk of developing and effects of treatment for certain diseases. Health costs of physical inactivity o The total cost of the 5 top diseases that physical activity could help minimise or prevent is worth over 16.0m yearly in Hertfordshire (Figure 8) 1. o Hertfordshire also has a significantly higher obesity and excess weight percentage in comparison to the national average which has meant that diseases linked with being overweight have seen an increase over the last few years. This has had an impact on the health care costs in Hertfordshire, for example a disease linked to physical inactivity such as Coronary Heart Disease currently costs 8,824,410 a year 2. Physical inactivity represents 10% of total costs when compared against other toptier Public Health concerns including sexual health, smoking, obesity and drug and alcohol misuse 7. It has been noted that physical inactivity is responsible for more deaths in comparison to smoking in four serious non-communicable diseases: coronary heart disease, type 2 diabetes, and colon and breast cancer. Individuals not spending at least 150 minutes a week doing moderate exercise causes between 6% and 10% of deaths in those four diseases (Medical News Today, 2014) 5. Disease and disability caused by physical inactivity cause serious and unnecessary human suffering and impaired quality of life. What unites all types of physical activity are the physical and mental health benefits, bringing about an immediate and beneficial physiological response and improving our overall wellbeing. As an example, daily physical activity can help reduce the risk of developing cancer, but can also support people living with and beyond cancer by increasing their quality of life. 6

7 Figure 4: Life expectancy inequalities in Hertfordshire. The graphs below shows the life expectancy for men and woman in Hertfordshire between Each chart is divided into deciles (tenths) by deprivation, from the most deprived decile on the left of the chart to the least deprived decile on the right. The steepness of the slope represents the inequality in life expectancy that is related to deprivation in Hertfordshire. If there was no inequality in deprivation then the line would be horizontal. You can see from the graphs below that Life expectancy is 7.0 years lower for men and 6.0 years lower for woman in the most deprived areas of Hertfordshire. Figure 5: Child obesity and excess weight in Hertfordshire. The table below shows the percentage of children aged 4-5 and in Hertfordshire who are obese or are in the excess weight category Hertfordshire England Difference Children aged % 22.2% 2.4% 5 Children aged % 33.3% 4.5% Figure 6: Excess Weight in Hertfordshire. The table below shows the percentage of adults in Hertfordshire who are overweight The table shows that in 2012, 61.8% of adults were classified as overweight. This is lower than the national average (Overweight adults 2.0%). Overweight Adults Hertfordshire England Difference 61.8% 63.8% 2.0% 7

8 Figure 7: Adult obesity rates mapped in Hertfordshire. The map to below shows the areas with the highest level of adult obesity. The lighter the colour the higher the level of obesity in the Medium Super Output Area (MSOAs). It is worth noting that these areas are also the most deprived areas (chart 1.3). You can see these obesity rates mapped for each district. Figure 8: Health costs of physical inactivity by the top 5 disease categories in Hertfordshire. The table below shows the actual cost of physical inactivity on the top 5 costing preventative diseases excluding obesity. You can see from the figures below the cost of inactivity in Hertfordshire per disease every year. Cancer Lower GI Cancer Breast Diabetes Coronary Heart Disease Cerebro- Vascular Disease Total Cost 1,014,400 1,044,340 3,312,000 8,824,410 1,880,160 16,075,310 8

9 Figure 9: Preventable deaths by increasing physical activity among year olds. The table below shows the number of lives saved amongst years olds if they become physically active. For example if 25% of people who are currently inactive become active we would save 26 lives a year. If 100% of people became physically active we would save 653 lives a year. It is also important to note that as well as saving these 653 lives, if 100% of people were physically active there would be a significant increase in the Quality-Adjusted Life Years (QALYs) of people living in Hertfordshire. The QALYs is a measure of disease burden including both the quality and quantity of life lived. It is used for assessing the value of a medical intervention, and healthcare resources can be assigned to interventions with a lower cost to QALYs saved. Hertfordshire currently has 71.0m worth of healthcare savings that can be attributed to physical activity a year 10. Hertfordshire has 390.6m worth of wider health benefits that can be attributed to physical activity. These are often referred to as Quality-adjusted Life Years (QALYs), and measure the quality and quantity of life 10. You can see the total economic value of physical activity in Hertfordshire on Health care savings in the table on the right hand side. The health gains of a year old who plays football are valued at 27,000 across their life time 12. Sport England notes that Local Authorities who prioritse physical activty have seen a return on investment of upto 450% 12. Evidence suggests a return on investment for physical activity intiatives that currently run, for example Birmingham Be Active delivers a 21 return for every 1 spent. 9

10 Figure 10: Effects of physical activity on reducing the risk of certain diseases. The table below shows the effects of being physically active to the recommended levels to reduce the risk of developing certain diseases. Disease Coronary heart disease Type 2 diabetes Stroke Breast cancer Colon cancer Osteoporosis Falls Mental Health All-cause mortality Effect of physical activity 20% to 35% lower risk of cardiovascular disease, coronary heart disease and stroke. 30% to 40% lower risk of type 2 diabetes (and metabolic syndrome) in at least moderately active people compared with those who are sedentary. 20% to 35% lower risk of cardiovascular disease, coronary heart disease and stroke. 20% lower risk of breast cancer for adults participating in daily physical activity. 30% lower risk of colon cancer for adults participating in daily physical activity. 36% to 68% risk reduction of hip fracture at the highest level of physical activity. 30% lower risk of falls for older adults who participate in regular physical activity. 20% to 30% lower risk for depression and dementia for adults participating in daily physical activity. 30% risk reduction when comparing the most active with the least active. Figure 11: Effects of exercise in the treatment of chronic disease The table below shows the effectiveness of physical activity in the management of most chronic diseases. Chronic Disease Ischaemic Heart Disease COPD Breast Cancer Bowel Cancer Cerebrovascular Disease Diabetes Impaired glucose tolerance Hypertension Depression/anxiety disorders Rheumatoid arthritis Osteoarthritis Osteoporosis Effect of physical activity 35-40% reduction in risk of event Improvement in aerobic fitness, quality of life, symptoms of dyspnoea, CV risk factors. 50% reduction RR of breast cancer death 50% reduction in bowel cancer death improvement of tolerance of cancer treatment. Improvement of aerobic capacity, sensorimotor function and CV risk factors 42% reduction in diabetes related mortality 32% reduction in diabetes related complications 42% reduction in risk of developing diabetes. Reduce systolic BP by 7.4mmHg and diastolic BP by 5.8mmHg Effect as good as standard pharmacological treatments for moderate depression. Improved aerobic fitness, disease activity, function and QoL Improved aerobic capacity, reduce fatigue and pain. Improve muscle strength and function. Reduction in risk of falls. Maintenance of BMD in men and postmenopausal women 10

11 Health care cost savings and an increase in QALYs (Quality Adjusted Life Years) through physical activity initiatives would have a substantial economic impact on public health, and the health and wellbeing of the local community. If the cost of physical inactivity continues to increase, particularly in relation to chronic diseases as well as obesity, osteoporosis and supported living, it is likely to result in significant reductions in public health and social care expenditure in other areas for an increasing number of people. By achieving a minimum level of 150 minutes of physical activity a week, an adult could potentially experience a 19% reduction in mortality risk. Furthermore, this reduction in mortality risk is reported to increase to 24% if an adult achieves seven hours of physical activity per week. If 25% of year olds in Hertfordshire were more active than 26 deaths from all causes would be prevented; 235 if 50% were more active; 444 with 75%; and 653 deaths would be prevented if all year olds were more active. 11

12 HERTFORDSHIRE PHYSICAL ACTIVITY & SPORTS PARTICIPATION This section will provide a range of data to show activity levels of the adult population in Hertfordshire. The majority of the data is taken from the Active People Survey (APS). This is a national survey conducted by the TNS-BMRB on behalf of Sport England. It is a telephone survey and the largest of its kind in Europe. APS provides reliable statistics on participation in sport and active recreation (moderate intensity) for all local authorities in England. Until July 2012, it surveyed adults aged 16+ only, since July 2012 the minimum age was reduced to 14 years. The survey is conducted over a 12 month period to take into account seasonal variations. It captures frequency of participation in moderate intensity sport and active recreation, sports club membership, sports volunteering and data collected includes variations between socio economic groups, gender, age, ethnicity and disability. The survey has been modified to capture the UK Chief Medical Officer s (CMO) guidelines of participating in moderate intensity sport and/or physical activity for at least 150 minutes per week. It also captures adults participating at least 1 x 30 minutes of sport per week, which is the focus by Sport England. Other participation measures include 3 x 30 minutes per week participation in sport and active recreation and zero participation in sport and zero participation in sport to allow comparisons to be made to the baseline (APS1). The Active People Survey was first conducted in October 2005 and data was collected through October 2006 (APS1). When comparing participation levels, it must be noted that it is not appropriate to compare Hertfordshire with its geographical neighbours. It is more appropriate to do a comparison with the Office of National Statistics (ONS) neighbours, i.e. Counties with similar demographics. Hertfordshire s ONS neighbours are: Buckinghamshire, Leicestershire, Nottinghamshire and Dorset. The following data will be presented below - Percentage of adults (16+) achieving 150 minutes of moderate intensity physical activity. - Percentage of adults (16+) classified as inactive (less than 30mins physical activity per week). - Percentage of adults (16+) participating in sport 1x30 minutes per week. - Percentage of adults (16+) participating in sport 1x30 minutes per week compared to ONS neighbours. - Percentage of adults (16+) participating in sport 3x30 per week. - Percentage of adults (16+) participating in sport 3x30 minutes per week compared to ONS neighbours. - Percentage of adults (16+) participating in no sport. - Percentage of adults (16+) that are inactive who have a latent demand for sport. - Market segmentation of the local area. 12

13 Figure 12: Percentage of adults (16+) in Hertfordshire achieving at least 150 minutes of moderate intensity physical activity per week in comparison to England % 58.0% 58.0% 57.5% 57.0% 56.5% 56.0% 55.5% 55.6% 55.0% 54.5% 54.0% Hertfordshire England Figure 13: Percentage of adults (16+) in Hertfordshire classified as inactive (physically active for less than 30minutes per week) % 29.0% 28.9% 28.0% 27.0% 26.0% 25.0% 25.3% 24.0% 23.0% Hertfordshire England 13

14 Figure 14: Percentage of adults (16+) in Hertfordshire participating in sport for 1x30 minutes per week % 40.0% 39.5% 39.0% 38.5% 38.0% 37.5% 37.0% 36.5% 36.0% 39.9% 38.9% 38.0% 37.6% APS1 (05/06) APS6 (11/12) APS7 (12/13) APS8 (13/14) Hertfordshire Figure 15: Percentage of adults (16+) in Hertfordshire participating in sport for 1x30 minutes per week compared to ONS neighbours 1. APS1 (05/06) APS7 (12/13) APS8 (13/14) 41.6% 37.6% 36.3% 37.2% 37.8% 34.0% 39.9% 38.9% 37.6% 35.1% 34.5% 34.9% 34.1% 34.5% 35.0% Buckinghamshire and Milton Keynes Dorset Hertfordshire Leicester, Leicestershire and Rutland Nottinghamshire 14

15 Figure 16: Percentage of adults (16+) in Hertfordshire participating in sport for 3x30 minutes per week % 18.0% 17.5% 17.7% 18.0% 17.0% 16.5% 16.0% 15.5% 15.0% 16.4% 15.8% 14.5% APS1 (05/06) APS6 (11/12) APS7 (12/13) APS8 (13/14) Hertfordshire Figure 17: Percentage of adults (16+) in Hertfordshire participating in sport for 3x30 minutes per week compared to ONS neighbours % 20.0% 15.0% 20.3% 19.3% 18.4% 17.7% 17.7% 18.0% 15.8% 16.0% 16.4% 16.7% 17.7% 16.8% 15.2% 15.3% 15.2% 10.0% 5.0% 0.0% Buckinghamshire and Milton Keynes Dorset Hertfordshire Leicester, Leicestershire and Rutland Nottinghamshire APS1 (05/06) APS7 (12/13) APS8 (13/14) 15

16 Figure 18: Percentage of adults (16+) in Hertfordshire who do not take part in any sport (zero participation) % 50.0% 49.5% 49.0% 48.5% 48.0% 47.5% 47.0% 46.5% 46.0% 50.2% 48.2% 48.3% 47.7% APS1 (05/06) APS6 (11/12) APS7 (12/13) APS8 (13/14) Hertfordshire Figure 19: Percentage of adults (16+) in Hertfordshire who do not take part in any sport (zero participation) compared to ONS neighbours % 50.0% 50.6% 48.8% 45.9% 53.9% 50.2% 50.2% 48.5% 47.7% 48.3% 53.7% 52.7% 52.3% 55.4% 53.8% 54.1% 40.0% 30.0% 20.0% 10.0% 0.0% Buckinghamshire and Milton Keynes Dorset Hertfordshire Leicester, Leicestershire and Rutland Nottinghamshire APS1 (05/06) APS7 (12/13) APS8 (13/14) 16

17 Figure 20: Percentage of latent demand for sport and active recreation for adults (16+) living in Hertfordshire who are currently inactive. Summary of participation in sport and physical activity in Hertfordshire o You can see from Figure 12 that Hertfordshire has a higher percentage of adults (16+) that are currently achieving 150minutes of moderate intensity physical activity per week in comparison to England (58.0% vs 55.6%). o Figure 13 shows that Hertfordshire has 25.3% of adults (16+) who are currently classified as inactive (physically active for less than 30minutes per week). o You can see from Figure 14 that the percentage of adults (16+) participating in sport 1x30 in Hertfordshire has decreased by 1.0% over the last year. o The percentage of adults (16+) in Hertfordshire participating in physical activity decreases from 1x30 (38.9%) to 3x30 (18.0%) by 20.9% (Figure 14 and 16). o Hertfordshire has a lower percentage of adults (16+) participating in physical activity 3x30 in comparison to Buckinghamshire and Milton Keynes and Dorset it s ONS neighbours by 2.3% and 1.3% (Figure 17). o The number of adults (16+) who don t participate in any sport has increased by 0.6% over the last year in Hertfordshire to 48.3% (Figure 18). o Hertfordshire has a high latent demand for sport and active recreation for adults (16+) who are currently inactive with 24.8% saying they would like to be active (Figure 20). 17

18 Market segmentation Sport England has worked with Experian to develop nineteen sporting segments to help us understand the nation s attitudes to sport, their motivations and barriers to participation. Each market segment has a detailed pen portrait to help understand the types of activities they are likely to want to take part in, motivations for being active, marketing channels, likely barriers to participation. The interactive market segmentation tool allows the user to find out what the dominant segments are in each district and the percentage of each segment living within each ward. Figure 21: The Hertfordshire adult population broken down into market segments The above table gives an overall picture of market segmentation but it is important to use the market segmentation interactive tool to analyse the breakdown of market segments at a local level (i.e. by super output area) when planning interventions. When looking at the local authority areas as a whole, the dominant segments are: Tim (settling down males, mainly aged years, sporty male professionals) 13. Phillip (midlife professional, sporty males with older children and more time to themselves mainly aged years) 13. Elaine (Midlife professionals who have more time for themselves since their children have left home. Aged 46-55)

19 Bibliography 1 The Active People Survey, Sport England (2014). 2 Sport England, Local Sport Profile Tools, February Office National Statistics, Census Herts County Council, Indices of Deprivation Public Health England, Health Profile 2014 Hertfordshire. 6 East and North Herts Clinical Commissioning Group, online Connect Sport, Online Sport England, Mini Local Sport Profile, Office of National Statistics, Population projections Sport England Economic Value of Sport, Local Model, Sport England, Sports role in improving the health of the nation, Start Active, Stay Active: A report on physical activity from the four home countries Chief Medical Officers, Department of Health (2011). 13 Sport England s Market Segmentation, Sport and Exercise Medicine A fresh approach National Child Measurement Programme Sport and Exercise Medicine A fresh approach National Child Measurement Programme Public Health Outcomes