Healthy Cities: From Strategy to Implementation

Transcription

1 Healthy Cities: From Strategy to Implementation Susanna Kugelberg PhD MSc Consultant, Nutrition, Obesity and Physical Activity Programme, Division of Non-Communicable Disease and Lifecourse WHO/Europe 05 April, 2016

2 Overview WHO Global Recommendations on physical activity Obesity and physical inactivity in the European Region WHO s Physical Activity Strategy for Europe Key steps for making cities more physically active

3 Physical Activity throughout the Life-course Throughout childhood and adolescence Basic motor skills and musculoskeletal development Throughout adulthood - Maintain muscle strength, increases cardiovascular fitness and bone health Among older people - Maintain health, agility, functional independence and enhance social participation

4 WHO Global Recommendations on Physical Activity for Health Provide guidance on the dose-response relationship between the: frequency duration Intensity type total amount The recommendations target three age-groups

5 Children and adolescents aged 5-17 Min 60 minutes of moderate- to vigorous-intensity of physical activity daily. Physical activity greater than 60 minutes daily will provide additional health benefits Most daily physical activity should be aerobic. Vigorous-intensity activities should be incorporated, including those that strengthen muscle and bone, at least 3 times per week

6 Adults aged At least 150 minutes of moderate-intensity aerobic physical activity, or 75 minutes of vigorous-intensity aerobic physical activity per week Aerobic activity should be performed in sessions of at least 10 minutes duration For additional health benefits, adults should increase their moderate-intensity aerobic physical activity to 300 minutes per week, or engage in 150 minutes of vigorous-intensity aerobic physical activity per week Muscle-strengthening activities should be carried out, involving major muscle groups, on 2 days per week.

7 Adults aged 65+ The same goals as for healthy younger adults. Strength training and balance exercises to prevent falls are of particular importance for this age group When older adults cannot achieve the recommended amounts of physical activity owing to health conditions, they should be as physically active as their abilities and conditions allow.

8 Sedentary Behaviour The case for specific consideration Emerging risk factor Independent of physical activity level Associated with all-cause as well as cardio-vascular disease mortality, type 2 diabetes in prospective studies Widespread behaviour (> 60 % awake time) Increasing trend Need for specific monitoring and surveillance Need for action by setting (worksite) Need for dedicated research (environment, interventions)

9 What is Physical Activity? There are many different forms, settings and levels of physical activity Gender, Age and Culture influence Physical Activity level

10 Non-Communicable Diseases Worldwide, physical inactivity causes 6 10% NCDs (CHD, diabetes, breast and colon cancer)* Physical inactivity causes 9% premature mortality* Known health effects on: - Mental health, e.g. reducing anxiety, stress, depression and possibly delaying Alzheimer s and dementia - Energy balance and weight control *Lee IM & al. 2012; **Hallal PC & al. 2012

11 Physical Activity in the European Region

12 Low Total Daily Physical Activity WHO estimates that in in the European region: More than half of the population is not active enough to meet health recommendations. One third of European young people aged 11, 13 and 15 years reported enough physical activity to meet current guidelines.

13 Physical Inactivity Adults Physical inactivity (%) among adults (18+) in the EU Male Female GRE EST LTU NET SVK CRO HUN BUL POL GER LVA CZH SVN DEN ROM FRA AUT FIN BEL UK SWE LUX SPA POR IRE ITA CYP MAT Global Health Observatory Data Repository. Geneva: World Health Organization ( accessed 10 April 2016). No data for ALB, AND, AZE, BLR, BIH, CYP, GEO, KAZ, KGZ, MNE, MDA, SMR, SRB, TJK, TKM, UZB

14 Percentage Physical Inactivity Adolescents 100 Prevalence of physical inactivity (%) among adolescents (11-17 years) in the EU Male Female 0 IRE BUL AUT CZH FIN SPA SVK LUX UK CRO POL LVA SVN HUN ROM NET MAT BEL GER LTU GRE EST SWE POR FRA DEN ITA CYP Global Health Observatory Data Repository. Geneva: World Health Organization ( accessed 10 April 2016).

15 Childhood Obesity Spain Italy* San Marino* Greece Malta Portugal Bulgaria Macedonia** Romania* Slovenia Lithuania Hungary Turkey Czech rep. Latvia Norway* Albania* Ireland Belgium Sweden Overweight - Males Obesity - Males Overweight - Females Obesity - Females Prevalence of overweight and obesity among children aged 7 years, 2012/13 (2009/10 for CZH, SPA HUN; 2007/08 for SWE). * Children aged 8 years, ** Children aged 6 years

16 Physical Activity Inequalities Some groups are less physically active and harder to reach for the promotion of physical activity than other, e.g: Adults and older people with low socio-economic status Female adolescents Minority ethnic groups People with disabilities

17 Determinants of Physical Inactivity Some of the determinants of physical inactivity are the result of systemic and environmental changes, e.g. - Urban sprawl, i.e. areas with greater distance between homes, workplaces, shops and places for leisure activities - Road safety concerns - Children and adolescents spend more time in school or day-care settings - Quality of neighbourhood environments - Increasingly sedentary forms of entertainment, e.g. screen-based activities - More technical aids, such as escalators

18 Physical Activity Strategy for the WHO European Region Global Policy Frameworks Guidance on Best Practice Landmark documents on Intersectoral collaboration Consultation

19 Mission To inspire governments and stakeholders to work towards increasing physical activity for all: Promote physical activity Enable environment Provide equal opportunities Remove barriers

20 Guiding principles Reduce inequities Promote a life-course approach Use evidence-based strategies Empower people and communities Promote integrated, multisectoral, sustainable and partnershipbased approaches Ensure contexuality of physical activity programmes

21 5 Priority areas Providing leadership and coordination Supporting child and adolescent development Promoting physical activity for all adults as part of daily life Promoting physical activity among older people Monitoring, surveillance, tools, enabling platforms, evaluation and research

22 Priority Area 1 Providing Leadership and Coordination for the Promotion of Physical Activity Ensure leadership to oversee, guide and integrate PA in policymaking and coordinate and promote alliances policy learning, dissemination and sustainability

23 Priority Area 2 Supporting the Development of Children and Adolescents Promote PA during pregnancy and for early childhood - Training of Health professionals - Promote physical activity in preschools and schools - Measures to ensure the nationwide implementation of quality physical education classes Promote recreational physical activity for children and adolescents - Out-of- school physical activity programmes - Innovative approaches to promote physical activity

24 Priority area 3 Promoting physical activity for all adults as part of daily life Reduce car traffic and increase walking and cycling suitability establish a mix of accessible walking and cycling infrastructures improve the availability and attractiveness of public transport congestion charges, tax incentives Provide opportunities and counselling for physical activity at the workplace by; o Regulations or guidelines with regard to cycle racks, changing rooms and adequate public transport options

25 Continuation Integrate physical activity into prevention, treatment and rehabilitation - Health professionals should promote PA in their daily activities Improve access to physical activity facilities and offers, particularly for vulnerable groups - Incentives for providers to offer physical activity programmes and opportunities for vulnerable groups

26 Priority area 4 Promoting physical activity among older people Improve the quality of advice on physical activity by health professionals to older people Provide infrastructure and appropriate environments for physical activity among older people flexible working hours and modified work environments for older people Involve older people in social physical activity make use of existing social structures to reach older people, in particular those from socially disadvantaged backgrounds, in order to encourage them to engage in physical activity.

27 Priority Area 5 -Supporting action through monitoring, surveillance, the provision of tools, enabling platforms, evaluation and research Strengthen and expand surveillance systems Deeper understanding of PA-patterns among different social groups, including by gender, age and socioeconomic status Strengthen the evidence base for physical activity promotion approaches to engaging vulnerable population groups across the lifecourse in physical activity, innovative approaches to promoting physical activity for adolescents, in particular through the use of technology and peer networks

28 From Strategy to Implementation

29 Key findings on Implementation Physical Activity in Cities Most member cities viewed physical activity as an important issue for urban planning. Most member cities reported actions targeting the built environment to promote walking and cycling. Many efforts are nested in programmes to prevent obesity among adults and children The health care sector was clearly involve das an arena to identify and reach sedentary individuals and to initiate disease prevention Faskunger JT. Active living in healthy cities. Journal of Urban Health (2012)

30 Barriers and Challenges Only a few cities mentioned an integrated framework specific for active living Frequently mentioned barriers included lack of funding and lack of commitment from decision-makers Better evaluation methods are needed to improve the evidence base for effective action Future challenges include establishing integrated policy, introducing a larger range of actions

31 Finland- Monitoring Risk Factors in Adolescents Move! A National Monitoring system for physical functional capacity Move! aims to increase physical activity among Finnish adolescents (aged years and years) (High Risk group) It is build around a system that monitors pupils physical functional capacity by measuring endurance, strength, speed, mobility, balance and basic motor skills. With the help of a feedback system, pupils, their guardians, health care professionals at school, as well as teachers receive information about pupils physical functional capacity, its connection to their well-being and advice on how to improve it.

32 Austria- Building Strong Partnerships to Promote Physical Activity for All The government has build strong partnership with the Austrian Sports for All organizations including their network of over sports clubs. The partnership has strengthened the Sports for All organizations capacity to provide a programmes such as: Move Children Healthy- Austria s largest intersectoral programme between the sports and education sectors. The initiative aims to build collaboration between sports clubs, preschools and primary schools and to promote an active lifestyle by offering a joyful and fun approach to physical activity for children aged 2 10 years. By the end of 2014, more than interventions have been provided to almost 7000 preschools and primary schools since 2009.

33 Netherlands- Integrated Programme to Support Disability Sports Active without Boundaries aims to make sports and physical activity available to all disabled individuals The programme has four sections: 1. collaboration at the local level 2. supporting those who provide the opportunities for sports and physical activity 3. facts and figures (monitoring and dissemination of information) 4. ensuring this population group is represented within other sports policy programme

34 From Strategy to Implementation- Summary Build commitment Form a leadership group Create a vision Profile the city, neighbourhoods and target population groups Consult with residents and stakeholders Map opportunities and constraints Identify funds and resources Adopted from A healthy city is an active city: a physical activity planning guide (2008)

35 Preparing a plan Create a conceptual model that link risk behaviours with factors in the social and built environment Develop key interventions and: Set priorities for intervention options in the built environment Set priorities for intervention options in the social environment Set priorities for intervention options in specific settings Strengthen individual intentions

36 Implementing the plan and measuring success Stage implementation Evaluate your progress (effectiveness) Share your results Review and update your plan Source: adapted from Community physical activity planning: a resource manual (2006)

37 Success in A healthy and active city is one that engages its citizens and continually assesses and improves opportunities in the built and social environments, individual capabilities and motivations to be physically active in day-to-day life.

38 Thank You