Walking for Health

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Walking for Health

• The natural environment as a health resource

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• Uses the countryside as a health resource.
• Involves the local community in practical
  conservation work.
• Promotes conservation activities as beneficial to
  physical and mental health.
• Improves the biodiversity of the local
  environment.

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Inactivity the silent epidemic

• 70 of people in the UK are not active enough to
  benefit their health
• Inactivity smoking 20 cigarettes per day
• 80 of people think they are fit!

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Whats the Evidence?
Blood Cholesterol gt5.2 mmol/l
Physical inactivity
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46
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Obesity
13
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Blood Pressure gt140/90mmHg
Smoking
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Inactivity the silent epidemic
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Inactivity the silent epidemic
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Death from CHD under 75 related risk factors
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Benefits of Physical activity

• Heart attacks (50)
• Strokes (50 in men)
• Diabetes (50)
• Fracture Femur (30)
• Colon Cancer (30)
• Breast Cancer (30)
• Alzheimers (25)

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How much? How often?

• 30 minutes moderate intensity exercise on 5 or
  more days of the week
• Moderate breathe deeper, feel warmer brisk
  walking

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Living without Fitness

• A consensus of opinion using available evidence
  is that low-moderate intensity physical activity
  may reduce the risk of CVD without having any
  notable influence on fitness
• European Heart Network 1999

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The costs of physical inactivity

• 40 of premature deaths every year through CHD
• 2 billion per year in UK
• 150 billion in US

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Scotland Statistics

• 2447 people in Scotland die prematurely each year
  due to physical inactivity
• 2162 from CHD (42 of total CHD deaths)
• 168 from stroke (25 of total stroke deaths)
• 117 from Colon Cancer (25 of total colon cancer
  deaths)

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Scotland Statistics

• If there were a 1 decrease of inactive Scots
  then 157 deaths would be prevented each year
  saving 85 million.
• Hospital admissions would fall by 2231cases each
  year saving 3.5 million

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Physical activity the best buy in public health

• If just 10 of the non-active population became
  active at the recommended level, there would be
  an estimated cost saving of 445 million per year.

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Benefits of walking

• Help weight management
• Improve blood lipid profile
• Boost immune system
• Possible reduction in breast cancer risk?

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Benefits of walking

• Helps build strong bones
• Reduces pain of arthritis
• Improves strength and balance
• Can relieve/improve back pain

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Mental health benefits

• Improves depression
• Relieves anxiety
• Reduces stress
• Makes you feel great!

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Does Green Space improve activity?
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Why walking?

• Almost perfect exercise
• Perceived as realistic
• Low impact
• Sociable
• Easily integrated into everyday lifestyles
• No special equipment

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Why walking?

• Uses free resource the footpaths and trails
• Better adhered to than gyms a biophilia
  effect?
• Lack of capacity in existing facilities these
  are already 80-100 full for only 30 active
  population

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How we are doing it

• 200 local schemes
• community or health condition groups
• Leisure/health/transport partnerships
• PR and marketing
• Raising awareness of benefits of walking
• Putting walking into health/transport plans

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How we are doing it

• Grant aid to local schemes
• 400 - 90.000 match-funded by local statutory
  authorities or 90 grants for charitable/community
  groups
• Training free to all at present
• Priority given to deprived areas/sedentary target
  group

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WHI package of support

• Training
• Insurance
• Grants
• Accreditation
• Evaluation
• Marketing materials

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www.whi.org.uk

• Re-launched April 02
• 10,000 visits per mth
• Discussion Forum 100 members, 3-4 pw
• Walkfinder unique resource
• FAQs, News, products
• More inclusive, user friendly, in depth

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Working directly with Primary Care

• Some WHI schemes run by pc teams
• Many more involve pc staff
• Ideal for sedentary people with no interest in
  gyms
• Patients recommended to walk
• No paperwork required by GPs

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What you see on the ground

• Programmes of volunteer-led walks
• Self-help information
• GPs encouraging walking
• Marked routes
• Small infrastructure improvements
• Incentives and promotional events

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Volunteers key asset

• gt5000 walk leaders trained in 2 years
• 57 between 50/70
• 83 active
• leading walks/searching routes/publicity/advocacy/
  scheme admin

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Betty

• Ive lost weight, got my confidence back, become
  involved in lots of projects at the community
  centre and got to know lots of people

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How we ensure safety

• Risk assess walks for suitability
• Concentrate on nursery slope walks
• Own speed walking, not racing
• Train volunteers, Loughborough University
  approved
• Screen newcomers
• Equip leaders, CPR skills

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a chance (of being sued) - but it is minute
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• endorses WHI and commends appropriate walking in
  cardiac rehab
• October 2001

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So does it work?

• Randomised Control Trial
• true life situation
• sedentary people from GP records (n260)
• 2 groups
• Both get advice
• One gets invite to Health Walks
• follow up over 12 months
• activity/health indicators/motivation/quality of
  life

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No. of People active gt 120 mins per week
13
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A local scheme Sonning Common

• Links with Green Gym
• 26 trained volunteers
• Walks 5 days per week
• Graded walks
• Own constitution
• Working in partnership with local
  authority/health centre

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Health Walks and Green Gym join forces

• 70 of people over 65 are unable to climb a stile
  with ease

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The Green Gym

• Offering variety for those who dont wish to walk
• Benefits walkers
• Complements walking programme
• High adherence rate (72 after 18 mths)

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Green Gym Vs Aerobics
Reynolds, 1999
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Green Gym Mental Health Scores
Reynolds, 2002
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The Green Gym

• 24 Green Gyms across UK
• Win, win win

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Step-o-meter campaign

• 400K campaign
• 70,000 step-o-meter giveaway
• Individuals and primary care teams
• 0.5 million media value

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Initial results

• 80 response rate to evaluation
• People walk up to 33 more
• Average UK adult walks between 3000 and 4000
  steps per day
• Aspirational 10000 steps unlikely to met met
  without building walking more into everyday lives

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Conclusion

• Walking and schemes like this may provide a
  part-answer to physical inactivity
• Need to recognise limitations
• Need a well-resourced national initiative with
  good LOCAL partnerships to ensure sustainability
  and effectiveness

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Brisbane October 2002

• Veronica Reynolds
• Walking the Way to Health UK

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Walking for Health

• The natural environment as a health resource

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Ageing or disease?

• Decline in strength and stamina related to
  decline in physical activity rather than ageing
  process alone

Simple reaction times (msecs) Old non
active 240 Young non active 170 Old
active 140 Young active 120
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The Giants of Geriatrics

• Incontinence
• Immobility
• Instability
• Intellectual impairment

Walking can help!
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How walking can help the transport agenda

• People taking part in health walks were less
  likely to use their car for short journeys.
• 27 said their transport habits had changed a
  great deal

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How walking can help the transport agenda

• Show people HOW and WHERE to walk
• Give them confidence and improve their health
  enabling them to chose walking

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Adelaide, October 2002

• Veronica Reynolds
• Walking the Way to Health UK

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Walking for Health

• Lessons from the UK initiative

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How walking can help the transport agenda

• People taking part in health walks were less
  likely to use their car for short journeys.
• 27 said their transport habits had changed a
  great deal

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How walking can help the transport agenda

• Show people HOW and WHERE to walk
• Give them confidence and improve their health
  enabling them to chose walking

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Conclusion

• Walking and schemes like this may provide a
  part-answer to physical inactivity
• Need to recognise limitations
• Need a well-resourced national initiative with
  good LOCAL partnerships to ensure sustainability
  and effectiveness