London Childhood Obesity Exchange Adapting the Environment to Enable - - PowerPoint PPT Presentation

ADPH London

London Childhood Obesity Exchange

Adapting the Environment to Enable Healthy Activity

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Outline of the Event

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Introductory Presentations 9.30 Welcome and Introduction to the event 9.40 What is the Problem and the Opportunity? Healthy Activity within a whole systems approach 9.55 Opportunities to build a healthy environment - TCPA 10.20 Examples of enabling a healthier environment in London & beyond 11.00 Coffee and Exchange of Knowledge & Ideas Facilitated Actions... 11.15 Working together to identify what is happening or could happen in your borough / area 11.45 Developing ideas and commitments to make small changes to make a big difference. 12.20 Into Action ... Resources and support to implement change 12.30 Close & Networking Lunch

ADPH London

Healthy Activity within a Whole Systems Approach

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What’s the problem?

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Physical Activity – Children aged 5-15

Health Survey for England 2015

• In London 16%
• f children meet

the CMOs physical activity guidelines

• This is lower

than the England average of 22%

• f children

meeting the CMOs physical activity guidelines.

London Obesity Leadership Group: Strategic workshop

Active travel: Transport to/from school

National travel Survey 2014/15

5 10 15 20 25 30 35 40 45 Walk Bicycle Car/ van Private bus Local bus Surface rail Other transport London England

Main mode of transport to and from school for children aged 5-16years (National Travel Survey 2014/15 combined)

% of children aged 5-16years

In London, 39% of children report walking as the main mode of transport to/from school. This is lower than the England average.

6 London Obesity Leadership Group: Strategic workshop

The Problem...

8 in 10 Children in London do not get the recommended levels of physical activity every day

Mackett, R. and Paskins, J. 2004. Increasing Children’s Volume of Physical Activity Through Walk and Play. Contribution to the Department of Culture, Media and Sport and Department of Health Consultation on ‘Choosing Health, Choosing Activity: A Consultation on How to Increase Physical Activity’ 7

The Opportunity

Children burn most energy playing

• utdoors, walking and cycling

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Active People Survey data in Public Health Outcome Framework’. Public Health England. Available online

What do Londoners say is the problem... What makes it hard to be healthy?

• 1. Too many cheap unhealthy food and drink options (60%)
• 2. Too many fast food shops (44%)
• 3. Safety concerns about children (not letting them play outside

unsupervised) (33%).

• 4. Too much advertising of unhealthy food and drink options (30%)

Great Weight Debate, 2016

Cultural Insights from Literature

Study with children from ethnically diverse sample of young children and parents in London:

• Lack of knowledge of guidelines and negativity towards physical

activity education at school among girls.

• Parents feel physical activity is role of schools.
• Influence of neighbourhood (lack of safety – gangs & dogs, fast food
• utlets).
• Places of workshop key focal points for social support - more focus

between healthy eating and religion than physical activity and religion.

• In South Asian families homework prioritised over physical activity.

Rawlins et l, 2012 10

Other Insights....

What stops access to open / green spaces? Insights from Portsmouth Project...

Portsmouth City Council & Portsmouth Primary Care Trust… Scoping Report 2009 by BrilliantFutures Limited 11

Positive Attitudes.... Parents and carers in Portsmouth had strong positive attitudes to physical activity and outdoor play. 92% agreed that ‘it is vital that children take regular exercise

• utside’ and 88% agreed that ‘children that play outside with nature around them

are happier’. Children Want to Play Outside 93% of parents or carers claiming that it is very easy or fairly easy to encourage children to play in the park. Need a purpose... Having things to do while at the open and green space (e.g. feeding animals or play areas) was both a main reason to visit and, where they were not present, a main barrier to visiting Perception that is not safe... Dogs, dog fouling, antisocial teenagers...

Insight-Driven Recommendations

Capitalise on motivation amongst our audience to increase use of open and green spaces through reducing barriers and providing opportunities to enjoy and use them locally. Overall Proposition It’s easy, fun and safe for their children to play outdoors in Portsmouth. Enabling this....

• Creating activity packs that can be hired (at low cost) at open and green

spaces and from selected partners (e.g. local retailers/cafes etc) near open spaces, with fun activities – e.g. Treasure hunts / ball games...

• ‘Happiness on your doorstep’ - communications activity to make people

aware of local open and green spaces and events and activities just around the corner.

• Communicating what the Council has been doing to increase safety in local
• areas. Developing high visibility clothing for PCC recreation and parks team

to wear communicating the ‘easy, fun, safe’ message.

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Opportunities within the complex system

Urban Planning – density and ‘visibility’ and normalisation of physical activity in the environment Education – Schools and Early Years Activity in and around school – Daily Mile, Active Lessons, School Sports Premium Media and Community voice and social norms Active journeys / Active Streets Parks and green / blue spaces – Increase PLAY – upskill community and voluntary sector Housing – ‘no ball games’, play streets....

Enabling Change... Making it Easy, Attractive, Normal..

Bristol…. Make Sundays Special….closed streets to pedestrianise town centre Use of Gamification – Pokemon Go / Beat the Streets – tie into children’s existing worlds. Community-led ideas– Hammersmith & Fulham hackathon for proposal to develop local parks / open space to encourage greater physical activity. Play Streets – London Play The Daily Mile Beat the Streets East London funded by Tesco Charity Partnership

How can we engage

• ther partners to make it possible?

At home At school or early years settings After school and weekends

HM Government Childhood Obesity A Plan for Action

• 1. Soft drinks industry levy
• 2. Taking out 20% of sugar in products
• 3. Supporting innovation to help businesses to make their products healthier
• 4. Developing a new framework by updating the nutrient profile model
• 5. Making healthy options available in the public sector
• 6. Continuing to provide support with the cost of healthy food for those who

need it most

• 7. Helping all children to enjoy an hour of physical activity every day
• 8. Improving the co-ordination of quality sport and physical activity

programmes for schools

• 9. Creating a new healthy rating scheme for primary schools

10.Making school food healthier 11.Clearer food labelling 12.Supporting early years settings 13.Harnessing the best new technology 14.Enabling health professionals to support families

16 Childhood Obesity Plan for Action: PHE Networks Briefing. Loretta Sollars Public Health England Food actions in red Schools actions in blue Other actions in brown

Align with Other Priorities.. Planning....

Healthy Urban Planning Checklist – NHS Healthy urban Development Unit

Transport for London’s

http://content.tfl.gov.uk/healthy-streets-for-london.pdf 18

Healthy Streets

Transport.....

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A Shift in Focus...

Downstream Upstream

Encouraging Change... Enabling Change

ADPH London

Engaging with Planning to Enable a Healthier Environment

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Michael Chang MRTPI, Town and Country Planning Association (TCPA) www.tcpa.org.uk/Pages/Category/health @TCPAHealth

Reuniting Health with Planning #healthyplanning Tackling obesity through planning and development

About the TCPA

Our objectives are to:

• Secure a decent, well designed home for everyone, in a human-scale

environment combining the best features of town and country

• Empower people and communities to influence decisions that affect them
• Improve the planning system in accordance with the principles of

sustainable development An independent planning charity campaigning to improve the planning systems in accordance with the principles of sustainable development. We have a legacy of more than 120 years of championing planning for good place-making. Cross sector membership organisation Work programmes and networks addressing issues of strategic planning, housing delivery and place-making.

Reuniting Health with Planning

To support and improve local capacity building in planning for and improving wellbeing through the planning system.

To identify gaps in current guidance, then

develop and provide accessible information to practitioners.

To further planning for health and wellbeing

research and reviews of statutory instruments

to facilitate systems integration.

To facilitate national engagement and

conversations with key stakeholder

• rganisations.

To continue to promote, share and disseminate good practice around the country and to target groups.

Capacity

Building

Guidance Research Raising

Awareness

OBJECTIVES ACTIVITIES

Chandler: ..apparently, walking, is too much exercise. Kids, kids, roll your way to childhood obesity! Monica: Wow, kids today have such an easier time getting fat.

2007 Foresight Tackling Obesities

Health-proof Development/ Regeneration

Source: TCPA Planning Healthy Weight Environments

• 1. Movement and Access

Evidence

• Evaluations of the cost-benefit impact
• f a number of walking-friendly

neighbourhood projects showed positive ratios.

• 65% of people that are currently not

active outdoors are more likely to participate less than two miles from home

Planning issues

• Walking and cycling environments
• Urban design of a site
• Restriction of car parking
• Accessibility and signage
• Thessaloniki. Michael Chang

• 2. Open Space, Play and Recreation

Evidence

• Urban greenspaces’ potential for

improvements in physical and mental health equivalent to £2.1 billion in reduced health costs.

• People who have good access to

green space are 24% more likely to be active Planning issues

• Open spaces
• Natural environment
• Leisure & recreational spaces
• Play spaces

Private Eye Magazine

• 3. Access to healthy food

Evidence

• Takeaway exposure associated with higher

consumption of fast food, and higher BMI. But some studies found no association

• Allotment gardeners aged over 50 had

significantly lower levels of perceived stress levels when compared to other adults of similar ages who were active in other

• utdoor and indoor activities

Planning issues – production & consumption

• Limit over-concentration of fastfood

takeaway frontages

• Manage proximity and access to

(un)healthy eating places

• Food growing (allotments)

David Lock Associates

• 4. Neighbourhood Spaces

Evidence

• Public realm improvements, like

pedestrianisation or adding seating and greenery, can increase retail footfall by about 30% and retail turnover by an average of 17%. Planning issues

• Provision of community/ social

infrastructure

• Local need and accessibility to

services

• Public spaces and public realm

Norwich City Council

• 5. Buildings (internal)

Evidence Eg: Where people live and the quality of their home have a substantial impact on health and wellbeing – areas of deprivation, social housing. Planning issues

• Homes – space standards,

storage, kitchen area etc

• Lifetime Homes
• Commercial building access

• 6. Local Economy

Evidence

• If an individual is poor, he or she is more

likely to be affected by obesity and its health and wellbeing consequences. (Public Health England 2014)

• Exacerbating existing skill shortages will

lead to a greater proportion of labour being sourced from outside creating unsustainable long distance commuting or added pressure on housing. Planning issues

• Diverse town centre/ high street retail

food uses and shops

• Local labour/ employment opportunities

and access

Barton Oxford LLP

“ Everybody actually knows that making

the population healthy is not delivered through the NHS; it is delivered through almost everything else.”

Emma Spencelayh and Dr Jo Bibby, The Health Foundation

Planning is a key delivery tool

“they (directors of public health) are having to become much more interested in the legal powers that might be available to them for pursuing public health objectives.” Professor John Ashton, Faculty of Public Health, 2016

2016

Not so far apart

“Planners have been trained to think about health impacts – it might not be called that but it is part of what you do when you’re a town planner.”

Director of Public Health, Gateshead

“Sometimes planners get rather downtrodden… [working with health] can reawaken that sense

• f standing up for the wider
• bjectives of the planning

system.”

Director of Planning and Transportation, Luton

Who is involved in planning and what is the role of the Town Planner in mediating interests

• n tackling obesity

Planner

Developer General Public Elected Members Government (legal/ policy) Special Interest Groups Industry Academia

National Planning Policy Framework (March 2012)

• Para 17 Core planning principle: take account of

and support local strategies to improve health.

• Para 171 Health and wellbeing evidence in Plan-

Making

• References throughout – open space and

recreation, air quality, noise etc

Planning Practice Guidance (March 2014)

• The role of health and wellbeing in planning

Joint Health and Wellbeing Strategy

2015 research – London Boroughs (33)

• 16 Borough JHWSs have no reference, link or actions
• n planning and built environment.
• 4 Boroughs have specific actions to address physical

activity and active travel through planning.

• 2 Boroughs seek to address health through HIAs.
• 1 Borough explicitly seeks to address the obesity issue

through restricting takeaways

• 21 (64%) of the Local Plans has the JSNA as part of the

evidence base while 12 (36%) of the Local Plans do not refer to the JSNA at all.

Local example: Collaboration for shared evidence

More than just the statutory Joint Strategic Needs Assessment (JSNA) Worcestershire planning and health

• To inform future planning policy

and decision making across the county

• Planning for Health workshops

(March, April, June 2015)

• Future opportunities for

secondment for planning in public health

Local example: Health in all policies or a Health policy?

Haringey’s Local Plan (2013) SP14 on Health and

• Wellbeing. The Council will seek to improve health

and well-being in Haringey. The Council will:

• Work with NHS Haringey in its goal to reduce

health inequalities in the areas with poorest health;

• Identify appropriate sites for new health

infrastructure including those in Haringey’s growth areas based on a health service delivery plan agreed by the Council and its partners;

• Protect existing facilities and support the

provision of new or improved health facilities through land use planning area plans, development management decisions, improved service management plans and through planning contributions;

• Prioritise interventions and resources to those

areas of the borough where health inequalities are greatest

HG6- Public Open Space in New Residential Developments TR2 - Cycling Provision in New Developments · TR3 - Pedestrians and People with Limited Mobility SH9 - Hot Food Shops RC1 - New Informal Open Space RC5 - All Allotments allocations RC8 - Recreational Routes DM5 – Design 3.6 – Children and young people’s play and informal recreation facilities 3.17 -Health and social care facilities

Local example: Checklists and health impact assessments in planning

• Health checklists (Wakefield, London HUDU,

Healthy Streets for London)

• Used as part of local Information requirements

for submitting planning applications – screening tool

• Undertaken by Developer
• Material consideration
• By who monitors/

assesses it?

Local example: Rise of health planning specialists – The Health Planner

• Knowsley - Principal Health

Promoting Environments Officer

• Stockport - Health & Environment

Advisor (Planning)

• Lincolnshire – Senior Programme

Officer – Planning and Environmental Public Health

• Sandwell – Healthy Urban

Environment Officer

• Warwickshire – 2 Health Planners

based on Infrastructure team

• Stoke - Healthy Urban Planning

Officer

“One thing the new – if fiendishly complex –

system seems to be doing is spurring people to relationships not structures as a way of building public health strategies and systems.” Jim McManus, Director of Public Health, Hertfordshire County Council

Concluding thought: Building relationships is crucial

Summary of resources

• Good practice guide: ‘Public health

involvement in planning’ (2015)

• Obesity and planning guidance: ‘Planning

healthy weight environments’ (2014)

• Case studies: ‘Building the foundations’

(2016)

• Twitter: @TCPAHealth
• Website:

www.tcpa.org.uk/Pages/Category/health

• Contact: Michael.Chang@tcpa.org.uk

ADPH London

A Whole Systems Approach to Activity in Haringey Debbie Millward

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ADPH London

Building Healthy Activity Enterprise Jessica Attard– Healthy London Partnership

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Healthy Communities Project

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Into Action

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Key learnings we can put in practice:

• Small changes across the system, by all players can make a big

difference and achieve the tipping point needed to reverse norms.

• Consider ‘what’s in it for me?’ for all stakeholders, engage them with

their priorities not just ours.

• Consider the changes made and adapt, based on intended and

unintended outcomes, keep evolving.

• Make sure we can measure changes and see what is working and isn’t

working...

• No blame..... Work together to make the system better...
• And believe it’s possible......

ADPH London

So how can we adopt this approach?

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ADPH London

Activities

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What’s next...

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Make the Change....Obesity leads co-ordinate action from today’s event... Access the Website ..(www.....) after election June 9th... . With presentations, resources, posters examples, toolkits Feedback progress, challenges and experiences at Ideas Exchange Wednesday July 12 Share knowledge, examples and activities with wider teams across Boroughs with materials available on the website.