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Public health issues


In the fi nal instalment of his series on the future of public health, Carl Bennett says that activity providers must rethink who they are targeting with their health offers


achieving strategic outcomes. T ese all merge to form a new and challenging way of working on the common health issues aff ecting our communities. Some areas are well ahead of the game and


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are already working on behalf of the local NHS structures to impact on local health issues. Some have embedded ‘health improvement’ within their structures and organisational goals by developing competencies and skills that mirror the health challenges. Others have even changed their name to better represent the services or activities they off er and to better enable them to embrace the new world of opportunities. Being able to adapt to


meet the ever-growing health demands, both organisationally and operationally, takes strong leadership and well-timed decision-making. As some organisations are fi nding, this is simply a way of reshaping their services, their outlook and their messages to others so that they best meet the demands of their communities. If we were to review our Active People Survey


e are all working in the most demanding of times. We have budget reductions; we want to encourage innovation to maximise quality, impact and effi ciency; we’re all thinking at least one step ahead and we are developing partnerships with joint responsibility or accountability for


MORE ACTIVE We are all tasked with getting more people, more active, more often. From an improving health point of view, this makes complete sense. Increased participation will impact on the health of communities in a positive way, according to all known sources of reliable evidence, including the chief medical offi cer. Even the President of the USA sees participation as a must-do, to address the growing health issues the USA is facing. Canada, Australia, Finland, and most other developed countries of the world are embracing the physical activity path to improve health over the long term. T e problem is, what do we get people to do? T e European network project Health Enhancing


POINT IN HAVING A WALKING GROUP THAT, GIVES NO


WHAT’S THE


OPPORTUNITY TO REALISE DESIRE FOR A MORE ‘UPPER MODERATE’ TYPE OF ACTIVITY


results, some of us would be looking forward and some would be looking back – looking forward to see how we continue to increase the sport and participation fi gures, and looking back to see what we need to change to get the desired shift from the negative (declining participation) to the positive (increasing participation) at the local level. I recall the sports development continuum or


‘pyramid’ – ‘foundation’ and ‘participation’ were the key objectives. Increase the numbers, and basic understanding and skills of participants and you were part way towards achieving performance and excellence. If we were to remap the continuum and place a simple heading over it that said ‘physical activity’, would the continuum look any diff erent?


Physical Activity (HEPA), which advocates all safe forms of physical activity, should inform our continuum objectives. With more than 65 per cent of our local populations inactive and many of them actually sedentary, we need to ensure there are opportunities with which everyone can engage, to make progression along an activity continuum possible. What’s the point in having a walking group that, once a person is happy with their fi tness level and has the confi dence to progress, gives no opportunity to realise their desire for a more ‘upper moderate’ type of activity?


REMAPPING A ROUTE TO FITNESS Increasing opportunities requires a rethink of how we develop the local landscape of physical activity, and how that landscape is mapped and navigated. It requires a rethink of what activities are most likely to work in certain areas, based on population needs and the probable health impact of such activities. A rethink taking us from a programme of off ers that has been built on a foundation of – or reliance on – cost and numbers to one that is evidence-based, refl ective of need and less reliant on actual cost


or ability to pay at point of access. For some, simply getting a foothold on a progressional continuum will provide the basis for a solid start. To ensure we are providing appropriate activities to


the right people, we need to review our segmentation tools and strategies. Our aim is to develop a pathway, which enables increased physical activity participation and builds capacity and competencies from within the communities most at need. T ese communities can then develop a basic understanding that physical activity is good for them and they ‘can do it’, so addressing the foundation element of the continuum. Once confi dent and motivated, people are able to


progress to more formalised and structured activity, which in the longer term translates into measurable behaviour change or participation.


Sportphysical activity &


May 2011 »27


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