Physical activity: a major public health priority. Professor Brian Oldenburg School of Public Health & Preventive Medicine, Monash University

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1 Physical activity: a major public health priority Professor Brian Oldenburg School of Public Health & Preventive Medicine, Monash University

2 What is health? Health is a state of complete physical, mental, and social well being, and not merely the absence of disease or injury. World Health Organization Constitution Influences on Health and Well being

3 Age Sex Genetic factors Biological factors Exercise Recreation Diet Sexual behavior Smoking & passive smoking Alcohol Lifestyle Prescription drugs Substance misuse Family relationships Housing tenure Personal circumstances Housing conditions Income Employment status Working conditions Vibration Smell Civic design Noise Hazards Soil quality Environment Public Safety measure Technological Development Water quality Waste Disposal Business activity Air quality Land use Natural resources Green space Economic conditions Availability of employment HEALTH& WELLBEING Job creation Quality of employment Distribution Of incomes Availability Of training Health care Shops Banking services Respite care Public transport Housing Discrimination Social services Access Advice Means of transport Fear of discrimination Childcare Education Social contact Social influences Community facilities Crime & Anti-social behavior Leisure facilities Education & training Workplaces, employment Opportunities & services Skills level Social support Community participation Pear pressure Fear of Crime & Anti-social behavior Socio Ecological Model PUBLIC POLICY: national, state, local laws HEALTHY POLICY! COMMUNITY: relationships among organizations INTERPERSONAL: family, friends, social networks ORGANIZATIONAL: organizations, social institutions INDIVIDUAL: Knowledge, attitudes, skills

4 Summary of Benefits of Physical Activity Physical (In)ctivity through the Public Health Lens 1.What is the problem? 2. Why is it happening? 3. What to do about it?

5 Facts on Physical inactivity At least 60% of the global population fails to achieve the minimum recommendation of 30 minutes of moderate intensity physical activity daily, that is, the equivalent of brisk walking. The risk of heart disease increases by 1.5 times in people who do not follow minimum physical activity recommendations. Inactivity greatly contributes to health care costs The public health perspective Increasing levels of physical activity is a problem for the whole society not just individuals Requires a population based, multi sectoral, multi disciplinary, and culturally relevant approach

6 Extent of the problem Physical inactivity is estimated to CAUSE 2 million deaths worldwide annually. Globally, it is estimated to cause about 10 16% of cases each of breast cancer, colon cancers, and diabetes, and about 22% of heart disease, that is, its very important for chronic disease A wide range of physical, social and mental health benefits Regular daily physical activity is important in preventing chronic disease, along with a healthy diet and not smoking Recent OECD report in last week Nearly half of all Australian adults (7.4 million people), were overweight or obese in Average weight of Australian adults has increased by.5kg to 1kg/year for past 20 years. Two-thirds of Australians will be overweight or obese with next 10 years, putting Australia in the top league

7 Why is chronic disease important? Chronic diseases including heart disease, diabetes, stroke, cancers and respiratory diseases account for 59% of the 57 million deaths annually, and 46% of the global disease burden By 2020 these deaths will account for 73% deaths and 60% of the disease burden. Globally, there are more than 1 billion overweight adults, at least 300 million of them obese. Obesity and overweight pose a major risk for chronic diseases, including type 2 diabetes, cardiovascular disease, hypertension and stroke, and certain forms of cancer.

8 Source: National Preventative Health Taskforce Australia the Healthiest Country by Mental Health problem Cancer Hypertension Major health problems and their risk factors are all interconnected Diabetes Injury & poisoning Cardiovascular Disease Lack of physical activity Chronic respiratory Diseases (asthma, COPD) Unhealthy foods Lack of Road safety Unhealthy environments Obesity Air pollution Smoking Stress

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10 Diabetes Predicted direct health care costs attributable to diabetes (diagnosed cases) in Australia: ,500 Minimum cost estimate Maximum cost estimate 2,075 2,300 2,000 1,850 $ (millions) 1,500 1, , Source: McCarty DJ, Zimmet P et al, 1996, The Rise and Rise of Diabetes in Australia, 1996 Cost of Obesity 515 Estimated increases in health system costs of obesity, M illions ($) Source: AusDiab Report, 2001; NHMRC,1997, Acting on Australia s weight

11 Overweight and obesity in children Prevalence of overweight and obesity in children aged 7-15, 1985 and 1995, Australia Percent Boys 1985 Boys 1995 Girls 1985 Girls 1995 Overweight Obese Source: AIHW 2001, Chronic diseases and associated risk factors in Australia 2001, p.130.

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14 Why are increasing levels of physical activity so important for the health of our population? Summary 1. Regular moderate physical activity is one of the easiest ways to improve and maintain health. 2. Contributes to prevention and control of many different diseases 3. Regular active play promotes healthy growth and development in children and young people 4. Healthy ageing, improving and maintaining quality of life and independence 5. Daily physical activity helps people with disabilities by improving mobility and increasing energy levels

15 Physical (In)ctivity through the Public Health Lens.. 1. What is the problem? 2.Why is it happening? 3. What to do about it?

16 Research is just catching up with what we ve suspected for a long time.. The physical and social environment of cities and urbanisation at the macro level.. At the more micro level, access to open spaces, playgrounds, gymnasium, stairwells and road networks Social factors such as levels of crime and the local sense of community.. GLOBALISATION

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20 Obesity Trends* Among U.S. Adults BRFSS, 1990, 1998, 2007 (*BMI 30, or about 30 lbs. overweight for 5 4 person) No Data <10% 10% 14% 15% 19% 20% 24% 25% 29% 30% Obesity Trends* Among U.S. Adults BRFSS, 1990 (*BMI 30, or ~ 30 lbs. overweight for 5 4 person) No Data <10% 10% 14%

21 Obesity Trends* Among U.S. Adults BRFSS, 1991 (*BMI 30, or ~ 30 lbs. overweight for 5 4 person) No Data <10% 10% 14% 15% 19% Obesity Trends* Among U.S. Adults BRFSS, 1992 (*BMI 30, or ~ 30 lbs. overweight for 5 4 person) No Data <10% 10% 14% 15% 19%

22 Obesity Trends* Among U.S. Adults BRFSS, 1993 (*BMI 30, or ~ 30 lbs. overweight for 5 4 person) No Data <10% 10% 14% 15% 19% Obesity Trends* Among U.S. Adults BRFSS, 1994 (*BMI 30, or ~ 30 lbs. overweight for 5 4 person) No Data <10% 10% 14% 15% 19%

23 Obesity Trends* Among U.S. Adults BRFSS, 1995 (*BMI 30, or ~ 30 lbs. overweight for 5 4 person) No Data <10% 10% 14% 15% 19% Obesity Trends* Among U.S. Adults BRFSS, 1996 (*BMI 30, or ~ 30 lbs. overweight for 5 4 person) No Data <10% 10% 14% 15% 19%

24 Obesity Trends* Among U.S. Adults BRFSS, 1997 (*BMI 30, or ~ 30 lbs. overweight for 5 4 person) No Data <10% 10% 14% 15% 19% 20% Obesity Trends* Among U.S. Adults BRFSS, 1998 (*BMI 30, or ~ 30 lbs. overweight for 5 4 person) No Data <10% 10% 14% 15% 19% 20%

25 Obesity Trends* Among U.S. Adults BRFSS, 1999 (*BMI 30, or ~ 30 lbs. overweight for 5 4 person) No Data <10% 10% 14% 15% 19% 20% Obesity Trends* Among U.S. Adults BRFSS, 2000 (*BMI 30, or ~ 30 lbs. overweight for 5 4 person) No Data <10% 10% 14% 15% 19% 20%

26 Obesity Trends* Among U.S. Adults BRFSS, 2001 (*BMI 30, or ~ 30 lbs. overweight for 5 4 person) No Data <10% 10% 14% 15% 19% 20% 24% 25% Obesity Trends* Among U.S. Adults BRFSS, 2002 (*BMI 30, or ~ 30 lbs. overweight for 5 4 person) No Data <10% 10% 14% 15% 19% 20% 24% 25%

27 Obesity Trends* Among U.S. Adults BRFSS, 2003 (*BMI 30, or ~ 30 lbs. overweight for 5 4 person) No Data <10% 10% 14% 15% 19% 20% 24% 25% Obesity Trends* Among U.S. Adults BRFSS, 2004 (*BMI 30, or ~ 30 lbs. overweight for 5 4 person) No Data <10% 10% 14% 15% 19% 20% 24% 25%

28 Obesity Trends* Among U.S. Adults BRFSS, 2005 (*BMI 30, or ~ 30 lbs. overweight for 5 4 person) No Data <10% 10% 14% 15% 19% 20% 24% 25% 29% 30% Obesity Trends* Among U.S. Adults BRFSS, 2006 (*BMI 30, or ~ 30 lbs. overweight for 5 4 person) No Data <10% 10% 14% 15% 19% 20% 24% 25% 29% 30%

29 Obesity Trends* Among U.S. Adults BRFSS, 2007 (*BMI 30, or ~ 30 lbs. overweight for 5 4 person) No Data <10% 10% 14% 15% 19% 20% 24% 25% 29% 30%

30 Physical (In)ctivity through the Public Health Lens.. 1. What is the problem? 2. Why is it happening? 3.What to do about it?

31 What is the Public Health message? "Physical activity includes all movement in everyday life, including work, recreation, exercise, and sporting activities..." WHO, 1997 World Health Day Move for Health Day 2007 Active Workplace" copyright World Health Organization 2002 Various Levels of Physical Activity and their Benefits

32 National Physical Activity Guidelines for Australians Think of movement as an opportunity, not an inconvenience Be active every day in as many ways as you can Put together at least 30 minutes of moderate intensity physical activity on most, preferably all, days If you can, also enjoy some regular, vigorous exercise for extra health and fitness

33 What can be done at the societal level in addition to the individual level? Create supportive environments through public policies that support and provide opportunities for physical activity

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36 A snapshot of initiatives and projects around the world

37 Active Australia Active Australia is a framework for several strategies which aim to encourage more Australians into sport and physical activity and to improve the places where sport and physical activity occur. 10,000 Steps Project The 10,000 Steps community wide prevention project in Rockhampton, Australia, aims to increase daily activity by encouraging "incidental" physical activity as part of everyday living. People experience significant health and well being benefits simply by physically moving as part of normal daily activities. For this reason, the project is recommending using pedometers to count daily activity. This is now a nationally recognised program for more information visit the website

38 Active & Safe Routes to School A national program that encourages people to use active ways of transportation to and from school. The benefits include: increased physical activity for children and youth; a healthier lifestyle for the whole family; less traffic congestion around schools; safer and calmer streets and neighbourhoods; improved air quality and a cleaner environment. For more information about this national program, visit the Go for Green web site at First Step Program A physical activity intervention for people with Type II diabetes. The First Step Program uses a pedometer as a motivation and feedback tool for participants. The First Step Program is designed to be delivered by a single facilitator, e.g., a diabetes educator or peer leader. For more information about each phase of the program, visit the Canadian Centre for Activity and Aging page on the University of Western Ontario web site at

39 Just Walk It A community based walking program that aims to increase the community's participation in regular and enjoyable physical activity. The program uses volunteer walk organizers to establish small groups of people who will walk in their local area. Just Walk It is a Heart Foundation program funded by the Queensland Government through Sport and Recreation Queensland. For more information about the program, visit the Heart Foundation web site at Active Transportation Community Solutions for Climate Change, Health, and Transportation Go for Green has made a presentation to the federal Standing Committee on Finance in Montreal. By implementing a minimum 7% national provision for active transportation infrastructure, Go for Green argued that federal government would demonstrate its commitment to healthy, active lifestyles, to reducing greenhouse gas emissions, and at the same time provide leadership in building healthier, safer communities. To link to Go for Green's full presentation to the Standing Committee, visit Go for Green's web site at

40 2008 Beijing Olympic Health Legacy Assessment Project The government s commitments to the people in Beijing and IOC The Beijing government has recognized that the 2008 Beijing Olympic Games would not only impact on economics, culture, the environment, tourism and sports, but also, would have a lasting impact on health, especially via the influence of the environment and people s life-styles in Beijing.

41 In Summary

42 The public health perspective Increasing levels of physical activity is a problem for the whole society not just individuals Requires a population based, multi sectoral, multidisciplinary, and culturally relevant approach Ottawa Charter for Promoting Health (WHO) Build healthy public policy Create supportive environments Strengthen community action Develop personal skills Reorient (health) services World Health Organization

43 We can't solve problems by using the same kind of thinking we used when we created them in the first place. Albert Einstein 85

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