Priorities for Health: Exercise
November 2006
Introduction
In August 2006, BMA Scotland conducted a survey of members to identify their priorities for health. Around 600 doctors from all branches of the profession responded to the survey and their priorities to get Scotland moving are reflected in this policy briefing.
Background
Physical activity is linked to good health. It can decrease the risk of heart disease, help prevent high blood pressure, assist in weight control, reduce stress and bring real improvements to physical and mental well-being [reference 1]. However, one in four Scots are at risk of dying early from diseases related to inactivity [reference 2].
Inactive people are at risk of being overweight or obese which increases the risk of other medical conditions. They have a greater risk of heart attacks and strokes, higher blood pressure, a higher risk of developing some cancers, more chance of developing diabetes and a higher risk of osteoporosis [reference 3].
Coronary heart disease (CHD) affects half a million Scots a year and, each year in Scotland, 37% of CHD events are attributable to pysical inactvity [reference4]. Although the number of deaths in Scotland from heart disease has reduced by nearly a third (from 14,977 in 1995 to 10,778 in 2004), Scottish CHD mortality rates are still remain among the highest in Western Europe [reference 5].
Inactive children are at risk of poorer self-esteem, greater anxiety and higher stress levels and are more likely to smoke and use drugs than physically active children [reference 6]. Inactive employees have more days off work than active employees and, in later life inactive people lose the basic strength and flexibility for daily activities. As a result, many lose their independence and have poorer mental health. There are therefore considerable public health benefits to be had by increasing the proportion of the public that is physically active.
Statistics show that 77% of those surveyed believe that taking regular exercise is very important in reducing the risk of CHD and 62% would like to, or have tried to, increase activity levels [reference 7]. Guidelines define an ‘active’ lifestyle approach as adults accumulating at least 30 minutes of moderate exercise at least five days a week and children accumulate around an hour [reference 1].
The Scottish Health Survey 2003, published in 2005, showed an increase in the number of men and women achieving the minimum recommended 30 minutes of moderate exercise on most days from 41% in 1998 to 44% in 2003 for men, and from 30% to 33% for women [reference 8]. However, around half of men in Scotland and more than two thirds of women continue to put their health at risk by exercising less than the recommended level. Figures for 13 year old children in Scotland show that around 54% of boys and 72% of girls do not take part in the minimum recommended amount of physical activity [reference 7].
Nearly 95% of doctors who took part in the BMA survey called for the development of a strategy to encourage teenagers and young adults to take part in regular exercise.
Interventions:
Increase levels of activity
Most people in Scotland are not active enough. Increasing the level of physical activity among both adults and children is an important priority and in addition to benefits to an individual’s health, a reduction in healthcare costs and chronic disease will be realised.
One of the single most effective ways to improve the health of the population would be to get those who are inactive to improve their activity levels. Physical activity is not just about taking time out to take part in sporting or leisure activity, it can be incorporated into daily living. Encouraging walking or cycling to travel is one way in which activity can become part of a healthy lifestyle.
Improve access to physical education in schools
Physical education at school is an ideal way to encourage activity and develop fitness among children and for many, this will be their only preparation for an active lifestyle. Not all children want to play competitive sports. Indeed, activities that can be sustained after leaving school, such as walking, cycling and swimming should also be encouraged.
In addition, to ensure that exercise remains a priority for schools, approximately 95% of doctors surveyed believe that protection against the sale of school playing fields should be strengthened. Nearly 90% of doctors surveyed agreed that there should be a choice in the type of exercise offered to children in schools.
Recommendations
To get Scotland moving, politicians should:
References
1. Public Health Institute of Scotland. Active commuting as a public health issue [www.phis.org.uk]. Accessed on 25 August 2006.
2. Cycling Scotland. Did you know? [www.cyclingscotland.org] Accessed on 25 August 2006.
3. Scottish Executive. The National Strategy for Physical Activity. 2004.
4. Scottish Executive. Coronary heart disease and stroke in Scotland. Update on strategy report 2004. Edinburgh. 2004.
5. Scottish Health Statistics. ISD Incidents of heart disease in 2004. (Heart Disease mortality - by cause (all heart disease, coronary heart disease, AMI, heart failure), year, health board, age group and sex 1995-2004;) [www.isdscotland.org] Accessed 28 August 2006.
6. Scottish Executive. Healthy Living. [www.healthyliving.gov.uk] Accessed on 28 August 2006.
7. Scottish Executive. Health in Scotland – Chief Medical Officer Annual report. Edinburgh. 2004
8. Scottish Executive. The Scottish Health Survey 2003 Results. Edinburgh. 2005.
For more information contact:
BMA Scotland Public Affairs Office
Tel: 0131 247 3050/3052
Email: press.scotland@bma.org.uk