Examination of Witnesses (Questions 133
- 139)
WEDNESDAY 7 FEBRUARY 2001
DR HUGO
CROMBIE, MS
LUCY HAMER,
MR LEN
ALMOND, MR
TERRY ROBINSON
AND MR
PETER ASHCROFT
Chairman
133. Can I welcome you to the second session
of the Committee's inquiry into Walking in Towns, and ask you
to identify yourselves for the record please?
(Mr Robinson) Good morning. I am Terry
Robinson, I am Head of Recreation and Tourism from the Countryside
Agency.
(Mr Ashcroft) I am Peter Ashcroft, I
am Project Manager for the Walking the Way to Health Initiative.
(Mr Almond) I am Len Almond, I am Director of the
British Heart Foundation's Medical Centre for Physical Activity
and Health.
(Dr Crombie) I am Hugo Crombie, Public Health Adviser,
Physical Activity, Health Development Agency.
(Ms Hamer) I am Lucy Hamer, Development Adviser, Health
Improvement Programmes at the Health Development Agency.
134. Thank you. Does anyone want to say anything
by way of introduction, or are you happy for us to go straight
to questions?
(Mr Robinson) Could I just make three points, Chairman?
We believe there are benefits to be gained from people walking
more. Secondly, we believe the means of achieving that is more
about removing barriers that discourage people but that once that
has been achieved there is some merit in then promoting walking
mainly through provision of information about where opportunities
exist. Thirdly, we believe achieving that has to be about activity
which transcends institutional barriers, in other words it has
to be joined-up activity.
(Dr Crombie) Just a brief statement about ourselves.
The Health Development Agency is a relatively new organisation
and we work to promote the health of the public across various
sectors. The work we do is around gathering evidence of what works
in public health terms, evidence of effective interventions to
promote health, dissemination of that evidence and sharing good
practice, and production and dissemination of guidelines and strategies.
As an example of that, recently we have worked to produce guidance
on the implementation of preventative aspects of the National
Service Framework on Coronary Heart Disease, which has a section
on physical activity, and that includes aspects of walking as
well. Physical activity promotion is going to be a key to addressing
a number of health problems in the future—issues like coronary
heart disease, stroke, diabetes, obesity—and walking is
going to be a key part of that for a number of reasons. Walking
can achieve the sort of level of activity that we are trying to
promote. It is the sort of thing which virtually the entire population
can do and that virtually everybody does at some time or another.
It does not have some of the negative aspects of other exercises
which sometimes are offputting in terms of having to be super-fit,
body-perfect, and that kind of thing. There are other benefits
to walking which are less well understood but are almost certainly
the case, in that walking provides access to the sort of facilities
we all need for a healthy existence, and I am talking about shops,
health care facilities, employment, recreation. Improving conditions
for walking is a key aspect in increasing the rate of walking,
and improving those conditions will benefit all sections of society,
and it is particularly employment for those people who are more
dependent on walking as transport, and I am particularly thinking
of those who do not own a car for whatever reason or are not able
to drive either through age or infirmity. Achieving these sort
of changes is going to require action by a large number of professional
groups in a large number of sectors and it is going to be achieved
by an accumulation of a large number of small changes. In some
ways walking can be seen like a barometer, achieving the situation
where a large number of people are happy to walk and do so demonstrates
that some activities are going right in a number of sectors, like
community safety, environmental conditions, planning, transport
and so on.
Chairman: Thank you very much. We have a series
of questions. I suspect you will agree amongst yourselves on many
of the answers, so please do not let us have it repeated, but
if you disagree please chip in.
MISS
MCINTOSH
135. How important is walking to health and
fitness compared with other activities?
(Mr Almond) I think you can see walking as the most
perfect form of exercise. It is amenable to everybody, it is not
expensive either, which is a major benefit. Its key factor is
it strengthens the main muscles of the body, it exercises the
heart and it can have a major impact on obesity, on diabetes,
on asthma, on osteoporosis, on mental health, and also we now
recognise on bowel cancer. The British Heart Foundation recently
released some figures to show that the attributable risk of inactivity
to heart disease was 37 per cent compared to only 18 per cent
for smoking, so inactivity is now rising in terms of its relevance
and significance to disease. Sport may be only accessible to a
small number of people, walking is accessible to everybody.
136. Can you actually specify what the increased
benefits would be in reduced mortality and morbidity and reductions
in obesity from increased walking? Do you believe there is sufficient
information available to the public that something as simple as
walking could have such positive benefits?
(Mr Almond) The answer is that only approximately
22 per cent of the population would recognise the value of walking
and the value of exercise for their health, which is very, very
small indeed. In terms of obesity, Dr Crombie might be able to
comment on the Audit Commission's work.
(Dr Crombie) There is a report due out very soon,
next week I believe, from the Audit Commission about the extent
and impact of obesity. I do not know the full details of what
it is going to contain but I am sure it will have interesting
information in there for this Committee. Physical activity generally
and walking as part of that are very important aspects in addressing
obesity. There is evidence that a large part of the increase in
obesity over recent years is due to reductions in activity rather
than increases in food intake, so addressing that imbalance is
very important. Also, generally speaking, successful interventions
to deal with overweight and obesity include physical activity.
Particularly when you are dealing with a population of people
who may be overweight and maybe unwilling or not keen on other
forms of vigorous physical activity, such as going to the gym
or aerobics or sport, walking is a very useful way of getting
them active.
Mr Olner
137. It is all right trying to encourage people
to walk to work, but for somebody who is on their feet all day
and doing exercise while they are doing their work that is very
different from somebody just going to work and sitting in a prone
position. Have you differentiated at all?
(Dr Crombie) There is evidence you can get people
to walk to work, there are a number of schemes which have been
very successful in doing that.
138. But have you differentiated between people's
occupations and their willingness to walk to work?
(Dr Crombie) Occupational work is taken into account
in looking at physical activities.
(Mr Almond) The largest surveys have taken that into
account and of course there is a considerable reduction in the
amount of physical activity in the workplace because of the reduction
in that type of activity, so it is important we encourage walking.
If we can increase the number of people walking by 5 per cent,
it is recognised in America they could save 2.6 billion dollars
just by increasing it by 5 per cent, and recent figures for 2000
would show that is in the region of 8 billion dollars. If you
look at the work done in Northern Ireland, which is the closest
to estimates of gain here, we could save 121 lives by increasing
walking by 5 per cent and 131 million in terms of economic cost,
and that is just in one small part of the UK. So there are substantial
benefits. If you would like, I have done a review of that and
brought a paper along with me, which reviews all the evidence
on economic benefits.
Chairman: That would be very helpful. Thank
you.
Miss McIntosh
139. If we accept there are benefits, how are
you actually going to get people to increase their habit of walking
by three or four times? Is it up to you as health-interested organisations
to do that or are you relying on local authorities to make areas
more pedestrian-friendly?
(Mr Ashcroft) You are asking how we can encourage
everybody to walk at the recommended level of 30 minutes a day?
That is a long-term vision and we must be ambitious in having
long-term aims, but any short-term gain year on year to encourage
a few people to walk a little bit longer than they are doing will
be of immense health benefit to the nation. This is a long-term
aim but we can get there.
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