The starting line

Trends suggest for the first time in history, children today may die five years younger than their parents. A recent study of children’s behaviour from 15 countries found Scotland bottom of two tables: levels of physical activity, and one for screen-based leisure such as television and video games.

Physical inactivity isn’t a problem exclusively of the young, however. Modern jobs tend to be sedentary and lifestyle choices are too, and a study published in the British Journal of Sports Medicine by Australian researchers showed lack of exercise is now the biggest risk factor for heart disease in women aged 30 and above. As women got older and more gave up smoking, it was overtaken by physical inactivity as the dominant influence on heart disease risk, the report found.
The Scottish Government’s own figures show physical inactivity causes around 2,500 premature deaths in Scotland each year, costing the NHS around £91m annually. It is the second biggest cause of mortality in Scotland, and being more active can help prevent and treat more than 20 chronic diseases.
Mental as well as physical health is improved by exercise. The Scottish Association for Mental Health (SAMH) runs a national campaign called Get Active, with celebrated Olympian Sir Chris Hoy as ambassador. At an event in February, Hoy said: “Increasing physical activity is one of the best steps to take towards better mental health.”
The 2014 Commonwealth Games has been a springboard for Scotland’s first ever national Physical Activity Implementation Plan, ‘A More Active Scotland’, which sets ambitious targets for the end of the year, and for five and ten years’ time. The document uses the gold-standard Toronto Charter for Physical Activity (2010) as a guide to improving disease prevention through increased physical activity.
As well as environment and workplaces, health and social care services will play a big role in this plan. By the end of 2014, increasing patient physical activity for the prevention and treatment of disease will be a routine part of primary care, the document says. Within five years, the National Physical Activity Pathway will be embedded in clinical settings all over the NHS, and in ten years’ time, it is expected more people will be physically active as a result of regular interventions by health and care services, resulting in fewer people requiring treatment.
This year, though, it is hoped the Commonwealth Games will inspire everyone to get a bit more active. A number of schemes have been launched as part of the Physical Activity Implementation Plan, but Public Health Minister Michael Matheson says change cannot happen overnight. “People underestimate the good they can do themselves with even low levels of physical activity – walking to the local shops or taking the stairs. These simple activities not only make people feel better quickly, they also add years to quality of life. Scotland ranks amongst those OECD countries with the highest obesity levels, so we need a real shift in culture to make physical activity a routine, normal part of everyday lives,” he says.
The £10m Active Places Fund has supported 110 projects, helping build and improve local community facilities across Scotland such as skate parks, outdoor adventure facilities and walking routes. One hundred and nine projects from 26 local authorities are already benefitting from the fund.
A series of ‘Games for Scotland’ events is seeing communities try different sports at their local facilities. The first was at Meadowbank Sports Centre in Edinburgh on 14 June as the Queen’s baton passed through the city, and saw families try out lawn bowls, netball and other sports for the first time.
Schools have been required to give at least two hours of physical education as part of the new Active Schools programme. The Cabinet Secretary for the Commonwealth Games and Sport, Shona Robison, told Holyrood the focus “has been quite unashamedly about getting young people into good habits”.
Adult inactivity, however, is also an issue, particularly in workplaces.
The British Heart Foundation’s Scotland Director, Marjory Burns, said: “Physical activity is essential for our good health and contributes to overall wellbeing, but too many of us struggle to achieve the recommended level for adults of 150 minutes of moderate physical activity each week. The good news is that doesn’t all have to be done at once and there are lots of different ways to build more activity into your working life – for example, walking or cycling to and from work, taking the stairs instead of the lift, or getting away from your desk at lunchtime for a walk or to try an exercise class.”
Modern workplaces are not generally active places, however. A survey by the Chartered Society of Physiotherapy (CSP) revealed one in five people in the UK works through their lunch break every day. Of those who do manage to take a break, 48 per cent said they ate at their desk. Evening exercise, too, is in decline, the survey found, with nearly half surveyed admitting to having regularly cancelled plans to exercise because of work commitments. Professor Karen Middleton, chief executive of the CSP, said: “Full-time workers spend a significant bulk of their week at work, or travelling to and from it. Finding ways to build in time to do at least 30 minutes of moderate intensity physical activity, five times a week, can be a challenge.”
The consequences of not doing so can be devastating, according to Middleton, resulting in ill health and prolonged absences. “Aside from the human cost, the price of inactivity for employers can be vast, with higher sickness absence costs and lower productivity,” she said.
As part of the Commonwealth Games legacy, the nationwide ‘Fit in 14’ campaign is an attempt to encourage Scotland’s workplaces to get more active by making physical activity a part of their everyday lives. Organisations of all sizes across Scotland are being encouraged to get involved in the campaign, with small and simple ways to improve the health and wellbeing of employees.
The British Heart Foundation (BHF) has also been actively encouraging employers. The charity commissioned its own poll of employees to mark its national cycling campaign this month. It found teachers and IT workers are the most physically active professions in Scotland, exercising an average of five times each week, closely followed by doctors, dentists and scientists. By signing up to the BHF’s national Health at Work programme, organisations receive a toolkit on physical activity and healthy eating. Six hundred and twenty-six Scottish companies, charities and other organisations have signed up. For Marjory Burns, the benefits for employers are clear. “For employers, the benefits of promoting better health in the workplace include increased productivity, reduced rates of absenteeism and improvements in morale,” she says.
Recent heart disease figures have been encouraging. There were 10.8 per cent fewer fatalities as a result of coronary heart disease in Scotland compared to the same period just a year ago, according to the National Records of Scotland. Dr Marc Dweck, BHF clinical lecturer at Edinburgh University, believes the drop can be attributed to a milder winter and the patent expiry of a powerful statin, making it easier to prescribe.

Burns points out coronary heart disease is still Scotland’s biggest killer. “The risks can be significantly reduced through simple lifestyle changes including increased physical activity. And that’s why we want to see more businesses and organisations taking the fight against heart disease into the workplace,” she says.
Outside of it, Scots are being encouraged to walk more. The Scottish Government and COSLA launched the 2014 National Walking Strategy last week to make walking part of people’s everyday journeys, and to encourage recreational walking in the outdoors.
Councillor Peter Johnston, COSLA’s Health and Wellbeing spokesman, says councils are well placed to enable a shift in culture “by improving the physical environment so that people have safe and attractive routes that they will want to use, and by helping to create a culture where walking is the first choice for shorter everyday journeys and for leisure and recreation.”
He adds: “We also need to make sure that walking routes are accessible to people who use a wheelchair, or face other difficulties with mobility, and it’s vital that we promote the benefits of physical activity to as many groups as possible.”