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Can Green Space and Biodiversity Increase Levels of Physical Activity?

Authors:
NATURAL FIT
Can Green Space and Biodiversity Increase Levels of
Physical Activity?
A Report by Dr William Bird
for the Royal Society for the Protection of Birds
Endorsed by the
October 2004
1
About the Author:
Dr William Bird is a former GP at Sonning Common Health Centre in South Oxfordshire. He
set up the first Health Walk scheme and Green Gym in the mid 90s and brought the
Countryside Agency and British Heart Foundation together resulting in Walking the Way to
Health. He was the medical adviser to The British Heart Foundation National Centre for
Physical Activity and Health at Loughborough University when it was first established.
He is an independent member of the National Access Forum, which advises the Countryside
Agency and Government on all aspects of the Countryside and Rights of Way Bill and other
access issues. He is also a vice president of BTCV (British Trust for Conservation
Volunteers).
He has held Honorary Research Posts at Oxford Brookes and Oxford University, but is now
the full-time Clinical Director of Health Forecasting at the Met Office.
The Royal Society for the Protection of Birds
The RSPB is Europe’s largest wildlife charity with over one million members. It manages one
of the largest conservation estates in the UK with more than 180 nature reserves, covering
more than 100,000 hectares. RSPB nature reserves provide a major recreational resource for
people, as well as conserving biodiversity: over 1.1 million visits are made to RSPB reserves
each year. Its reserve volunteering programme benefits the health of participants, as well as
assisting land management for biodiversity. The RSPB advocates creation of more
opportunities for people to enjoy the countryside in ways that do not harm the very resources
people wish to enjoy, including wildlife.
Further copies of this report can be downloaded from www.rspb.org.uk/policy/health
The Faculty of Public Health
The Faculty of Public Health sets and maintains professional standards in specialist public
health practice. The Faculty works to improve the public's health through its three key areas
of activity: professional affairs, education and standards and advocacy and policy
contribution. For more information visit the Faculty's website www.fph.org.uk.
1
Contents
1 Executive Summary 3
2 Recommendations 6
3 Introduction 9
PART A: THE BURDEN OF PHYSICAL ACTIVITY
4 Physical activity in the UK 11
5 What is moderate exercise? 15
6 What are the health benefits of moderate exercise? 18
7 What is the cost of physical inactivity? 26
8 How can physical activity be promoted? 28
PART B: LINKING WILDLIFE-RICH SPACE AND PHYSICAL ACTIVITY
9 Is the Government linking green space with physical
activity promotion? 33
10 What green space is available for physical activity? 38
11 Can more green space improve the health of a population? 43
12 Can green space increase levels of physical activity 46
13 Can biodiversity contribute to the promotion of physical
activity in a green space? 54
14 How can a wildlife-rich green space be managed to promote
activity and increase public health? 58
Appendix 1: The Economic Benefit Of Green Space and
Physical Activity 68
Appendix 2: Unemployment and Income Deprivation Per 20 ha
Green Space by Local Authority Area. 76
References 90
Natural Fit Report for the RSPB. Dr William Bird
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3
Executive Summary
1 Physical inactivity is a major preventable health risk, which affects about 60% of
the population, and correcting this is a public health priority. There are clear
Government guidelines on the amount of physical activity required for optimum
health. The recommendation for adults of 30 minutes of moderate activity at
least 5 days a week is still not as well understood as diet or smoking
recommendations. The maximum benefits of physical activity are in the elderly
who are currently the least active.
2 The benefits of physical activity can be achieved through moderate exercise,
which includes brisk walking, cycling, swimming and nature conservation or
gardening activities. Exercise through sport, gyms or aerobics appears not to
add any further health benefits. Moderate exercise can be identified by an
increase in pulse and breathing rate and a feeling of increased warmth.
3 It is now recognised that physical inactivity is adding a catastrophic burden to
society, leading directly to chronic disease and lack of independence in the
elderly. For children, inactivity is helping to create a future generation who are
more likely to become inactive and obese adults. Moderate regular activity
appears to maintain the vitality of the body and prevents heart disease,
diabetes, strokes, cancers, disability, osteoporosis, depression, anxiety and sleep
problems. Without regular exercise, there is a decline of function in virtually
every system of the body, which will eventually require support from the NHS
and social care.
4 The cost of physical inactivity to the economy is calculated to be £8.2 billion
(£1.7 billion for the NHS, £5.4 billion for work absence and £1 billion for early
mortality). If a group of 120 healthy individuals aged over 60 years become
active, then over 10 years (compared to an inactive group) there will be about
20 fewer deaths, 7 less heart attacks, 3 less strokes, 2 less new diabetics, and
13 less people with osteoarthritis of the knee becoming disabled. In other words
a walking group which includes 60 men or women over 60yrs could prevent 1
death a year assuming that they would otherwise have remained inactive.
Natural Fit Report for the RSPB. Dr William Bird
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5 Physical activity promotion should be close to where the patient lives and with
an emphasis on walking. As recreational walking is one of the few activities that
is increasing, this is a suitable activity to use to increase physical activity levels.
It is also cheap to put into practice and is supported by substantial evidence.
People who need more specific exercise treatment may have to start with an
exercise referral scheme but move on to self-sustained physical activity. For
most people attendance at a gym does not provide the best way of increasing
and sustaining physical activity. Physical activity specialists in the NHS need to
be aware of the potential of green space.
6 The rise in inactivity and obesity is now high on the Government agenda. There
is growing recognition that natural green space can increase levels of physical
activity. However, the huge potential that green space can offer is still not fully
recognised. A better understanding of the relationship between exercise and
wildlife-rich open space will help the Government reach targets to increase
levels of physical activity, as well as provide a significant economic reason to
maintain green space.
7 More than 5 billion day visits are made to the English countryside each year, and
about 2.5 billion visits to urban parks. Despite the large population density in
the UK, there is existing natural green space to support physical activity. The
most important of this green space is near to large populations.
8 There is evidence that green space in an urban environment can improve life
expectancy and decrease health complaints. Much of this is thought to be due to
a favourable environment for people to exercise. Parks and tree-lined streets
have a specific significant relationship with increased longevity. The
psychological (and social outcomes, if the activities are shared) benefits may
also increase motivation to exercise.
9 Local access to safe natural green space can help individuals sustain levels of
physical activity. The motivation to continue physical activity schemes is more
likely to be sustained through the natural environment. Activities in which
exercise becomes secondary to environmental or social benefits (e.g. Gardening,
Green Gym or walking in green space) appear to be more sustainable than
activities in which exercise remains the primary driver. This may help unlock the
Natural Fit Report for the RSPB. Dr William Bird
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problem of maintaining change in physical activity levels and may explain why
schemes that only concentrate on exercise tend to have a higher participant
drop out rate. Children increase their physical activity levels when outdoors and
are attracted to nature. Overall, physical activity levels increase where
participants have convenient and close contact to green space.
10 The benefits from increased physical activity may be even greater in hospitals or
residential care homes. Good design of wildlife-rich gardens can be used to
increase physical activity in sedentary and vulnerable patients or residents.
11 Biodiversity can have a ‘direct use’ economic value for those engaging in
physical activity. One measure of the attractiveness of a park is the amount of
nature it can offer to the visitor. Exercise becomes simply a method of travelling
to, and engaging with, the benefits of nature. Being in the countryside is an
important motivator, but this is due to variety both by time (seasons) and space
(biodiversity). The more wildlife-rich the more variety. People put a value on
biodiversity and UK Government Plans include targets to conserve threatened
species and habitats, which could be extended.
12 It is possible to estimate the economic benefits that green space can provide
through provision of physical activity. The estimates are based on an urban park
providing 20% of total local physical activity provision and a 3km footpath
providing 16% of total local physical activity provision, and are dependent on
the population (density) who can access the green space. Using this, a park in
Portsmouth, for example, could, annually, save the economy £4.4 million,
including £910,00 to the NHS. A 3 km footpath on the edge of Norwich would
save the economy £1 million, including £210,00 to the NHS.
13 To increase physical activity levels in a green space, the space should be
accessible (within 2 km of home), have a good surface with no obstructions
such as stiles, but above all, it should feel safe. There is a need for imaginative
ways to promote a wildlife-rich green space, and for it to be marketed to
different age groups. The green space must appear attractive; being natural,
but access routes and facilities must be well kept. It is possible to have sensitive
wildlife-rich areas visible from smaller well kept areas, without promoting
physical access to them, as the view of nature is a main motivator.
Natural Fit Report for the RSPB. Dr William Bird
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Recommendations
1 Both the short and long-term benefits of moderate exercise, and in particular
walking, should be promoted to the public as many people still believe that
health improving exercise means the gym or vigorous exercise.
2 For the NHS physical activity promotion specialists should work with local
authorities to identify local green space and rights of way as a major resource to
increase levels of physical activity.
3 In principle, biodiversity should be brought to people by developing areas of
green space within villages, towns and cities. Large reserves and wildlife sites
outside towns should continue to become more inclusive and less restrictive. It
is recommended that access to these areas is both equitable and sustainable.
This includes walking, cycling and public transport.
4 All green space, including nature reserves, should aim to fulfil people’s physical
activity needs. This should become a success criterion alongside environmental
and educational objectives.
5 Each local authority needs to understand the current use of local green space
for exercise and in particular the reasons why local people do not currently use
open green space. The public should be consulted as to how local green space
could be improved to become more inclusive particularly for those wanting
informal exercise.
6 Conservationists, landscape designers, architects and NHS physical activity
promotion specialists should work together to design diverse green space
benefiting the health of both the environment and local population. This may
include the use of buildings whose exercise facilities merge seamlessly into the
natural environment.
7 New recommendations should be set up for a minimum quantity of green space
that will provide enough opportunities for physical activity for a given
population. Even small public gardens may act as destinations for a walk in cities
with a high density population.
Natural Fit Report for the RSPB. Dr William Bird
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8 Schools and local communities should open up areas of safe, but wild green
space rich in wildlife for children to explore learn and play freely. Children
should be offered the chance to do conservation work or gardening instead of,
or as well as, formal sport.
9 Green circular walks should be created within walking distance of every
household (above a minimum population density) in the UK. This route will be of
high quality and accessible to the disabled allowing regular short walks and
where appropriate being part of a network linking several destinations.
10 Minimum levels of accessible green space and circular walks for every new
housing development should be set. The circular walks and green space will be
safe, accessible and designed to maximise levels of physical activity among the
new residents.
11 All local authorities should adhere to the Green Flag and Green Pennant concept
for all their public green space. Both these awards should be reviewed to ensure
that the needs for physical activity are adequately addressed.
12 NHS Estates should encourage a more wildlife-rich environment on the land it
owns in order to benefit patients, relatives and staff. The evidence that green
space offers a restorative function for patients is strong, so even small wildlife-
rich gardens can act as a destination for patients and encourage them to be
active. Improving grounds and rights of way within or near to NHS
administration buildings would set an example and encourage physical activity
for staff.
13 This report would like to endorse the recommendations made by the Urban Task
Force, chaired by Lord Rogers, to create green networks which encourage safe
walking or cycling between two city destinations, but maintaining a natural
backdrop.
14 New ways of managing public green space are needed to attract more local
participation and ownership. This may include not for profit companies or
charities that could gather income from the public, local business (for use by
employees), local government, social services and the NHS.
Natural Fit Report for the RSPB. Dr William Bird
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15 The NHS should contribute to the upkeep of Green Space and circular walks,
based on local authorities meeting certain success criteria, including a
measurable increase in levels of physical activity.
16 The role of Local Access Forums should include recommending high quality
rights of way that can help increase levels of physical activity through walking,
cycling and horse riding. Each forum should include a representative from the
local primary care trust or strategic health authority to advise on using the
network to increase levels of physical activity.
17 Agencies and funding bodies that can target health and/or the environment
should consider the recommendations of this report and review their funding
policies and criteria to give support to the further development and expansion of
natural green space for the benefit of public health.
18 The Policy Commission on the Future of Farming and Food in England supported
the idea that public money should be used to pay for public goods. Given the
major public benefit from increasing physical activity, there would be benefit in
developing agricultural policies to assist access to green space. Allocating
adequate resources to the new environmental stewardship schemes to support
wildlife-rich and accessible farmland would help fulfil this objective.
Natural Fit Report for the RSPB. Dr William Bird
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Introduction
This report, commissioned by the RSPB, looks at the evidence to support the theory
that the availability of safe, accessible natural green space encourages the uptake
and continuation of physical activity. It also looks at the role of biodiversity in
enhancing this relationship.
It is written for policy makers, those promoting physical activity and those involved
with maintaining a wildlife-rich natural environment. But most of all it is written for
those who believe that a healthy natural environment is also good for our health, but
have needed evidence to substantiate this. Generations have intuitively understood
this relationship better than us yet the evidence has been slow to arrive.
This is part of a wider debate about the health benefits of a wildlife-rich
environment. Other types of outdoor space such as playing fields, water and sport
facilities are important to the promotion of physical activity but lie outside the remit
of this report.
I will take the introduction from an Australian review “Healthy Parks Healthy People”
which summarises the vision of civic leaders three generations ago. It is worth noting
that randomised control trials and systematic reviews were not available to these
planners instead they acted in faith1.
When parks were first designed in the nineteenth century the officials had a strong
belief in the possible health advantages that would result from open space
2
. It was
hoped that parks would reduce disease, crime and social unrest as well as providing
‘green lungs’ for the city and areas for recreation. It was also understood that
exposure to nature fostered psychological well-being, reduced the stresses
associated with city life and promoted physical health. On this basis, parks and other
green space were set up in the cities, and woodland, down, heath and moor was
preserved outside the cities for public use
3
.”
Biodiversity is the variety of life on earth.
Natural Fit Report for the RSPB. Dr William Bird
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There is a need to return to the original remit which helped set up so much green
space and use improved physical and mental health as a driver to increase
standards. What has happened since then is a major shift of emphasis towards their
use as a venue for leisure and sport. 4
Three important health reports were published in 2004. The Wanless report,
Securing Good Health for the Whole Population
, from HM Treasury was published in
February. The Chief Medical Officer commissioned a report on the main health
effects of physical inactivity
At Least Five Times a Week
, which published in April and
finally a public health white paper
Choosing Health
is due to be published by the end
of the year. These reflect the Government’s thinking in shifting the emphasis away
from treating disease to a strategy of prevention, with physical activity promotion
sharing centre stage along with other major risk factors such as diet and smoking.
Biodiverse green space is our own great outpatient department in urgent need of a
refit. It requires careful maintenance and improved access. It should be welcoming
and peaceful, and treat and prevent many illnesses without the need for doctors or
nurses, appointments or medicines.
This report helps to draw together what is already known and set the direction
towards a public health policy that includes our natural environment.
Dr William Bird, August 2004
Natural Fit Report for the RSPB. Dr William Bird
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PART A
THE BURDEN OF PHYSICAL ACTIVITY
Physical Activity in the UK
Recommendation
Current Department of Health recommendations are that adults should participate in
30 minutes of moderate physical activity on at least five days per week5 and that all
young people should participate in physical activity of at least moderate intensity for
one hour a day6. This may be divided into smaller bouts of 10 minutes7. The activity
can be lifestyle activity (climbing stairs or brisk walking) or structured exercise or
sport or a combination of these8.
Gender
In 1998, only 37% of men and 25% of women met this recommendation9.
Ethnicity
Men: The highest levels of physical activity are found in Black Caribbeans and
Whites, followed by Indian, Chinese, Pakistani and Bangladeshi men. Black
Caribbean men are more than twice as likely to reach the recommended level of
activity as Bangladeshi men.
Women: There is a similar ethnic order of physical activity, but with a steeper
gradient, so that Black Caribbean women are four times more likely to reach the
recommended level of activity as Bangladeshi women10.
Social Groups
There is little change of total physical activity levels across the social group in
women, but in men there is a significant increase in high levels of activity between
social group 1 and 5 (31 to 50% respectively) due to work related exercise9.
Natural Fit Report for the RSPB. Dr William Bird
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However, for leisure walking it is the higher social groups that are more active, with
an increase of 38% in men and 67% in women between the lowest and highest
social groups11.
Age
As men become older, they become less active with a steep decline after the normal
retirement age of 65 years. In women, this steep decline starts in their early 50s. By
the age of 75 only 7% of men and 4% of women are taking enough exercise to
benefit their health9.
Level of inactivity by age and sex, 1998 England
0
10
20
30
40
50
60
70
80
90
16-24 25-34 35-44 45-54 55-64 65-74 75+
Age
% Inactive (less than
30min a week)
Men
Women
Figure 1. Level of inactivity in adults by age and sex9.
In 1997, 61% of boys and 42% of girls aged 7-18 were active at this level in the
UK12.
Natural Fit Report for the RSPB. Dr William Bird
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Inactivity (less than 30mins on five days a week)
children in
0
10
20
30
40
50
60
70
2 4 6 8 10 12 14
Age
% Bo
y
s
Girls
Figure 2. Levels of inactivity in children by age and sex12.
Figure 3. Total physical activity by region by average number of minutes per day12.
Natural Fit Report for the RSPB. Dr William Bird
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EU Country % No physical activity
Finland 10
Sweden 12
Ireland 14
Austria 16
Netherlands 19
Luxembourg 20
Denmark 24
UK 24
Germany 31
EU Average 32
France 36
Spain 37
Italy 39
Greece 40
Belgium 42
Portugal 61
Table 1: Percentage of adults aged 15 and over who do no physical activity in a typical
week, 1997, European countries13.
Summary
There are clear Government guidelines as to the amount of physical activity required
for optimum health. Along with many other western countries, the UK has a low level
of physical activity in all age groups and correcting this is a public health priority. The
maximum benefits of physical activity are in the elderly who are currently the least
active.
Natural Fit Report for the RSPB. Dr William Bird
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What is Moderate Exercise?
Moderate exercise includes walking, cycling, swimming, gardening, horse riding and
conservation work (if possible in the context of a wildlife-rich environment). This
level of activity is enough to raise the pulse to over 60% of the maximum heart
rate8, which is the threshold to improve cardiovascular health.
180
A consensus is now emerging that low to moderate intensity physical activity may
reduce the risk of cardio-vascular disease (CVD) without having any notable
influence on fitness14. Walking is now known to be equally effective in providing
health benefits as more vigorous forms of activity particularly in over 60 year olds15.
It can therefore be safely assumed that brisk walking provides the important benefits
of physical activity without the hazards associated with contact sports or more
vigorous activity.
Gardening and conservation work offer a range of activities of moderate activity that
can suit any level of fitness. Compared with walking and cycling they also involve
upper body strength.
CALCULATING MODERATE EXERCISE USING HEART RATE
The maximum heart rate can be roughly calculated as 220 minus your age. If you
are 40 years old then your maximum heart rate would be 220-40=180. To calculate
60% of 180 is:
180 x 60/100 = 102. This is the pulse rate that indicates you are undertaking
moderate exercise. However, you are undertaking the correct level of moderate
exercise if your breathing rate increases but you are able to continue a conversation
and feel an increased warmth.8
Natural Fit Report for the RSPB. Dr William Bird
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Table 2. METS* and calories per hour for outside activities in a natural environment16.
* A MET is a metabolic equivalent and is a multiple of your resting metabolic rate, which equals one
MET. At a MET of 2 you use up twice the energy consumption as when resting a MET of 3 is three times
etc.
Level of
activity
Activity Intensity
METS*
Kilocal/hour
Walking and Running
Light Walking slow (2mph) 2.5 75
Moderate Walking average (3mph) 3.3 99
Moderate Walking brisk (4mph) 5.0 150
Moderate Hiking cross country 6.0 180
Vigorous Running (6mph) 10 300
Vigorous Running (7mph) 11.5 345
Cycling
Moderate Cycling (less than 10mph) 4.0 120
Vigorous Cycling (10-12mph) 6.0 180
Vigorous Cycling (12-14mph) 8.0 240
Horse Riding
Light Horse riding walking 2.5 75
Moderate Horse grooming 6.0 180
Vigorous Horse riding trotting 6.5 195
Vigorous Horse riding galloping 8.0 240
Water Activities
Moderate Treading water in pool 4.0 120
Moderate Swimming leisure, ocean or lake 6.0 180
Vigorous Swimming crawl slow 8.0 240
Vigorous Swimming breaststroke 10.0 300
Moderate Canoeing for leisure 4.0 120
Moderate Sailing 3.0 90
Conservation work and Gardening
Moderate Mowing lawn (power mower) 4.5 135
Moderate Mowing lawn (hand mower) 6.0 180
Moderate Planting seeds, shrubs 4.0 120
Moderate Planting trees 4.5 135
Moderate Raking lawn 4.0 120
Moderate Weeding, cultivating garden 4.5 135
Moderate Digging, spading 5.0 150
Moderate Clearing land, hauling branches 5.0 150
Moderate Hoeing 5.0 150
Moderate Chopping wood 6.0 180
Natural Fit Report for the RSPB. Dr William Bird
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Physical activities by region (minutes per day)
0
5
10
15
20
25
Northern Ireland
London
North East
Yorkshire and Humber
Scotland
North West
UK
West Midlands
South East
East Midlands
South West
Wales
East
Minutes per day
Jogging/Running
Swimming
Biking
Fitness
Walking
Gardening
Figure 4: Physical activities by region. (This excludes ‘other’ physical activities, which add
about 5 mins to Northern Ireland and 9 mins to the East)17.
Summary
The benefits of physical activity can be achieved through moderate exercise, which
includes brisk walking, cycling, swimming and conservation or gardening activities.
Despite popular belief, sport, gyms or aerobics do not appear to add any further
health benefits. Most of these health benefits can still be gained without any notable
increase in fitness levels and with less risk of injury compared with more vigorous
activities. Moderate exercise can be identified by an increase in pulse and breathing
rate and a feeling of increased warmth.
Natural Fit Report for the RSPB. Dr William Bird
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What Are The Health Benefits of Moderate Exercise?
Mortality
Adults who are physically active have a 20-30% reduced mortality risk compared to
those who are inactive18.
For men and women over the age of 60 there is a 50% reduction in mortality. For
example a group of 60 men and 60 women over the age of 60 who did no activity
would expect 4 deaths a year compared to just two deaths a year for a similar but
active group19 20.
Coronary Heart Disease (CHD)
Coronary heart disease includes angina and heart attacks, resulting in associated
pathology such as heart failure (a condition where the heart muscle is weakened
leading to breathlessness caused by retention of fluid in the lungs or legs) and atrial
fibrillation. (A condition when the heart beats irregularly causing it to be less
efficient).
Natural Fit Report for the RSPB. Dr William Bird
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Coronary heart disease causes 117,000 deaths and results in 387,000 hospital
admissions. These cost the NHS £1.6 billion, with a burden of 85,000 heart attacks
each year in the UK21. Up to 37% of deaths from CHD in the UK are due to a lack of
physical activity22. For those that have had a heart attack, physical activity through
cardiac rehabilitation, is associated with a 38% reduction in mortality23.
Recreational activity of four hours or more per weekend, moderate or heavy
gardening and regular walking are all associated with reduced coronary heart
disease. Burning 1,500 kilo calories per week (3.5 hours of brisk walking) in leisure
time activity may slow down the build up of atheroma (deposits in the coronary
artery). Burning 2,200 kilo calories per week (5 hours of brisk walking) may slowly
reverse the formation of existing atheroma24. Physical activity reduces blood pressure
in people with high blood pressure which itself results in 13% of deaths from CHD25.
The annual cost of angina due to physical inactivity is £215 million to the
NHS and £455 million due to lost earnings.
The annual cost of heart attacks due to physical inactivity is £89 million to
the NHS, and £194 million due to lost earnings.
In addition, there are 44,000 CHD deaths due to inactivity costing
approximately £900 million in lost years26.
Stroke
There are 68,400 strokes each year in the UK, causing 55,000 deaths and costing the
NHS £1.36 billion each year. A large study has shown that regular walking in women
reduced the risk of stroke by about 30%27. Most studies agree that vigorous activity
adds no further benefit than moderate activity in the protection from stroke.
The annual cost of strokes due to physical inactivity is £59.8 million to the
NHS and £118 million in lost earnings. In addition, there are 14,000 stroke
deaths due to physical inactivity costing £260 million in lost years26.
Diabetes
Diabetes comprises a group of disorders characterised by a raised blood glucose
level. About 1.3 million people in the UK have diagnosed diabetes and a further 1
Natural Fit Report for the RSPB. Dr William Bird
20
million have undiagnosed diabetes. This equates to up to 3,000 diabetics in a
population of 100,000 including one in 20 people over the age of 65 and one in 5
over the age of 85.
The most deprived 20% of the population have a 50% increased risk of Type 2
diabetes28. Mortality rates from coronary heart disease are up to five times higher for
people with diabetes while the risk of a stroke is up to three times higher. Diabetes is
the leading cause of kidney failure, the second commonest cause of lower limb
amputation and the leading cause of blindness in people of working age.
Up to 9% of the entire NHS budget and 10% of all hospital in-patient resources are
used for the care of people with diabetes. This represents a total of approximately
£5.2 billion a year29.
Moderate physical activity and weight loss can reduce the risk of developing diabetes
by about 60% in patients who are already at high risk of developing diabetes and by
up to 50% in an average population. This is a greater effect than the preventative
use of the anti-diabetic drug Metformin, which reduced the incidence by 31%30.
Similar studies have shown that physical activity on its own can reduce the incidence
of diabetes by 46%31.
A large study following up a population of nurses showed that regular walking halved
the risk of developing diabetes, which was similar protection to those women who
undertook vigorous exercise32.
The annual cost of diabetes due to physical inactivity is £56.5 million to
the NHS and £204 million in lost earnings26.
Cancer
Exercise is associated with a reduced cancer risk, particularly cancer of the colon33
(40-50% reduction) and to a lesser extent that of breast (30% reduction)34 35.
Exercise can improve physical function in cancer patients and may have other
beneficial effects, such as reducing fatigue and nausea. The positive effect on
psychological well-being can reduce the level of cancer pain. Exercise appears to be
a safe and tolerable intervention for cancer patients36.
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There is some evidence that physical activity may reduce the risk of lung, prostate,
testicular and endometrial cancer8.
The annual cost of colon cancer due to physical inactivity is £7.7 million to
the NHS and £37.4 million in lost earnings with 2,500 colon cancer deaths
per year attributable to inactivity26.
Arthritis
In the UK, 8% of men and 18% of women over 65 have osteoarthritis (OA) of the
knee. 500,000 people have moderate to severe changes on x-ray of their knee
leading to 35,000 knee replacements each year. Although there is no evidence that
physical activity prevents osteoarthritis, there is evidence that moderate exercise can
prevent pain, stiffness and disability in patients with existing disease37.
In a major US trial, adults with OA of the knee who undertook an 18 month
programme of regular walking (three sessions of 40 minutes a week) reported less
disability and pain, scored better on tests of activities of daily living, performed
better on tests of walking, stair climbing and lifting and carrying than a comparison
groups who received only health education. The more the participants walked the
greater the improvements in disability pain and performance scores38.
Another study showed that regular walking reduced disability in adults over 60 with
OA of the knee by 43% over 8 years39.
The annual cost of osteoarthritis is £675 million40 to the NHS and 36
million working days lost costing £3.2 billion in lost earnings41. If inactivity
contributes to 30% of the cost of treatment and disability then this is
£202 million for NHS costs and £960 million in lost earnings.
Obesity
Obesity is a consequence of physical inactivity. The UK is experiencing an epidemic
of obesity with 22% of men and 23% of women being obese42. This means that one
adult in five is obese, which is three times as many 20 years ago43.
16% of children aged between 2 and 15 are obese. There has also been a 50%
increase in obesity in children over the last 10 years and up to 60% of fat children
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become fat adults44. This increase in prevalence is apparent at a young age, with
obesity in 2-4 yr old children almost doubling from 5% to 9% between 1989 and
199842.
The annual cost to the NHS due to obesity is £480 million, of which £9.5
million is the direct cost of treating obesity itself45. It is predicted that if
the present trend continues, the annual cost to the economy in 2010 will
be £3.6 billion46.
Depression
Mixed anxiety and depression is the most common form of mental illness in the UK,
and increased from 7.8% of the population in 1993 to 9.2% in 200016. An inactive
lifestyle over five years can lead to clinical depression. Physical activity has a
significantly large anti-depressant effect in depressed older adults47.
Several studies have indicated that physical activity is at least as effective for treating
depression as psychotherapy48 49. Two studies have shown that physical activity can
be as successful at treating depression as medication. One study showed that after
16 weeks, exercise equalled the effect of a standard anti-depressant drug and after 6
months, those who continued to exercise were more likely to recover than those
solely on medication50 51.
The annual cost of adult depression to the NHS is £370 million. There were
109.7 million working days lost and 2,615 deaths leading to a total cost to
the UK economy of over £9.0 billion52. If physical inactivity contributes to
between 10% and 15% of depression then this would be £37 million for
the NHS and about £1billion to the UK economy.
Well-being, Stress and Sleep
People who are physically active feel happier and more satisfied with life in all ages.
Even a single bout of physical activity can result in improved mood and energy.
Activity programmes can result in general improvements in well-being over several
weeks.
Physical activity can also make people feel better about themselves, particularly in
those with initially low self-esteem53. There is a positive effect on anxiety with single
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exercise sessions immediately reducing levels of anxiety. Physical activity can also
help people cope with the impact of stress as measured by blood pressure or muscle
tension54.
People who are regularly active fall asleep faster, and sleep longer and more deeply
than those who are inactive. There is also a protection against sleep disorders in
those who are regularly active55.
Many of these benefits are primarily due to the release of serotonin, endorphins and
noradrenalin (which are natural chemicals found in the nervous system that make us
feel much better) but effects of increased blood flow to the brain and the confidence
created by a sense of achievement are also important.
Osteoporosis and Hip Fractures
Osteoporosis is a degenerative bone disease that is characterised by low bone mass
and which is therefore more likely to fracture. There are 14 000 deaths from about
60,000 hip fractures each year in UK which is estimated to increase to 120,000 by
2015 56. After a fracture, 50% of people can no longer live independently.
Physical activity that physically stresses the bone such as running, jumping and
skipping can increase bone density in adolescents, maintain it in young adults, and
slow its decline in old age. Sustained physical activity into the mid-20’s maximises
peak bone mass. Activity continues to be an important factor in reducing bone loss in
old age. Increased amounts of walking has also been associated with a 40%
reduction in hip fractures in Asian women57 and by 30% in white women58.
When treating hip fractures the cost of social care is twice that of NHS
treatment59. The health and social care costs of osteoporosis in the UK
amounts to £1.7 billion, up to 85% of which are due to hip fractures60.
If physical inactivity contributes to about 30% of hip fractures then this
produces costs of £140 million to the NHS and £290 million for social care.
Children
There is a link between inactivity and obesity: less active children are more likely to
have excess fat. Also activity programmes have resulted in clinically significant
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decreases in body fat and body mass index in obese children61. Schoolwork may be
improved by physical activity. A major review found that there is a positive
relationship between physical activity and cognitive functioning that includes
concentration, memory and language62.
There is strong evidence to show that by the time children leave secondary school
their attitude to exercise is highly predictive of whether they will be physically active
as adults. The strongest relationship is between the quality of exercise they have
experienced as opposed to the quantity of exercise8.
The Elderly
Several studies have identified the importance of physical activity to the health of the
elderly:
‘The greatest risk for older adults is sedentary living’.
63
‘The dominant effect of fitness over the other risk factors, and its apparent effect as
an antidote for other risk factors, makes physical fitness perhaps the single most
important thing an older adult can do to remain healthy’.
64
‘Physical activity is the crux of successful aging regardless of other factors’.
64
Physical activity improves functional capacity and maintains independent living. It
improves well-being leading to an improved quality of life and the inclusion of older
people in society65.
As people get older, there is a decline in performance of concentration, language and
memory, known as cognitive decline. There is evidence from a large trial that for
every 1 mile walked per day there is a 13% reduced risk of cognitive decline66. There
is also some evidence that a lifetime of physical activity can protect against
Alzheimer’s disease67 68.
Summary
It is now recognised that physical inactivity is adding a catastrophic burden to society
leading directly to chronic disease and lack of independence in the elderly. For
children, inactivity is helping to create a future generation who are more likely to
become inactive adults. Moderate regular activity appears to maintain the vitality of
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the body and prevents heart disease, diabetes, strokes, cancers, disability,
osteoporosis, depression, anxiety and sleep problems. Without regular exercise,
there is a decline of function in virtually every system of the body eventually
requiring support from the NHS and social care.
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What is the Cost of Physical Inactivity?
Economic Costs
The health economics model from the Cabinet Office calculates that inactivity in
England costs £8.2 billion (£1.7 billion for the NHS, £5.4 billion for work absence and
£1 billion for early mortality)26.
The Scottish Office calculated that if there were a 1% decrease of inactive Scots then
157 deaths would be prevented each year, saving £85 million in lost years. Hospital
admissions would fall by 2,231 cases each year, saving £3.5 million69.
It has been calculated in the US that every $1 invested in physical activity leads to
$3.2 in medical cost saving. There is an annual saving of $330 for each person that
has become active. The total cost of physical inactivity on healthcare in the US is
about $76 billion in year 2000 dollars70.
Health Costs
The effects of inactivity can be summarised by comparing a group of 60 men and
women who are fully active, with a group of 60 men and women who are inactive, to
give the health benefits of activity that accrue over 10 years (Table 3a and 3b).
The tables show the 10 yr incidence of medical conditions in a group of 60 people
over the age of 60.
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Table 3a. The health benefits over 10 yrs for a group of 60 men aged over 60 years who
walk on average 2 miles 5 days a week, compared to an inactive group.
Table 3b. The health benefits over 10 yrs for a group of 60 women aged over 60 years who
walk on average 2 miles 5 days a week, compared to an inactive group.
Summary
The cost of physical inactivity to the economy in England is calculated to be £8.2
billion (£1.7 billion for the NHS, £5.4 billion for work absence and £1 billion for early
mortality). That is equivalent to £164,000 per 1,000 people for the economy,
including £34,000 per 1,000 people for the NHS. If a group of 120 healthy individuals
aged over 60 years started to walk 2 miles per day, then over 10 years there will be
approximately 20 less deaths, 7 less heart attacks, 3 less strokes, 2 less new
diabetics, and 13 less people with some disability from osteoarthritis of the knee
when compared to an inactive group. In other words two lives are saved a year.
For group of 60 males aged over 60 during 10 years Condition
(References
included in report) Number in
inactive
group
Reduction of
incidence
due to
activity
Number in active
group (walking 2
or more miles a
day)
Reduction of
number with
condition
Death 20 50% 10 10
Heart Attack 11 50% 6 5
Stroke 6 30% 4 2
Disability due to
knee arthritis
16 40% 9 7
Diabetes 2 50% 1 1
For group of 60 females aged over 60 during 10 years
Condition
(References
included in report) Number in
inactive
group
Reduction
of incidence
due to
activity
Number in active
group (walking 2
or more miles a
day)
Reduction of
number with
condition
Death 20 50% 10 10
Heart Attack 5 50% 3 2
Stroke 3 30% 2 1
Fractured Hip 2 30% 1 <1
Disability due to
knee arthritis
15 40% 9 6
Diabetes 2 50% 1 1
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How Can Physical Activity be Promoted?
The Health Development Agency has examined physical activity promotion at a
national, regional and local level71. Other references have been added to this
structure.
National
The evidence shows that incentives to encourage walking and cycling to school are
effective and should be introduced. There should also be the introduction of physical
activity facilitators in primary care to promote exercise in communities.
Regional
Incentives must be introduced for local authorities to preserve playing fields and
other open spaces and to address quality and safety concerns among users; safe
play environments within open spaces, including ranger and park keeping schemes
and safe walking environments should be introduced. This can be co-ordinated with
local schemes to promote walking for health by signed routes, maps, local publicity
and advice from health professionals.
Locally
Evidence shows four interventions that work.
1. Walking versus Facility
Following a systematic review of physical activity promotion schemes around the
world72 Hillsden et al stated:
‘Interventions that encourage walking and do not require attendance at a facility
are most likely to lead to sustainable increases in overall physical activity’
They went on to say that:
‘The emphasis placed on attending a leisure facility and the neglect of walking as
a form of exercise is inconsistent with the findings of this review’
The amount of walking or cycling to work or school has fallen by 26% over the past
20 years73. However, in the last 10 years there has been a rise in leisure walking.
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62% say that walking is their main exercise74 and walking over 2 miles (3.2 km) once
a month is three times more likely than the second commonest exercise (swimming
at 15%)75.
44% of men and 38% of women having taken a recreational walk of more than 2
miles over the past four weeks. The totals for 1987, 1993 and 1997 were 38%, 41%
and 44.5% respectively76. It is harnessing this rise in leisure walking within green
space that could offer an unlimited resource to increase the levels of activity in the
UK.
2. Physical activity promotion using professional interventions
There are some patients with specific conditions that often need personal advice
from a professional as to the type and intensity of physical activity required as part
of the management of their condition. There is good evidence that these
interventions should be ‘a routine part of primary care using referral to properly
trained and resourced physical activity and lifestyle coaches’77.
It is therefore important that these professionals are aware of the benefit of local
green space to increase the physical activity levels of specific patients. Exercise
referral schemes encourage the GP to refer patients with specific conditions to
leisure centres or gyms for exercise. Although some schemes show sustainable
improvements in physical activity, there is increasing concern about their
effectiveness and best value at national and local levels78.
These schemes are not the answer to increasing levels of physical activity in a whole
population. There is even evidence that structured exercise may decrease overall
activity levels as there is a feeling of ‘saving one’s energy’ for the next exercise
session79.
There is a place for rehabilitation schemes for people who have had a recent heart
attack and those with chronic obstructive pulmonary disease (COPD) and heart
failure. While the gym may be the most suitable setting initially, the evidence shows
that any physical activity promotion is less likely to succeed if it relies on attendance
at a facility.
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3. Stages of change in Physical Activity Promotion.
There is strong evidence that individually adapted health behaviour change
programmes are effective in increasing physical activity levels77. The understanding
of the stages of change of an individual can apply to promoting physical activity in a
green space. The key to this is that a change of behaviour comes in stages80:
1 Precontemplation (not thinking about physical activity)
Marketing task: Create awareness change value
2 Contemplation (thinking about undertaking physical activity)
Marketing task: Persuade motivate
3 Preparation (have decided to try physical activity)
Marketing task: Create action
4 Action (trying physical activity for the first time)
Marketing task: Create action
5 Confirmation (Committed to physical activity)
Marketing task: Maintain change
This can be used to understand the stages that a person goes from being totally
unaware of visiting green space to becoming regularly active through visits to
local green space. However, to successfully market physical activity one has to
have a deep understanding about the exact needs for each group of people. For
example, research on behalf of Cheshire County Council and Countryside Agency
identified five groups of walkers81. This classification can help to target marketing
to the needs of these groups.
Serious walkers: those that look forward to going for a walk and who
walk regularly
Social walker: those that walk for social benefits
‘We choose a pub and then we go for a walk. I always choose a circular route
and like to include a pub at the end for lunch’
Emotional Walkers: those who go for a walk to try and ‘clear their
heads’ because they are feeling stressed due to work or family
pressure, or who walk when they are feeling down/depressed.
‘Well before you go for a walk you’re not doing much and you might be doing
housework and that and you’re a bit overburdened with jobs and things and its a
miserable feeling and then when you go for your walk, you change.’
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Apathetic walkers: those who have little desire to go for walks, but do
so under duress for example: when under pressure from a partner.
‘When you get back, you feel, you know, you’re glad that you’ve been on it’
Non walkers: People who do not walk and who have no desire to do so.
‘Do I heck, since I got my car’
It is therefore more likely that the level of physical activity for a particular
individual will be increased by understanding their motives and stage of change
at that point in time.
4. Social Support interventions
There is a need for individuals to support and encourage each other to change
levels of physical activity. The energy within a community to improve health is
often overlooked but if harnessed can help drive change further than if owned by
professionals alone.
Figure 5. Components of physical activity promotion.
Figure 5 illustrates the balance between the three main components that make up
physical activity promotion; motivating the individual, empowering a community and
improving the local environment. Ideally, an individual can draw on community
(friends and family) support, and a healthy safe environment as resources to sustain
Individual
Environment Communit
y
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their levels of physical activity. Giles–Corti quantified this relationship and found that
an attractive local environment for walking (trees, minor traffic, pavement and a
local shop) was associated with double the chance of someone achieving the
recommended level of physical activity when compared with a poor environment. A
motivated individual was three times as likely to reach the required levels and a
supportive community resulted in somewhere between the two82.
Summary
Regionally there should be incentives for local authorities to develop green space to
increase levels of physical activity as well as co-ordinate local schemes to promote
walking.
At a local level, physical activity promotion should be done close to where the patient
lives and with an emphasis on walking. As recreational walking is one of the few
activities that is increasing then this is a suitable activity to look to increase physical
activity levels. Attendance at a gym does not provide the best way of increasing
physical activity in a population. Physical activity specialists in the NHS need to be
aware of the potential of green space.
Successful promotion relies on a balance between motivating the individual,
empowering the community and improving the environment.
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PART B
Can the provision of wildlife-rich green space benefit the health of a
population by increasing levels of physical activity?
Is the Government Linking Green Space with Physical
Activity Promotion?
Many Government departments are turning towards the problem of obesity and
inactivity in the population. This is a cross-government issue, which has been
acknowledged by the Cabinet Office Strategy Unit. At the same time, the value of
biodiversity and access to green space is being given a higher priority. The following
examples show areas where these two spheres of natural environment and physical
activity promotion are coming together.
Cabinet Office
Game Plan, from the Cabinet Office Strategy Unit26, aims to increase physical activity
and competitive sport in the UK by co-ordinating policy across Government. The
report, published in December 2002, sets targets of participation of physical activity
from the current 32% to 70% by 2020. This would involve a further 21 million extra
people becoming active. The only mention of the natural environment is in
paragraph 2.73:
‘Therefore, the maintenance of otherwise under-used community settings (parks,
playing fields and walking/cycling routes) may have a significant role to play in the
development of the quality of life in communities’.
There has been concern that competitive sport and physical activity have been
brought together in Game Plan. A pan-European Union survey found that on average
25% of Europeans cited the sporty image of physical activity as a major deterrent83.
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DEFRA
A key aim of the Countryside and Rights of Way Act 2000 was to increase public
access to mountain, moor, heath, down and common land. It also looked at
improving access to rights of way and states that:
‘Every local highway authority …shall, within 5 years …prepare and publish a plan, to
be known as a rights of way improvement plan, containing: ...the opportunities
provided by local rights of way for exercise and other forms of open-air
recreation’.
84
Advised by 50 local access forums, Local Authorities have started to work on these
rights of way improvement plans and will be consulting widely over the next 2 years.
The Biodiversity Strategy for England
Working with the Grain of Nature
aims to
‘mainstream’ biodiversity into all our activities so that it is embedded in all the main
sectors of economic activity. There is mention of using the countryside as an
additional motivator for physical activity and to bring biodiversity to people as well as
increasing access to biodiversity. There is also mention of using NHS Estates to
increase biodiversity within NHS grounds.
Department of Health (DH)
The NHS National Service Frameworks (NSF) for coronary heart disease, the elderly,
diabetes and children state that all NHS bodies working with Local Authorities should
have agreed and be contributing to the delivery of the local programme of effective
policies on increasing physical activity. However, the natural environment is not
mentioned at all85.
A series of pilot projects (called LEAP) to promote physical activity has been set up in
several areas of the country. The partnership includes the Countryside Agency and
DH and one scheme uses local parks as a health resource.
A white paper on public health entitled,
Choosing Health,
will be published in autumn
2004. The consultation document
Choosing Health, Choosing Activity
is published by
DoH and the Department for Culture Media and Sport. One area for consultation is
‘Improving the environment in which we live to encourage safe and active lifestyles’
There is an understanding in the consultation that:
Natural Fit Report for the RSPB. Dr William Bird
35
‘countryside, coast, canals, rivers, and informal green areas in and around towns and
cities also provide a natural resource for people to be active at little cost’.
The Chief Medical Officer’s (CMOs) report on physical activity published in April 2004,
At Least Five a Week
8 focuses on the evidence of benefits of physical activity but
makes no mention of suitable environments to exercise. The Health Development
Agency (HDA) reviewed interventions that get people more active. They found that
interventions that promote moderate intensity physical activity, particularly walking,
and are not facility dependent, are also associated with longer-term changes in
behaviour77. At a regional level, the review states the importance of preserving
playing fields and other open spaces and mentions the use of ranger and park
keeping schemes and safe walking environments77 71.
NHS estates, which look after the infrastructure of the NHS such as hospitals and GP
surgeries, do not have any policy of using their grounds to encourage physical
activity for patients or the elderly.
Countryside Agency
The Countryside Agency has been at the forefront in linking levels of physical activity
with green space.
The development of Community Forests has provided opportunities to use the land
to promote physical activity:
‘Doctors will be able to suggest that patients take exercise on the new health walks
being created by the Great Western Community Forest partnership, East Wiltshire
Healthcare Trust and Wiltshire Health Promotion Service.’
86
The Countryside Agency is working with the British Heart Foundation to deliver
Walking the Way for Health Initiative (www.whi.org.uk) by using rural and urban
green space to promote over 400 walking schemes in the UK. This is to be extended
by a scheme called ‘Your Countryside Your Health’ that aims to spend £25 million
over six years to improve the health of 2 million people in disadvantaged areas by
investing in paths, parks and open spaces.
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There is a consultation led by the Countryside Agency and Groundwork called
‘Unlocking the potential of the urban fringe’ that will create a comprehensive strategy
to improve green space around towns with physical activity as one of the named
benefits.
Greenways are an initiative of the Agency, which aims to give better mobility and
access for people on foot, bike or horseback or for people with disabilities.
Greenways are designed for shared use and largely exclude motorised vehicles. They
are in and around towns, cities and the countryside.
HM Treasury
The Wanless report ‘Securing Good Health for the Whole Population’ has reported
that more funding effort and direction should be given to promoting good health
rather than just treating it. Lack of physical activity and the rise of obesity are
singled out as high priorities.
English Nature
In its document,
Revealing the Value of Nature
, English Nature recognises that there
is evidence of the psychological and physiological health benefits of having access to
natural areas87.
Forestry Commission
A report commissioned by the Forestry Commission stated that physical exercise was
one of the four areas that are widely advocated as being important in promoting
individual and public health88.
Office of Deputy Prime Minister
The Urban Summit 2002 organised by the Office of Deputy Prime Minister looked at
understanding the environment’s contribution to health. Anna Coote from the King’s
Fund highlighted the role of the NHS in promoting health through environmental
measures and corporate citizenship.
CABE Space, established in 2003, is part of CABE, the Commission for Architecture
and the Built Environment, and is publicly funded by the Office of the Deputy Prime
Minister (ODPM). CABE space is likely to become the lead organisation to improve
urban green space. It is actively looking to improve green space to increase the
Natural Fit Report for the RSPB. Dr William Bird
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opportunities for physical activity. In its publication
The Value of Public Space
89 there
is a section on the impact that high quality green space can have on physical and
mental health:
‘By encouraging us to walk more, to play sport, or simply to enjoy a green and
natural environment’.
There is also the recognition of the benefits of biodiversity:
‘provides an opportunity for people to be close to nature, with the associated positive
impact that this can bring in terms of mental health and the simple pleasure of
experiencing trees, birds, squirrels, ladybirds and other wildlife in an urban situation.’
More recently, CABE Space have published a guide to help local authorities produce a
park and green space management plan as well as a good practice guide90 91.
Ministry of Defence
The MOD aims to take appropriate account of environmental, public access, social,
planning and heritage factors in managing its estate. It has an aim to meet its
declared presumption in favour of safe public enjoyment of its estate wherever this is
compatible with operational and military training uses, public safety, security,
conservation and the interests of its tenants.
Summary
The rise in inactivity and obesity is now high on the Government’s agenda. There is
growing recognition that natural green space can increase levels of physical activity.
However, the huge potential that open space can offer is still not fully recognised. A
better understanding of the relationship between exercise and wildlife-rich open
space will help the Government reach targets to increase levels of physical activity as
well as provide a more sustainable economic model for maintaining green space.
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What Green Space is Available for Physical Activity?
There are over 5 billion visits to the countryside in England every year92 and 2.5
billion visits to urban parks. Despite the high density of population, there are many
areas of green space within the UK. The countryside can be seen as a great
outpatient department whose therapeutic value is yet to be fully realised. This
chapter highlights some areas of public access that can contribute to physical activity
within green space.
Rights of way
There are 91,300 miles of footpath, 19,900 miles of bridleway and 3,700 miles of
roads used as public paths/restricted byways in England93.
National Cycle Network
This network has 8,000 miles of cycle and walking access, and will extend to 10,000
miles by 2005. A third is on paths free from traffic, which make use of disused
railway tracks, canal towpaths, routes through forests, paths through country parks
and bridleways. This is being co-ordinated by the charity Sustrans in partnership with
many local organisations.
Open Country
An extra 1.1 million hectares of access land (mountain, moor, heath, down and
common) will be open to the public in England and Wales from 2005 through the
Countryside and Rights of Way Act (200). Local Access Forums being currently set up
in consultation with local authorities and organisations such as the Ramblers, the
RSPB, British Horse Society, Countryside Landowners’ Association etc, will ensure
that the public can benefit from this access to the full.
Types of Habitat
Woodland
Woodland extends over some 1 million hectares of England and 247,000 hectares in
Wales. Only 29% of woodland in England and 46% in Wales is open for public access
Natural Fit Report for the RSPB. Dr William Bird
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beyond rights of way. 333 million leisure day trips were made to woods or forests in
England and Wales. Importantly, there is a positive correlation between the
proximity to woodland and frequency of visits. The majority of day woodland visits
last less than two hours. The average distance travelled to woodland is 14 miles94.
As with many visits to the countryside 61% of visits to woodland are for walking with
sport and cycling accounting for 11% and 6% respectively. The English Forestry
Strategy aims to promote public access and recreation activities in woodland95. Most
woodland is in discrete areas of between 2 and 10 hectares in size. Even these small
areas of woodland near to a population can be used for frequent daily visits.
Community Forests
These 12 areas cover 452,649 hectares of England and are situated around the
major cities such as Middlesbrough, Liverpool, Manchester, Sheffield, Bedford,
London, London and Bristol. Millions of trees are being planted to allow local people
to enjoy, learn and exercise. There are 26 million people that live within 12 miles of
these forests that are being developed jointly by the Countryside Agency, Forestry
Commission and Forests for the Community96.
Inland Watersides
There are 24,900 miles of rivers, 1,740 miles of canals and 1,600 lakes in England
and Wales. The majority of riverbanks and lakeshores are privately owned, but most
canal towpaths are owned by British Waterways, which is a public company. The
advantage of canal towpaths is that they pass through major cities and provide a
good flat surface for walking or cycling. There are about 180 million day visits to
canals or rivers each year94.
The quality of rivers influences the positive experience to the visitor by increasing the
diversity of wildlife. 94% of rivers are now of good or fair quality, up from 86% in
1990. However, 55% of rivers still have high phosphate levels and 32% have high
nitrate levels.
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Wetlands
There are approximately 200,000 hectares of grazing marsh, 5,000 hectares of
reedbed and 1,500 hectares of flood plain meadow in England. There were 3,380km2
of undrained fenland in England in the 1700s, but this is now to 10km2 97.
The Coast
There is 4,400km of coastline in England and Wales. The coast is increasingly
popular with a 7% per year rise in usage during the mid-90s. 27% of visitors to the
coast visit it to walk, compared to 17% who visit for sightseeing94.
Country Parks
There are 350 Country Parks in Great Britain including 267 in England. Most were
developed in the 1980s and are in a serious state of decline. They provide a gateway
between town and country. Following the Rural White Paper, these parks will receive
both Lottery funding and funding from the Countryside Agency grant scheme. They
receive 73 million visits per year, which averages out at 570 visits per park per day98.
Urban Parks
14% of the area of our towns and cities is park and open space. There are 27,000
urban parks in the UK covering 143,000 hectares, which receive £630 million for
upkeep. This has fallen by £1.3 billion in the past 10 years, which has led to a
decline in standards. For many people without transport they represent the only
contact with green space. If the urban population of England is assumed to be 37.8
million, then it is estimated that some 33 million people make over 2.5 billion visits
each year to urban green space99.
A local government report found that local councils and their communities are
increasingly using parks as ways to involve and consult people, regenerate
communities and contribute to more inclusive communities100.
The Urban Task Force chaired by Lord Rogers101 acknowledged that green space was
a vital part of urban development. In an attempt to safeguard this green space, they
said that:
‘There is a need for a sophisticated approach in protecting and designating green
space. There are important green buffer zones and strategic gaps both within and
between our urban areas that could be given the same weight in development
Natural Fit Report for the RSPB. Dr William Bird
41
control terms as the Green Belt designation. This would help to protect urban
biodiversity and ensure strong urban green space networks’.
Types of Management
Designated Sites
In the UK, land is conserved for biodiversity reasons as SSSI (Site of Special
Scientific Interest), or as sites designated under the EU Birds and Habitats Directives.
In England, SSSIs have an important role in access provision: 7.5% of the land area
provides 55% of the land open under the new statutory right of access from the
CROW Act (2000).
State-Run Nature Reserves
In England, there are 213 national nature reserves and 660 local nature reserves
covering an area of over 30,700 hectares. They range from heathlands and mudflats
to cemeteries and old railway cuttings. 35% of local nature reserves are urban and a
further 33% lie within 1km of an urban area. Through positive management and
partnership with local communities, these reserves can bring the benefits of nature
closer to people and people closer to nature97.
Non-Government Organisations
Numerous non-governmental organisations manage nature reserves in the UK. For
example, RSPB nature reserves, cover more than 97,000 hectares, and provide a
major recreational resource for people, as well as conserving biodiversity: over 1.1
million visits are made to RSPB reserves each year. The RSPB’s reserve volunteering
programme can benefit the health of participants, as well as assisting land
management for biodiversity. The National Trust’s land holding is approximately
250,000 hectares, and the Wildlife Trusts have over 80,000 hectares.
Summary
There are over 5 billion day visits to the English countryside each year and about 2.5
billion visits to urban parks. Despite the large population density in the UK there is
existing natural green space to support physical activity. The most important of this
space is in and around large populations. The large number of organisations that
look after land with public access makes a policy for increasing physical activity more
difficult.
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The value of green space is hard to measure and therefore vulnerable to spending
cuts, so that without investment and promotion the value to the local population is
significantly reduced. Local authorities and Primary Care Trusts are in a good position
to identify and improve communities that are poorly served by good quality green
space.
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Can More Green Space Improve the Health of a
Population?
Contact with nature is good for health. In a review for the American Journal of
Public Health102 103 nature was associated with fewer sick call visits among
prisoners104 improved attention among children with attention deficit disorder105 and
improved self discipline among inner city girls106. There is also evidence that contact
with nature enhances emotional and values related development in school
children107.
Even looking at nature through a window can lead to improved recovery and lower
requirement for pain relief following operations in hospitals108, and reduced stress
and enhanced work performance in the office109.
Other work has shown that the presence of nearby natural areas to be related to
reduced crime, aggression and violence110, as well as increased civility and
neighbourliness111. This sense of using nature to build communities is strengthened
by participation in local nature activities that has been shown to increase the sense
of pride in one’s community112 and strengthen urban neighbourhoods113.
There is direct evidence that green space within an urban environment can benefit
health and increase longevity, with one study demonstrating a dose response (i.e.
the more the better). The authors of two reports suggest that physical activity is
likely to be responsible for some of these benefits although the methodology did not
allow them to measure this quantitatively.
The first study from Tokyo114 found that the five year survival of senior citizens
increased with more space for taking a stroll near their residence and with nearby
parks and tree lined streets near the residence. The authors comment:
‘If favourable walkable green streets and spaces were provided, the health of senior
citizens would be promoted further regardless of their socio-economic status’.
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The availability of a green space within walking distance is likely to promote physical
activity outside the home, especially in densely populated urban areas with a high
proportion of flats without gardens114.
The European Heart Network makes the same connection115:
‘Making changes to the environment to support physically active lifestyles aims to
increase the supply of appropriate environments where physical activity can take
place, for example programmes can focus on green space.’
The second study from Holland 116 showed that living near green space created less
health complaints and both better mental and physical health than an urban
environment.
‘For every 10% increase in green space there was a reduction in health complaints
equivalent to a reduction of 5 years of age’.
Other work117 has used aggregated data to show a positive correlation between
woodland/farmland area and lower death rates for residents of cities with a
population density of more than 4,000 inhabitants per km2. However, the correlation
did not occur among cities having a lower population density. Areas of low density
urban populations representing urban sprawl have been studied and, despite having
more trees and gardens, have been shown to have higher rates of obesity, physical
inactivity and hypertension118. This is thought to be due to a greater dependency on
the car to reach local services or areas of public space compared to more compact
neighbourhoods.
Summary
Contact with nature has been shown to reduce stress, pain, crime and aggression
and improve community integration, children’s behaviour and a sense of pride in the
community. These all indirectly can improve the health of a community. There is
more direct evidence that green space in an urban environment can improve life
expectancy and decrease health complaints. Much of this is thought to be due to a
favourable environment for people to exercise. There was a specific significant
relationship between parks and tree lined streets with increased longevity. The
psychological benefits of nature may also increase motivation to exercise. Suburban
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sprawl is associated with higher levels of obesity, high blood pressure and inactivity,
because of the high dependency of the car.
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Can Green Space Increase Levels of Physical Activity?
As discussed in previous chapters, walking is the most effective means of physical
activity promotion. Evidence also shows that green space in a city is associated with
increased health and that some of this is due to increase opportunity of taking part
in physical activity.
There is also evidence that the Government is beginning to see the opportunities
that green space can bring to healthy lifestyles and physical activity promotion in
particular.
The following chapter discusses the relationship between physical activity levels and
proximity of green space to a community.
Walking and Local Green Space
There have been two major reviews investigating the relationship between the
environment and physical activity119 120. In summary levels of total walking which
meet the current requirements are more likely to be met when there is:
o Local access to public space or beach
o Local area is attractive with enjoyable scenery
o Safe Footpaths
o Minor traffic with trees
o Pavements
o Diversity of land use
o Easy access to public transport
o Neighbourhood is friendly
There is much more research being undertaken to identify these links. The following
studies are representative of many others. A study from Perth, Western Australia,
found that people were twice as likely to walk at recommended levels in a high
scoring physical environment with the most important environmental factor being
local access to attractive public open spaces82.
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Women living within walking distance of a park or footpath walked more (as
measured by a pedometer) than those living near a community centre, pub, bar,
coffee shop, post office or library121. Another study in the UK showed that walking
over 150 minutes a week was associated with ‘feeling safe’ and ‘access to shops’ for
women, but for men it was ‘access to a park or open space’ 122.
In summary the natural environment and local scenery is consistently important in
increasing physical activity levels in communities.
The following three case studies have used the natural environment to increase
physical activity in a healthcare setting.
Walking the Way to Health (Health Walks)
Health walks started in South Oxfordshire in 1995 based on the hypothesis that
social and environmental factors are both essential to maintain levels of physical
activity within a community setting123 124 125 126. There are three parts to the scheme:
1. Way marked short Health Walk routes that are graded for difficulty and length.
2. Health Walks led by trained volunteers that encourage those who prefer a social
incentive, safety and guidance on where to walk.
3. Leaflets that show these walks on illustrated maps.
There are now over 350 similar schemes, being led by over 10,000 trained
volunteers in the UK, co-ordinated by the British Heart Foundation and Countryside
Agency as the ‘Walking the Way to Health’ initiative127.
A four year review of the first Health Walk scheme in Sonning Common, involving
16,407 participations on 1,724 walks, demonstrated that the most popular walks are
between 1.5 and 2 miles in length with a clear preference for walks that offered a
variation in natural environment and with trees124. It found that:
‘Varied scenery was an important aspect of motivation with less attendance on walks
with poor contrast and few or no trees.’
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In a commissioned report125 on a Health Walk scheme in Reading, a sample of 476
health walkers were asked what motivated them to continue walking (Figure 6). Out
of 13 questions the four most important factors were (in order):
improve my fitness levels
have a chance to be in the countryside
the health walks are nearby and convenient
they are enjoyable and fun.
Women were statistically more likely to strongly agree about the positive nature of
the countryside and seasons125.
Although the walks were designed to increase fitness and improve health, figure 6
shows that a chance to be in the countryside became the joint top reason to
continue with the participation. Even watching the seasons go by was a more
important motivating factor than any of the health benefits. The local effect of health
walks has other consequences with 64% of current or past participants saying that
their transport habits have changed with 27% saying that they now walk rather than
drive short distances. The most significant aspect is a lasting change in participants’
patterns of exercise.
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Figure 6. Factors that motivate participants of Health Walks to continue. The Key
question was ‘ I will continue health walking because…’
Walking outdoors may offer other advantages (compared with using a gym). A study
comparing adults walking indoors to outdoors showed that when asked to walk ‘Fast
but without over-exertion’ the percentages of their maximum heart rate and walking
speed were significantly higher for outdoor compared to indoor (treadmill) walking,
yet their rate of perceived exertion was similar for both. This showed that when
outdoors they walked faster and used up extra energy without feeling any extra
effort. This may be partly due to the ground being easier to walk on than a treadmill,
but the varied scenery and the natural surrounding (compared to a treadmill and
wall) may provide a positive distraction from the actual exercise128.
Green Space in a Hospital or Residential Care Setting
Patients, visitors and staff in hospitals or residential homes are often under stress or
recovering from a stressful illness or operation. There has been a significant shift
from design of the interior to that of the outdoors so that any open space can be
used for healing relaxation and exercise. There is now considerable evidence to
indicate that hospital patients looking out onto green space with varied vegetation
recover from operations more quickly, have shorter stays in hospital and need less
analgesia than those who have a view of just a wall129.
Writing in ‘Healing Gardens’ Professor Roger Ulrich says:
0
10
20
30
40
50
60
70
80
90
% Respond ants
Improve fitn ess
In countrys ide
Nearby and c onvenient
Enjoyable and fun
Seasons
Socia li s e
Energy
Sleep bett er
lose wei ght
Told to exe rcise by GP
Strongly agree
Slightly/strongly
disa
g
ree
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‘There are sound scientific grounds for contending that gardens in healthcare
facilities will improve health outcomes to the extent they are effective in fostering
restoration and coping with respect to the stress that accompanies illness and
hospitalisation.’
‘Accordingly, supportive gardens in healthcare facilities can be an important
complement to the healing effects of drugs and other modern medical technology
and help improve the overall quality of care.’
130
Ulrich goes on to say that there are three ways that designers can capitalise on
gardens as effective ways of increasing physical activity:
Small gardens can be designed to serve as destinations for a walk through the
hospital. So even a small atrium with a tree and flowers and birdsong will be a
small oasis of restoration to which the patient may have to walk across the
hospital.
Gardens alongside corridors with windows may increase the motivation to walk
around the hospital. This is more suitable during the winter or when raining.
A larger garden can provide paths and walking loops with clear access to
encourage patients and staff to walk during breaks in work or treatment.
The elderly in residential care are vulnerable to inactivity. The ambulatory person
may spend as much as six hours sitting in the same chair and the non-ambulatory
resident up to 12 hours131.
A report by the American Hospital Association described
the optimal patient unit as providing interesting areas for walking and a tangible goal
outside the patient’s room to encourage walking132.
To increase activity outdoor gardens must be easy to navigate with chairs to allow
rest and possibly hand rails to provide confidence. To make the garden worth a visit
colourful plant materials and amenities to attract wildlife are used along with
different leaf textures, forms, smells, and perhaps taste, to stimulate the senses and
memory.
The Green Gym (Conservation Work, Physical Activity and Green Space)
The Green Gym133 uses conservation work to increase both physical and mental
health and is led by the British Trust Conservation Volunteers (BTCV). There are over
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50 schemes within the UK encouraging physical activity through the natural
environment.
A commissioned study134 of the Portslade Green Gym near Brighton found that:
‘50% of members felt that being in the countryside was a very important factor at
the beginning of the scheme but after six months this increased to 75%. Keeping fit
was very important in 100% of members at the start but fell to 45% after six
months.’
(Figure 7)
20
30
40
50
60
70
80
90
100
Start 6 months
Time from starting Green Gym
% of participants
To Keep Fit
Being in the
Countryside
Figure 7: Factors that were very important in continuing participation in the
Green Gym134.
Although this deals with a small sample, most people joined the scheme because of
the need to become fit. However, it appears that being in the countryside became a
more important motivating factor to encourage people to continue with the Green
Gym. Organisers of the Green Gym schemes throughout the UK have noted this
trend of people entering conservation with a ‘health ticket’, but continuing through a
developing relationship with nature134.
The main difference for the person undertaking exercise through gardening or
conservation work is that they concentrate on the job in hand rather than seeing it
primarily as a source of exercise. There is a similar rise in heart rate with both the
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Green Gym and step aerobics (Figure 8). However, participants in the Green Gym
were less aware that they are exercising than with step aerobics and were happier to
continue for longer in order to finish the task.
Figure 8: Comparison of heart rate between 60 mins of step aerobics and Green Gym
session135.
General comments from members on why they continue with the Green Gym:
‘Now that I am not working anymore it was a way of getting out and I love being in
the country.’
(Noel, 34 yrs old)
‘Being surrounded by nature is what I like about it.’
(Paul, 65 yrs old)
With the Green Gym, the aim of the morning session is the conservation task in hand
not ‘how much exercise will I do by lunchtime?’. This is an example of achieving
exercise as a by-product of doing something else that is enjoyable or with purpose.
Children’s Physical Activity and Green Space
There is very strong evidence that being outdoors is the most powerful correlate of
physical activity, particularly in pre-school children136. Children’s physical activity
levels are also associated with the number of play spaces near their homes and the
amount of time children use those play spaces137.
Comparison of heart-rate response during two sessions of activity
0
50
100
150
200
Time Minutes
60
Heart Rate
Green Gym
Step aerobics
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Contact with the elements of nature - sunlight, fresh air, soil, water, plants and
animals - is a fascination for children, encouraging them to go outdoors where they
are more active. The advice from those who have designed these gardens for
children is to ‘Provide as wide a range of natural settings as possible within the
constraints of climate and available space’.
Allowing children to play freely is important to their development. A safe natural
environment allows children to exercise by exploration by jumping streams or
puddles, rolling in the grass, climbing trees or rocks, etc. Great diversity of
vegetation and wildlife with hands on planting and harvesting can keep children
interested and very active. Local green space within walking distance is therefore
vital to maintain levels of physical activity in children. Using green space for
gardening or conservation work may provide some children with physical activity as
an alternative to sport at school.
Summary
Local access to safe natural green space and attractive scenery is associated with
high levels of physical activity within communities. Research on two national
schemes show that health reasons motivate people to join, but experiencing close
contact with nature becomes the more important factor in maintain levels of physical
activity. Activities in which exercise becomes secondary to environmental or social
benefits (e.g. cycling, gardening, Green Gym, walking in green space and many
sports) appear to be more sustainable than activities in which exercise remains the
primary driver.
Children increase their physical activity levels when outdoors and are attracted to
nature. Physical activity levels benefit from living close to a green space. The
benefit from increased physical activity may be even greater in hospitals or
residential care homes. Good design of wildlife-rich gardens can be used to increase
physical activity in sedentary and vulnerable patients or residents.
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Can Biodiversity Contribute to the Promotion of
Physical Activity in a Green Space?
Biodiversity
Biodiversity is the earth’s life support system. It includes all plants, animals and
micro-organisms and the places where they live138. A recent definition of
Biodiversity89 is considered to be the most appropriate. In simplified terms, the
authors suggested that biodiversity is best considered at three levels
Genes: The number of subspecies and genetic variation
Species: The number of different species
Ecological: The number of interactions between all forms of life.
An economic value has been calculated for biodiversity in a recent DEFRA report139,
that discusses how the value of biodiversity is ultimately governed by the population
(the consumer) rather than experts. For example, a piece of land that is the habitat
of a ‘cute’ animal will hold more value to the public regardless of the view of experts.
There are two main ways a wildlife-rich value can be realised by the public:
Direct
o ‘Use value’ - This makes direct use of biodiversity. For those taking part in
physical activity this may be the sound of birdsong, flowers, the variety of
trees and the sight of birds or animals. An important motivator for
maintaining physical activity through health walks is the change of
seasons, that are be more pronounced in a wildlife-rich environment.
o ‘Passive-use value’ - This is when people care about species richness
because they care about naturalness and the knowledge that a species
will be preserved for future generations.
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Indirect.
o This is the reliance of biodiversity which people exploit in order to
produce goods and services. For example, a golf course uses the natural
processes of biodiversity in its design, such as shelter provided by trees
and pollination of flowers by insects.
Using two specific examples, in Cambridgeshire and Northumberland the value that
each local person is willing each year to pay to protect against biodiversity loss are
£45 and £38 respectively, per year. Biodiversity is hard to value, but this study
shows that people are prepared to place a value on increased biodiversity near to
where they live. In the US there are countless ballot outcomes showing people’s
willingness to be taxed for urban green spaces and for the preservation of nearby
farms and forests140.
Despite this, a lot of wildlife-rich land in the UK has been lost over this century97:
Lowland Heathland: 75% loss in England since 1800.
Downland: 50% loss in Dorset between 1950s and 1990s.
Wet Grassland: Estimated 40% loss between 1930s and 1980s.
Caledonian Pineforest: Approx 99% loss.
Upland Heath: 27% of heather moorland in England and Wales lost
between 1947 and 1980.
Ancient Woodland: 46% has been converted to plantation or agriculture
since 1946.
Lowland Meadows: 97% loss over the past 50 years.
These habitats are rich in biodiversity, and support unique and varied wildlife. The
loss should not just be measured in species and hectares, but also by the loss of
associated potential physical and mental health benefits.
The Government’s
UK Biodiversity Action Plan
141 outlines the actions needed to
protect and enhance wildlife in the UK. It includes actions for creating open-country
habitats. The RSPB’s
Futurescapes
142 goes further, arguing that the relatively
modest BAP targets should be raised: it presents a vision for large-scale habitat
recreation to enhance wildlife, the natural environment, and people’s quality of life.
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In the context of this report, the value of these habitats to human health can be
measured by the loss of potential physical activity. This may be from day trips with
the family to a walk, cycle or horse ride, if situated close by. The family day trip is
important as it introduces children to outdoor exercise, which if maintained through
childhood, is more likely to remain with them into adulthood.
Nature
In the DTLR report, ‘
Improving Urban Parks, Play Areas and Green Spaces’
99, all the
focus groups, right across the spectrum of underrepresented groups, spoke of the
opportunities that their local green spaces offered for contact with nature. This
included ‘the value of experiencing wildlife, nature, the changing scenery, flowers
and the environment in general’. The attraction of the park is related to the ‘variety
of nature’ or biodiversity. As 80% use the park for some kind of physical activity and
many who come to relax will have walked, then exercise becomes a means to enjoy
the close contact with nature.
So the health of the natural environment can be connected to human health.
Increasing the diversity of the landscape must also become a health issue. Below are
two examples of the reversal of the decline in some sensitive habitats in which
human health has been acknowledged as a major benefit.
‘At Wicken Fen the National Trust is expanding their property, aiming to acquire
3,700 ha of neighbouring farmland for biodiversity and a green lung for the people of
Cambridge and Newmarket’.
97
‘Close to Leeds, Wakefield, Castleford, Pontefract and Selby is an area of former
coal workings. Next to it are a power station, a chemical works, a railway and a trunk
road. Yet the RSPB has created a reserve that is home to large numbers of birds,
and at the same time is a gateway for local people to experience the beauty and
wonder of wildlife and wild places, close to these big urban areas.’
142
Summary
Biodiversity can have a ‘direct use-value’ on those engaging in physical activity.
Being in the countryside is an important motivator but this is due to variety both by
time (seasons) and space (biodiversity). The more wildlife-rich the green space, the
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more varied it is perceived as being. People put a value on biodiversity and the
significant public support enjoyed by conservation organisations in the UK
demonstrates widespread support for maintaining biodiversity. UK Government plans
to do this through habitat restoration and creation are described in the UK
Biodiversity Action Plan’ 141.
Use surveys show that one measure of the attractiveness of a green space is the
amount of nature it can offer to the visitor, and this is the main reason why someone
would chose to use a park that is not their closest park. Exercise has been shown to
be simply a method of travelling to, and engaging with, the benefits of nature.
Nature is a major motivating factor for exercise.
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How Can a Wildlife-Rich Green Space Be Managed to
Promote Activity and Increase Public Health?
Why Do People Choose Green Space?
This report has found that there are two ways that green space can increase levels
of physical activity:
1. Green space is a destination within walking or cycling distance.
2. Physical activity (e.g. walking, cycling) within a green space adds value to the
experience of a natural setting.
It appears that the reward of visiting a green space is primarily the emotional well-
being generated by both the green space itself and the physical activity involved in
reaching the destination or fully experiencing the space.
Improving Green Space to Increase Emotional Well-being
Restoration from stress is perceived as the most consistently important benefit of a
natural setting. This may be due to social support, physical activity and temporary
escape. However, viewing nature appears to provide the most benefit. A study in
Sweden using EEGs (Electroencephalogram) to measure brain activity demonstrated
that a view of nature was significantly more effective than a view of buildings in
eliciting a relaxed yet wakeful state143.
After watching videos of nature or buildings, patients who were stressed showed a
significantly faster recovery, as measured by blood pressure, muscle tension and skin
conductance, with the nature videos compared to those with buildings videos. The
recovery effect peaked within 3-4 minutes. Other ratings suggested that the nature
settings produced significantly higher levels of positive feelings and lower levels of
fear and anger144.
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How Can Green Space Be Improved to Increase Emotional Well-being?
Much research has looked into peoples’ preferences for outdoor scenery. Overall,
people do not prefer to look at large, wide-open spaces devoid of trees. There is a
widespread preference for ‘natural’ scenes that are moderately complex yet
coherently organised and include large trees, maintained ground areas, smooth
ground cover, and where buildings do not dominate145.
Users of an arboretum near Chicago146 also perceived specific features such as lush
vegetation, large trees, flowers and openness as particularly restful. Vegetation,
water, and savannalike qualities such as scattered trees, grass and spatial openness
were perceived as particularly restful amongst urban park users147.
The ideal park was determined by focus groups to include99:
Variety: its good to have many different experiences, meadows, formal areas,
water
Vegetation: trees, greenery and flowers
Water: fountains, lakes, ponds, streams and waterfalls
Sensory stimulation: scent, colour
Opportunities for play
Provision for young people
Comfort: seating, shelters and toilets
Lack of urban noise
The design of green space to attract people can be summarised using evidence from
the two most eminent research groups who have studied this area in depth. This
design takes into account the emotional attractiveness of a green space4 145 148. In a
green space people prefer:
Many separate elements (Complexity, wildlife-rich)
‘A focal point and other order or patterning.’ (Coherence)
‘Moderate to high level of depth that is clearly defined’ (Legibility i.e. landmarks
are clear and easy to follow)
The ground is smooth and looks like people could move through it, which
involves having ‘lush, grassy or herbaceous ground covers’. (Accessibility)
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‘A defected or curving sightline is present, conveying a sense that the new
landscape information lies immediately beyond the observer’s visual bounds’
(Mystery – they want to explore)
‘There is little in the way of perceived threat’ (Safety)
There is water.
Improving Green Space to Increase Levels of Physical Activity
Studies in Australia concluded that parks are more likely to stimulate physical activity
if they are aesthetically pleasing and have tree lined walking paths rather than empty
open space149. This is backed up by a 2003 UK survey of 2,000 adults that found that
the most important reasons for choosing to visit a park which was not the nearest
was that it was attractive (21%), it was well maintained (17%), the setting (14%)
and its flora and fauna (11%)150.
In Australia, local people believed that most park or recreation land was set up for
organised team sports, but the majority of residents preferred unstructured activities
such as walking and cycling. Space for physical activity was available, but it was not
appropriately designed151.
The evidence suggests that people are satisfied with walking through small, well-
designed parks with views on larger areas that may support more sensitive
habitats36. In other words, biodiversity and humans can co-exist by good design and
using the view rather than increased access to areas that are sensitive.
Improving Rights of Way to Increase Physical Activity Levels
Paths and cycle routes are used for purpose or pleasure. In rural areas, footpaths
often provide the only opportunity for walking, and therefore are as important as
urban parks in promoting physical activity. They can only be correctly laid out by
extensive public consultation. At present many paths have dead ends or lead to
places that have since disappeared or become less important. This means that they
are unsuitable for purpose and by not providing a circular route, are less likely to be
suitable for pleasure.
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Research in Cheshire found the reasons most people did not use footpaths were:
Personal safety: personal attack or worry that there may be a medical
emergency
Terrain: Lack of knowledge about the terrain puts people off particularly with
joint and balance problems and low levels of fitness.
Uneven Surface/soft hard surfaces
Steep Hills
Obstacles e.g. stiles
Poor maintenance of paths and hedges
Facilities on route e.g. toilets and benches.
Right of Way Improvement Plans will be implemented in England from 2005. This is
an opportunity to allow the public access to areas of the countryside currently
inaccessible such as watersides, coast, woodland and viewpoints. New rights of way
can allow people to travel between destinations without having to use the road.
Importantly they can link existing footpaths or bridleways to create a circular route
with a variety of landscapes152. Local access forums have been set up following the
Countryside and Rights of Way Act 2000 to gather data including advice on the
extent to which local rights of way meet the present and likely future needs of the
public. There is also the opportunity, which has yet to be taken up, of including an
NHS representative in the forum.
Based on the available evidence, an ideal circular walk:
Is between about 2 and 3km.
Is local and accessible (clear signs and an area for parking or the ability to
walk to, and join any part of the walk).
Is mainly flat with any gradients being slight.
Has a firm surface with no obstructions such as stiles, mud or overgrowth.
Has a path wide enough for a wheelchair or pushchair.
Has at least one landmark of interest that can act as a focal point.
Has a variety of natural vegetation, wildlife and views that provide continuous
and changing interest.
Has contrasting environments which break up the walk into several sections
Is well promoted.
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Feels safe with good visibility adjacent to the walk.
Is maintained to a high standard.
Local Access
Much of the evidence has indicated that opportunities for physical activity must be
local to the population, literally on the doorstep. Local access is one of the key
motivating factors for people to carry on with health walks. 20% of those who do not
use parks state that being too far away is the main barrier99 Being overweight or
obese is associated with poor local access to open space or not being within walking
distance (5 minute drive) of a cycle or footpath153, and those who are unable to walk
to a public park within 10 mins are less likely to meet physical activity targets154.
Linking areas of green space together particularly between town and country has
been actively promoted by the Countryside Agency as greenways or green corridors,
which can increase access to green space. For example, a town park may be linked
to the urban edge by a green corridor combining woodland, semi-natural grassland,
a cemetery, a linear green space along a river or canal, or an area of farmland. This
can serve as a wildlife corridor, a passage for walking or cycling, a landscape feature
and a strategic break between developments. It may also contain a linked series of
footpaths or parks, which can become a nature trail99.
Recommendations from the UK Man and the Biosphere Urban Forum and English
Nature advise that there should be standards for access to urban green space155.
These standards are:
An urban resident should be able to enter an urban green space of at least 2 ha
within 0.5km of their home. (For children 280 metres is the threshold in which
parents feel able to let their children visit this space on their own)
Provision should be made for Local Nature Reserves in every urban area at the
minimum level of 1 ha per 1,000 population.
In addition there should be
1 x 20 ha site within 2 km of all residents
1 x 100 ha site within 5 km of all residents
1 x 500 ha site within 10km of all residents
Natural Fit Report for the RSPB. Dr William Bird
63
The Institute of Leisure and Amenity Management (ILAM) define a four level
hierarchy of parks:
1. Principal Park of more than 8 hectares with a city wide catchment area
2. District Park of up to 8 hectares with a catchment area from 1.5 to 2 km.
3. Neighbourhood Park of up to 4 hectares serving a catchment area of between 1
to 1.5 km.
4. Local Park up to 1.2 hectares serving a catchment area of between 0.5 and 1 km.
These definitions and recommendations have not been devised with respect to
physical activity needs and so there remains an opportunity for future
recommendations.
Overgrowth, Mud and Stiles
A good firm walking surface is important both for safety and to allow an ideal
walking speed. This may be grass, but with firm alternatives if the paths get muddy.
There should be encouragement to build hard paths within wild natural landscapes to
allow more people access to experience nature. It is important that paths have some
signs to aid direction.
In one questionnaire, 30% of respondents found that overgrown vegetation (e.g.
stinging nettles) was either a slight or significant problem. Women were twice as
likely to find it a deterrent. Mud was less of a barrier with only 9% of men and 18%
of women stating that it prevented them from walking as much as they would like in
the countryside156.
Stiles are frequently found on some footpaths and are a significant problem. 43% of
those over 70 years cannot climb a stile with ease. Of this age group, 66% had not
climbed a stile within 6 months compared to 30% in the 51-70yrs group and 23% in
the under 50s.
Keeping Local Green Space in the Public Eye
A park, reserve or any green space will only reach its full value if promoted. There
needs to be a concerted marketing effort to motivate those who rarely take any
exercise outside. The young are neither motivated nor are knowledgeable about
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64
where to walk (Figures 9 & 10). Promoting local green space is likely to benefit from
a more wildlife-rich environment which will have something worth visiting for every
season of the year (e.g. bluebells, birdsong in spring, leaves turning in the autumn,
etc). These may appear obvious but they provide excellent marketing opportunities
to increase awareness of local footpaths, nature reserves and parks at different times
of year.
Lack of motivation or interest being a factor in preventing walking in the
countryside
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
11-30 31-50 51-70 71+
Age Ba nd
Significant problem
Slight problem
Not a problem
Figure 9: Percentage of respondents by age who find ‘lack of
motivation or interest’ prevents them walking in the countryside.
Don't know where to walk
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
11-30 31-50 51-70 71+
Age Band
Significant problem
Slight problem
Not a problem
Figure 10: Percentage of respondents by age who find ‘Don’t know where to walk’
from preventing them walking in the countryside as much as they would like.
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65
Safety
Any exercise within a green space can be a concern among women who want to
walk on their own. Figure 11 shows that 73% of women find walking alone in the
countryside a problem. In a questionnaire for local parks, 49% of women said that
safety fears put them off from using urban green spaces; this is ranked third after
dog mess and vandalism. This is a major barrier to increase access to rural and
urban green space and increase physical activity.
Parks are perceived as risky when they are more densely vegetated, particularly
when it is not maintained157. Park wardens are a possible solution and their cost
would be worthwhile compared to the health savings if they were to increase the
number of people using the area.
Feeling vulnerable when alone
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
11-30 31-50 51-70 71+ Women Men
Age and Sex
Significant problem
Slight problem
Not a problem
Figure 11: Percentage of respondents by age who find ‘Feeling vulnerable
when alone’ prevents them from walking in the countryside.
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66
Quality of green space
The Green Flag Awards were launched in 1996 to encourage the provision of good
quality public parks and green spaces that are managed in environmentally
sustainable ways. The Award has achieved a 58% year on year growth in
applications leading to 240 applications in 2003 of which 182 were judged to be of a
high enough standard to win a green flag. In addition, the Green Pennant Awards
introduced in 2002 to recognise high quality green spaces in England and Wales that
are managed by voluntary and community groups. They are run by the Civic Trust
with majority funding from CABE Space. There are eight criteria158:
A welcoming park: Good and safe access
A healthy, safe and secure park: The park must be a secure place for all
members of the community to use or traverse
A clean and well maintained park: A policy on litter, vandalism and
maintenance should be in place, in practice and regularly reviewed
Sustainability: Pesticides should be minimised and peat eliminated
Conservation and heritage: Attention should be paid to the conversation of
natural features, wildlife and flora
Community involvement: Park management should actively pursue the
involvement of members of the community, with representation of as many park
user groups as possible
Marketing: Good provision of information to users and effective promotion of
the park as a community resource
Management: Clear objectives which can identify the contribution the site is
making to an area.
This list has been developed looking at many aspects that are important to people’s
view. However, opportunities for physical activity are not specifically addressed.
Summary
To increase physical activity levels in a green space it should be local (less than
2km), with a good surface, no obstructions such as stiles and, above all, it must feel
safe to users. There need to be imaginative ways to promote a wildlife-rich green
space, and market it to different age groups. The green space must appear
attractive. This has now been well defined as ‘natural but well kept’, which means
Natural Fit Report for the RSPB. Dr William Bird
67
that it is wildlife-rich, but facilities and access routes are well maintained. It is
possible to have sensitive wildlife-rich areas visible from smaller well-kept areas, as
the view of nature is a main motivating factor.
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68
Appendix 1. The Economic Benefit of Green Space and
Physical Activity
It is possible to model the approximate value that Green Space can offer by its ability
to support physical activity within a community. However, there are many
assumptions; where possible these have been treated conservatively.
This model provides a rough estimate to illustrate the potential value that green
space and footpaths could provide given our current state of knowledge. Even if
more accurate data resulted in a reduction of the current estimates, the figures are
likely to remain surprisingly high. This highlights how green space and public rights
of way have been undervalued in the past.
These estimates make no allowance for the non-linear relationship between inactivity
and health benefits, although this would add value to less frequent users of green
space and may increase the overall benefit. There has also been no profile of users
of green space to determine whether they are already fulfilling their exercise
elsewhere. There has been no adjustment for age, sex and socio-economic profiles
of individual users, although again this may add benefit since the highest values are
in the most densely populated and most deprived areas.
The final figures are unlikely to be appropriate to all the areas in England as there
are considerable regional and local variations in activity and quality of green space.
However, these figures may be used as a guide to the potential of available green
space.
More research is urgently needed to create a more robust model.
This report has identified the cost of physical inactivity, calculated by the Cabinet
Office Strategy Unit, as £8.2 billion/yr. The following analysis estimates the
proportion of physical activity that green space (a public park and a circular walk)
can contribute to the total amount of physical activity undertaken. It then estimates
the economic benefit of this physical activity. To do this, the following questions
need to be answered:
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69
A. How many visits to the park does the local population make?
B. How many of these visits involve exercise?
C. How many of these ‘exercise visits’ fulfil 30 minutes of moderate exercise?
D. What is the catchment area covered by the park?
(With a similar set of calculations undertaken for a footpath)
E. What is the population density?
F. What is the cost of inactivity in the population?
A. How many visits to the park does the local population make?
The report ‘
Use of public parks in England
2003’ 150, shows the frequency of visits to
a public park:
Daily More than once
a week
Weekly Fortnightly Monthly
10% 20% 16% 8% 13%
Table 4: Percentage of the local population visiting a public park.
From this the number of days of exercise for the local population can be estimated.
The full exercise requirement is participation in exercise 5 days a week.
Frequency of
Visits
% of
population
Assumed no.
of visits per
week
% of exercise
days required
% of total population’s
required exercise days
Daily 10% Over 5 100% 10%
More than once a
week
20% 3 60% 12%
Weekly 16% 1 20% 3.2%
Fortnightly 8% 0.5 10% 0.8%
Monthly 13% 0.23 5% 0.6%
Total 27%
Table 5: The contribution of a public park to physical exercise.
The park could therefore contribute about 27% of the recommended number of days
of exercise for the local population.
B. How many of these visits involve exercise?
Between 60% and 75% of people used parks solely for walking, and 6-11% used the
space for sport, 15-23% for dog walking and 26% for any informal activity (these
are not mutually exclusive as each person may state several reasons why they go to
the park). From the survey, ‘
Park Life’
98 it was found that about 70% of people
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70
walked to the park. For a park situated within 1 mile of them, 87% of people walk to
the park and 90% of these walkers take less than 20 minutes to get there. So even
those that use a park to sit and relax take some exercise in getting there and back.
Taking into account that about 80% use the parks for some form of exercise and
87% walk to a park within one mile, we will conservatively assume that 90% of
users gain some exercise on their visit.
C. How many of these ‘exercise visits’ fulfil 30 minutes of moderate exercise?
Not everyone who is exercising will have the full 30 minutes of moderate exercise.
However, the average time spent in a park visit is between 1-2 hours with only 12%
using it for less than 30 minutes. One research group covertly observed walking
speeds of those using the park for walking and found that when the same speed was
recreated on a treadmill it fulfilled the criteria of ‘moderate exercise’159. From this it is
estimated that about 80% of users who have exercised in the park will have had the
full benefit of 30 minutes of physical activity.
The total amount of physical activity supported by the urban park is therefore:
27% of the recommended 5 days a week
90% of these days involve exercise
80% of this exercise is 30 minutes of moderate exercise
The total amount of physical activity provided by an urban park within 2km of a local
population is 27% x 0.9 x 0.8 = 19.4%. For ease of estimation, we will round this
up to 20%.
D. What is the catchment area covered by the park?
English Nature recommendations are for a 20 ha public green space within 2km of
every person or the 8 hectares per 2km which defines a district park 155 99. The
catchment area within 2 km of a 20 ha park is approximately 16 km2.
The Health and Economic Benefit of a 3km Circular Walk
The activity-use estimation for a park (C above) can also be made for a circular walk:
The Sonning Common Survey156 of 350 residents demonstrated that 11% of
residents in a semi-rural village had used a footpath over 7 times in 2 weeks. This is
Natural Fit Report for the RSPB. Dr William Bird
71
not a representative sample of the population, but data in this area is very limited, so
it will be used to guide the analysis for a footpath.
The rate of footpath use was:
More than six in
two weeks
4-6 in two
weeks
1-3 in two
weeks
None
11% 10% 32% 47%
Table 6: % of participants who used a footpath to visit the countryside156.
From this, the contribution of the footpath to the total physical activity needs of the
local population can be estimated. For full exercise participation of 5 days a week,
the total number of visits for the population is 10 sessions in two weeks.
Frequency of
Visits
% of
Population
Assumed no
of visits per
two weeks
% of full exercise
requirement (of 10
visits in 2 weeks)
% of total physical
activity need for the
local populations
More than six in
two weeks
11% 8 80% 8.8%
4-6 in two weeks 10% 4 40% 4%
1-3 in two weeks 32% 1 10% 3.2%
Total 16%
Table 7: The contribution of a public footpath to the physical exercise requirement
of a local population.
The footpath can therefore contribute to 16% of the total physical activity needs
for the population within 1km. The economic benefit of local 3km circular walk would
look at the population living within 1 km of a footpath; the 3km circular walk would
have a radius of 0.5 km, and the catchment area will extend a further 1 km beyond
that, giving a circular catchment area with a radius of 1.5 km. This catchment will
have a total area of 7 km2. One can make the assumption (rightly or wrongly), that
all those using the footpath took 30 minutes of moderate exercise.
E. What is the population density?
The Office of National Statistics calculates population densities for each local
authority, which can be used to estimate the number of people in the catchment
area.
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72
F. What is the cost of inactivity in the population in England?
Using figures on levels of physical activity in England12 and the percentage who are
totally inactive16, the population’s rate of physical activity can be calculated. As
before, physical activity is assumed as 30 minutes, 5 days a week (or 260 days each
year).
Number of days physical
activity
% of
population
% of physical activity
requirement
Total contribution to
physical activity
5 days a week 30% 100% 30%
1-4 days a week
(assume 2 days)
32% 40% 13%
Less than 1 day a week
(assume 1 day a fortnight)
14% 10% 1%
Totally inactive 24% 0% 0%
Total 44%
Table 8: Percentage of Physical Activity Undertaken in England
In England, the population is only undertaking 44% of its physical activity needs,
therefore the inactivity rate in the population is 56%. As the relationship between
physical activity and health benefits is not linear, the difference between 0 and 1 day
of exercise a week will provide significantly more benefit than the difference between
4 and 5 days. This is likely to lead to an underestimate of benefit. The Cabinet
Office calculates that the cost of inactivity in England is £8.2 billion for the economy
and £1.7 billion for the NHS. This is for an England population of 50 million, who as a
whole are undertaking only 44% of the physical activity target of 30mins 5 days a
week. For this model, this is equivalent to 56% of the population being inactive.
Therefore, the cost to the economy of physical inactivity is £293 per inactive person,
including £61 costs to the NHS.
The Potential Value of the Green Space for Physical Activity
The potential value of the contribution of green space in supporting physical activity
can be estimated as the costs saved from avoided inactivity.
The estimated current contribution from an urban park to its catchment population’s
physical activity is 20%, and for footpaths it is 16%. The number of people using the
green space for physical activity is dependent on the population density in the
Natural Fit Report for the RSPB. Dr William Bird
73
relevant catchment area of the green space. The estimated physical activity value for
a green space with a catchment of 1,000 people is shown in table 9 below.
Green Space with catchment of 1,000 people
Park Circular Footpath
Population’s physical activity supported 20% 16%
Number of people’s activity supported 200 160
Potential Value per person
To NHS £61 £61
To Economy £293 £293
Total Potential Value in Catchment of 1,000 people
To NHS £12,200 £9,760
To Economy £58,600 £46,880
Table 9: Value of physical activity supported by green space.
Using population densities from the Office of National Statistics and the area that is
served by the park (16 km2) or circular walk (7km2), the total population potentially
benefiting from a green space can be estimated. A value can be put on this in the
same way as in table 9 above. Representative values for an urban park and a rural
footpath are shown in tables 10 and 11 below.
Potential value of physical activity when 20% of population within 2km use a 8-20 hectare
green space to reach their activity target of 30 mins 5 days a week
Urban Area Population Density
(population/Sq km)
Potential Saving to
Economy, £000s
Potential Saving to
NHS, £000s
Inner London 9,297 8,717 1,815
Portsmouth 4,671 4,380 912
Manchester 3,652 3,424 713
Newcastle 2,294 2,151 448
Edinburgh 1,699 1,593 332
Table 10: Value from physical activity in 20 hectares of urban green space
The potential value of an urban park, in terms of avoided inactivity, is estimated for
a selection of UK cities at between £1.6 million and £8.7 million to the national
economy, including £0.3 million to £1.8 million to the NHS. The large ranges reflect
the different population densities examined.
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74
Potential value of physical activity when 16% of population within 1 km use a 3 km footpath to
reach their activity target of 30 mins 5 days a week
Area Population Density
(population/Sq km)
Potential Saving to
Economy, £000s
Potential Saving to
NHS, £000s
Norwich 3,117 1,023 213
Middlesborough 2,485 815 170
Wirral 1,975 648 135
Surrey Heath 838 275 57
West Lancashire 313 103 21
Table 11: Value from physical activity on a 3km footpath.
The potential value of a 3 km footpath, in terms of avoided inactivity, is estimated
for a selection of UK areas at between £0.1 million and £1 million to the national
economy, including £21 thousand to £213 thousand to the NHS. The large ranges
reflect the different population densities examined.
A full list of local authority areas, showing the estimated potential values for a 8-20
ha green space and a 3km footpath, are shown in appendix 2. There is considerable
evidence linking poor health with low incomes and unemployment. The number of
people in these groups in certain local authority areas, who could hypothetically
benefit from access to green space, are also shown in appendix 2.
Reality Check
The recommended area of green space where population densities are high is a 20ha
green space within 2 km of the population. This would serve a catchment area within
2 km of the space. If the green space was square, this would be approximately 16
km2. Taking a population density of 3,500 per sq km (which is exceeded in only a
few cities outside London), this catchment would contain approximately 56,000
people. Physical activity is supported amongst 20% of these; 11,200 people. They
each would use the site 5 times per week, (meaning about 8,000 per day) for 30
minutes. If you take 10 hrs in the day, this gives 20 periods of 30 minutes, this
implies 400 people per 30 minutes. If people walk in pairs (on average), then 200
pairs of people will use the park for physical activity at any one time.
In a 20 ha (50 acre) green space, this would mean 10 pairs of people per ha (or 4
pairs per acre). This is a relatively high density of people, but is realistic. It is
maximum estimate, as:
Natural Fit Report for the RSPB. Dr William Bird
75
It is based on the maximum population density in most urban areas, at such
high densities, more green space than a site within 2km of everyone would
be beneficial.
People get exercise in travelling to and from the green space, therefore, not
all will need to spend 30 minutes using the space.
If the demand for use of the green space is higher, the area available for
activity can be increased, by increasing the length of footpath available, or
creating open space (e.g. lawns).
The density of people may also be an underestimate, because use of the green
space may not be evenly spread through the day, resulting in higher use of the
green space at peak times. It is assumed that these under and over-estimating
factors roughly balance with each other.
Summary
It is possible to estimate the potential economic benefits that green space can
provide through provision of physical activity. The estimations are based on an urban
park providing 20% of total physical activity needs and a 3km footpath providing
16% of total physical activity needs. Each year a park in Portsmouth could potentially
save the economy £4.4 million, including £910,00 to the NHS. A 3 km footpath on
the edge of Norwich could potentially save the economy £1 million, including
£210,00 to the NHS.
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76
Appendix 2. Potential Green Space Values, Unemployment
and Income Deprivation per 20 ha Green Space by Local
Authority Area.
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77
Potential Cost Savings, £ 000’s per year
URBAN PARKS 3KM FOOTPATH
Local Authority Area
Area
(sq km)
People per
sq. km
to Economy to NHS to Economy to NHS
Kensington and Chelsea 12 13,609 10,660 2,210 3,498 725
Islington 15 12,181 9,541 1,978 3,131 649
Hackney 19 11,027 8,637 1,791 2,834 588
Hammersmith and Fulham 16 10,566 8,276 1,716 2,716 563
Tower Hamlets 20 10,462 8,195 1,699 2,689 557
Lambeth 27 10,136 7,939 1,646 2,605 540
Camden 22 9,498 7,440 1,542 2,441 506
Westminster 21 8,875 6,952 1,441 2,281 473
Southwark 29 8,710 6,822 1,414 2,239 464
Wandsworth 34 7,859 6,156 1,276 2,020 419
Haringey 30 7,609 5,960 1,236 1,956 405
Lewisham 35 7,220 5,655 1,172 1,856 385
Newham 36 7,013 5,493 1,139 1,802 374
Brent 43 6,302 4,936 1,023 1,620 336
Waltham Forest 39 5,751 4,505 934 1,478 306
Ealing 56 5,554 4,350 902 1,427 296
Merton 38 5,112 4,004 830 1,314 272
Greenwich 47 4,677 3,663 759 1,202 249
Portsmouth UA 40 4,671 3,659 758 1,201 249
Barking and Dagenham 36 4,636 3,631 753 1,192 247
Southampton UA 50 4,438 3,476 721 1,141 236
Redbridge 56 4,326 3,388 702 1,112 231
Luton UA 43 4,295 3,364 697 1,104 229
Harrow 50 4,193 3,284 681 1,078 223
Sutton 44 4,126 3,232 670 1,060 220
Blackpool UA 35 4,065 3,184 660 1,045 217
Kingston upon Thames 37 4,031 3,157 655 1,036 215
Liverpool 112 3,947 3,092 641 1,014 210
Croydon 87 3,890 3,047 632 1,000 207
Hounslow 56 3,870 3,031 628 995 206
Leicester UA 73 3,868 3,030 628 994 206
Southend-on-Sea UA 42 3,802 2,978 617 977 203
Watford 21 3,751 2,938 609 964 200
Slough UA 33 3,725 2,918 605 957 198
Birmingham 268 3,697 2,896 600 950 197
Barnet 87 3,694 2,893 600 949 197
Manchester 116 3,652 2,861 593 939 195
Nottingham UA 75 3,619 2,835 588 930 193
Bexley 61 3,612 2,829 587 928 192
Reading UA 40 3,574 2,799 580 919 190
Bournemouth UA 46 3,547 2,778 576 912 189
*Note: These Local Authorities have population densities above 3,500 people per km2, the density used
for the reality check on page 74.
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78
Enfield 81 3,486 52,731 566 896 186
City of Bristol, UA 110 3,482 72,727 565 895 186
Wolverhampton 69 3,447 42,700 560 886 184
City of Kingston upon Hull,
UA
71 3,379 42,647 549 868 180
Sandwell 86 3,329 52,608 541 856 177
Norwich 39 3,117 22,441 506 801 166
Dudley 98 3,112 62,438 505 800 166
Coventry 99 3,089 62,420 502 794 165
Stevenage 26 3,068 22,403 498 789 163
Gosport 25 3,043 22,384 494 782 162
Richmond upon Thames 57 3,038 42,380 493 781 162
Brighton and Hove UA 83 3,023 52,368 491 777 161
Plymouth UA 80 3,000 52,350 487 771 160
Worthing 32 3,000 22,350 487 771 160
Ipswich 39 2,976 22,331 483 765 159
Oxford 46 2,952 32,312 479 759 157
Hastings 30 2,886 22,261 469 742 154
Derby UA 78 2,861 52,241 465 735 152
Worcester 33 2,801 22,194 455 720 149
Gloucester 41 2,727 32,136 443 701 145
Cambridge 41 2,719 32,130 442 699 145
Harlow 31 2,572 22,015 418 661 137
Stoke-on-Trent UA 93 2,553 62,000 415 656 136
Middlesbrough UA 54 2,485 31,946 404 639 132
Walsall 104 2,428 71,902 394 624 129
Tamworth 31 2,418 21,894 393 621 129
Oadby and Wigston 24 2,411 21,888 392 620 128
Lincoln 36 2,408 21,886 391 619 128
Northampton 81 2,404 51,883 390 618 128
South Tyneside 64 2,365 41,852 384 608 126
Exeter 47 2,363 31,851 384 607 126
Cheltenham 47 2,360 31,849 383 607 126
North Tyneside 82 2,321 51,818 377 597 124
Rushmoor 39 2,320 21,817 377 596 124
Newcastle-upon-Tyne 113 2,294 71,797 373 590 122
Stockport 126 2,246 81,759 365 577 120
Salford 97 2,224 61,742 361 572 119
Crawley 45 2,219 31,738 360 570 118
Hillingdon 116 2,131 71,669 346 548 114
Poole UA 65 2,130 41,668 346 547 113
Havant 55 2,103 31,647 341 540 112
Torbay UA 63 2,081 41,630 338 535 111
Tameside 103 2,063 61,616 335 530 110
Eastbourne 44 2,055 31,610 334 528 109
Sunderland 137 2,030 91,590 330 522 108
Spelthorne 45 1,998 31,565 324 514 106
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79
Havering 112 1,997 71,564 324 513 106
Trafford 106 1,978 71,549 321 508 105
Bromley 150 1,977 91,549 321 508 105
Wirral 157 1,975 10 1,547 321 508 105
Epsom and Ewell 34 1,960 21,535 318 504 104
Castle Point 45 1,935 31,516 314 497 103
Bolton 140 1,871 91,466 304 481 100
Sefton 153 1,840 10 1,441 299 473 98
Bury 99 1,823 61,428 296 469 97
Knowsley 86 1,745 51,367 283 448 93
Broxbourne 51 1,701 31,332 276 437 91
Wigan 188 1,603 12 1,256 260 412 85
Weymouth and Portland 42 1,539 31,205 250 396 82
Oldham 142 1,535 91,202 249 395 82
Nuneaton and Bedworth 79 1,518 51,189 246 390 81
Basildon 110 1,512 71,184 246 389 81
Chesterfield 66 1,500 41,175 244 386 80
Halton UA 79 1,494 51,170 243 384 80
Fareham 74 1,466 51,148 238 377 78
Redditch 54 1,459 31,143 237 375 78
Eastleigh 80 1,454 51,139 236 374 77
Adur 42 1,448 31,134 235 372 77
Woking 64 1,406 41,101 228 361 75
Sheffield 368 1,392 23 1,090 226 358 74
Broxtowe 80 1,345 51,054 218 346 72
Gateshead 142 1,340 91,050 218 344 71
Medway UA 192 1,307 12 1,024 212 336 70
Elmbridge 95 1,307 61,024 212 336 70
Rochdale 158 1,305 10 1,022 212 335 70
Leeds 552 1,299 35 1,017 211 334 69
St Helens 136 1,296 91,015 210 333 69
Bradford 366 1,292 23 1,012 210 332 69
Mansfield 77 1,278 51,001 208 328 68
Thanet 103 1,236 6968 201 318 66
Dartford 73 1,188 5931 193 305 63
Cannock Chase 79 1,182 5926 192 304 63
Blyth Valley 70 1,160 4909 188 298 62
Aberdeen City 186 1,127 12 883 183 290 60
Hyndburn 73 1,121 5878 182 288 60
Solihull 178 1,119 11 876 182 288 60
Warrington UA 181 1,064 11 833 173 273 57
Ashfield 110 1,043 7817 169 268 56
Blackburn with Darwen UA 137 1,018 9797 165 262 54
Runnymede 78 1,011 5792 164 260 54
Erewash 110 1,009 7790 164 259 54
Bracknell Forest UA 109 1,002 7785 163 258 53
Reigate and Banstead 129 978 8766 159 251 52
Gravesham 99 971 6761 158 250 52
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80
Kirklees 409 953 26 746 155 245 51
North Down 81 952 5746 155 245 51
Hartlepool UA 94 940 6736 153 242 50
Wakefield 339 934 21 732 152 240 50
Gedling 120 933 8731 152 240 50
Three Rivers 89 929 6728 151 239 50
South Ribble 113 926 7725 150 238 49
Hertsmere 101 924 6724 150 237 49
Ellesmere Port and Neston 88 920 6721 149 236 49
Barrow-in-Furness 78 919 5720 149 236 49
Wansbeck 67 914 4716 148 235 49
Preston 142 914 9716 148 235 49
Christchurch 50 900 3705 146 231 48
Thurrock UA 163 889 10 696 144 228 47
Stockton-on-Tees UA 204 881 13 690 143 226 47
Rotherham 287 871 18 682 141 224 46
Wokingham UA 179 845 11 662 137 217 45
Surrey Heath 95 838 6656 136 215 45
North East Lincolnshire UA 192 824 12 645 134 212 44
Burnley 111 804 7630 131 207 43
St Albans 161 800 10 627 130 206 43
Chester-le-Street 68 788 4617 128 203 42
Swindon UA 230 785 14 615 127 202 42
Castlereagh 85 780 5611 127 200 42
Welwyn Hatfield 130 751 8588 122 193 40
Newport 190 729 12 571 118 187 39
Torfaen 126 723 8566 117 186 39
Blaby 130 702 8550 114 180 37
North Lanarkshire 470 684 29 536 111 176 36
Milton Keynes UA 309 682 19 534 111 175 36
Windsor and Maidenhead UA 197 678 12 531 110 174 36
York UA 272 670 17 525 109 172 36
Corby 80 669 5524 109 172 36
Barnsley 329 662 21 519 107 170 35
Renfrewshire 261 659 16 516 107 169 35
Dacorum 212 650 13 509 106 167 35
Easington 145 648 9508 105 167 35
Arun 221 643 14 504 104 165 34
Blaenau Gwent 109 638 7500 104 164 34
East Dunbartonshire 175 615 11 482 100 158 33
Caerphilly 278 613 17 480 100 158 33
Swansea 378 591 24 463 96 152 31
West Dunbartonshire 159 584 10 457 95 150 31
Newcastle-under-Lyme 211 579 13 454 94 149 31
Redcar and Cleveland UA 245 569 15 446 92 146 30
Telford and Wrekin UA 290 553 18 433 90 142 29
Charnwood 279 550 17 431 89 141 29
Rhondda, Cynon, Taff 424 545 27 427 88 140 29
Natural Fit Report for the RSPB. Dr William Bird
81
Pendle 169 533 11 417 87 137 28
South Bedfordshire 213 533 13 417 87 137 28
Newtownabbey 151 532 9417 86 137 28
Calderdale 364 531 23 416 86 136 28
Great Yarmouth 174 526 11 412 85 135 28
Inverclyde 160 521 10 408 85 134 28
East Renfrewshire 174 516 11 404 84 133 27
Bridgend 251 514 16 403 83 132 27
North Somerset UA 374 507 23 397 82 130 27
Doncaster 568 506 36 396 82 130 27
Merthyr Tydfil 111 504 7395 82 130 27
Chorley 203 500 13 392 81 129 27
Wyre Forest 195 498 12 390 81 128 27
Wycombe 325 497 20 389 81 128 26
Darlington UA 496 0389 81 127 26
South Gloucestershire UA 496 0389 81 127 26
Bath and North East
Somerset UA
491 0385 80 126 26
Falkirk 297 490 19 384 80 126 26
Rossendale 138 477 9374 77 123 25
Guildford 271 476 17 373 77 122 25
Colchester 329 472 21 370 77 121 25
Carrickfergus 81 472 5370 77 121 25
Durham 187 470 12 368 76 121 25
Rochford 169 468 11 367 76 120 25
Chelmsford 339 465 21 364 76 120 25
Peterborough UA 343 460 21 360 75 118 25
Wellingborough 163 453 10 355 74 116 24
Warwick 283 453 18 355 74 116 24
Tonbridge and Malling 240 453 15 355 74 116 24
Bolsover 160 452 10 354 73 116 24
Chiltern 196 451 12 353 73 116 24
Brentwood 153 448 10 351 73 115 24
Fylde 166 447 10 350 73 115 24
Amber Valley 265 441 17 345 72 113 23
Canterbury 309 440 19 345 71 113 23
South Buckinghamshire 141 437 9342 71 112 23
Congleton 211 432 13 338 70 111 23
Tendring 338 415 21 325 67 107 22
Bromsgrove 217 412 14 323 67 106 22
Sedgefield 217 399 14 313 65 103 21
Hart 215 391 13 306 63 100 21
Mid Sussex 334 381 21 298 62 98 20
Wyre 283 378 18 296 61 97 20
West Lothian 427 374 27 293 61 96 20
The Vale of Glamorgan 331 363 21 284 59 93 19
Epping Forest 339 358 21 280 58 92 19
Kettering 233 355 15 278 58 91 19
Natural Fit Report for the RSPB. Dr William Bird
82
Isle of Wight UA 380 355 24 278 58 91 19
Maidstone 393 355 25 278 58 91 19
North East Derbyshire 276 352 17 276 57 90 19
Flintshire 438 341 27 267 55 88 18
Hinckley and Bosworth 297 339 19 266 55 87 18
Swale 373 336 23 263 55 86 18
Waverley 345 336 22 263 55 86 18
Dover 315 333 20 261 54 86 18
Vale Royal 380 324 24 254 53 83 17
Tandridge 248 321 16 251 52 83 17
Lewes 292 319 18 250 52 82 17
North Hertfordshire 375 315 23 247 51 81 17
Derwentside 271 314 17 246 51 81 17
West Lancashire 347 313 22 245 51 80 17
Bedford 476 313 30 245 51 80 17
Tunbridge Wells 331 313 21 245 51 80 17
Mole Valley 258 311 16 244 51 80 17
North West Leicestershire 279 310 17 243 50 80 17
Waveney 370 306 23 240 50 79 16
Neath Port Talbot 441 305 28 239 50 78 16
Clackmannanshire 159 302 10 237 49 78 16
Sevenoaks 369 294 23 230 48 76 16
Craigavon 282 290 18 227 47 75 15
Macclesfield 525 285 33 223 46 73 15
Lichfield 331 281 21 220 46 72 15
Derry 381 279 24 219 45 72 15
East Hertfordshire 476 273 30 214 44 70 15
Shepway 357 271 22 212 44 70 14
East Staffordshire 387 270 24 211 44 69 14
Chester 448 265 28 208 43 68 14
Fife 1,325 265 83 208 43 68 14
South Staffordshire 407 261 25 204 42 67 14
Crewe and Nantwich 430 259 27 203 42 67 14
Rushcliffe 409 259 26 203 42 67 14
Wrexham 504 257 32 201 42 66 14
Rugby 351 253 22 198 41 65 13
South Derbyshire 338 248 21 194 40 64 13
Lisburn 447 245 28 192 40 63 13
Mid Bedfordshire 503 243 31 190 39 62 13
Basingstoke and Deane 634 241 40 189 39 62 13
East Dorset 354 239 22 187 39 61 13
Stroud 461 235 29 184 38 60 13
West Wiltshire 517 234 32 183 38 60 12
Lancaster 576 232 36 182 38 60 12
Horsham 530 231 33 181 38 59 12
Midlothian 354 228 22 179 37 59 12
New Forest 753 226 47 177 37 58 12
Taunton Deane 462 224 29 175 36 58 12
Natural Fit Report for the RSPB. Dr William Bird
83
Cherwell 589 222 37 174 36 57 12
North Warwickshire 284 221 18 173 36 57 12
Braintree 612 220 38 172 36 57 12
Broadland 552 216 35 169 35 56 12
Restormel 452 216 28 169 35 56 12
East Hampshire 514 213 32 167 35 55 11
Penwith 304 210 19 164 34 54 11
Vale of White Horse 578 202 36 158 33 52 11
Stafford 598 201 37 157 33 52 11
Kerrier 474 198 30 155 32 51 11
Ards 380 195 24 153 32 50 10
Carrick 458 194 29 152 32 50 10
Sedgemoor 564 191 35 150 31 49 10
South Oxfordshire 679 189 42 148 31 49 10
Tewkesbury 414 187 26 146 30 48 10
Aylesbury Vale 903 185 56 145 30 48 10
Teignbridge 674 181 42 142 29 47 10
Ashford 581 180 36 141 29 46 10
Test Valley 628 176 39 138 29 45 9
Huntingdonshire 906 174 57 136 28 45 9
Wychavon 664 172 42 135 28 44 9
South Lanarkshire 1,772 171 111 134 28 44 9
Bassetlaw 638 170 40 133 28 44 9
Maldon 359 168 22 132 27 43 9
Rother 509 168 32 132 27 43 9
Wealden 833 167 52 131 27 43 9
High Peak 539 166 34 130 27 43 9
Staffordshire Moorlands 576 165 36 129 27 42 9
Newark and Sherwood 651 164 41 128 27 42 9
North Wiltshire 768 164 48 128 27 42 9
Winchester 661 163 41 128 26 42 9
Shrewsbury and Atcham 602 159 38 125 26 41 8
South Somerset 959 158 60 124 26 41 8
Boston 362 157 23 123 25 40 8
East Devon 814 155 51 121 25 40 8
East Northamptonshire 510 154 32 121 25 40 8
Fenland 546 154 34 121 25 40 8
Forest of Dean 527 153 33 120 25 39 8
North Ayrshire 885 153 55 120 25 39 8
St Edmundsbury 657 150 41 117 24 39 8
Oswestry 256 149 16 117 24 38 8
Forest Heath 378 147 24 115 24 38 8
South Cambridgeshire 902 145 56 114 24 37 8
Babergh 594 143 37 112 23 37 8
Mendip 739 142 46 111 23 36 8
Chichester 786 136 49 107 22 35 7
West Oxfordshire 714 135 45 106 22 35 7
East Lothian 679 134 42 105 22 34 7
Natural Fit Report for the RSPB. Dr William Bird
84
South Kesteven 943 133 59 104 22 34 7
Harborough 592 132 37 103 21 34 7
Isles of Scilly 16 132 1103 21 34 7
Scarborough 817 131 51 103 21 34 7
Selby 599 130 37 102 21 33 7
South Northamptonshire 634 129 40 101 21 33 7
Suffolk Coastal 892 129 56 101 21 33 7
Malvern Hills 577 126 36 99 20 32 7
South Norfolk 908 124 57 97 20 32 7
Wear Valley 503 122 31 96 20 31 7
Caradon 664 120 42 94 19 31 6
Stratford-on-Avon 978 116 61 91 19 30 6
Antrim 421 116 26 91 19 30 6
Coleraine 486 116 30 91 19 30 6
Harrogate 1,308 115 82 90 19 30