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Time for policy to influence health

The dangers of a sedentary life have been well documented for years, but recent studies highlight the negative implications of inactivity as a stand-alone problem, says Beda Higgins.

The dangers of a sedentary life have been well documented for years linking it to obesity, but recent studies highlight the negative implications of inactivity as a stand-alone problem.

The digital era has transformed our lives but there are few jobs requiring physical activity that would satisfy the Department of Health's (DH's) recommended guidelines of at least 12 sessions of moderate exercise over a month.

It is a mushrooming problem, dealt with only when complications arrive at the surgery door, such as hypertension, diabetes and heart disease. We know prevention is better than cure, and yet today's children are the least fit they've ever been. If we don't act soon, it will be the norm for the next generation to have a chronic disease.

There can be few people who don't know the importance of being active, but it can be difficult to know how or where to start. Eight out of 10 Britons now live in an urban environment, where areas for exercise are limited or expensive. Despite various cycle schemes, our roads aren't cycle friendly, our parks and recreational areas are suffering cutbacks. Nurses can suggest walking if an individual can't afford gym membership or cycle gear, but walking in deprived areas isn't appealing and can be dangerous.

The World Health Organization has suggested that inactivity needs to be tackled at government level, including town planners, transport networks, as well as health and sports facilities.

In the 1970s, Finland did just this. Finland's health was terrible, with unacceptably high levels of coronary heart disease. The then Government took extreme measures and began massive community-based interventions. It made exercise easy and cheap. Local authorities were given the funds and responsibility for their own budgets.

Competition was encouraged between towns and villages – with prizes for the most successful. Schemes were rolled out across the country, and with persistence, they drew inactive people into activity. They also encouraged daily active routines such as commuting to and from work, particularly for those who 'didn't have time to exercise'. This was supported by a hundred kilometres of new walking and cycle paths. Money was provided to keep it well lit and maintained. Elderly people were given spikes to clamp on their shoes, so they could still go out in winter months. The pavements were kept clear of ice, and individuals who didn't clear their patch of pavement were fined. Finland became one of the fittest nations at that time.

The UK today is very different demographically from Finland in the 70s, but the Finnish policy proves mass change can be achieved with mass intervention. If we are to stop this epidemic of inactivity it is time for a national strategy with environmental interventions. Health promotion and education in the surgery only touch the tip of the iceberg.

Bernadette Higgins, practice nurse, Newcastle