Healthy bodies, Healthy Planet?

Getting fresh on Merseyside

Bringing affordable local food into the heart of deprived communities

Lack of access to fresh fruit and vegetables is a growing problem in many poor inner city communities, as local food shops close and supermarkets shun unpromising areas. But it’s not inevitable. In Huyton, on Merseyside, local people have formed a food co-op linking residents with nearby farms to ensure affordable supplies of fruit and veg.

The scheme is simplicity itself: residents drop off their food orders at a local school; these are sent out to the farmers taking part in the scheme, who deliver the produce back to the school, where volunteers make up the order for the clients to come and collect. People with mobility problems can have the order delivered to their door.

The prices are broadly on a par with supermarket ones. As one local pensioner who enthuses about the scheme says: “It’s much more convenient for me as the shops are quite far away from where I live.” It’s not just individuals who benefit: school canteens and nurseries are among the customers, while volunteering offers some hope to the area’s long-term unemployed. “The experience of working in the food co-op has given me the confidence that I lost when I lost my job”, says one volunteer. “I’m meeting people, and also feel that I’m helping them to gain better health - so everyone wins.”

The project has won the community category of the Merseyside Health Action Zone’s Sustainable Health Awards.* MHAZ co-ordinator, Marie Armitage, applauds the fact that the co-op is open to the whole community, and that it “recognises the link between diet and health”. Huyton Community Partnership’s Health development manager, Jackie Patterson, sees the co-op as a real role model: “I firmly believe that linking the community development approach to health is the future for sustainable health change in the long term.”

MHAZ; 0151 480 3356, www.haznet.org.uk

Travelling right

Cutting down on car use can lead to dramatic improvements in health and well-being

The connection between health, the environment and transport choices is, quite frankly, a no-brainer. Sitting in your car does not keep you fit; walking for 15 minutes does. The emissions pumped out by your car help give people asthma; the only pumping associated with a bike is the one for the tyres. Roads full of cars tend to cause more lethal accidents than ones full of cycles and pedestrians. So who’s translating blindingly obvious logic into practical policy? Government initiatives are for the most part of the exhorting, rather than enabling, kind (hence the heartstring-tugging TV adverts warning of the tragic consequences of a sedentary lifestyle). But some practical advice is to be found in Walk In to Work Out - an information pack for travel plan co-ordinators, espousing the health benefits of ‘actively’ commuting to work, along with journey planning information and safety tips. You could be forgiven for a touch of scepticism as to its potential to change people’s travel habits, but it’s based closely on a successful pilot carried out by the Greater Glasgow Health Board, the University of Glasgow and the Health Education Board for Scotland. Research found that the pack was effective in doubling rates of walking to work, and in improving general physical and mental health.

0870 1226 236; dtlr@twoten.press.net

Strolling away from the school run
Sustrans, the sustainable transport charity, has joined with the British Heart Foundation to promote the health benefits of ‘Active Travel’ - principally cycling or walking - in a bid to build on the success of the well-established Safe Routes to Schools project.

Safe Routes is inspired by the Danish experience - where more than 60% of children cycle to school. In Britain, the proportion of children going to school under their own steam has plummeted in recent years - largely due to the real or perceived dangers of motor traffic - hence the emphasis on safe routes.

Along with other organisations, Sustrans has ensured that over half of all local authorities now have some form of Safe Routes programme - although that’s still a far cry from their Danish colleagues, where they’re legally obliged to ensure the protection of children from traffic danger on their school journey.

A typical Safe Routes scheme includes a combination of cycle routes, cycle lanes, road safety training, traffic calming and low speed zones. Kesgrave School near Ipswich is a fine example of what can be achieved when a Safe Routes programme is implemented fully, with 70% of its children now walking or cycling to school.

On a national scale, there are also some encouraging signs that we may have passed the peak of school run madness [see table]. Something to ponder on 2 October - ‘International Walk to School Day’...

Now Sustrans are hoping to extend some of the learning from Safe Routes to other organisations, including business, local authorities - and even the NHS, too. In particular, the charity is offering free guidance to help businesses determine the viability of providing links into the National Cycle Network for staff and customers.

Proportion of cars on the road at peak times engaged in a school run
1989 1995 2000
14% 20% 16%
Proportion of primary school children walking to school
1989 1995 2000
67% 54% 56%

Good health begins at home

Sick houses mean sick people, so savvy health authorities are getting into the home improvement business

It requires no great leap of faith to accept the fact that living in cold, damp conditions will lead to health problems. Costs incurred by the NHS in treating illnesses linked to ‘sick homes’ have been estimated at anything from £1 billion to £2 billion annually. Hence an increasing interest in treating the cause by improving housing conditions - and thereby also creating jobs, tackling greenhouse emissions, and saving some of the poorest families money, too. There are several projects under way in England and Wales which aim to do just that. They include initiatives such as the training of health professionals in energy advice and in grant referral schemes, and the use of NHS funds for energy efficiency improvements to tackle damp and cold homes. Here are a few of the most effective.

Easing asthma with money
Faced with growing numbers of children suffering from asthma, the Cornwall and Isles of Scilly Health Authority allocated £300,000 to local authorities’ housing budgets to allow the installation of central heating and insulation to council homes where the asthmatic children lived. This simple gesture helped produce significant reductions in the number of school days lost as a result of asthma, along with measurable improvements to the children’s respiratory health.

Repairs on prescription
The links between housing and health are the focus of an imaginative strategy adopted by Sandwell Borough Council in the West Midlands. Repairs on Prescription, funded through the Health Action Zone programme, aims to tackle housing conditions that are associated with respiratory illness, cardiovascular disease, and falls and other causes of hospital admissions among the elderly. As in Cornwall, the programme features a particular focus on childhood asthma: if children with asthma come from a home without central heating, their parents can apply to have it installed free of charge. Posters and leaflets advertising the scheme are displayed in the housing department, so when people come to see about housing problems they find some of their health problems addressed as well. A three-year study is currently being carried out to monitor the impacts, and so far the results show that there has been a definite improvement in children’s health.

Into the heart of the forest

Art, drums and heart monitors are helping young people reconnect with their health and well-being.

The djembe drums of Africa aren’t the first thing you associate with healthy living centres. But they’re the heartbeat of an imaginative new scheme under way in the Wyre Forest, on the western edge of the Black Country, which aims to bring the principles of healthy living home to children and young people in the area.

The Forest Heart Project is centred around a heart and blood pressure monitor in the forest’s Discovery Centre. The monitor itself has been cleverly incorporated in a sculpture by local artists, which allows children to take their blood pressure and listen to their own heartbeat. This is then ‘amplified’ by a series of activities such as drama, music and story-telling - with the djembes used to help the kids reconnect with the natural rhythms of their bodies, particularly their hearts. At its core is the idea that getting in touch with their hearts will encourage people to look after them better.

It brings art, health and the forest together through a range of partners including the Forestry Commission, Wyre Forest District Council, West Midlands Arts and the Bewdley Primary Health Care Trust. The project builds on other healthy living initiatives based around walks, games and music, which have been running for several years in the Discovery Centre, during which time over 10,000 people - mainly schoolchildren - have taken part. The emphasis is on a carefully composed mix of exercise, enjoyment, social interaction and forest appreciation - so weaving together physical and psychological health with environmental awareness.

Meanwhile, the Brambles Trust uses the forest and the centre for activities with children who have been bereaved, and the adjoining restaurant, appropriately enough, has won the Heart Beat Award for a healthy menu.

With thanks to Dr Malcolm Rigler.

Discovery Centre, 01299 266929; discoverycentre@wyreforest.net

No pills just press ups (and line dancing and trees)

It’s exercise, gym, but not as we know it...

To say that exercise referral schemes are the new rock ‘n’ roll of health promotion isn’t just a cliché. Where once GPs keen on such measures prescribed patients a 10- week fitness regime in the local gym or swimming pool, nowadays the prescription might include anything from yoga to line dancing. In each case, the doctor receives a report on the completion of the work. The last decade has seen a rapid growth in this area, with over 200 referral schemes now in operation across the country. Many of the new prescriptions are aimed at the older gym-shy generation, or indeed anyone who may not fancy donning lycra and braving the exercise machines on their own.

As referral schemes, with government blessing, surge in popularity, so they are increasingly the product of partnerships between local and health authorities, sports and healthy living centres, and NGOs. One of the latest trends is prescriptions for patients to take part in conservation projects. On the surface, this may sound like a soft option, but research by Oxford Brookes University has shown that up to 30% more calories are used per hour spent in coppicing or pond clearance as are burnt up in a step aerobics class. Those are two of the activities prescribed by Leicester’s Eco Active scheme (a partnership between Leicester City Council, the Leicestershire and Rutland Health Promotion Agency, and Environ), which focuses on conservation as an alternative to gym-based work.

It’s backed by growing evidence that spending time in ‘greenspace’ helps produce significant benefits in terms of psychological health. Stockport Borough Council persuaded local GPs to prescribe walks in local greenspace for people suffering from depression, as well as those recovering from surgery. The initiative was based on the ‘biophilia effect’, as discovered by researchers who found that post-operative patients recovered more quickly and with fewer complications when their hospital beds overlooked such space.

The study also showed that ‘green gyms’ help overcome depression and have an overall positive effect on mental health. The British Trust for Conservation Volunteers are old hats at the Green Gym idea, having already trademarked the term.

The initiative is part of the ‘Are you doing your bit?’ campaign, and again GPs, nurses and health visitors play a role in recommending it to their patients.

Meanwhile, the soothing properties of greenspace are also at the heart of the design concept for Glasgow’s new homoeopathic hospital. Numerous patients have referred to the calming, even healing, effect of the gardens within which the hospital is set.

BTCV; www.btcv.org/greengym/
EcoActive scheme; 0116 222 0236, www.environ.org.uk

Oranges and lemons (not Snickers and crisps)

Schools that dare to take on the junk food culture are reaping the benefits.

'Catch ’em young’ is the mantra of many a health care professional. But a casual glance through any school gate would suggest that the people doing the catching are the manufacturers of the sweets, snacks and sugar-saturated fizzy drinks that are the drug of choice of many a primary schoolkid. With research showing that one in five children eat virtually no fresh fruit at all, and evidence increasingly linking junk diets to everything from attention-deficit disorders to asthma (and in later life enhanced risks of cancer and heart disease), there’s clearly room for improvement in the playground. So who’s on the case?

The National School Fruit Scheme is the biggest government initiative aimed at improving child health at school since the introduction of free milk in 1946. It aims to provide over two million children aged four-to-six with some free fruit each school day by 2004. Pilot programmes have had promising results, with 97% of teachers reporting that it helped them teach pupils about healthy eating. Some also report a positive effect on attention levels. The scheme should start to bring benefits to local farmers and growers, too, as its co-ordinators are looking at ways to maximise the use of local produce.

Of course, doling out a piece of fruit when Snickers and crisps are still luring kids at break time is a bit contradictory. Wolsey Junior School in Croydon is tackling this head on by ‘banning the bad stuff’. Crisps and fizzy drinks are no longer available at the tuck shop. In place of junk food, pupils now get through three boxes of bananas, two boxes of apples and three boxes of satsumas every week. The small amount of money the tuck shop makes is used to subsidise the purchase of more exotic summer fruit such as nectarines and peaches. Head teacher Peter Winder enthuses over the results: “The children are calmer and more controlled... Our SATs results have improved enormously.”

Vending machines in the school corridors are another bete noire of health campaigners - but not when they take the form of The Green Machine. Sourcing organic products wherever possible, this specialises in healthy snacks and slurps, without artificial additives, colourings or flavours. It is produced by Organic & Natural, whose founder, David Berney, insists that it’s about more than just selling healthier stuff. “We are offering every school that installs a machine a support programme that includes visits from nutritionists and farm and factory tours.”

Each of the schools initiatives featured here is part of the Healthy Schools Programme (www.wiredforhealth.gov.uk) - led jointly by the Health and Education Departments. Activities centre on drug education, school grounds, mental health, physical exercise and healthy eating.

Organic & Natural Food Company,
020 8971 0055,
Manchester Healthy School Award, 0161 882 2313, www.mhsa.org.uk

Health Action Zones are a government initiative targeting areas of the country that have the poorest health. HAZs are partnerships between the NHS, local authorities, community groups and the voluntary and business sectors. HAZ programmes represent a new approach to public health - linking health, regeneration, employment, education, housing and anti-poverty initiatives to respond to the needs of vulnerable groups and deprived communities. Merseyside HAZ is the largest and most complex in the country, covering 1.4 million people. It was also the venue for the first Sustainable Health Awards - set up to recognise community groups and companies that make a contribution to health, well-being and sustainability.

Walking back to wellness To maintain basic health, experts recommend being active for at least 30 minutes a day, on five or more days of the week. This reduces the risk of developing heart disease and high blood pressure, controls weight and eases stress. A brisk walk of a mile in 20 minutes every day to work (or to the station, or the bus stop, or even from a more distant car park) will, roughly speaking, burn up as many calories as running a mile in 10 minutes or doing aerobics for 16 minutes...

A ‘before and after’ study in Hackney, east London, looked at the impacts of a series of improvements to one local council estate, drawn up with residents’ health in mind. Following the work, residents’ visits to GPs fell by 30% and outpatient admissions by 20%.

Cola, cola everywhere (nor any drop to drink) Many children suffer a range of discomforts, from stomach ache to lethargy, because they don’t drink enough water (as opposed to sugary drinks). A study in Manchester revealed that 62% of schools had no accessible drinking water for children. To remedy this, local school nurses have started promoting the use of water fountains in schools, so the kids can grab a glass of water at almost any time.

30 May 2002

Emily Felton and Martin Wright