When did you last move? It might seem an odd question and to many the answer is simple – to make a cup a tea, to answer the door, or just to stretch. However, to others it is not so simple. Some of you might find it harder to answer this question. There may be a whole range of reasons why you have not moved much at all, including anxiety, illness, due to health conditions or due to a lack of access to appropriate facilities. Barriers to moving can have a devastating impact on people’s health and life chances. Yet, at a time of ever-increasing health inequalities, movement has never been more important and, while the recent Scottish Government announcements to cut waiting lists are welcome, still more needs to be done to put preventative healthcare front and centre of the reform agenda.
Movement for Health
Movement for Health is a coalition of national health organisations working on increasing physical activity levels to improve the social, physical, and mental health of people living with long term health conditions. We work with a range of academics and government agencies to promote and support physical activity provision and choices for people with health conditions. We regularly engage with the Scottish Government and representatives from all parties represented in the Scottish Parliament to advocate for greater prominence and investment to be given to realising our ambition. And we support health and social care professionals, leisure and physical activity providers, acting as a hub on relevant policy, tools and practise across Scotland.
The imperative for change
As the Scottish public health system struggles to cope with ever-increasing demand, movement can and should play a fundamental role. We hear a lot about the importance of preventative health from politicians and policy makers, yet the reality is that preventative healthcare is chronically underfunded and is not given the political nor clinical leadership it requires.
At present, the results of physical inactivity are putting public services under increasing strain, with the costs of meeting the increasing demand running into the billions. The World Health Organization estimates that, globally, the cost of physical inactivity to public health care systems between 2020 and 2030 will be about $300 billion, so approximately $27 billion per year, if levels of physical inactivity are not reduced.
In Scotland, around 3,000 preventable deaths are directly attributable to physical inactivity, with just over a half of the adult population being able to meet the recommended physical activity guidelines. Unsustainable pressures are set to continue as some 47% of the adult population in Scotland are living with at least one long term health condition, with our most deprived communities being disproportionately impacted.
Movement matters
All movement matters. In order for people to be able to achieve the global physical activity guidelines of 150 aerobic minutes of movement per week and the essential strength and balance minimums, we need to engage using positive framing that suits the individual and their circumstances. Appreciating that minor movement is absolutely crucial to achieving those longer-term goals.
Some people will remain limited by conditions, so for them the guidelines are unachievable. Yet, what they can do matters, is valuable, has purpose and should be recognised and celebrated. Without starting with and celebrating minor movement, our society will not see the shift we need to become a moving nation.
A new public health framework, published by the Scottish Government, helps frame the implementation of physical activity, but only through a focus on movement and implementation through partnership and collaboration – and adequate finance – will the benefits of the framework be reaped. The First Minister’s recent announcement on NHS reforms are welcome, but they don’t go far enough to address the need to put physical activity and preventative health at the heart of the system.
The need for reform and partnership
This is why we believe that movement and physical activity should be placed at the centre of all efforts to alleviate public health pressures and tackling health inequalities. By refocusing on such preventative measures and making them a priority investment on an equal footing with clinical interventions, there could be as much as 1:14 return on investment, as evidence showed at our first national conference in June 2024. This will require a whole systems approach, pioneered by Public Health Scotland, with all sectors collaborating to promote movement for everyone within society. The third sector, community and local government organisations particularly have a key role to play in developing new referral pathways, including social prescribing, and ways to offer appropriate and available support in the individual’s community.
Much can be achieved through partnership and sharing information. We need to keep sharing learnings, sharing good practice and examples across the community and across sectors. . The whole system approach promotes the concept that all sectors need to collaborate to promote movement for everyone within society. This encompasses a multidisciplinary method, which includes not just excellent physical activity programmes but modification of environments externally and internally.
Fundamentally though, there needs to be a step-change to our approach to social prescribing and patient referral pathways. NHS organisations and GPs and other primary care professionals are under increasing strain to cope with the levels of demand.
If Scotland is to address health inequalities and increase physical activity, the NHS and the way we prioritise preventative health must change. The third sector, community and local government organisations must play an increasing role in the future of our healthcare.
Movement is for everyone, movement is to be free, movement is to be seen.
Emma Anderson leads the Movement for Health coalition, the national programme, and the community of practice. For more information please visit their website and engage with their podcast Movement in Conversation: Movement for Health | We Move Together