Features

Unfit for life?

11 April 2019

Physical inactivity among the UK’s children is at crisis point. What can be done? Journalist Georgina Wintersgill reports.

Central to London’s successful bid to host the 2012 Olympic and Paralympic Games was the government’s commitment to improve competitive sport and the sporting habits of young people (All-Party Parliamentary Group (APPG) on a Fit and Healthy Childhood, 2019). But a survey published last December by Sport England (2018) makes for dismal reading: just 17.5% of children aged five to 16 do the recommended 60 minutes of physical activity every day, while 32.9% do less than 30 minutes. The survey looked at more than 100,000 children and young people.

Sport England chief executive Tim Hollingsworth said of the findings: ‘This research is a big wake-up call for all of us. We all care about the health and wellbeing of our children. These results tell us that what is currently being done to support them is not enough and change is required.’


39% of children from the least affluent families do less than 30 minutes of physical activity every day, compared to 26% from the most affluent families - Sport England, 2018


Meanwhile, a report by the Active Healthy Kids Global Alliance (AHKGA, 2018), compared childhood physical activity levels in 49 countries. Researchers from each participating country produced a report card, and UK countries did not fare well. England got a C- for overall physical activity and a D+ for sedentary behaviour; Wales got a D+ for overall physical activity and an F for sedentary behaviour; and Scotland got an F both for overall physical activity and sedentary behaviour. On other measures - organised sport and physical activity, and active transportation - Scotland fared better (B and C respectively) and scored higher than England
and Wales.

Northern Ireland didn’t participate in this global report. However, the most recent Department of Health survey (2017) found that just 13% of 11- to 16-year-olds in the province reported doing at least 60 minutes of physical activity every day in the past week, and 8% said they didn’t do 60 minutes on any day in the last week.

Should a reminder be needed on why being active from a young age is so important, a Change4Life evidence review looked at the effect of physical activity on children aged five to 11 (PHE, 2015). It found the physiological outcomes with the strongest evidence for a positive association with physical activity were muscular strength, bone health, aerobic fitness and cardiometabolic health (which means a lower chance of developing risk factors for cardiovascular disease, including type 2 diabetes, hypertension and obesity). The psychological outcomes with the strongest evidence for a positive association with physical activity were self-esteem, academic achievement, cognitive functioning, attention/concentration, and anxiety/stress (a negative association). The social outcomes were confidence and peer acceptance/friendship.

So why are children’s activity levels in the UK so low, and what can be done to make a lasting change?

The unfit factors

Experts acknowledge that there’s no single reason for children’s poor activity levels, but a rise in car use, an increase in screen time, and a perception that the outdoor world is less safe than it used to be are often cited as factors.

Ukactive is a not-for-profit health body for the physical activity sector. Jack Shakespeare, head of ukactiveKIDS, says: ‘Lifestyle changes have happened over the generations: [as well as] more car use and more sedentary entertainment, the way in which children communicate with each other means they don’t necessarily need to go anywhere to socialise. We’ve also lost that trust in allowing children to go off and be active in those places where we were once active, like parks and local football pitches.’

Professor Gareth Stratton is professor of paediatric exercise science and director of the Applied Sports Exercise Technology and Medicine Research Centre at Swansea University. He agrees that one of the main problems is that children no longer spend enough time outside.

‘They are always more active when they do that,’ he says. ‘Many parents who played out when they were young won’t allow their own children to do that as they feel it’s not safe outside anymore. But it’s probably even less safe inside when children are sitting down, surfing the internet.’

He also says the environment around our homes has become less conducive to outdoor play. ‘Cars occupy a lot of space outside our front doors; they’re right up to the front of our houses now. We don’t have gardens anymore.’

Physically disengaged

With competing demands on their leisure time, many children simply aren’t interested by what’s on offer. Jack says: ‘There’s a big group who are not engaged by the current offer, and we need to do something about that. It’s worth delving into the detail of who’s not active. Who are those children who are disengaged from physical activity? Where are they coming from? What families are they in? We need to get to the bottom of who they are, and that will help us identify how to change the offer.’

The Sport England survey (2018) found that certain groups are less likely to be active than others. Young people aged 13 to 16 are least likely to be active every day. Girls are less likely to be active than boys: just 14% of girls are active every day compared with 20% of boys, and the gap becomes wider from age nine to 11 upwards. Children from poorer families are generally less active than those from wealthier families, and ethnicity has an impact too: girls from Asian and black backgrounds are less active than girls from other communities.

Tackling the problem

Experts agree that society as a whole – parents, schools, government, the sport and leisure industry, as well as healthcare professionals – must take responsibility to help address the crisis of children’s physical inactivity. The question is, how can we ensure that all children are engaged with what’s on offer, have the opportunity to take part and are encouraged to do so?

Involving families is one solution. Sport England found that when parents are less active, less confident or less interested in sport and activity, children are less likely to value and prioritise being physically active themselves (Sport England, 2017). Professor Stratton, who also led the development of the Wales section of the AHKGA report, suggests facilities such as leisure and sports centres should offer more family activities. He says: ‘Activities tend to be designed for either kids or parents. What about designing activities for kids and parents?’

Encouraging active transportation is another solution. Japan, which has a long tradition of children walking to school, scored the best grades for active transportation in the AHKGA report.

Earlier interventions, while activity levels are still high, may also help. A new study with six- to 11-year-olds found that moderate to vigorous physical activity remained relatively stable until age eight but dropped at age 11 (Schwarzfischer et al, 2019). Researchers identified this period as a crucial time for intervention.

Improving children’s physical literacy – developing basic movement skills such as running, jumping, catching, throwing and kicking – not only improves fitness, but gives children more skills to be able to engage in other sports. Professor Stratton says: ‘The Dragon Challenge, developed by Sport Wales to assess children’s physical competence, found that 62% of children didn’t achieve an expected level of physical competence [Active Healthy Kids Wales, 2018]. The most important thing is physical literacy, and the broader range you have, the more opportunities you have for engaging in activities. My big challenge for the sport and leisure industry is to work on giving children the skills to be active when they’re not with them, which is the vast majority of a child’s time.’

‘The political system needs a much clearer, longer-term focus for helping children get active’

Experts agree that listening to what all children want is at the heart of increasing activity levels. Ben Jessup is a policy adviser for the Sport and Recreation Alliance, the representative body for national sport and recreation organisations in the UK. He says: ‘A key finding in a report we published last year was a lack of youth voice. Parts of the sport and recreation sector are really good at listening to young people, and we see the outcome from that, where engagement can be really impactful. For example, Young Ambassadors for England Golf and the Golf Foundation help to run national campaigns such as Girls Golf Rocks. But there are significant gaps.’

Findings also suggest that some aspects of PE provision in schools need to improve. Recommendations have included increasing time spent on PE in initial teacher training (APPG on a Fit and Healthy Childhood, 2016).


30 % of adults have a negative or very negative experience of sport at school and 40% say this directly influences their current habits - Sport and Recreation Alliance, 2018


Ben also stresses the importance of collaborative working. ‘There needs to be much more dialogue across government. There’s so much good work going on, but it’s all operating in silos and that has to change – bringing people together has to be the first step. We need to think about how the main political parties can work together, regardless of which party is in government, so the political system has a much clearer, longer-term focus for helping children get active.’

See The governments’ response below for how the four UK countries are dealing with the issue.


The government's response

What are the UK countries' governments doing to address the issue?

ENGLAND

  • Dr Michael Brannan, national lead for physical activity at Public Health England (PHE), says: ‘PHE takes a family approach and also a community approach. For example, Change4Life focuses on all drivers and opportunities for children and young people to be active by providing resources and activities for families to do together, within schools and outside of school through community physical activity opportunities.’
  • In 2013, state primary schools in England were allocated £150m funding per year to improve PE and sport provision (APPG on a Fit and Healthy Childhood, 2019). In 2017, the amount doubled (Department for Education, 2017).
  • Free training is now on offer to 17,000 secondary school PE teachers, aiming to improve attitudes towards PE in schools (Sport England, 2018).
  • As for the future, a cross-government plan – the School Sport and Physical Activity Action Plan – is due out this spring, informed by Sport England’s survey. Although details have yet to be confirmed, the government has said it will encourage families to get active together and will give all children access to high-quality PE, sport sessions and clubs, both in and after school, during weekends and holidays. Schools must ensure children are physically literate and young people have the opportunity to take part in competitive sport. A key aim will be to engage the least active groups (Department for Digital, Culture, Media and Sport, 2019).

SCOTLAND

  • Scotland’s Active Schools programme provides opportunities for young people to take part in physical activity before and after school and during lunch breaks (Sport Scotland, 2016).
  • The Daily Mile began in a primary school in Stirling in 2012 and the Scottish Government wants to make Scotland the first ‘Daily Mile nation’ with a roll-out to all nurseries, schools, colleges and universities (Scottish Government, 2017).
  • Through sportscotland, the Scottish Government is working with local authorities to create community sport hubs, providing information on a range of physical activities to make it easier for local people to get active.

WALES

  • In December, the Welsh Government made £2m available to local authorities for play opportunities for children, such as buying equipment for street play and road closure (Welsh Government, 2018).
  • Sport Wales’ national lottery-funded primary school programme, Dragon Sport, enhances the provision of PE, aiming to give every child the opportunity to develop mkey physical skills.
  • Sport Wales’ secondary school programme, 5x60, is funded by the Welsh Government and complements existing PE provision in schools by creating physical opportunities for young people.

NORTHERN IRELAND

  • Sport Northern Ireland runs a schools programme, Activ8, which aims to increase participation in physical activity.
  • The Active Schools Travel Programme is funded until 2021. At the end of the 2017-18 school year, the number of children in participating schools who were walking, cycling or scooting to school rose from 34% to 44% (Sustrans, 2019).
  • In March 2019, Sport Northern Ireland announced a collaboration with Working with Parents in Sport, a company supporting parents and coaches to provide children with the best possible sporting experiences (Sport Northern Ireland, 2019).

Addressing inequality

Professor Stratton believes offering non-traditional activities can help engage children from less physically active ethnic groups. ‘It’s about approaching the family unit,’ he says. ‘We need to capture culture in our activity, and one of the best ways is by investing in a range of activities that enable people to interact. Play and dance both work well.’

Jack of ukactiveKIDS says that secondary school children, especially girls, are often forgotten when it comes to sports provision. He says: ‘We need to make sure there’s an offer for that age group, that there’s somewhere for them to go. Social acceptance is really important at that age and that has to be built into the offer.’ One solution, he says, is opening up gyms to teens. ‘This country has thousands of good gyms, but most don’t let anyone under 15 use the equipment – let’s change that. What’s more dangerous, a lifetime of inactivity or a young person going on a treadmill?’

A ukactive study found that, during the summer holidays, fitness levels of the most deprived young people fell 18 times faster than those of the most affluent (Mann et al, 2018). Jack suggests opening up schools and providing activities during holidays. He adds: ‘What we have to do is meet the guidance [for 60 minutes of physical activity every day] with an offer that engages everyone. We need to make sure children have variety in schools, that they are able to access extra-curricular activities regardless of how deep their parents’ pockets are, that everyone can access opportunities at the weekends 
and in school holidays.’

Two activity schemes in the UK that have had great success are both free and inclusive. ‘The statistics and outcomes of both ParkLives and parkrun are really positive,’ says Jack (see Exciting initiatives and resources, below). ‘Both have common themes: they’re free, they’re accessible and they promote mass participation. What they do particularly well is to set up friendly, positive, inclusive, physically active experiences that are more about participation than winning or losing. For someone to want to keep doing an activity, it needs to feel meaningful.’

How can you help?

Professor Stratton recommends that all community practitioners use the Making Every Contact Count approach. He says: ‘For everyone who makes contact with children, it’s really important to understand that physical activity and movement is absolutely essential for growth, development and learning.’

Health visitor consultant trainer Julia Haynes, who developed the NHS app Born to Move, is passionate about giving babies an active start. She says: ‘I encourage all families to be aware that babies are born to move and need awake tummy-time. Daily movement and active play are vital to help them reach developmental milestones, and each time they move and interact, their bodies fill with feel-good hormones that build a love of physical activity from the start.’

Where do community practitioners come in? ‘Health visiting and children’s centre teams can work together to make families aware of play sessions locally and the importance of getting out each day,’ says Julia.

In Sleaford, Lincolnshire, health visitors encourage families to come to the children’s centre for free ‘Let’s get active’ sessions. Early years locality lead Ros Mills says: ‘When people come to the children’s centre for their child’s 12-month or two-year check, or for antenatal classes, the health visitors promote the setting and all the activities that go on here.’


93% of children say they like being activePHE, 2017


But she says the ‘Let’s get active’ message is for all ages. ‘It’s about promoting physical activity and getting healthy lifestyle messages to families. During the sessions the leaders talk about tummy-time, five-a-day, and limiting screen time and other sedentary activities.’

The range of challenges means there’s no silver bullet to solve the crisis, which requires input from all areas of society. Dr Michael Brannan from PHE says: ‘We need a whole-system approach where individuals, communities and organisations from the public, voluntary and private sectors all play their role. But it’s not something that can be solved overnight or by a single body or sector. It requires long-term, sustained change in culture and behaviours through actions across sectors at national, local and community levels. We all have a part to play in supporting a more active society.’


Exciting initiatives and resources

Throughout the UK, inspiring initiatives are encouraging a more active lifestyle among children and families. Explore the schemes and websites below for ideas on helping your clients to move more...

  • The Daily Mile Many schools in England, Scotland, Wales and Northern Ireland have signed up this initiative aiming to get school children running or jogging outside for 15 minutes every day. thedailymile.co.uk
  • ParkLives is a national programme of free family activities in parks and green spaces currently available in a number of cities across England, Scotland and Wales. parklives.com
  • parkrun organises free weekly 5km runs in hundreds of locations around the UK. Junior parkrun is a 2km version for children aged four to 14. parkrun.org.uk
  • NHS Born to Move app is for parents of children aged 0 to five to use with HVs to encourage active play. kentcht.nhs.uk/service/kent-baby/born-to-move
  • walkswithbuggies.com & buggyfit.co.uk help new parents get into fitness.
  • NHS Change4Life offers games and information to get children active. nhs.uk/change4life/activities
  • Sport and Recreation Alliance provides news and information from the representative body for national sport and recreation organisations. sportandrecreation.org.uk

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