2 Public health need and practice

2 Public health need and practice

There is increasing recognition of the need to encourage healthier lifestyles and the government has set specific targets to increase physical activity levels (Department of Culture, Media and Sport 2002; DH 2004; Health Development Agency 2004; House of Commons Health Committee 2004; Wanless 2004).

Physical activity is essential for good health (DH 2004). Increasing activity levels will help prevent and manage over 20 conditions and diseases including cancer, coronary heart disease, diabetes and obesity. It can also help to promote mental wellbeing (DH 2004; Pate et al. 1995). Physically active employees are less likely to suffer from major health problems, less likely to take sickness leave and less likely to have an accident at work (Dishman et al. 1998).

Around 65% of men and 76% of women aged over 16 are not physically active enough to meet the current national recommendations (that is, they spend less than 30 minutes on 5 or more days a week involved in at least moderately intense activities). Physical activity levels vary according to age and gender. Women tend to be less physically active than men, and older people tend to be less physically active than younger people. Levels also vary according to socioeconomic class and ethnicity, although these relationships appear to be complex (Joint Health Surveys Unit 2004).

Trends highlighted by health surveys undertaken in England in 1997, 1998, 2003 and 2004 found a small increase in physical activity levels between 1997 and 2004. However, national travel surveys show that the average distance people walk and cycle has declined significantly in the last three decades (National Statistics 2004).

The cost of physical inactivity in England, including the direct costs of treatment for major lifestyle-related diseases and the indirect costs caused through sickness absence, has been estimated at £8.2 billion a year (DH 2004).

Sickness absence

In the fiscal year 2005–2006, an estimated 30.5 million working days were lost as a result of work-related illnesses and injuries. On average, each sick person took 16 days off work in that 12-month period. Mental health problems (stress, depression or anxiety) and musculoskeletal disorders accounted for the majority of working days lost, leading to an estimated 10.5 million and 9.5 million days off work (full-day equivalent) respectively (Health and Safety Executive 2007). (The incidence of stress, depression or anxiety and musculoskeletal disorders can be reduced by physical activity.)

Government policy

The government aims to promote health at work by 'improving working conditions to reduce the causes of ill health related to work, and promoting the work environment as a source of better health' (DH 2004). In addition, by 2010, its 'Government setting an example' programme aims to reduce by 30% the number of working days lost through accidents and cases of ill health in the civil service and the rest of the public sector (Health and Safety Executive 2005).

In the wider context, 'Revitalising health and safety strategy' (Department for Environment, Transport and the Regions 2000) sets national targets to be achieved by 2010. These are to reduce:

  • by 10% the rate of fatal and major injury accidents

  • by 20% cases of work-related ill health

  • by 30% the number of working days lost per worker as a result of work-related injury and ill health.

Increasing national physical activity levels is also central to:

  • national service frameworks (NSFs) on coronary heart disease, diabetes, mental health, older people and long-term conditions

  • DH policy documents on physical activity including 'Choosing activity' (2005), 'At least five a week' (2004) and 'Healthy weight, healthy lives' (2008).

It is also relevant to Healthcare Commission targets, local area agreements and local delivery plans.

The guidance

This guidance considers workplace-based policies and initiatives that aim to increase employees' physical activity levels and are applicable in England. It also considers similar initiatives outside the workplace that are initiated or endorsed by employers. It covers all employed adults including volunteers, subcontractors and temporary staff. It is not aimed at people who are self-employed.