24 Jan 2022 Guest Blog: Austerity – the elephant in the room and why it’s not the answer to tackling physical inactivity
Happy New Year to all our readers! Our first guest blog of 2022 is from Dr Rob Noonan, Lecturer at the University of Liverpool, to discuss why without addressing the social conditions that underpin physical inactivity, the Government will be walking backwards not forwards.
The health and economic burdens of physical inactivity are well documented [1,2]. In the UK, physical inactivity is responsible for the same number of deaths as smoking (one in six) and costs the economy over £7 billion every year. Based on current trends, the UK population is predicted to be 35% less active by 2030 .
The UK Government has set a year on year target to increase the number of adults taking part in at least 150 minutes of physical activity a week and to reduce the number taking part in less than 30 minutes per week. But their ambitious goal is destined to fail. Fail they will because they do the same thing over and over again, but expect different results. The definition of “insanity” according to Albert Einstein.
The Government’s favoured use of educational campaigns neglects the fact that many people simply don’t have the same opportunities or resources to be as physically active as others do. The reality is that people’s activity behaviours are heavily influenced by the conditions in which they live. Whether they have the time, money, and resources to have an active lifestyle. Whether they have a safe walkable community that provides access to green space and essential services.
A decade of austerity has impacted the physical activity opportunities of all people in the UK but especially the poorest. At the individual level, living costs in the UK have risen, wages have stagnated, and welfare benefits have been cut heavily [4,5]. A consequence of these social and economic changes is that a majority of families have less disposable income now than they otherwise would have had . The reality is, when family budgets shrink, leisure opportunities are reduced.
Against this backdrop, local authorities in the poorest parts of the country have faced the largest budgetary cuts. These cuts have impacted the provision of leisure and recreational services, either through facility closures, reduced opening hours, increased user charges, or reduced commitments to the maintenance of parks and green spaces.
Evidence of the impact of austerity on child and adult health is extensive [7,8]. Austerity kills [9,10]. Adverse health trends were apparent in the UK even before the covid-19 pandemic hit following almost a decade of austerity. Life expectancy had stalled, infant mortality was rising, a growing number of children were living in poverty, more families were using food banks and more people were living on the streets [11,12,13,14]. But the pandemic has exacerbated these social inequalities.
Physical activity promotion is critical in tackling many of the public health challenges of our time including obesity, mental health and health inequalities [15,16,17,18]. Rates of obesity in adults had nearly doubled in just over a decade to 2015 and almost one third of children under the age of 16 in England are currently overweight or obese . The long-term economic impacts of the covid-19 pandemic are predicted to be greater than the 2008 financial crisis, with the resulting adverse mental health impacts likely to be just as grand if not greater [20,21].
Physical activity behaviour change is much easier when people have a sense of control and are in a good emotional state. In a bid to build back better from the covid-19 pandemic , the UK Government has just ended the £20 increase to universal credit payments which was introduced to support low-income households deal with the extra adversity brought by the pandemic.
When people lose income their leisure activity is impacted in two ways – directly and indirectly through its effect on motivation. The last thing on a person’s mind when they’re struggling to make ends meet, either because of a loss of work, wage stagnation or cuts to welfare benefits – is to exercise more.
As the country comes out of the covid-19 pandemic, it’s more important than ever that the Government adopts a new approach to tackling physical inactivity, and reducing inequalities linked with poor health. Policies of austerity will no doubt exacerbate existing inactivity and health inequalities.
The costs of reinvesting in preventive services like leisure centres and green spaces and increasing revenue to support the most vulnerable in society will prove a great investment compared to the scale of future health costs. By failing to tackle the social conditions that underpin physical inactivity the Government will be walking backwards not forwards.
The economist Milton Friedman is credited for saying that “Only a crisis – actual or perceived – produces real change”. The covid-19 pandemic has been a crisis and a period of great change – spanning many spheres of life. If ever there was an opportunity to entrench physical activity into our daily lives, and shift society to a more active, more equitable and more sustainable one, surely this must be it! To achieve this goal the Government will need to “build back fairer.” .
Dr Rob Noonan is a Lecturer in the Department of Psychology at the University of Liverpool.
- Ding D, Lawson KD, Kolbe-Alexander TL, et al. Lancet Physical Activity Series 2 Executive Committee. The economic burden of physical inactivity: a global analysis of major non-communicable diseases. Lancet 2016;388:1311-24.
- Lee IM, Shiroma EJ, Lobelo F, et al. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet 2012;380:219-29.
- Public Health England. Physical activity: applying All Our Health. London: Public Health England, 2019.
- Jenkins RH, Aliabadi S, Vamos EP, et al. The relationship between austerity and food insecurity in the UK: A systematic review. EClinicalMedicine 2021;33:100781.
- Lancet Public Health. Poverty is a political choice. Lancet Public Health 2018;3(12):e555.
- Padley MA, Stone J. Households below a Minimum Income Standard: 2008/09 – 2018/19. York: Joseph Rowntree Foundation, 2021.
- Taylor-Robinson D, Whitehead M, Barr B. Great leap backwards. BMJ 2014;349:g7350.
- Taylor-Robinson D, Wickham S, Barr B. Child health at risk from welfare cuts. BMJ 2015;351:h5330.
- McKee M, Karanikolos M, Belcher P, et al. Austerity: a failed experiment on the people of Europe. Clin Med 2012;12(4):346–350.
- Stuckler D, Reeves A, Loopstra R, et al. Austerity and health: the impact in the UK and Europe. Eur J Public Health 2017;27(4):18–21.
- Loopstra R, Reeves A, Taylor-Robinson D, et al. Austerity, sanctions, and the rise of food banks in the UK. BMJ 2015;350:h1775.
- Taylor-Robinson D, Barr B. Death rate now rising in UK’s poorest infants. BMJ 2017;357:j2258.
- Taylor-Robinson D, Barr B, Whitehead M. Stalling life expectancy and rising inequalities in England. Lancet 2019;394:2238-9.
- Taylor-Robinson DC, Lai ET, Whitehead M, Barr B. Child health unravelling in UK. BMJ 2019;364:l963.
- Geidl, W, Schlesinger S, Mino E, et al. Dose–response relationship between physical activity and mortality in adults with noncommunicable diseases: a systematic review and meta-analysis of prospective observational studies. Int J Behav Nutr Phys Act 2020;17:109.
- Strain T, Wijndaele K, Dempsey PC, et al. (2020). Wearable-device-measured physical activity and future health risk. Nat Med 2020;26:1385–1391.
- White RL, Babic MJ, Parker PD, et al. Domain-Specific Physical Activity and Mental Health: A Meta-analysis. Am J Prev Med 2017;52(3):653–666.
- Zhao M, Veeranki S P, Magnussen C G, et al. Recommended physical activity and all cause and cause specific mortality in US adults: prospective cohort study. BMJ 2020;370:m2031.
- Public Health England. Tackling obesity: empowering adults and children to live healthier lives. London: Public Health England, 2020.
- Barr B, Taylor-Robinson D. Recessions are harmful to health BMJ 2016; 354 :i4631.
- Whitehead M, Taylor-Robinson D, Barr B. Poverty, health, and covid-19. BMJ 2021;372:n376.
- UK Government. Build Back Better: our plan for growth. London: UK Government, 2021.
- Marmot M, Allen J, Goldblatt P, et al. Build back fairer: the covid-19 Marmot review. Institute of Health Equity, 2020.