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Get moving — for your heart’s sake!

Topics: Human Wellbeing | Comments

Get moving — for your heart’s sake!

Dr Rob Grenfell was, until recently, the National Director of Cardiovascular Health for the Heart Foundation, an Australian organisation working to reduce the incidence and severity of cardiovascular disease, which accounts for 32% of total deaths in Australia each year.
It does not take long to realise why he is such an outspoken and passionate advocate for the inclusion of green spaces in our metropolitan cities.
“We are grossly physically inactive and physical inactivity is an independent risk factor for chronic disease,” Dr Grenfell says.
“The World Health Organisation rates physical inactivity as the fourth leading risk factor for global mortality.”
This startling fact brings home the message that physical activity cannot just be an added extra or an optional component in our lives—it is a necessity. Lack of physical activity has major implications for the prevalence of non-communicable diseases and for the overall health of people across the globe.
“Physical activity is good both for managing disease risk and for managing established disease,” Dr Grenfell says.
He cites cardiovascular and kidney diseases, as well as stroke, arthritis, Alzheimer’s, breast and colon cancers, depression and risk of falls as conditions that can be ameliorated by patients increasing their physical activity levels.
“For example,” he says, “strength training in cases of heart failure decreases the risk of re-admission to hospital by 30%”.
Encouraging physical activity is therefore a key mechanism for maintaining and improving health status.
“The question to be asked is whether the environment we live in is conducive to physical activity. That is why open spaces are so important,” says Dr Grenfell.
“This is where the role of governments comes into play. We need space, and space is administered by governments.”
“Urban development therefore needs to foster physical activity for health and for community adhesion.”
Indeed, rather than parks and health being seen as two separate entities, Dr Grenfell argues that parks can and should be seen as a setting for community health.
The two factors he cites as crucial to enable parks to perform this health function are the quality of the parks, including their amenities and facilities, as well as their accessibility to the communities in which they are located.
“People who are poor, especially those without access to a motor vehicle, have the worst access to public space,” he says.
“If a park is on a busy road with no footpath and no public transport services, residents like mothers with babies in prams, who don’t have a car, just can’t get there.
“If a park is maintained, has shade and is easy to get to, people will go there.”
Reducing the inequity in access to quality open space is one of Dr Grenfell’s priorities. This could be achieved by addressing the glaring and obvious gulf that exists between suburbs in Australia’s metropolitan cities. Another is to help people realise what great places parks are to spend time in.
Dr Grenfell explains that for many people visiting parks has not been part of their lives and they need help in actually realising the fun and enjoyment to be had in them.
“People are not socialised in how to use parks, or what to do when they get there.”
So as well as physical barriers to park access, like lack of transport, there can be barriers within an individual who has no understanding of what parks are for and how to use them.
He says these barriers to park usage are being overcome through the leadership of individuals in healthcare, local government, sports, educational and other community organisations that assist in implementing targeted interventions to particular groups. For example, in the Geelong region , Dr Grenfell was a key player in the Healthy Parks, Healthy People Active in Parks Program. Undertaken as a pilot project to increase levels of physical activity throughout the community, the project involved collaboration from a range of stakeholders across government, health and community organisations.
One initiative was a ‘green scripts’ program, which provides trainers to deliver accredited exercise programs – exercise ‘prescriptions’ instead of pharmaceutical ones — at pre-arranged times to people selected by their general practitioners. Professional trainers provide direction and motivation, guiding participants through a structured program, and supervising the correct use of equipment. For some people, this is their first experience in a scheduled exercise program.
Dr Grenfell cites the leadership of maternal and child health nurses, who helped members of mothers’ groups meet at the park instead of indoors.
“This normalises physical activity and instils in children the habit of being outside from an early age,” he says.
In another example, children were given custodianship of an area within the botanical gardens to grow vegetables, so that being active and outside became part of their routine. In a further example, a group of people recovering from mental health issues began monthly visits to parks, which helped them transition from health care facilities back to the community.
“The feedback from these participants, which included people recovering from illnesses such as schizophrenia, was mind-blowing,” he said.
Other initiatives aimed at the general population — such as Parks Week — can operate in tandem with activities for specific groups.
“It is about multifaceted interventions that build local ownership and develop community resilience,” Dr Grenfell says.
The National Heart Foundation, through its funding of research to improve the incidence and treatment of cardiovascular health, is also supporting further study into the relationship between heart health and access to green spaces.
In its funding program for this year is a project by Dr Thomas Astell-Burt from the University Western Sydney, who is investigating the extent to which green space influences cardiovascular disease.
As Dr Grenfell explains, the science is moving away from relying on studies that indicate a correlation or an association between improved health status with time spent outdoors, and is now looking to build a scientific case of causation between green space and health outcomes. Measuring the effect of access to green space is an important progression.
Dr Grenfell says that work on developing a liveability co-efficient is also being done to quantify the features and factors that make a community a safe, happy place to be residing – and green space is part of that.
As he said to a Parliamentary inquiry in 2011, “The evidence of health benefits of accessible open spaces is compelling.
“The further you reside from an accessible open space, the more likely you will suffer from ill-health and essentially a shortened life.
“The essence of a community is the connection with your neighbours, friends and family, and you need open space to do that.”

An Active in Parks toolkit, based on work carried out in Geelong and in other areas, will be launched by People and Parks Foundation at the IUCN World Parks Congress 2014 to be held in Sydney in November 2014. This will enable all communities, both in Australia and overseas, to develop their own Healthy Parks Healthy People programs.


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