Adding Activity to the City

“The city is not a concrete jungle, it is a human zoo.” (Desmond Morris)

Introduction - Promoting Active Cities Throughout Europe (PACTE)

It will not be a controversial idea to readers of ICSSPE News that regular physical activity is important. We now know, for example, that there is a close relationship between physical activity and health, and the awareness of the health costs of sedentary behaviours is so advanced that inactivity is recognized as a major public health concern: sitting is set to over-take smoking as a public health concern.

There is a trend for sedentary lifestyles across most developed countries, and the costs can be considerable, as was highlighted by the Designed to Move agenda:

Figure 1: economic costs of the school in activity in developed and emerging countries (source: Nike / ICSSPE / ACSM, 2013, Designed to Move – Main Report. Beaverton, OR: Nike, Inc.

EU data confirm the sedentary turn that the world has taken. Physical inactivity has reached epidemic proportions and is growing at an alarming rate. A million deaths per year in the European region alone can be attributed to physical inactivity, as well as reduced quality and quantity of life for countless people. This poses a major threat to the health, happiness and prosperity of individuals, communities, and nations.

It is also becoming clear that a number of social and economic factors influence activity, with one set of results being that some groups of people are particularly disadvantaged in terms of opportunities to be physical active. Women, persons with a disability, minority ethnic groups, and the poor are typically reported to be less active and / or less sportive than their peers, and – ultimately – these groups face additional risks to their well-being.

ICSSPE has joined forces with a number of agencies to examine an under-researched area of the physical activity agenda: namely, the role of cities and municipalities.

Acting as a direct follow-up to our earlier PASS project, PACTE seeks to take a further step towards increasing active cities across the continent.

Why Cities and Municipalities?

Cities are increasingly becoming the dominant form of environment around the world, and represent the heart of many communities. However, to date, physical activity promotion policies have tended to focus on the national level. It is something of an oddity that cities and municipalities have received so little attention from researchers. After all:

• Local policies have a more direct impact on citizens than national ones do;
• Most people in most continents live in cities (in Europe, over 70% of the European population lives in cities and urban areas);
• Approaches focusing solely on changing individual behaviour have had limited success;
• There is increasing evidence that policies and practices are more likely to be successful if they modify the local physical and social environments;
• Policy changes at the local level can be particularly effective by making physical activity an easier choice;
• Cities contain many settings for the promotion of physical activity, including:
  • Cycle paths
  • Parks
  • Sports clubs
  • Schools
  • Workplaces
  • Green space
  • Pavements / Sidewalks

Cities offer numerous opportunities to be physically active, and some have turned their built environment into a space that encourages health and activity for all. Active cities are walkable and cyclable. They are safe and well lit, with good public transport and appropriate management of obstacles and barriers. Recent studies report[1] significantly higher physical activity levels among residents where the built environment is supportive of physical activity.

PASSPORT

A central part of the PACTE Project was the development of ‘PASSPORT’ by ICSSPE. It aspired to offer a representative survey of policies and practices in order to identify the status of municipalities' physical activity policies across Europe, and to investigate gaps in policy and practice. The PASSPORT questionnaire was developed as a standardized tool to provide a systematic approach to capturing details of relevant physical activity policies. Its aim was to understand the situation of those cities and municipalities regarding the physical activity of their citizens as a basis to help improve them. The development of this measurement instrument was informed by the limited number of pre-existing audit tools, then trialled in a heterogeneous group of European cities. The final version was translated into seven languages, and was completed by 663 cities and municipalities.

Initial findings of the PASSPORT survey can be summarised as follows:

1. Cities and municipalities are both important settings of physical activity, and crucial mediators of public health messaging. Physical activity was widely recognised as an important area of responsibility, although there was some inconsistency regarding the ‘ownership’ of this responsibility. It was apparent that physical activity connected with many areas of responsibility for municipalities, including sport, health, education, community development, and city planning, and the delivery of physical activity policies often required the involvement of these and other branches of local governments.
2. Local governments fulfil a vital role in ensuring that all citizens have access to a variety of physical activity opportunities, although the extent to which this happens varies considerably by geography and setting. In some cases, there appears to be a general acceptance of the importance of physical activity promotion at the level of municipalities. Examples of this acceptance include the support of families and younger children. Elsewhere, engagement is more mixed, such as in workplaces and high schools. Lack of involvement with work environments and schools by cities and municipalities is a cause for concern, as these are the settings in which the greatest number of people can be reached with public health communication. The reasons for such disparity are unclear, and would require further investigation. Limited finances might be one factor; another might be inconsistent communication between different levels of governments.
3. Most of the municipalities surveyed reported having a physical activity policy (70%), local recommendations or action plan on physical activity levels (63%), and targets for the population to be physically active (58%). However, only 34% of the sample reported that their physical activity policy was a part of a national programme.
4. Policy documentation was indicated in a wider range of settings. The most positive response at the municipal level was with sport and leisure, urban design, environment, tourism, kindergarten, and primary school. Strongly positive responses of municipalities working with other levels of government included high schools, primary health care, transport, and tourism. Respondents also identified population groups that were targeted by specific actions or activities.  Findings reinforced the account of wide variation in the role of government intervention in physical activity promotion. The workforce receives relatively low support on various governmental levels. People with disabilities also received relatively low levels of targeting. Overall, children, families, girls, boys, older adults, and low SES groups were the groups most strongly identified as populations within the remit of cities and municipalities.
5. When it came to monitoring and evaluation of the policy implementation, on average more than 50 percent of respondents reported that their cities and municipalities do not have it in place. Municipalities were also asked about the types of physical activity strategies they had in place. With the exception of ‘Walking Bus’ schemes (an organised group of children who walk to school together, accompanied by volunteers), all of the physical activity promoting strategies suggested - cycle lanes and cycle paths, cycle parking spots, designated walking tracks, active parks, skate parks, open-access sports pitches - were reported to be in place by the sample overall.
6. It was reported that 74% of municipalities worked with a political leader/designated department for physical activity, with the figure varying from 95% in Belgium, to 48% in Italy. In almost every case, fewer municipalities had local level communication or mass media strategy aimed at raising awareness and promoting the benefits of physical activity.
7. Two questions about employees and businesses where answered with similar responses, with 60% of the sample stating that they both work with private businesses or companies in the delivery of physical activity opportunities, and make physical activity available to employees.
8. Judgements about the importance of increasing the levels of physical activity compared with other areas of work in their municipality or city resulted in an overall score (on a scale of 1 to 100) of 70, suggesting a moderately strong response. The relatively low score from France, Switzerland, and the German-speaking respondents is difficult to explain without further qualitative evidence.
9. The promotion of physical activity in cities and municipalities requires both a breadth of information about its state and status, and in-depth information about the personal and contextual settings in which physical activity policy making takes place. The findings of the PASSPORT survey provide a unique insight into the former. The latter requires further consideration, whether by subsequent surveys which go beyond scratching the surface of the current situation, or qualitative data gathering.

Putting it Together

Cities and municipalities are vitally important settings for promotion of physical activity. However, success has proved harder to come by, and there is an urgent need for inter-agency and intersectoral cooperation. Initial findings from the PACTE Project suggests that communication between the shareholders within cities can be poor, so there is a necessity case for a shared and honest recognition of the challenges facing each city, and a genuine commitment to improvement at all levels. Hopefully, the information generated by the PACTE Project will help inform such developments.

Richard Bailey and Iva Glibo (ICSSPE Office)