DRAFT DRAFT DRAFT DRAFT DRAFT
At the begining of 2021 I have finally had more time to read the multitude of papers and reports that usually pass across my desk.
The Health Foundation Report - Using economic development to improve health and reduce health inequalities - landed just at the right time. I have committed myself in 2021 through SajeImpact to continue to tackle poverty and inequality in my areas of greatest interest - economic regeneration, sport and physical activity and general wellbeing.
This report sums up for me a wide range of the hundreds of thoughts that have been racing through my mind about what that might look like in practise. It makes sense of the various strands of thought. It makes the correct link to why healthy populations depend on more than the healthcare available to them - it is shaped by social, economic , commercail and evironmental conditions in which people live.
Alongside the recent Marmot report it highlights that the last decade have seen massive health inequalities reinforced - and amongst the poorest - life expactancy stagnate and even in some segments decraese.
At its simplest level the report reinforces the point that economic developemt has to be about creating an inclusive economy. Whilst I have raised this when I can I certainly know I need to do more in this area and push the point more, asking tough quetions of programmes and delivery agencies..
As you can see form the table below I remain committed to combining my interests because each is interlinked. This is also why you will hear far more from me on Systems Thinking and Complexity. As you can see fom the table it is bad enough that life expectancy is 10 years lower for the bottom 10th, but you also see the length of time from 52.3-73 a person is ill through poor health conditions. It is no longer about life expectancy but length of healthy life.
Levels of inactivity is greater than the top 10th who live longer but also live well longer! Inactivity and poverty are interlinked and I am worried that our public service delivery (and in leisure and sport) delivers to those most likley to live longer and well already. This is where there is a great deal of reverse causality built into some of our metrics to show the ‘power of sport’. The system looks after those already healthy and pre disposed to stay healthy!
Just think how much greater our SROI would be if we invested more of public monies in tackling the inequalities and not into the worried well?
On a wider national scale I will be reinforcing the point about making the case for wider measures of success. The New Zealand model of Wellbeing measurement is still early in its development but certainly a model I would like to see developed here. Others are already working on this concept of a wellbeing measure and we will support them.
It also helps to join up the dots of the wider system I have been grappling with over the last decade. I have been on a personal journey in sport adminstration. Much of the time I have been interested in ‘sport policy’ and physical activity but over the last few years as austerity and poverty remained endemic in society and the massive inequalities remained in both society and sport and physical activity I have shifted my interest and emphasis into tackling these - not trying to promote the sports system per se. I think taking over as Chair of the Sport for Development Coaltion in January 2021 was a natural progression for me. I still love sport but from a policy perspective i understand why it has its limitations.
In 2013 I started working on the Designed to Move campiagn and my general interest in physical activity began to change. It was no longer a nice to have but a question of justice and inequality. It still is. Levels of activity are still strongly linked to social group and poverty. In one sense my move to promote sport into the LLEP and economic agenda in 2016 had two results. First we did make some minor wins embedding workplace wellebing and recognition of the sports economy in the Leicestershire economy. But at the same time it reinforced my view that we had to tackle the root cause of poverty, and insecurity before we started taking on the issues of inactivity. Poor health and inequality are of course linked. But we need the humility in the sector to understand the complexity of people’s lives when they are so poor they can’t feed their family.
The case for physical activity is strong. I will write more about this over time as it requires the case to be made more simply without exaggeration. But our system appraoch to physical activity isn’t serving our poorest communities. It has failed them. Martyn Allison in his work for us at the Sports Think Tank is very strong. He argues there is an empathy gap. I agree.
This is why my head has been spinning becasue this links to another blog I have in my head (and started) about the distance between policy makers politicians and the communities they serve. My reading of the book Beyond the Red Wall helped me cement these thoughts and a half started blog has some of the answers. I was already onto this with a similar piece when observing our planning for the Loughborogh Town Deal. I think some of this is already well expressed in some of the work of the Sport England Delivery Pilots and written by Joel Brookfield I said something similar 2-3 years ago in my Sports Management column about co creation of solutions in community rather than sport descending and delivering its perceived solutions. You see it’s all circular. I lamented the loss of community development officers. It seems we need to go full circle and create what we have lost.
All of this has been thrown into sharp focus with Covid-19 as the financial crisis has thrown a spotlight on large parts of the system - and it has failed. I have been working with a range of partners looking at the repurposing of public lesiure for example. Whilst it is complex and there is a whole body of work to do put simply there is a question mark for public leisure and who it serves! If local authority involvment in community leisure is not delivering health improvement outcomes but competing in a market for lesiure provision what is the point? Yes its a service but for whom? What does it achieve that couldn’t by the market (which has been pretty adept at creating low cost solutions) Don’t get me wrong there are many great examples and case studies of some of thes Trusts and local authorities delivering programmes and some parts of the provision would be unlikely to exist if it wasnt for public intervention. I am thinking in particular for swimming pools which struggle even under the current model. Many of them were at risk pre covid.
But if public policy is to be involved in the promotion of sport and physical activity where should the investment go?
For me given how little investement is available (DCMS lottery and exchequer funding to SE and UK sport is about £500m the same as Liverpool FC turnover) it has to be invested where it will have most impact. For me that means system change to get the inactive becoming active. If we look at the evidence base for this the investments that work will include a wider range than just sport ad recreation.
The 8 investments that work from ISPAH is a great illustartion to demonstrate how sport and recreation is a very small part of the solution. The real benefits will come from engagement with the wider eco system. We are never going to get the entire naiton interested in gyms and sports. But we can help build reasonable levels of physical activity back into their lives.
We also need to be humble and not overclaim. I am afraid I dig out my 2007 Foresight graphic at every opportunity to make a couple of points.
Sport and physical activity is not the answer to obesity. It is a small part of the system change required in an obesegenic environment/ society. We should stop using reduction in costs of Obesity on the NHS as wins for the sport and gym sector.
There is no single or simple solution so we need to start thinking systems and collaborative leadership if we aim to achieve anything.
So where next for me?
I will be using the tools and evidence to continue to create system thinking in Leiecstershire by developing my own Theory of Chnage model for sajeimpact and the leadership roles I have acorss the County needed to tackle these twin evils. Poverty and ill health (As we have seen strongly interlinked)
Working with others we will continue to build the evidence and case studies that can help change behaviours across the system in Leiecsterhire but through the Sports Think Tank. We will create a learning hub for all of the sport and physical activity sector..Sport England, Active Partnerships, LGA etc. I would love to see others learning from our journey and that of other Active Partnerships and LEPS that have been trying to make these changes.
There is a need for system leadership. It is easy to look across the system and assume that means somebody else. I need to step up through my minor leadership roles at LRS and the LLEP to help and perhaps even lead sme of this work.
I need to keep learning and developing networks of like minded people
I have been so buy ‘doing’ for most of my life have not really had enough time and space to stop think and plan. Now I have and want to craete the ‘impact’ part of our name!