Valerie A Little, Dudley Director of Public Health

1. Green Spaces to Healthy Places
The Dudley Healthy Towns Story

2. The Evidence Base - 1
• Better health overall positively related to greenspace, regardless of
socio-economic status
• Levels of physical activity positively related to greenspace
• Greenspaces most valuable for physical activity when high volume
use
• Greenspaces need to be accessible, connected and safe
• Consistent negative relationship between levels of stress and
access to greenspace

3. The Evidence Base - 2
• Primary value placed by people is ‘destressing’; physical activity
second
• Frequently noted as places of attachment
• Populations exposed to the greenest environments have lowest
levels of health inequality.
• Causal pathways not well understood
• Dose/response relationships not well understood
Croucher et al (2007); Mithcell and Popham (2008)

4. What is the Healthy Towns Programme?
• National Pilot Fund available for the prevention of obesity
(£30 million) through environmental change.
• Dudley PCT/Council Joint Bid
• One of 9 successful bids nationwide
• £4.5m awarded for ‘Lets Go Outside’
• Dudley’s Programme
– Healthy Hubs
– Active Travel Corridors
– Service Reform

5. Why was obesity prevention receiving
funding?
• 2/3 of the population of England are overweight or obese.
• Obesity has grown by 400% over the past 25 years.
• Obesity will surpass smoking as the greatest cause of premature death.
• The costs of treating the conditions attributed to poor diet, low activity levels
and obesity run into £billons
• The UK has the fastest accelerating rates of childhood obesity in the
world
• Today’s generation of children will be the first for over a
century for whom life expectancy falls

6. What is the “environment” and why was it a focus?
• The environment refers to all of the objective structural factors,
external to the individual, that both positively and negatively
influence a person’s behaviour
(Baranowski et al. 1997)
• Environmental Interventions contribute to behaviour change
by advocating and implementing measures that will make it
easier for people to engage in health enhancing activities,
whether they are aware of it or not, while making it more difficult
to engage in competing and less desirable behaviours

7. Environment tiers
• Healthy hubs (specific local)
• Active Corridors (wider general)
• Service reform
(Borough wide and sustainable)
Healthy Towns

8. What is a Healthy Hub?
• 5 Parks (one in each Select Committee area)
• New building
• Staff
• Outdoor gym
• Pathway improvements
• Play areas and MUGAs
• Programmes and events

9. Why did we take this approach in Dudley?
Issue Approach Rationale outcome
The evidence base for Increase PA opportunities Low levels of physical Increased PA levels
the prevention of activity (PA) within the within the parks and
weight gain is to Borough via active corridors
increase physical (see evaluation
activity (PA) with findings)
dietary support.
People felt unsafe in Get committed police Dudley Lifestyle Police are committed
parks, and generally involvement from the survey 2004 showed partners, with formal
felt that safety was a start. Recruit on site that 66% of people protocols signed off by
barrier to be physically rangers, increase could be more active if the Chief inspector.
active. footfall. safety issues were Rangers appointed 2x
addressed. per site. Footfall
massively increased
Barriers to PA (next slide)
Not enough facilities Provide new buildings Previous park work, See Hub slides
and services locally with toilets, kitchens Livability,
new paths, play areas Transforming your
MUGAs walking and space (TYS) National
cycling infrastructure LEAP pilot, Steps to
Health and the Play
Pathfinder
consultations.
The need for Supportive Hubs , corridors and National and local evidence Five Hubs, 30km of active
Environments to enable service reform and guidance corridors, service reform
and support behaviour and policy development
change

10. Why parks, existing and potential?
Barriers to activity Potential of Parks
• Cost • Free
• Lack of time • Local, can be accessed
• Not the sporty type quickly
• Access • People don’t have to be sporty
• Transport • Within 15mins of home/work
• Personal safety • On site staff
• Lack of welcoming facilities • Welcoming facility

11. Typical Hub Building
New Build

12. Unisex and disabled toilets with baby change facility

13. Covered outside space

14. Outdoor Gyms

15. Active Travel Corridors
• Improve access to and from hub
• Linkage with wider borough travel infrastructure
• Cycle and footpath infrastructure
• Traffic calming
• Signage

16. Active Corridors (On road)

17. Active Corridors (Off road)

18. Service Reform
• Physical Activity on all agendas
• Transformation of Parks Service
• Safety considered at all levels
• Partner impact on health recognised
• Planning guidance in place to tackle the obeseogenic environment
Make it Sustainable

19. Service Reform
Transformation of the Parks Service
Park Keeper - Scale 2 - 3 Park Ranger - Scale 3 - 4
Experience
Relevant practical experience of working with Relevant practical experience of working with
the public in a front line position the public in a front line position
Must be able to demonstrate a basic knowledge Some experience of risk assessment and
of Health & Safety requirements including some knowledge of health & safety
experience in preparing risk assessments
Some experience of working with community Some experience of working in a park, sport or
groups community environment
Some experience of supervising staff, trainees Some practical experience of working with a
or volunteers range of age groups
Qualification/training
NVQ level 1 in amenity horticulture or equivalent A minimum of NVQ level 2 in; play work, sports
coaching/gym instruction, customer services,
amenity/environmental subject
Willingness to undertake any training in relation Willingness to undertake any training in relation
to the job requirements to the job requirements
Advertised
Horticultural Week Leisure Opportunities

20. Successes and opportunities
• High profile of the health agenda at senior Council and Elected
Member level
• High profile and support at regional level
• Strong police commitment
• Joint Core Strategy
• Changes to departmental structures
• Alcohol strategy, Clean air plan, HPS
• Recruitment, maintenance, adherence and exit for supportive
services
• Umbrella term

21. Evaluation
• Relevant Targets (RT):
• More children and families more active over initial base
line.
• An Increase in Parks/ Hub usage over baseline
• Increased perceptions of safety in and around the
Hubs.
• An increase over baseline of numbers of children and
families walking and cycling.
• An increased awareness and understanding of the
Change 4 Life messages.

22. Is it working?
Final evaluation report – October 2011
Some interim findings:-
- 11,000 structured attendances September 2010 – July 2011
- 65% gym users use it > 1 week
- 54% male, 68% female gym users
‘think about other ways to be more active’
as a result of outdoor gym use

23. Is it working? Findings so far
User comments:
• ‘I feel healthier because I am outdoors and I am physically more active’. (male aged 46).
• ‘Nice to be able to be active with the whole family’ (male aged 41)
• ‘It has inspired me to generally lose weight and spend more time with my kids’( female aged 34)
• ‘I go with my husband and daughter. She sees mum and dad being active and it encourages her also to be active.
She goes on to the park and also socialise with other children which is great. We can all keep fit now and it doesn’t
cost a penny’ (female aged 27)
• ‘Single person can getting out more, mixing with other people of all ages in a friendly environment’ (female aged
55).
• ‘I can use this now for free instead of paying for the gym’ Paul says, ‘I think it’s great, I only came over with the
baby and now I’ve done a workout, really think its brilliant’.
• ‘I use it because it keeps me healthy, it’s free and I can’t afford to use other gyms. It’s really good because I think
people of all ages will now be able to get fit outdoors and people can also strengthen their muscles’
•
‘Having the gym equipment installed and the introduction of the park rangers has been a marvellous concept. This
has led to more people using the facilities on the park, so of course leading to residents of the area being healthier
as a whole. I look forward to see what changes will be happening on the park in the future, if the events over the
last few months are anything to go by in this exciting embryonic stage’.

24. Is it working?

25. Healthy Towns “Health is Everyone’s Business”
Increased Budget
Youth
Services
Improved Mental
Health
No 1 PCT Strategic
Plan
Children’s
Services
Weight
Management LAA Phases
N18 56 NI57
Green Space
StrategyLocal Area Increased
PPG 17 Action Plans Activity in
JCS
Parks Recruitment
Retention and exit WEA Tandrusti
Reduction in ASB Social Cohesion
Links to external for Services
partners
Inequalities
Strategy

26. Healthy Towns Embedded ?
Police Political Buy In
Youth Increased Weight Watchers
Services Budget Support and exit
National Profile Improved Mental No 1 PCT
Children’s Obesity Strategy
Services Health Strategic Plan
Five hour offer Clean Air Act Weight
Management Phases
PPG 17 Local Area Increased LAA Cardiac GP Referral
JCS Action Plans N18 56 NI57 Rehab
Activity in
Parks Increased
Green Space Community Recruitment WEA
Strategy Regeneration Activity Retention and Tandrusti
Reduction in exit for Services
ASB Social Cohesion
PA Strategy Links to external Age
partners Concern
Reduction in
Crime
Inequalities DACHS
Strategy Social Inclusion

27. Next Steps
• Full evaluation report due October 2011.
• Local and national dissemination.
• Use report recommendations to plan the next three
years of service delivery.
• Embed the programme into core business.