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A manifesto priority? It should be...

Dear politicians,

It's that time again! time to dust off priorities old and new, and polish them up to make them as attractive as possible for your manifestos and speeches – and we all know that 'health' will, as ever, be front and centre, as it is for voters.

So, what if I told you that there was a cheap drug that could cut cancer and cardiovascular disease, help to keep obesity rates down, stem the tide of type 2 diabetes (that alone accounts for around 10 per cent of the NHS budget), and has huge benefits for mental health?[1] In your manifesto, would you prioritise universal access to this, and pledge to ensure that its use was not often restricted only to people living in well-off neighbourhoods? Of course you would – there would be uproar if you didn't.

But it isn't a drug, it's physical activity – and, despite all the evidence, last time around it only really squeaked into most of the 2015 manifestos:*

  • The Labour Party (86-page manifesto) said: 'A greater emphasis on prevention and public health is essential, not just to improve outcomes and tackle inequalities, but to ensure the NHS remains sustainable…. We will set a new national ambition to improve the uptake of physical activity.' There is also a brief mention of cycling (but not walking), in a transport context: 'We will support long-term investment in strategic roads, address the neglect of local roads, and promote cycling.'

  • The Conservatives (83-page manifesto) said, under the slightly peculiar heading of 'We will boost sport in your community' (physical activity isn't all about 'sport'): 'We will continue to invest in participation and physical activity, recognising sport’s vital benefits to health and to NHS England’s campaign to prevent diabetes.' Cycling – but not walking – got a mention: 'We want to double the number of journeys made by bicycle and will invest over £200 million to make cycling safer, so we reduce the number of cyclists and other road users killed or injured on our roads every year.'

  • The Liberal Democrats (158-page manifesto) do a little better: 'It is better for patients and for the NHS if we keep people healthy in the first place, rather than just waiting until people develop illnesses and come for treatment. This means doing more to promote healthy eating and exercise… Improving our environment is a vital step to improving people’s health… by opening up more sports facilities and building more cycle routes we can cut obesity and reduce heart problems'. This includes 'promote evidence-based ‘social prescribing’ of sport, arts and other activity to help tackle obesity, mental health problems and other health conditions'. A new Green Transport Act was also proposed, with 'new incentives for local schemes that cut transport-related pollution, and encourage walking and cycling'.

  • Well out in front was the Green Party (86-page manifesto), with several mentions including: 'The Green Party takes a whole society approach to health... Intervention by a trusted health professional can make the difference at an individual level. This can often be linked to local services, such as advice centres, opportunities for physical activity, lunch clubs and so on', 'an increase in outdoor education and physical activity so children establish an early and strong relationship with their local environment', and a far greater on transport and active travel.

It will doubtless be argued that there are 'more important' things to focus on in this election... But even given the huge repercussions of Brexit, keeping people healthy and happy (not to mention our impact on the climate – the 'biggest global health threat of the 21st century'[2]) must be right at the top of the list? Making it easier, safer and more attractive to walk and cycle** is one of the very best, most inclusive ways to deliver this.

Our political times are changing in new ways that are not split along traditional left/right lines – so could one of those changes be a renewed focus (backed up with purposive funding and action) on what *really* improves health?

I will be watching your manifestos with interest. We may have ratcheted down to become a largely sedentary population over the course of a couple of generations, but there is no good reason why we can't make a further shift into a more active, happier future. It will take work to link up all the different sectors that influence our habits, but being active could once again be something that we do without thinking about – not because it's 'good for me', but because it's fun, easy, cheap, the quickest way to get about, safe, and sociable.

Wishing you fortitude for the coming 50 days (and going for a brisk walk will help you through it).


* Being south of the border, I've not looked at the SNP for this - but I will be scrutinising their new manifesto, along with the Women's Equality Party.

** Oh, and if you're worried about car-lash, it isn't as divisive an issue as you might think: a survey published today found that, in London, over 7 out of 10 drivers are in favour of new bike lanes being built; in these times of swingeing constitutional change on a 2 per cent margin, 70 per cent sounds like an overwhelming majority to me!

[1] Evidence on health benefits is myriad and growing: just today (20 April) an article links active commuting with significantly lower rates of cancer and heart disease: C.A Celis-Morales et al., 'Association between active commuting and incident cardiovascular disease, cancer, and mortality: prospective cohort study' (2017) BMJ 357. For more information on the physical- and mental-health benefits, see, for example, Public Health England, 'Everybody Active Every Day' (2014), p.7.

[2] A. Costello et al., 'Managing the health effects of climate change' (2009) The Lancet (373) 9676: 1693–733.

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