Thoughts from Clare - Learning from the Dutch
What have a recent family holiday to Holland and the latest report from The Health Foundation got in common?
On the face of it, nothing at all. And perhaps the phrase ‘in common’ is a bit of a misnomer. But it got your attention, so bear with me.
I’ve just returned from a week’s holiday in southern Holland with my husband and two children (aged 10 and 6). Apart from mistakenly buying 2 litres of buttermilk thinking it was normal milk (and therefore developing a new found love of buttermilk pancakes), the one other thing my kids have raved about in relation to the holiday was how much time they could spend on their bikes, and how easy it was to cycle to the supermarket/shops/cafes/ice-cream parlour/beach etc. Of course, the Dutch obsession with cycling is not new news, and nor is the enviable infrastructure that they have in place which allows cycling to be the easiest transport option.
My greater surprise was that it really is for everyone; we saw an older lady cycling with her crutch tucked under her arm, we saw a person in a wheelchair being pushed along by someone using a bike, we saw dogs being ‘walked’ by cyclists, very young children in cargo bikes and bike trailers, office workers, tourists, delivery drivers – all using 2 wheels (and sometimes 3 as we certainly spotted more than the occasional trike) to move easily around.
And so to the second part of this blog. On 25th July The Health Foundation published a new report, ‘Health in 2040: Projected Patterns of Illness in England’. There are some sobering facts in there:
The amount of time people are projected to live with major illness is expected to increase from 11.2 years in 2019 to 12.6 years in 2040;
The number of people living with major illness is projected to increase by 2.5 million by 2040, more than a third. This implies a shift in the share of the adult population living with major illness, from almost 1 in 6 in 2019 (6.7 million) to almost 1 in 5 in 2040 (9.1 million). Most of the increase in people living with major illness is among those aged 70 years and older.
The number of people living with major illness in England is projected to increase by over a third (37%). But the number of 20–69-year-olds (approximately the working age population) is projected to grow by just 4%. This is the group that generates the bulk of government revenues, which are used across all areas of government spending including the NHS.
The report is also keen to point out, however, that whilst on the face of it these projections are sobering, they are also a testament to progress; “there have been large improvements in life expectancy over the past 100 years, driven by improved living standards, public health interventions and advances in medical technology. Over the next 20 years, we project on average that people will spend their additional years with major illness rather than live longer in good health”.
I’m not aware that there is a similar report into the health in 2040 of the Dutch population, but I would hazard a guess that at least one key risk factor - exercise – has the potential to improve the picture somewhat. The Dutch have set a target that 75% of the population achieve the recommended 150 minutes of exercise per week target by 2040 (the latest picture in England is 63.1%). Building physical activity into very day life by using active travel seems like it is essential to reaching such a target, whilst simultaneously contributing to other essential targets around carbon neutrality and air quality.
Active Travel England is the government’s executive agency responsible for making walking, wheeling and cycling the preferred choice for everyone to get around in England. The Health Foundation Report highlights that “the projections also have implications for wider public services, such as social housing and community services” and I would argue that Active Travel England’s role to prioritise active travel must be viewed as part of ‘community services’ and therefore be part of a cross-governmental response to the issues raised by The Health Foundation; active travel can ultimately serve as a much needed service to our communities.