Exercise: we calculated its true value for older people and society
This article by Carys Jones, Research Fellow in Health Economics at the Centre for Health Economics and Medicines Evaluation is republished from The Conversation under a Creative Commons license. Read the original article.
Taking up exercise is one of the most popular New Year’s resolutions for people wanting to improve their health. But our research shows that the benefits of older people going to exercise groups go beyond self-improvement and provide good value for society, too.
Less than two-thirds of UK adults reach the recommended physical activity levels of 150 minutes of moderate intensity exercise a week. Keeping active is especially important for older people because it can help reduce falls and improve independence and the ability to carry out everyday tasks. It also boosts mental wellbeing.
Older people are more vulnerable to loneliness and social isolation, and forming friendships and the social aspect of taking part in group exercise is a good way of protecting them from this. A study that followed older people in Taiwan over 18 years found that people who regularly took part in social activities were less likely to be depressed than those who did none. Research has also shown that having a strong social network decreases the risk of death over time.
But our research has now also found that exercise groups for older people are valuable not only to those who take part but also for the wider community.
We carried out a study of the social value generated by the Health Precinct, a community hub in North Wales that grew out of a partnership between local government, the NHS and Public Health Wales. People with chronic health conditions are referred to the Health Precinct through social prescribing. Social prescribing is a way of linking people to non-clinical services that are available in their community. The idea is that offering services in a community setting rather than a hospital or clinic will provide a non-threatening environment and encourage people to go.
Although the scheme is open to people of all ages with chronic conditions, so far it has mainly been used by older people and the most common reasons for referral are issues with mobility, balance, arthritis and heart conditions.
After someone is assessed at the Health Precinct, they receive a tailored 16-week plan that sets realistic goals and encourages them to take part in exercise groups at the local leisure centre. The Health Precinct promotes health and wellbeing improvement by encouraging social participation, independence and self-management of conditions.
Our approach to measuring the value of the programme was to carry out a social return on investment analysis. This method explores a broader concept of value than market prices, and puts a monetary value on social and environmental factors such as health status and social connectivity.
To establish what the impact was at a societal level, we included in our analysis the effects on people who attended the Health Precinct, their families, the NHS and the local government.
Over a 20-month period, we asked people aged over 55 and newly referred to the Health Precinct to fill out a questionnaire at their first appointment, and again four months later. We were interested in measuring changes to their physical activity levels, health status, confidence and social connectivity.
We also asked family members to fill out a questionnaire on changes to their own health as we thought they may worry less about their loved ones and increase their own activity levels.
We calculated potential savings to the NHS by collecting information on how the individuals’ number of GP visits changed after taking part in the Health Precinct. We also estimated the impact on local government by looking at patterns of leisure centre attendance, and explored how likely people were to take out annual memberships after they had finished a 16-week programme.
A monetary value was then assigned to all of these factors to estimate what the overall amount of social value generated by older people doing regular exercise at the leisure centre was. This figure was compared to the annual running costs of the scheme.
Our findings suggest that the value generated by the Health Precinct outweighs the cost of running it, leading to a significant positive social return on investment.
Investing in health
In the current climate of squeezed health and social care budgets, it is more important than ever to identify services that offer good value for money and benefit multiple people and organisations.
The model of social prescribing and managing health and social care services in the community is increasingly popular. One of the more established examples is the pioneering Bromley by Bow Centre in London, which celebrated its 35th year in 2019.
Investing in community assets that encourage older people to get active physically and socially are key to not just improving their wellbeing but also generating future savings for society by lowering demand for health and social care services.
Publication date: 9 January 2020