Will the government be able to reach the goals it has set for itself in the 2004 Spending Review? Will the year on year increase in childhood (under 11s) obesity halt by 2010? Will it manage to reduce the morbidity rate from coronary heart disease? Will there be a decline in the number of falls in the elderly? Bigger problems, new targets, the same way of working.
The National Network for the Arts in Health (NNAH) has long advocated that the Arts improve health. For some, this is clear. Yet, as a nation, we still apologise for investing in the future of arts and culture. The arts are a luxury, not a way of life. What practical contribution can the arts really make in improving health, and reaching these Public Service Agreement (PSA) targets?
Politicians appear to be brave to set targets high enough to raise eyebrows and expectations, but too scared to try anything innovative to help these be achieved. How will the year on year increase in childhood obesity be stopped by 2010? How will the morbidity rate from coronary heart disease be reduced? How will the number of falls by the elderly be lowered? The same answer, a different year: sport.
Sport England should really be praised for its ability to convince those with the purse strings that wrapping the same activities in different wrapping paper will make a difference. Through LEAP, Local Exercise Action Pilots, £2.6 million will be invested, less than 5% of which has been allocated to dance, much less any other arts activity.
LEAP is jointly funded by the Department of Health, the Countryside Agency and Sport England. It is designed to test the best ways of encouraging people to be more active, especially those who do little exercise and those at risk from health problems.
Something, of course, must be done. The strain on the NHS from these health targets alone is great. In 2000, there were over 100,000 deaths from coronary heart disease. 1.3 million people in England have diabetes. Each year, 110,000 people in England have their first stroke with just under 30% expected to have subsequent strokes. Over 400,000 older people per year are admitted to hospital following a fall, with 14,000 annually dying from an osteoporotic hip fracture.
All of this, of course, has a price tag. The poor health of this nation, much of which can be attributed to poor diet and the lack of exercise, results in 18 million days of sick leave; 30,000 deaths with nearly half before retirement age; £0.5 billion cost to the NHS and £2 billion indirect cost to the economy.
The government has responded with a tried and tested answer: increase the number of opportunities for physical activity and sport. While Arts Council England had its allocation from the Department for Culture, Media and Sport frozen, Sport England yet again walked off with the trophy. Where is the lateral thinking? If those struggling with their weight and living with a bad diet and lack of exercise were inclined to sports activity, would LEAP be necessary? How many (funded) community football clubs are there versus dance groups? It seems the government has missed the boat.
In fact, when you are over weight or obese there is a stigma associated with team sports and exercise. You often suffer as well from asthma and depression. If you are embarrassed to wear gym kit or a swimming costume, suffering from asthma, and depressed by your own self-image, will you want to play sport?
I received a telephone call from a friend few weeks ago whose 11 year old nephew had just been admitted to hospital, with a suspected stroke. He, like his mother, is morbidly obese. His lack of exercise is exacerbated by a poor diet and low self-esteem. He is often kept at home as the result of severe bullying. I have no doubt about whether sport or the arts have the greater power to engage this young boy or which would prove more persuasive with his worried mother.
The arts make a significant contribution to tackling many of the root causes for lack of physical activity. For instance, studies such as Bronchial Boogie have shown that people suffering from asthma - even those with severe asthma - that sing or play a wind instrument improve significantly, using their inhalers less. Further, feeling better about yourself mentally is a step closer for anyone to feel better physically and this has an impact on even wider community targets.
LEAP is not just about younger people. What physical activity is there for over 55s, 65s, 75s? The Countryside Agency are partners in LEAP and walking forms a significant part of the physical exercise programme for the elderly. However, how far will you want to walk after a double hip replacement?
Dancing and creative movement for older people offers more flexibility and involves a broader spectrum of physical abilities. For instance, you may dance standing or sitting; in a group or alone. Creative movement in older people improves agility, reducing the risk of falls. It also increases circulation, lowering risk of urinary tract infection, another major problem of ill health in the elderly. When combined with singing and reminiscence work has had a significant impact on lucidity in early Alzheimer's patients.
Young or old, we are indeed a dancing nation. As the Foundation for Community Dance taught us in its video and publication, Dancing Nation, "in the year 2000, over 4 million people took part in dance activities in their local communities initiated by dance professionals, companies and agencies in England alone." We all dance. Each of us has a song that makes us want to wiggle each time we hear it. An innate desire for creative movement and dance knows no age barrier or physical restriction.
Gateshead learned the lesson of the attraction to dance over exercise through a set of healthy heart posters created by artists John Angus and Alison Jones. The 12 posters were sponsored by MSD Limited and distributed to many health centres across the country. The artist created one image of a person dancing with the message "Dancing Makes the Heart Grow Stronger". When first presented, those commissioning the project argued the poster should encourage "exercise", not "dance". In the end, a compromise was reached. They published a limited print run of both messages, with health centres having the opportunity to chose. The overwhelming number agreed with the artist, "Dancing Makes the Heart Grow Stronger".
What can we do to turn the tide and change minds? There are ten LEAP initiatives in nine regions:
- North East - Durham Dales Primary Care Trust (PCT)
- Yorkshire & Humberside - North Kirklees PCT
- North West - Ashton, Leigh and Wigan
- West Midlands - Dudley Beacon & Castle (with Dudley South) PCT
- East Midlands - Nottingham City PCT
- East of England - Great Yarmouth PCT
- South West - West of Cornwall PCT
- South West - Plymouth PCT
- South East - Hastings & St Leonard's PCT
- London - Wandsworth PCT.
Contact one near you and explain that encouraging people to engage in more physical activity is not about spending more, rather spending more wisely. Present dance and creative movement as an innovative way of achieving PSA targets that will engage a broader spectrum of the community, regardless of age or physical ability, whether urban or rural.
The Foundation for Community Dance, as well as the National Network for the Arts in Health have information and resources including articles and publications that offer convincing testimonies to help you make your case. Further, of the ten LEAP initiatives, two do offer dance as a part of their scheme.
In Hastings and St Leonard's Primary Care Trust, after school activities include two dance sessions. One targets 12 - 13 year old girls, while another is for children aged 9 - 11. Wandsworth PCT encouraged people to keep active over Christmas by "dancing around the house". Do a bit of research into the PCT and Local Authority funded dance activities in your region. Pointing to initiatives in other areas can go a long way to convincing others that dance is an important option.
Finally, it is essential to feed information back to the Foundation for Community Dance and The National Network for the Arts in Health about your dance and creative movement initiatives for these and other target audiences. The more information these organisations hold, the more we are able to share with others.