Cycle of ill health

Seonag Mackinnon

Heart disease is the number one killer in Glasgow. In an attempt to reverse this, more people are being encouraged to take exercise as part of their daily lives. Seonag MacKinnon reports

The concept of a major new campaign, Fit For Life, the biggest health project of its kind in the UK, was born a few years ago in the privacy of a Glasgow cardiac consultant's room.

Discovering that the patient on the couch was the council's director of roads, Professor Henry Dargie seized the moment. He put it to the recumbent Donald Carruthers that a combined health and transport campaign might encourage more people out of their cars and into a state of health which makes visits to heart doctors less necessary. It would also cut traffic congestion and pollution. Mr Carruthers agreed.

Now wind forward to a rainy evening this month at Cleveden Secondary in Glasgow's West End, and a meeting of roads and health experts to explain the scheme to children and their parents.

The council is new, but some of the players are the same, including cycling officer Erl Wilkie, who was charged by Mr Carruthers with implementing the plan which for the first time would draw in Glasgow University and Strathclyde Passenger Transport as well as the Council and Greater Glasgow Health Board.

The idea of the campaign is to per-suade people to build exercise into their daily routine as previous car-less generations did - the number of seven to 11-year-olds driven to school in Britain has climbed from 1 per cent to 30 per cent in one generation.

Earlier this year, Glasgow commuters were urged to give escalators a miss by cardboard figures exhorting them to use the stairs. Now they are being encouraged not to drive, but to walk or cycle.

There will be three prongs to the six-month pilot. A workplace scheme, involving 70 adults from private and council workplaces, split into three groups - 20 cycling, 20 walking and 30 controls; a coronary rehabilitation project with 20 walkers and 20 cyclists invited into a 12-week exercise programme on the penultimate week of their rehabilitation course; and a school project involving fourth-year pupils at four Glasgow secondaries - Cleveden and Penilee, Drumchapel High and Bellahouston Academy.

Ten volunteer pupils in each cycling group have been supplied with a new bike, a safety helmet and fluorescent wear for dark winter days, and given cycling proficiency training. Foot and cycle ways are being installed or upgraded - each school has a one-mile cycle route and, finances permitting, Bellahouston and Penilee will see two more routes built. At school there will be a bike rack, a locker for clothing and equipment, and a shower. The walkers also receive protective clothing and maps highlighting the four new cycle routes leading to the schools.

Glasgow University medical staff will visit the project schools at regular intervals in a jazzy bus adorned with knock'em-out garish colours and the Fit For Life logo to assess the progress of participants' fitness with questionnaires and medical tests. An unlucky control group receives only this treatment, no Pounds 160 bikes or clothing.

In its report The Way Ahead, Fit For Life presents some grisly figures. The number of lung cancer victims in Glasgow is 50 per cent above the Scottish average. Respiratory disease is 80 per cent higher and assorted other fatal disorders are 30 to 40 per cent above the national average. But at almost 3,000 deaths a year in a population of 618,000, heart disease is the number one killer. The Pounds 1.95m cost of the scheme is being called by the organisers Today's Best Buy in Public Health, on the premise that prevention costs nothing compared with treatment for the thousands of citizens making an early exit. There is disappointment, however, that the European Commission has expressed interest but as yet failed to pour any money into it.

Organisers say the scheme will be extra cost-effective, since the health message will reach many more than the participants. They hope to build up among peers a desire to improve.

As we came out of the meeting at Cleveden, a crowd of new Secondary 1 pupils left their Welcome Disco. The faces of the adolescents who could have been from any school in the city seemed as luminous as the fashionable glow sticks they brandished. But far from glowing with health after their exertions, they were pink, out of breath and sweating. Some were decidedly chubby. As if to confirm a less than healthy lifestyle, they descended in droves on the fizzy drinks machine in the hall.

Ironically, many were wearing the sportswear that is the uniform of this generation. But the gear bears testimony less to real interest in sport than the success of multi-national sportswear companies. If only the health educationists had the same know-how and resources to influence this group.

On the day the bikes are handed out and the participants receive lots of attention from the medics in the jazzy bus, younger children cluster round agog, asking for a shot. "Gets on your nerves," says 15-year-old Gary Whitelaw unconvincingly about the envy and attention. Gary is less than wild about having to wear a helmet, but is happy about the mini convoy arrangement at 7.55am with fellow participants from the Summerston area for the 10-15 minute, one-mile journey. Riding in a pack on dazzling new wheels is cool, even with helmets. The exertion is not daunting since, like many on the scheme, Gary and his parents are more interested in health and fitness than the average person. This fact may make any improvement in fitness after the six months less marked than it could be, but organisers felt obliged to base the scheme on self-selection, since they needed a high level of commitment to the full term of the experiment.

Gary is definitely not typical of Glasgow children. A 1993 Health Education Board survey of 10 to 15-year-olds indicated that one quarter exercised out of school only once a week or less. Girls are particularly prone to be sloths. A 1994 Health Board survey demonstrated that 17 per cent of fourth-year girls did not take part in any of the 35 sports listed.

Professor Dargie reveals his own reaction to fitness tests on young people. "The results were so low, I thought there was a mistake in the figures. "

Further research indicates that people are more likely to be active as adults if they have been active when young. Gary's parents serve salad and pasta. Chips are an occasional treat. The frying pan is in disuse. Cigarettes are nowhere. Fellow cyclist Jason Broadfoot, aged 14, does football, judo and swimming. Gordon Haveron, also 14, plays football every spare moment in the day and wonders at so many of his peers who exercise not at all. "Must be boring, " he observes. Walker Kate O'Connor, aged 15, loves walking places. "I go out in all weathers. It doesn't bother me - it's fun."

Erl Wilkie says that more girls would be active if they received encouragement to play football rather than "boring hockey". Cleveden headteacher Ian Valentine points out that aerobics classes introduced recently to the school attract 30-40 girls. But he watches children of both genders troop to the butcher's shop at lunchtime to buy bridie and chips, and knows that when they get home, tea may not be optimal either. Mores have changed, he says. "It used to be unacceptable to forget to clean the stair and fail to put a decent dinner on the table. The whole idea of dinner on the table has gone."

We ponder how to reach more hearts and minds with the health message. Mr Valentine confirms the bleak news: "It is very difficult for adults to reach alternative youth culture."

In an interview with TES Scotland earlier this month, Sam Galbraith, the new health, sports and children's minister, revealed definite ideas of his own on how to reach children. More lottery cash will be channelled into school sport he said. "The way in is through the schools and I am more convinced than ever."

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