Let's get Scotland Walking - The National Walking Strategy

5. Recognising the Benefits of Walking

The huge benefits and contribution of walking require much more recognition and promotion than they currently receive. Increased walking opportunities contribute to each of the five objectives in the Scottish Government's National Performance Framework ^[13] ; Wealthier and Fairer, Healthier, Safer and Stronger, Smarter and Greener, helping to achieve at least ten of the Scottish Government's fifteen National Outcomes anda large number of the National Indicators.

Walking as a regular activity, improvement of the walking environment and the use of walking for mental and physical health improvement, transport and community empowerment can help to realise the four pillars of public sector reform; partnership, person-centred, prevention, performance - set out in the Christie Commission Report, Commission on the Future Delivery of Public Services (2011) ^[14] . The Commission recognised that a focus on reactive spending is resource intensive and represents lost opportunities to have a more transformative impact. Christie highlighted that the adoption of preventative spending will contribute to making best use of money, eliminating duplication and waste.

Wealthier and Fairer

Walking is good for the economy. An improved walking environment can assist in providing access to jobs, to local facilities and to public transport for longer trips; and town centres and shopping areas can become more attractive places which will often assist the local economy by encouraging more visitors and tourism. At an individual level, walking is also financially beneficial as it is a low-cost alternative to motorised transport and especially to car use. There are proven economic effects of pedestrian-friendly urban areas due to increased walking leading to increased retail activity. Research suggests that making places better for walking can boost footfall and trading by up to 40% ^[15] .

Regeneration projects which incorporate new routes for walking, such as the Helix Project in Falkirk, and the Woodlands In and Around Towns initiative, also bring a range of health, economic and social benefits. They link communities, encourage visitors from outwith the area, regenerate derelict land and provide new access to work - both in terms of active travel and new jobs. By using the principles within Good Places, Better Health ^[16] regeneration professionals can examine their role and the role of others by working back from an outcomes-focused approach. It will enable them to view their actions through the prism of health by offering an analytical approach which recognises that better health and reduced health inequalities are central to sustainable economic growth and that the physical environment has a key role to play in achieving health outcomes that align with regeneration outcomes.

Within the workplace research has shown that the financial impact of poor mental health at work is significant. Presenteeism or lower productivity alone costs Scotland's employers £1.24 billion per year. However, mental health problems need not have such a dramatic impact if employers invest in promotion and wellbeing programmes, particularly those that encourage their staff to be more physically active during the working day ^{[17] [18]} .

Recent research shows that in Scotland there were 12,752,000 domestic trips in 2012 with 43,218,000 overnight stays and a total spend of £2,891 million. 52% of overseas visitors to Scotland went for a walk in the countryside and 29% walked by the coast. The most popular activity by far is walking. Numbers are broken down into 2.2 million short walks (up to two miles or up to one hour) and 1.8 million long walks (more than two miles or more than one hour). This is a higher proportion than shown in other parts of the UK ^[19] and is indicative of the popularity of walking among visitors to Scotland and the significant economic value of this sector. The visitor economy supports many jobs across Scotland, including supporting many businesses in rural communities such as village shops, accommodation providers, caravan parks. We need to play to our strengths, by turning our natural and cultural assets into visitor experiences that can maximise their economic contribution ^[20] ( e.g. the contribution of Scotland's National Forest Estate, National Parks, Nature Reserves, Scotland's Great Trails or historic properties).

Walking offers a huge preventative spend opportunity. There are numerous economic benefits associated with walking including reduced costs to the NHS through reduced chronic ill health, and improved productivity due to reduced sickness absence and reduced mortality and morbidity among people who are currently irregularly active. Analysis conducted in 2013 show a range of estimated primary and secondary care costs for five disease areas associated with physical inactivity. At a national level the costs to the NHS have been calculated at around £94.1 million annually (within a sensitivity range estimated at £91.8 million to £96.4 million). This equates to a mean cost of physical inactivity of approximately £18 per Scottish resident per year ^[21] .

This is based upon five conditions specifically linked to inactivity, namely coronary heart disease, stroke, diabetes, colorectal cancer and breast cancer. This figure represents a conservative estimate, since it excludes the costs of other diseases and health problems, such as osteoporosis and falls, which affect many older people. The National Institute for Health and Care Excellence ( NICE) calculated the quality-adjusted life year ( QALY) ^[22] for a physical activity brief intervention to be £20-£440 which represents outstanding value for money ^[23] .

The economic benefits associated with increased physical activity levels far outweigh any initial costs. Cost Benefit Ratios for walking developments show significant value for money. Social Return On Investment ( SROI) evidence shows a return of approximately £8 for every £1 invested in health walk and path development projects ^[24] . A report in 2006 estimated that the Fife Coastal Path generated £24-£29 million expenditure in local businesses each year, and supported 800-900 FTE jobs ^[25] . In addition, significant job creation opportunities arise from path construction, especially for small civil engineering contractors and small farmers who can benefit from spending on maintenance of existing paths in remote areas ^[26] .

These benefits can deliver cost savings for health and social care services. However, the benefits of physical activity extend further to improved productivity in the workplace, reduced congestion and pollution through active travel, and healthy development of children and young people. Remaining active and being able to access outdoor spaces is a vital part of maintaining quality of life in later years. Society (and public expenditure) will benefit greatly from a more active and healthy ageing population.

Crucially, with regard to tacking inequalities, walking acts as an important leveller in variations in participation. We know that participation in sport varies by age, gender, area deprivation and household income, but when we include walking for recreation, these participation gaps narrow ^[27] .

Healthier

Walking can prevent illness, improve and save lives. Physical activity is both a prevention and a treatment e.g. it reduces the relative risk of disease progression/mortality for coronary heart disease, breast, prostate, colorectal and lung cancers and reduces the recurrence for breast and colorectal cancers. Evidence shows that physical activity can reduce the risk of depression, dementia and Alzheimer's. It also shows that walking can enhance psychological wellbeing, by improving self-perception and self-esteem, mood and sleep quality, and by reducing levels of anxiety and fatigue ^[28] . Many of these benefits are enhanced by doing exercise outdoors in the natural environment.

Walking has been described as near perfect exercise ^[29] . It can be incorporated into everyday life, can be done almost everywhere, usually requires very little equipment and can be sustained into old age. Indeed, physical activity can help maintain autonomy and independence in later life ^[30] . Importantly, it is also an ideal start up activity for those who are sedentary or very overweight, and has the potential to sustain wellbeing and independent living in vulnerable populations, hence health walks and programmes promoting walking are particularly aimed at people who need or want to improve their health and wellbeing by becoming more active ^[31] . The better promotion of existing walking opportunities is very important through improved signage and associated information to raise awareness of what is available close to home, work or in more distant locations. The promotion of short walks is especially important to encourage inactive people to adjust their lifestyle.

Walking is an important sport and recreation activity. Hillwalking, rambling and long distance walking are hugely popular activities in Scotland with a wide range of opportunities to participate. It is also integral to sporting activities in themselves, such as a round of golf. This strategy is relevant to walking for sport and recreation and aims to engage with and promote such activity through clubs and club development, Community Sports Hubs, schools, training, leadership and skills development, information provision, facility and infrastructure development, events and festivals and facilitating people to become involved.

Figure 2: 30 minutes x 5 days per week

Image provided by STV ^[32]

If you walk for 30 minutes x 5 days per week, you can reduce the risk of...

Safer and Stronger

Walking can help promote a sense of community. Well-connected and attractive public places, routes and streets encourage more people to walk and make active travel choices in their daily routines ( e.g. shopping, banking, exercising, meeting people). People and places should be at the heart of the planning and design of town centres, urban areas and rural communities. With a better environment for walking, residential areas will be better places for everybody, enhancing community pride through an increased 'sense of place'.

The social and individual capital of volunteering cannot be underestimated. Volunteers play a key role in promoting and developing individual and community participation in physical activity in turn leading to improved self-confidence and community empowerment.

The ability to make independent visits to the shops or to visit friends can contribute to a sense of belonging to the community and to personal esteem. It can reduce feelings of social exclusion, isolation and reliance on others, thus creating a more inclusive community. Improving the walking environment can help to foster a sense of community and concern for others. An increase in the attractiveness of walking as an option for local journeys can benefit all in society. Safe and convenient pedestrian facilities can provide an increased sense of community identity, feelings of 'belonging' and can lead to expansion of social networks, as areas can become hubs for social walking which can be empowering. In particular older people, people with mobility difficulties and those who do not have access to a car may be able to play a greater role in community life. Improved standards of surfacing on paths and pavements; the provision of seating at suitable stages and at bus stops; the long-term management and maintenance of existing (and the provision of new or shorter) links within the urban area or between towns and villages; all may enable new journeys to be made, especially by people with impaired mobility.

Greener

Scotland can be perfect for walking. Scotland has outstanding opportunities for walking both in urban and rural areas. Our spectacular scenery, our range of green spaces (including parks), our walkable urban centres and world-class cities, our community routes, our long distance route networks and our world-class access rights all combine to give Scotland a unique set of 'walking-friendly' factors. Whether walking for pleasure, recreation or for a more functional reason, there should be opportunities for everyone close to where they live. By increasing opportunities to walk within and around communities, the paths, pavements and greenspaces can become a place to meet as well as a place to walk.

Research has shown that greenspace and people-centred places deliver a wide range of quality of life and quality of place benefits relating to health and wellbeing, economic development, biodiversity, climate change, mitigation and adaptation. Investment in local greenspaces and paths within and around communities can realise more of these benefits, particularly when targeted at areas of disadvantage.

Walking also contributes to the improvement of air quality and the reduction of congestion and noise pollution - achieved by all or part of a commuter journey being made on foot. Replacing car trips with walking, cycling or public transport will also help address climate change (Greener Scotland) issues by reducing greenhouse gases. Land use decisions can be considered in terms of their contribution towards the promotion of health and the mitigation of poor health. Design of facilities to support walking in urban and rural areas should be inclusive, providing for all people regardless of age or ability.

Scotland's world-class access rights ^[33] and a range of outstanding recreational assets for walking, including National and Regional Parks, Nature Reserves, Scotland's Great Trails, the National Cycle Network, Core Paths, canal towpaths and the wood and forests of the National Forest Estate. These assets need to be effectively managed and promoted if more people are to be encouraged to use them. Awareness and use of the Scottish Outdoor Access Code by land managers and walkers also needs to be developed, especially among young people.

Smarter

The promotion of walking for children can take place during school, as well as part of travel (walking and cycling) to and from school - 50% of pupils were recorded as walking to school in 2013 ^[34] . Evidence shows that walking to school can improve performance, concentration and learning ^[35] . Learning can take place in the outdoor environment and in the community. Regular visits for outdoor learning to local woodlands, beaches or other greenspaces incorporating opportunities for walking help young children learn healthy and active habits and make connections across all curriculum areas. Establishing walking groups within schools helps to provide alternatives to formal sports activities and encourages all pupils to adopt active lifestyles.