A new path to health

This November, Natural England and The Centre for Sustainable Healthcare raised the question of how we are going to ensure everyone engages with the natural environment to improve our mental health and wellbeing.

The conference, bringing together healthcare professionals and industry experts, was called ‘Transforming mental health and Dementia provision with the Natural Environment’.

Ramblers’ health policy and advocacy officer, Roberta Antonaci, went along.

A new path to health 

“Above all, do not lose your desire to walk. Everyday, I walk myself into a state of well-being & walk away from every illness. I have walked myself into my best thoughts, and I know of no thought so burdensome that one cannot walk away from it. But by sitting still, & the more one sits still, the closer one comes to feeling ill. Thus if one just keeps on walking, everything will be all right.”

These are not my words, but those of 19th century philsopher Søren Kierkegaard, and whilst the world has changed a lot since he strolled amidst bracing North Sea air, the benefits of walking have not.

In fact, when it comes to our health and our state of mind, these benefits have never been more important. Dementia and other mental health problems are on the rise in the UK, with 1 in 4 people in England experiencing a mental health problem in any given year and dementia - currently affecting around 800,000 people in the UK - recently overtaking heart disease as the leading cause of death in England and Wales.

This places a heavy toll upon carers, wider society and of course health services – yet so much more could be done, both in terms of prevention and treatment.

At the Ramblers, we know what a positive impact even a small amount of exercise outdoors can have on people’s lives, and every day it feels as if I hear from another person for whom walking has dramatically changed their life for the better.

Then there’s our successful Walking for Health programme, which we run in partnership with Macmillan, Cancer Support with the aim of giving everyone access to a short, free, friendly health walk within easy reach of where they live, to help them become and stay active. A recent independent evaluation of Walking for Health has shown that a significant short-term overall increase in levels of weekly physical activity among participants after first joining the programme and there was an improvement observed in a number of measures of wellbeing, including general mental health, loneliness, and social interaction.

Health walks are organised by approximately 415 different local schemes across England. The walks are open to all, however, targeted activities are aimed at engaging and supporting inactive people and people at risk of inactivity. This includes people from deprived communities and those living with cancer and other long-term health conditions, or those at risk of developing them. A great example is North Kesteven Strollers, who recently won the Go Outdoors award at the UK Active Flame Awards. As well as a busy programme of regular health walks, the scheme offers a walk for the visually impaired and a dementia-friendly walk.

"We've been running the dementia friendly walk for around a year now, and it's been very rewarding and well received with around 50 regular walkers”, says scheme coordinator Carly Togher, “ We received public health funding for training from Dementia Adventure, an organisation that helps people with dementia overcome barriers to making the best of the outdoors."

Clearly then, when it comes to improving physical and mental health, walking works.

The evidence amassed in support of this goes well beyond Ramblers as well. Natural England’s research with University of Exeter found outdoor walking groups can increase activity rates and result in improved self-esteem and mood states, and their recent report on dementia found that informal walking was the most commonly cited activity by people living with dementia. Carers reported that walking had a calming effect on the person they were caring for. 

Yet despite all this evidence, the people who can make this happen – the policy makers, commissioning bodies and service users – have yet to incorporate the need to promote nature-based interventions (that’s walking in the outdoors to you and me) – at the heart of their plans.

How do we unblock this impasse? Well conference attendees seemed in agreement that part of the answer was to work together to develop common and clear messages about the benefits of being outdoors in the natural world, but efforts must go much further than this, particularly in protecting and making better use of the paths, parks and other green spaces we walk in.

They certainly need our help. Only last week the Ramblers published the results of our Pathwatch survey, the nation’s biggest ever footpath survey which amassed data on the state of the 140,000-mile path network in England and Wales. The results are mixed, with almost half of our paths requiring improvement and a further 10% in serious disrepair.

The local authorities who care for our paths are under sustained financial pressure and the pressure to cut rights of way budgets can be hard to resist. However – as the health costs alone demonstrate - doing so can be a false economy. In fact a Guardian editorial went as far as to say that we need paths to help keep the NHS solvent.

As local authorities take on more responsibility for the health of their residents – and the ‘graph of doom’ predicts that by 2020 pretty much all their budgets will be swallowed up by health and social care costs - perhaps it’s time then to rethink how we fund and support those places where we can walk.

This requires leadership from central Government, and as she prepares for next week’s Autumn Statement Prime Minister Theresa May – not a stranger herself to the benefits of walking – would do well to make the link between making health savings and protecting our paths and green spaces so that we can all ‘walk ourselves into our best thoughts’.

This blog is one of a series being produced on the theme of ‘Transforming Mental Health and Dementia Provision with the Natural Environment’ to support the conference of that name which took place on the 10th November, at St Barts, London.  For further details please contact sarah.preston@naturalengland.org.uk