The South West Coast Path Health and Wellbeing Assessment 2020 Report Dr Carolyn Petersen, University of Exeter 2 The South West Coast Path Health and Wellbeing Assessment 2020 Report 1 Contents 1. Executive summary 2. Introduction 3. The health and wellbeing benefits of being in natural environments and of exercising outdoors i. A review of the general literature ii. The health and wellbeing benefits of walking iii. Blue spaces and the benefits of visiting the coast iv. Who visits the coast? v. Risk factors and Coronavirus (COVID-19) effects on outdoor physical activity and health in the UK in 2020 vi. Existing health and wellbeing valuations of UK coast paths and other green spaces 4. Review of methods, data sources and methodological considerations for health and wellbeing assessments Countisbury, Exmoor. Photo by Tor McIntosh i. Summary of data sources ii. Review of valuation tools Acknowledgements a. WHO HEAT tool The South West Coast Path Association (SWCPA) would like to thank Dr Carolyn Petersen, Centre for Rural Policy Research (CRPR), University of Exeter for b. QALYs undertaking this research and Prof. Matt Lobley and support staff at the University c. UEA MOVES tool of Exeter for their supervisory and organisational support for this research. iii. Overall choice of valuation method and guidance on implementation A SWCPA steering group comprising Julian Gray, Director and Alex Turner, Project 5. SWCP health and wellbeing valuation results Co-ordinator worked with Dr. Petersen to commission and co-ordinate the work. i. Results of the WHO HEAT Valuation Thanks to the the SWCPA Health and Wellbeing Working Group comprising: Carol Grant (Chair), David Morris, Eve Bampton-Wilton (SWCPA Trustees) who inputted ii. UEA MOVES tool results to the final report. iii. Connecting Actively to Nature (CAN) valuation results The author would like to thank the South West Coast Path Association (SWCPA) iv. Summary of health and wellbeing valuation results team and Trustees for their input (particular thanks to Alex for responding to v. Differentiating the health and wellbeing benefits for different types of visitors multiple queries on SWCPA data) and to Active Devon for providing additional to the SWCP (segmentation) data on the Connecting Actively to Nature (CAN) programme. 6. Towards an assessment of the qualitative health and wellbeing benefits and benefits ISBN: 978-0-902746-48-x for mental health of walking on the SWCP Contacts: i. Qualitative and mental health benefits South West Coast Path Association ii. SWCP CAN programme qualitative and mental health data southwestcoastpath.org.uk Unit 11, Residence 2, Royal William Yard, Plymouth PL1 3RP iii. Qualitative and positive mental health outcomes from visits to the coast in England Charity No: 1163422. Registered with the Fundraising Regulator: 112197 7. Conclusions [email protected] 8. Recommendations for future research and partnership working Dr Carolyn Petersen 9. Limitations of this research http://socialsciences.exeter.ac.uk/research/centres/crpr CRPR, University of Exeter Lazenby House, Prince of Wales Road, Exeter, EX4 4PJ. 10. References [email protected] 11. Appendix 1 – Additional tables and figures (see next page) Cover photo: Plymstock Coastal Walking Group. Photo by Liberty Pearl Photography 2 The South West Coast Path Health and Wellbeing Assessment 2020 Report The South West Coast Path Health and Wellbeing Assessment 2020 Report 3 1. Executive Summary Exercising outdoors, and the There has been growing connects many communities List of main tables and figures List of tables in Appendix 1 health and wellbeing benefits interest in quantifying and to the diverse nationally associated with being in demonstrating the health and important landscapes along Figure 1: The health benefits of walking Table A1: Visit number estimate details – natural environments has well-being benefits of green the region’s coast. comparing MENE, ECP and SWCPA estimates Table 1: Comparison of previous health and taken on new importance and blue spaces in the UK, The report reviews methods wellbeing evaluations Table A2: Additional figures for visit numbers during the coronavirus including the coast and trails for health and wellbeing including low and high estimates (walkers (COVID-19) pandemic. such as the South West Coast valuation and then uses the Table 2: Key characteristics of South West only) COVID-19 has exposed Path (SWCP), influenced by Coast Path assessment data sources WHO HEAT tool v4.2 and the and exacerbated existing growing research on health- UEA MOVES v2.0 tool to Table A3: Comparison of average time walked health and socio-economic environment links. The Table 3: Figures for annual visit numbers per person per day using time and distance produce valuations. It draws inequalities as well as significant health and on methods and outputs from Table 4: Results of WHO HEAT Tool data disparities in access to wellbeing benefits (both for previous valuations, Valuation for SWCP Table A4: Comparison of WHO HEAT natural environments physical and mental health) of particularly the England that need to be urgently doing physical activity Table 5: Summary of results assessments for differing visitor numbers, Coast Path baseline average time walked figures and values of a addressed. But at the same outdoors and connectedness to assessment study (ICF et al. Table 6: Summary of CAN MOVES results for statistical life time, since the advent of nature are now well evidenced. 2019a and b). An assessment different age groups this crisis, our natural This report provides a health of mental health and Table A5: Detailed parameters used within environments have attracted and wellbeing valuation of qualitative benefits is Table 7: Summary of CAN valuations and ROI HEAT larger numbers of visitors, the South West Coast Path included overleaf. using HEAT and MOVES tools including a variety of people Table A6: Parameters from within the WHO based on available visitor and who were not traditionally Table 8: Summary of main health and HEAT model population data on visits to wellbeing valuation results using these environments this National Trail. It was Table A7: Full MOVES results for 2019 SWCPA before. The pandemic has commissioned by the South Table 9: Percentage of types of visitors estimate of visitor numbers therefore provided real West Coast Path Association (England Coast Path figures) and opportunities to engage with (SWCPA), a registered charity segmentation of health and wellbeing Table A8a: Example MOVES Tool output new user communities to whose mission is to help benefits including parameters used bring greater health and people access, enjoy and wellbeing benefits and to Table 10: Qualitative benefits reported in the Table A8b: Example MOVES Tool output - protect Britain’s longest forge stronger connections SWCPA 2020 online survey health outcomes (for 61+ age group) National Trail. The SWCP with our green spaces and is 630 miles long and Table 11: Summary showing count and % of Table A9: MOVES Tool recalculated age natural environments. types of comments categories using MENE data for coast path visits (England) Table 12: Mental wellbeing measures for CAN programme Table A10: Breakdown of employment status for England Coast Path respondents Table 13: Qualitative experiences of visits to the coast and England Coast Path from MENE Table A11: Visit numbers: South West data compared with countryside and town Research Company Ltd 2019 figures for the or city SWCP by county 4 The South West Coast Path Health and Wellbeing Assessment 2020 Report The South West Coast Path Health and Wellbeing Assessment 2020 Report 5 Results Summary of the main health and wellbeing valuation results The MOVES valuation is However, what is also left out The economic health and West Coast Path. It is MOVES tool measure the in addition to the HEAT of this analysis is the wellbeing valuation measures measured in different ways by savings in health care costs valuation, because it is based potential value of the the estimated economic value different tools – HEAT from reduced ill-health and on the reduced occurrence of substantial benefits that 3 of the physical health benefits measures the value of the disease. disease . Valuations using the would accrue from expanding from walking on the South reduced death rate; and the MOVES tool, which quantify the usage of the South West the savings in health care Coast Path to the large Valuation results costs based on the reduced numbers of inactive and incidence of disease, give a relatively inactive people as Valuation tool Value for SWCP (per year) What this measures value of £7.4 million per well as socio-economically (based on 2019 SWCPA figures) year (value of Quality disadvantaged and Black, WHO HEAT £5.5 million Value of reduced death rate (based Adjusted Life Years gained). Asian and Minority Ethnic directly attributable on standard statistical value of a life)1; The MOVES results also show (BAME) groups who are not that the relative health yet accessing this trail. £69.1 million in total directly attributable value: 8% of total benefits and return on The research literature MOVES (UEA / £7.4 million Savings in health care costs based on investment (ROI) are much highlights that recreational Sport England) the reduced incidence of disease greater for older age groups visits to the coast in England, – with an ROI of 55% for age particularly for walking, 16-30 compared with 3162% are more likely to be made The report also gives a on the SWCP who would not million for overnight for the 61+ years age group. valuation of the health and be walking elsewhere (an visitors2. This is important by people from lower wellbeing benefits from the estimated three premature since local people are likely to The assessment of the mental socio-economic backgrounds SWCP Connecting Actively to deaths avoided per year be able to use the path more health and qualitative compared to other natural Nature (CAN) programme of directly attributable).