All doom and gloom about the NHS this week – and I thought we needed some light relief so started with play.
In our road we have a street play scheme. As in other places this followed a popular annual street party, and involves getting council permission to close the street to through traffic on 4 days in the summer to allow children to play out. When we started I did not particularly care how they played. In fact I was interested to see how they might use the space, which unlike a playground does not dictate terms. (Street parties have included a good deal of speedy scooter and bike riding, paint and chalk all over the road, and gaggles of children moving up and down the street in unpredictable ways.)
We were pleased to get support from the council for the idea of playing out. An enthusiastic man came on his bike to offer advice and explain the rules. He turned out to be from the Walk to School team and brought with him generous gifts: skipping ropes, balls and stilts. Without realizing it we had become part of the drive to get children to be physically active. A recent paper in Sociology of Health and Illness notes a similar connection, charting ‘the emergence of active play as a health practice in Canadian public health’ – and in an example from the UK, Hackney now has 31 play streets sponsored by the council. In my town it’s not only the language but also the equipment that signals opportunities for ‘active play’ – for example when the council play-bus disgorges its peculiar mix of scooter boards, hoops, hoppers and ribbons.
But it’s not just the young who are being targeted by public health drives for ‘active’ living. Balancing and walking were on agenda for older people too this week. A series of articles in the Daily Mail by the former ‘Chief of Knowledge’ for the NHS, Sir Muir Gray, advised readers how to ‘sod 70’ with ‘a few simple tweaks to your lifestyle’.
Those who read on got tips on maintaining posture and balance (stand on one leg while brushing your teeth), looking after your brain (do crosswords) and fitness (take the stairs or get off the bus early). Nothing ground-breaking here. But that was the point. The tips were made so pragmatic that no one could possibly feel intimidated.
Now I’m keen on walking, but there’s something a bit unnerving about the way in which more and more ordinary activities are enrolled into the project of ‘health’ rather than remaining pleasures. Muir Gray suggests that people make phone calls or listen to the radio while walking for fitness, or research family history to keep their brain active. In current public health activities like crosswords, radio, dance, family history, walking and play can all be seen as ‘health promotion’. And walking seems to be up there as an activity that can be promoted to young and old alike.
But there are different logics in these initiatives.
In her book Material Participation Noortje Marres observes that there are contrasting versions of participation in politics. In the ‘liberal’ model (associated with John Locke) she suggests that political involvement comes from ‘making things easy’. This holds that low effort will increase the chance that people will participate in reasonable numbers. In contrast the ‘action-based engagement’ model, which she associates with pragmatist thinkers, celebrates effort as a means of drawing people into debate and further involvement: ‘the more invested the more engaged’ is the principle. Muir Gray’s approach in the Daily Mail fits with the first model: ‘The trick … is to build exercise into everyday life so that it doesn’t feel like a chore,’ he asserts. But by trying to disguise exercise as something else, something that people have to be tricked into doing, or trick themselves into doing, activity is painted in a negative light. Street Play asks for more conscious staging of events and healthy choices – a carnivalesque approach to keeping children active, and an effort to create new positive associations between exercise and play or community building. I’m not sure which will be more ‘effective’ in public health terms, but I think the contrast is intriguing.
I know I said I was trying to offer some light relief this week, but I’m sorry, I’m going to finish with a more pessimistic note. Against these images of children playing and 60-somethings walking in circles while on the phone, I’ve been haunted by a Guardian story about air pollution that I read before Christmas. Air quality in Beijing is now so poor that children can’t play outside and people stay at home on bad days. Even in the UK traffic pollution ‘could be killing almost the same amount of people as smoking‘. Let’s hope that public health people are putting at least as much effort into air quality as promoting physical activity yet again. Or perhaps if we articulated more positive views of exercise and provided proper infrastructure, then more people would walk and cycle with pleasure and air quality would improve all by itself…