The Olympics were warmly embraced by the UK public. Overnight we became fans of beach volleyball, long distance running – sports we might’ve heard of but rarely watched. Swimming was one of the sports people enjoyed watching during the Olympics and in the UK is one of the most popular sports people participate in. With such a high popularity, swimming is a sure-fire way to increase levels of physical activity – something policy-makers, politicians and health professionals have been trying to do for years.
Scotland, Wales and England have all introduced free swimming programmes but reduced government budgets have meant many of these programmes have been substantially or entirely cut. In England the Free Swimming programme existed from April 2009 – July 2010. When central funding was cut by the Coalition government some local areas tried to maintain the services but subsequent cuts were seen around the country. After the funding was cut and prices increased, many areas saw the number of young swimmers drop immediately.
The England Free Swimming programme was evaluated by Pricewaterhouse Coopers (PWC). Based on these findings the Coalition government concluded that “although 18 million free swims were taken up in the first year – many of those who took part would have done so anyway, even if they had to pay…cost was shared between five government departments”. Whilst the report found that ‘The scheme demonstrated the inability/unwillingness of unskilled social groups to pay to swim and that if the financial barrier is removed, unskilled social groups increase uptake” (p.10), overall there was little effort to understand who went swimming and any effect of the policy on health inequalities.
Before the PWC evaluation began and soon after Free Swimming was introduced in England, Dr. Suzanne Audrey, research fellow at DECIPHer at the University of Bristol, thought this was an opportunity to try to get health inequalities “higher up the agenda”. Spurred on by the Marmot review, Suzanne met Marmot’s challenge to academics when they said “there was little research on how services are delivered across the gradient”. Instead of looking just at the numbers, Suzanne examined who was swimming and whether Free Swimming had the potential to reduce health inequalities.
Suzanne’s research examined whether the Free Swimming initiative in Bristol was associated with higher uptake in more affluent areas. The research found Free Swimming did not enforce health inequalities and may have addressed them:
- Take up of Free Swimming occurred across the social gradient – unlike so many other programmes, where the rich have a higher uptake of an intervention.
- There was no dramatic drop-off between primary and secondary school, so Free Swimming encouraged physical activity in young adolescents – a difficult group to reach.
- Free Swimming was popular with girls – another group that has proved difficult to engage with exercising.
- Distance mattered – if you had a long way to go to get to the pool it really mattered – especially in the winter.
The research has led to further conversations with the local council. Suzanne is working with them to look at other council policies and examining who is using the services and to value more than just the total numbers.
Suzanne’s research is an example of the bridges that can be created between academics and local service providers – which in turn, can lead to practical research that influences local health inequalities.
Dr. Tammy Boyce (@TamBoyce) works with DECIPHer as a Knowledge Exchange consultant.