In the first blog, I examined my some of my life experiences, the rationale for Equal Teams and the progress made. In this piece I wanted to spend a little time considering the public health evidence and what might be possible for people with learning disabilities as these are the main issues for discussion in the @WeLDNurses Twitter chat on 20th February from 8-30 until 9-30pm.
Conversations with Ann Gates (@exerciseworks) over the past 6 months helped us identify the strength of the evidence of public health for other groups of people.
Dr David Shiers (a retired GP, with a special interest in physical health in mental health) joined the conversation and shared a very useful and moving lecture about public health issues and people with mental health issues delivered Professor Helen Lester. This held startling parallels with my understanding of the same issues within the learning disability field which prompted me to reconsider the Disability Right Commission report Equal Treatment : Closing the Gap (2006) where it was observed that there are more obese adults with learning disabilities in the UK, than there are in Birmingham and Coventry combined. While people in those areas would not be excluded from public health programmes, access to those programmes, for people with learning disabilities, was sadly lacking.
Many studies (McGuire et al. 2007; Melville et al, 2007) have identified the issues that obesity poses particularly in people with learning disabilities and authors have identified that within this group obesity can act as a secondary disability. Salaun et al (2014) suggests that this group are particularly vulnerable due to individuals being unable to or wanting to identify with the negative consequences of their weight issues which serves to protect their self esteem. This in itself gives some indication of ways to encourage young people into sporting activities, focussing on the health benefits, is almost always the wrong tack, observing the social opportunities and inviting people to join a group. While there is much debate about any linkages between self esteem and weight loss, it is clear that moving from a position of no exercise, to doing some exercise is definitely an improvement. If I reflect on my own experience, as a man who likes looking good – or at least not looking too bad!- those first few runs in 2004/5 had me feel nervous and self conscious, but the satisfied having taken the risk to start, somewhere. Then the experience of finding a running partner who was willing to accept me as a novice and all that that entailed enabled me to progress and find myself in running.
Grandisson et al (2012) extols the virtues of inclusive sports, that of people with and without learning disabilities playing on the same teams but also highlights the challenges that this poses to peoples attitudes, through portrayal in the media and the competence of coaches to manage mixed ability groups. In Equal Teams FC experience, it was identified that participating in the Kent Disability League was the best course of action in the absence of any ‘unified’ leagues being available, and while that has bought players in to the club, the game and therefore getting exercise and a social outlet, there are questions how we might further encourage integration and inclusion. Equal Teams FC has been lucky to have a senior coach from the outset, who is also a parent carer who has a good understanding of the requirements and has adapted his coaching to the mixed abilities of the participants.
Along with the positive public health results of participation in sports, the supplementary benefits are not inconsiderable, and these gains appear to be generalizable to other areas of life like employment and education (Roswal & Damentko 2006) along with the development of healthy life habits and social competency. Whilst the opportunities for integration and inclusion through sports such as Equal Teams FC and the work that Carolyn Rogers is doing with the Football Healthy 4 Life project (Penfold, 2014), further support is required to develop greater unified sports experiences and to continue to review, develop and facilitate new exciting opportunities to engage people with learning disabilities in sports and exercise. Further frameworks need to be developed to ensure that all healthcare professional are ensuring that their public health assessments and messages are right for that patient group.
This blog has been written by Daniel Marsden (@dmarsden49) in preparation for the @WeLDNurses & @EqualteamsFC chat on 20th February 2014 on exercise and public health and people with learning disabilities.
This is to support Daniel’s fund raising efforts for Equal Teams FC by running the London Marathon. If you would like to sponsor him go to http://uk.virginmoneygiving.com/DanielMarsden49
Disability Rights Commission (2006) Equal Treatment – Closing the Gap. Available online at http://disability-studies.leeds.ac.uk/files/library/DRC-Health-FI-main.pdf
Grandisson, M et al (2012) Enabling Integration in Sports for Adolescents
with Intellectual Disabilities. Journal of Applied Research in Intellectual Disabilities 2012, 25, 217–230
McGuire B. E., Daly P. & Smyth F. (2007) Lifestyle and health behaviours of adults with an intellectual disability. Journal of Intellectual Disability Research 51, 497–510.
Melville C. A., Hamilton S., Hankey C. R., Miller S. & Boyle S. (2007) The prevalence and determinants of obesity in adults with intellectual disabilities. Obesity Reviews 8, 223–230.
Penfold, J. (2014) Community sports project helps clients reach their goals. Learning Disability Practice. 17 (1) 8-9.
Roswal G. M. & Damentko M. (2006) A review of completed research in sports for individuals with intellectual disabilities. Research Yearbook 12, 181–183.
Salaun, L et al (2014) Adapted Physical Activity Programme and Self-Perception in Obese Adolescents with Intellectual Disability: Between Morphological Awareness and Positive Illusory Bias. Journal of Applied Research in Intellectual Disabilities, 27, 112–124