With just one year to go before the start of the 2012 Olympic and Paralympic Games in London, the focus should be on obtaining evidence on how the Games will affect public health, claim a group of public health experts in a Viewpoint published Online First in The Lancet.
A robust assessment of the long-term health and socioeconomic impacts of both individual interventions and the event as a whole has the potential to justify the enormous investment and to establish the possible health gains of staging future events, state Kaye Wellings and colleagues from London School of Hygiene and Tropical Medicine, London, UK.
"An emphasis on legacy…not just in terms of sporting infrastructure but also the effects of urban regeneration and the stimulus of physical activity and sports participation on the wellbeing of the population…is a unique and distinguishing feature of the 2012 Olympics", explain the authors.
At a cost of over £9 billion, the equivalent of £150 for every man, woman, and child in the UK, the population has been promised a wide range of lasting benefits. In particular, huge urban regeneration of one of the most impoverished parts of the UK has the potential to address the structural determinants of health by creating affordable housing, doubling the area of green space, and increasing employment opportunities.
In the past, host countries have failed to assess the health and social effects of regeneration programmes, and this lack of a public health vision has led to missed opportunities and damaging health outcomes. The authors say: "Absence of previous assessment is partly attributable to the complex effects of non-health interventions on health, particularly interventions that are implemented across a large geographical area with major physical change."
For the 2012 Games, the UK Department of Culture, Media, and Sport has commissioned a meta-evaluation to address six legacy promises relating to sport and physical activity, regeneration, culture, sustainability, the economy, and disability. Each of these areas has implications for health or relates to socioeconomic determinants of health. If all the promised improvements were achieved, the health effects would be substantial.
But according to the authors, these initiatives will not be easy to measure. They say: "The catalytic effect* impedes measurement of the additional increment of the Olympic initiatives, which are not classic public health interventions with conventional health-related endpoints." Adding to this difficulty, the effect of structural improvements on the health of local populations will be costly and could take a generation to be realised.
They conclude: "Undertaking the meta-evaluation will require agility, methodological flexibility and a substantial research effort…[and] it will require the understanding that the real legacy of the Olympics might have greater effects on the social and structural determinants of health than on health itself……[But] the dividend will be that not only the host nation obtains evidence on the benefits and costs of such an enormous investment, but also future candidate cities will have improved evidence on the possible gains for health of staging the Games, how best to maximise these gains, and what pitfalls to avoid".
Professor Kaye Wellings, London School of Hygiene and Tropical Medicine, London, UK. T) +44 (0) 207 927 2270 or +44 (0)7986 095 296 (mobile) E) kaye.wellings@lshtm.ac.uk
Or Paula Fentiman, London School of Hygiene and Tropical Medicine Press Office T) +44 (0) 207 927 2802
Notes to Editors: * The 2012 Olympics is seen as a catalyst to increase mass participation in physical activity through a possible demonstration effect and access to world-class sporting facilities, improvements in the environment that promote physical activity, and opportunities for active travel.
Journal
The Lancet