Without decisive action, by 2050 England faces unprecedented increases in healthcare costs: 40% for cancer, 54% for coronary heart disease, 100% for dementia, and 85% for stroke.
The stark reality is that in 21st Century Britain, your postcode still largely determines your health outcomes. This is not just a healthcare challenge; it's a matter of social justice that demands immediate attention.
At the Advanced Wellbeing Research Centre (AWRC) at Sheffield Hallam University, we're witnessing first-hand how this crisis is unfolding. But we're also seeing powerful evidence of how we can transform our approach to public health through community-led innovation and a fundamental shift in how we think about physical activity and movement.
The current model of healthcare delivery, while essential, is inherently reactive. We wait until people become ill before intervening, by which point we're often managing chronic conditions rather than preventing them in the first place. This approach is not only costly but fails to address the root causes of poor health outcomes. The social determinants of health - the conditions in which people are born, grow, live, work, and age - are at the heart of why rates of preventable conditions are rising. Addressing these conditions through community health building can have a far greater impact on population health than medical interventions alone.
Our work at the AWRC has shown that physical activity can be part of the solution to transforming population health, as well as a powerful catalyst for change in economic growth. This can only happen, if we fundamentally reimagine how we integrate movement into everyday life. This isn't about telling people to exercise more or creating more gym memberships. It's about redesigning our communities and systems to make movement an accessible, natural part of daily living for everyone.
Prevention legacy
That’s why today, in Westminster, we’re launching a new report Delivering the Prevention Legacy for the NHS, which sets out the critical action that needs to be taken to help achieve that change.
We have outlined three key recommendations for the UK Government, to support them to achieve their prevention ambitions. These are: prioritise investment in community health building and community-driven health initiatives; expand established and evidence-based rehabilitation (including prehabilitation) programmes and develop a workforce equipped to prioritise physical activity in healthcare.
Our recommendations are based on our experience and understanding of what has worked here in South Yorkshire and could be scaled up across the country. By bringing together experts, including those with lived experience from engineering, psychology, elite sport, and community health, we're creating innovations that directly respond to local needs. But what makes these initiatives successful isn't just the technical expertise - it's our commitment to putting communities in the driving seat. When we empower residents to identify their own challenges and co-design solutions, we see sustainable changes that transform lives.
Sustainable changes
This shift demands changes at multiple levels. First, we need policy frameworks that prioritise health equity across all government departments. Health isn't just the responsibility of the NHS - it should be a consideration in every policy decision, from urban planning to education. Second, we need to redesign our healthcare training to emphasise prevention and community engagement. And third, we need to create organisational structures that facilitate genuine collaboration between institutions and communities.
A prime example of this is the Active Together programme, developed here at the AWRC, with communities and professionals, which integrates community-based exercise, nutritional advice and psychological support into personalised cancer care, helping those diagnosed to prepare for and recover from treatment.
The programme is funded by Yorkshire Cancer Research and is delivered in partnership with Sheffield Teaching Hospitals NHS Foundation Trust.
Moving beyond traditional treatment models and exemplifying the shift from hospital-based to community-focused care, the programme has made a difference to the experience of treatment and outcomes from it for hundreds of patients, with the potential to benefit many thousands more across the country. It is also reaching those who need it most - with almost half of those referred to the programme from the most deprived communities.
The evidence is clear: prevention-focused, place-based approaches work. They not only improve health outcomes but deliver significant economic benefits – the Active Together programme could save the NHS more than £100 million over five years if implemented nationally. However, implementing these approaches requires a dramatic shift in how we allocate resources and make decisions about public health. We need to move towards systems that support community-led action and prioritise addressing the socio-economic conditions that make healthy behaviours difficult for many communities. By addressing these structural barriers through community-led innovation as well as government policy, we can create environments that support and encourage healthy living.
This isn't about quick fixes or one-size-fits-all solutions. It's about understanding local contexts and working alongside communities to create conditions that benefit everyone.
As we look to the future, the opportunity before us is clear. We can continue with our current reactive approach and watch health inequalities widen, or we can embrace a new vision for population health - one that puts prevention and community empowerment at its heart. At the AWRC, we're committed to the latter, and we're seeing promising results.
We have the knowledge and capabilities to create a health and care system that doesn't just treat illness but actively promotes wellbeing. A system that serves all communities equally and builds a healthier, more active future for generations to come.
The question isn't whether we can afford to make these changes - it's whether we can afford not to. The cost of inaction, both in human and economic terms, is simply too high. Together, we can transform our approach to public health and create a fairer, healthier society for all.
This article was first published in the Yorkshire Post.
