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					   Balancing the Spade Deficit: Importing a
Proven & Winning Program from Great Britain

       Time for Green Gym America
            William F. Benson
  Chair, IA2 (International Association
          for Indigenous Aging)
    Principal, Health Benefits ABCs
Consultant, CDC’s Healthy Aging Program
               May 14, 2009
       Green Gym - BTCV

Want to improve your health and
well-being but not too keen on
running machines or lycra?

Then why not take a look at our
award-winning alternative . . .
        Green Gym - BTCV

. . . you could be helping the environment
as well as yourself!

We all know we should try to be healthier
and fitter. We are increasingly aware of
the importance of our natural resources
and environment. Green Gym ticks all the
       Green Gym - BTCV

The BTCV Green Gym® is a scheme
which inspires you to improve both
your health and the environment at the
same time.
         BTCV Green Gym®

“Tea break is very important!
  Refreshments will usually be provided -
  some groups are experts at bringing
  along home made cakes as well!”

• Environmental Alliance for Senior
 Involvement (EASI)
  • PaSEC
• American Association for International Aging
• Conservation Volunteers Alliance
• British Trust for Conservation Volunteers
• Green Gym – North America

• Green Gym USA
• Demonstrate GG Can Work Here
• Develop Evidence-Base
• Build Working Partnership(s)
• Take to Scale
• Improve American Health, Well-Being &
• SPARC as a Model
                A Perfect Storm
• Going Green
• Civic Engagement
• Livable Communities/Communities for All
    Ages/Healthy Communities
•   Health Care Costs (e.g. Medicare Insolvency,
    LTC) & Health Care Reform
•   Prevention/Healthy Aging
•   Multi-generational
•   Demographics
•   Boomers & Health Status
 Percentage of Population Over Age 65
                2000                                 2015


            5%-9.9%          10%-14.9%   15%-19.9%   20-30%

Source: U.S. Census Bureau
Demographic Impact on Aging Policy

• “In general, the aging of the baby boom
 generation will lead to a sharp growth in
 federal entitlement spending that, absent
 meaningful reforms, will represent an
 unsustainable burden on future
 generations.” (GAO-05-564T)
  Medicare & Social Security Board of
   Trustees Report – May 12, 2009
Medicare's Hospital Trust Fund Will Be Insolvent
 by 2017, According to Trustees Report

  Significant growth in the number of people
  eligible for Medicare – aging “baby boomers”
  Increase in prices as a result of higher wages for
  health care professionals and inflation
  Individuals requiring more services (utilization)
  as well as more complex services (intensity)
         Health Care Expenditures
          for Chronic Conditions
  83% of all Health Care Spending Involved
  People with Chronic Conditions in 2001

   –   Medicare – 98%
   –   Medicaid – 83%
   –   Privately Insured – 74%
   –   Uninsured – 72%

Source: Medical Expenditure Panel Survey, 2001, and
  Partnership for Solutions
Chronic diseases account for 75% of the
 $1.4 trillion we spend on health care

  1980                  $245 billion
                an average of $1,066 per person

      2001                      $1.4 trillion
                       an average of $5,039 per person

          2011                         $2.8 trillion
                              an average of $9,216 per person

                   Heffler et al. Health Affairs, March/April 2002.
           Long-Term Care

• Policy-makers focus a great deal on
 Medicaid especially Medicaid LTC

• “Financing the increasing demand for
 long-term care services will be a
 significant 21st century challenge for
 the nation.” (GAO-05-564T)
      LTC Expenditures: A Lot
    Now & Much More in the Future

In 1999, CBO projected that total LTC expenditures for
   seniors (including government and private spending but not
   the value of donated care) would rise from about $123
   billion in 2000 to $346 billion by 2040.

That estimate of a relatively modest increase in spending
  incorporated the assumption that the prevalence of
  impairment would decline at a rate of about 1.1 percent per

CBO 2004
   Threats to Health Among Seniors

73% age 65 - 74 report no regular physical activity

81% age 75+ report no regular physical activity

61% - unhealthy weight

~35% - fall each year

20% - clinically significant depression; age group
at highest risk for suicide

  Sources: State of Aging and Health, 2007;;
        What’s the health picture for
By 2030
  More than 6 of every 10 will be managing more than
  one chronic condition
  14 million (1 out of 4) will be living with diabetes
  >21 million (1 out of 3) will be considered obese
   – Their health care will cost Medicare 34% more than others
  26 million (1 out of 2) will have arthritis
   – Knee replacement surgeries will increase 800% by 2030

   “When I’m 64: How Boomers Will Change Health Care ”, American Hospital Association, May 2007
Diabetes Trends Among U.S. Adults,
   BRFSS 1990, 1996, and 2003
          1990                       1996


No Data      <4%   4%–6%     6%–8%   8%–10%   >10%
Indicator 28 – Use of Time
A Few Words About Prevention
    Factors in the Decision to Work in Retirement (%)
                                                Pre-retirees who plan                Working
                                                to work in retirement                Retirees
Desire to stay mentally active                  87                                   68

Desire to stay physically active                85                                   61

Desire to remain productive or useful           77                                   73

Need health benefits                            66                                   20

Desire to help other people                     59                                   44

Desire to be around people                      58                                   47

Need the money                                  54                                   51

Desire to learn new things                      50                                   37

Desire to pursue a dream                        32                                   20
                    Source: S. Kathi Brown, "Staying Ahead of the Curve 2003: The AARP Working in Retirement Study,
Some findings from
 Green Gym/BTCV
        BTCV Green Gym®

“In order to run a Green Gym, the key
activities are to:
“Run a programme of practical conservation
or gardening sessions that are held at least
once a week throughout the year.
“Provide active and stimulating gardening or
conservation activities, which are pulse
raising and keep peoples interest.
         BTCV Green Gym®
“Establish links with local health services, for
example a local health centre, who could
endorse your Green Gym and recommend
people to take part.
“Publicise the Green Gym activities, and
recruit new members.
“Follow health and safety procedures,
including warm-up and cool-down exercises
at the beginning and end of each session.”
         BTCV Green Gym®

Research shows that:
 100% of participants interviewed during
 the current National Evaluation agree
 that taking part in the Green Gym has
 benefited their mental health, boosting
 self-esteem and confidence through
 learning new skills and completing new
        BTCV Green Gym®

Green Gym provides moderate
physical activity: People who are
regularly active at this level are 50%
less likely to suffer from a heart attack
or stroke than inactive people
Working out in green spaces is a great
way to relieve stress and can help to
combat depression
       BTCV Green Gym®

Taking part in the Green Gym improves
muscle strength, which is particularly
important for older people, helping to
maintain independence in later life
Participants report feeling fitter and
having more energy than before
         BTCV Green Gym®

Almost a third more calories can be burnt
 in an hour of some Green Gym
 activities than in doing a step aerobics
      Potential Challenges
Sustainability (absence of local council
Generating fees to support local GG
activities (e.g., paying for the work)
Competitive Threat
          Looking Ahead to
           the 21 st Century

“A window of opportunity exists now for
  planners and policymakers to prepare to
  address the needs of an aging society”

(U.S. Census Report, 1985)
    Thank You!

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