Bathing faculties and health phronesis: tackling English obesity

The UK has an obesity crisis. Part of the solution could involve the construction of local sports facilities, including swimming pools. The study used mixed methods and involved four lines of inquiry. First, it conducted a structured review of literature surrounding swimming pools and health from antiquity to present. Second, it analysed the influence of swimming pools and other factors on mortality (2018) in 404 English locales (nomothetic, cross-sectional). Third, it modelled construction trends from 1900-2016, looking for deviations from expectations (nomothetic, time series). Finally, the study enriches its statistical investigations with qualitative case study research on two English and one German facility. Mixed methods sequential research in five phases. Research questions and hypotheses • RQ1: Does the geospatial distribution of swimming facilities impact health? (Nomothetic). (H10: Pools is insignificant vs. H1A: Pools is significant) • RQ2: Is the construction of swimming pools adequate for national health need? (Nomothetic). (H20: Forecast pool construction stable vs. H2A: Forecast pool construction increases) • RQ3: What policy learning emerges from idiosyncratic cases? (Idiographic & qualitative) Approach After problematisation (1) and structured literature review (2), the study conducted cross-sectional analysis of excess mortality and swimming pools (3a & 3b) and longitudinal analysis of pool construction (3c-e). Cross-sectional investigation involved factor analysis (3a) to explore and regression to analysis (3b) to investigate English mortality and its covariates (3b). The For the time series analysis, the study analysed 120 years of English pool construction data using autoregressive distributed lag models - ARIMA (3c), ADL (3d) and ECM (3e). Data Cross sectional analysis Deaths (DV, Yd): ONS standardised mortality ratio (2013-2017). Observed total deaths from all causes (by five year age and gender band) as a percentage of expected deaths. Access Leisure (IV, X1): reflects accessibility to 727 leisure centres, swimming baths or 2,738 health clubs in kilometres. Liverpool University’s Consumer Data Research Centre, Access to Healthy Assets and Hazards (AHAH) index. Obesity (IV, X2): percentage of adult population with a body mass index (BMI) of 30 kg/m2 or higher, age-standardized, WHO 2389 NCD_BMI_30 (2020). Deprivation (IV, X3): deprivation score for English small areas, sourced from Index of Multiple Deprivation (2019). Environment (IV, X4) measures accessible blue and green space, sourced via SE (2020), data constitutes an element of AHAH (2017). Pools (IV, X5): reflects pools per 10,000 in 2018. Data extracted from SE Active Places Power (APP) Time series analysis Pools constructed (PC & ∆PC): English swimming pools constructed each year during a 120 year period since 1900, SE Active Places Power (2020) database. English output (GDP & ∆GDP): Bank of England millennium of macroeconomic data UK (2017) provides historical macroeconomic and financial statistics. English population (Pop & ∆Pop): English population and population growth 1900-2020, Office for National Statistics (ONS): Total population (2018).

Are we building enough local pools for the health of the nation?

Swimming pool sparsity is associated with excess mortality
Pool construction needs to increase to re-balance construction series
Research could not rule out 'accumulation by dispossession' but identified asset management and health phronesis concerns