London School of Hygiene & Tropical Medicine

With just one year to go before the start of the 2012 Olympics in London, the focus should be on obtaining evidence on how the Games will affect public health, experts at the London School of Hygiene & Tropical Medicine claim.

Writing in The Lancet, Professor Kaye Wellings and colleagues argue that a robust assessment of the long-term health and socioeconomic impacts has the potential to justify the enormous investment and to establish the possible health gains of staging future Games.

“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”, the authors say.

At a cost of more than £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 country has the potential to help 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 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”.