Play sufficiency – a population health priority

Wednesday March 15, 2023

Framed in the language of a population health approach, this post is about why we need to protect and improve children’s opportunities for play in the public realm and what local government and health organisations can do about it.

Despite the horrendous number of deaths, the misery suffered by victims and their families, the risks faced by front line workers and the constraints imposed on everyday life – conversations about ‘lockdown’ often turn to what might be different after the current crisis is eventually over. Now seems a good time to take stock and to think about what really matters and how we might want our society to change for the better. This crisis has highlighted the critical importance of the simple pleasures we often take for granted. Children’s ability to play out and about with friends is one of those simple pleasure, although we would argue it has become increasingly difficult for many children to do so irrespectively of the current pandemic. For a significant number of children who we’ve met through our research, lockdown, unfortunately, isn’t as different from their normal everyday lives as adults might think.

We believe it is reasonable to expect that children aged eight/nine years and over should be playing out regularly, without the need for adult accompaniment. We also believe the experiences of this age group of children are an indicator of the experiences of children both younger and older. Where children in this age group are regularly playing out independently of adults, it’s very likely in the preceding years they are also experiencing playing out with their families and carers, enjoying increasing amounts of freedom of movement. Equally, where children in this age range are playing out regularly it indicates they will still enjoy these freedoms in the coming years as their interests change. For this reason, much of our research is with this age group of children.

One of our favourite research activities we do with children to establish the range of spaces they frequent and use for play/socialising involves three concentric circles on a sheet of paper. The centre circle is labelled ‘close to home’, the next ‘local area’, and the third ‘further away’. Children are first asked to identify all the places they can go and play without an adult having to be with them. Children who play out regularly will often list between five to ten outside spaces, beyond the home. References to electronic devices are usually limited, even though they’re likely to use them. However, for children who don’t play out, or play out rarely, the focus can be very different. These children often start by listing different rooms in their own homes and the various electronic devices they use for entertainment and social networking. Their play experiences are confined to their homes and/or alternative virtual worlds and so that is all they can draw upon when asked about the places where they play.

If parents didn’t know it already, many of them will now… a reliance on electronic devices for entertainment isn’t so much a cause of children not playing out but rather is a symptom of it. When children can’t play out together their playing increasingly moves online. If we want children to play out with friends in their local neighbourhoods, it has to be as easy and attractive as picking up a phone and playing on that instead. Importantly, in our experience, where local conditions are supportive of children playing out that is what they regularly choose to do.

Unfortunately, at a local and national government level, and particularly in England, we simply haven’t been concerned enough that children are finding it difficult to do something as basic and vital as meeting up with playmates and having fun, without adults having to arrange it for them. The majority of adults know that playing out was at the heart of so many of their most cherished childhood memories and that it had a big role in shaping their personalities, yet it receives little attention in public policy. Rarely is children’s ability to find time and space for play addressed in any meaningful (let alone comprehensive way) within policy areas that impact directly or indirectly on children’s lives.

Most adults agree children’s freedom to play has reduced significantly compared to when they were young yet pick up most public health, education, social care, housing or planning strategies and you’ll be lucky to find more than a few references to children’s play (in many cases you’ll be lucky to find more than a few references to children or childhood in general). By way of example, one of the largest cities in the UK, one aiming to be a great place for children to grow up, has a health and wellbeing strategy that doesn’t mention play once!!! In our opinion talking about children’s rights and/or their wellbeing but failing to pay attention to their opportunities for play is something of a non-starter. Play is what children do, if we mean to provide for a good childhood we must ensure children can play.

Pic Credit: Mick Conway

Play – a protective factor

“Playing becomes a highly attractive form of self-protection for children, and the very ‘unwittingness’ of this from a child’s perspective adds to its value: for children, play is simply about having fun, messing around and being with friends. It also represents ‘ordinary magic’: for many children, play is just something that happens, but it has the potential for the emergence of magical properties, to support survival and enhance well-being.” (Lester and Russell, 2010.)

Children’s ability to support their own well-being and to contribute to the well-being of their communities is often overlooked. Playing is central to children’s experience and interaction with the world, their subjective sense of well-being, and their physical and mental health. Playing enables children to be adaptable and resilient – essential qualities in an increasingly uncertain world. Having sufficient time, space and permission to play together must, therefore, be seen as an essential protective factor in children’s lives. It also follows that an inability to play must be recognised as a significant risk factor to the well-being of children and their communities.

A play-full childhood will support happy and healthy children to live in active, vibrant communities. A play-less childhood will result in children that are less happy and less healthy with a reduced sense of community well-being. Ensuring children have enough opportunities for play throughout their childhoods must, therefore, be seen as a critical part of preventative public service planning. Equally, a lack of opportunities for play creates more pressure on public services to fix problems that could have been avoided if more attention was paid to the quality and quantity of children’s everyday opportunities for play.

Play – a population health issue

For a simple introduction to the concept of population health, check out the video produced by the King’s Fund charity.

A population health approach is about recognising and paying attention to the whole range of factors that influence people’s health and well-being. This includes the availability, capacity and quality of health care services but also the many other aspects of life that support our well-being; in particular those that enable people to keep themselves well. As the King’s Fund explains:

“our individual actions and social connections, the places and communities that we’re part of, the services that are delivered in our neighbourhoods, and decisions made by local and national government all play a vital role in keeping us healthy”

Children’s ability to support their own health and wellbeing is dependent on the ease by which they can meet up with friends and play out and about in their local neighbourhoods. However, their opportunities for doing so are influenced by a wide range of variables at home, in their local neighbourhoods and across wider society.

We’re not just talking about the provision of designated play areas here. This is about reimagining spaces and places that might currently preclude or discourage playing, with a view to creating networks of playable space that taken together make for a much more playable neighbourhood. A population health approach aims to reduce inequalities of access to the things that support people’s health and wellbeing. This must include addressing constraining factors that prevent children from having equal access to time and space for play in the public realm.

A population health approach extends responsibilities for people’s health and well-being beyond traditional health care professions to also recognise the contribution that many other service areas can make to cultivating the sorts of environmental and societal conditions where people are enabled to support their own health and wellbeing. This is about a collective responsibility, which necessitates partnership working to make and sustain improvements.

The variables influencing children’s opportunities for play cut across many local government service areas, meaning that a wide range of departments and organisations have some degree of responsibility for impacts on children’s opportunities for play. Rather than seeing play as a service that can be provided by one particular team or department, we need to recognise that many service areas can contribute to cultivating more favourable conditions for children’s play. This means working together towards the common aim of ensuring children have enough time, space and permission for play as an essential part of their everyday lives. The outcome of which will be more children playing out more of the time. A clear population health benefit.

Population health indicators for play

Once we accept the value of play as an outcome, we can think about what indicators we might use to determine whether children are playing out enough and to what extent our efforts are improving their opportunities for play. This might include:

  • the age at which children are allowed out to play
  • the regularity and duration of time spent playing out
  • the number and range of places children are playing in
  • the number of other people children play with
  • the roaming distance of different aged children
  • children and parent’s satisfaction with opportunities to play

These types of indicators need to be embedded within local government performance frameworks to ensure attention is consistently paid to children’s opportunities for play. They are the kind of thing that should be found in an overarching Health and Wellbeing plan. All of these indicators are also useful measures of parental confidence and people’s sense of community safety. Most importantly, however, they require adults to pay attention to children’s actual lived experiences. By focussing on play, we can engage with children on their terms and provide adults with unique insights into their lives. Almost everyone has experiences of playing and so play can also provide a common language that professionals can use to bridge policy areas and find common ground.

Pic Credit: Isle of Play

Play sufficiency – a population health approach

This brings us to what can practically be done to address the wide range of variables that influence children’s opportunities for play and ensure that consideration of children’s right to play is embedded throughout local government systems. We believe the answer lies in the concept of play sufficiency, as promoted by the United Nations Committee on the Rights of the Child and legislated for by both the Welsh and Scottish Governments.

Play sufficiency is about making a high-level commitment to ensure all children have access to enough time, space and permission to play throughout all aspects of their lives. Paying attention to, protecting and improving opportunities for play at home, at school and throughout the public realm.

Play sufficiency is an on-going process of research, action, repair and maintenance. Success will depend on bringing together and involving a diverse range of partners, continuously developing and deepening people’s appreciation of play and how best to support it. A simple outline of the process might look like this:

  1. Initial assessment phase starts by doing case study research with children and their carers exploring localised conditions for play and their individual lived experiences of playing. The examples captured through research allows for the identification of specific interventions to address the experiences of individual children and/or communities. Patterns will also emerge across different people’s experiences helping to identify the ways in which organisational systems can be developed, improving conditions for ‘doing’ play sufficiency.
  2. Practitioners and policy leads are involved in the assessment, exploring the implications of the findings from the research with children and their carers. This, combined with service and policy mapping, supports the identification of strategic priorities and the organisational systems that need to be developed to address them.
  3. Multi-disciplinary and cross-departmental engagement develops evidence-based and targeted interventions that can be made at both a neighbourhood and organisational level. Resulting in the development of a strategic action plan, ensuring that financial and human resources are used to the greatest effect.
  4. Implementation phase, where one or more organisations lead on the implementation of the action plan and other developmental work associated with addressing the findings from the assessment.
  5. Assessment phase begins again with the aim of evaluating progress, collating data and identifying priorities for further action.

The final image illustrates the approach taken by one local authority in Wales across three cycles of assessing and securing play sufficiency. This includes the strategic priorities identified through research, the organisational systems developed, examples of the actions taken and the subsequent increase in children’s satisfaction with their opportunities for play.

For more information about our play sufficiency package for local authorities and public health organisations click here.

Suggested citation for this publication:

Barclay, M., Tawil, B. (2020). Play sufficiency – a population health priority. Ludicology, Wales.

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