Complexity of Childhood Obesity Liz Plastow Public Health Nursing Advisor to NST Childhood Obesity H - PowerPoint PPT Presentation

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Title: Complexity of Childhood Obesity Liz Plastow Public Health Nursing Advisor to NST Childhood Obesity H


1
Complexity of Childhood ObesityLiz
PlastowPublic Health Nursing Advisor to NST
Childhood Obesity (Healthy Weight)
2
Aim
  • An understanding of the purpose of collecting
    NCMP data
  • An awareness of the complexity of the obesity
    agenda and what realistically school nurses may
    add to this agenda
  • An understanding of the myths and mixed messages
    which are skewing public opinions and access to
    services
  • Why commissioning is vital to a successful
    outcome

3
The Scale of the problem
  • The prevalence of obesity has trebled since the
    1980s.
  • In 2006 - 23.7 of men and 24.2 of women were
    obese.
  • Just under two-thirds of adults were overweight
    or obese (61.6 or 31 million)
  • In reception year (4-5 yrs) almost one in four
    children are overweight or obese.
  • By Year 6 (10-11 yrs) one in three children are
    overweight or obese.
  • The prevalence of obesity is significantly higher
    in Year 6 than in reception 17.5 compared to
    9.9 respectively.
  • BMI increases with age (until age of 75)

4
Obesity trends among children aged 2-15 years, by
sex, 1995-2006
5
Future trends -Children
  • By 2050 it is projected that
  • 25 of all children will be obese
  • 70 of girls will be overweight or obese
  • 55 of boys will be overweight or obese

6
Health Risks of Overweight and Obesity
  • The link between obesity and premature death is
    now well known.
  • It is estimated that, on average, obesity reduces
    life expectancy by between
  • 313 years (the excess mortality being greater
    the more severe the obesity and the earlier it
    develops).

7
Relative risks of health problems associated with
obesity
8
The current cost of obesity
  • In 2007, the total annual cost to the NHS of
    diseases for which elevated BMI is a risk factor
    was estimated to be 17.4 billion
  • This equates to around 6 of NHS costs
  • 4.2 billion of this is directly attributable to
    overweight and obesity
  • 2.3 billion for obesity alone.
  • (Source Butland, 2007)

9
Future trends - Adults
  • Adults
  • By 2015, it has been estimated that 36 of men
    and 28 of women in England will be obese
  • By 2025 this rises to 47 and 36 respectively
  • By 2050, this rises to 60 and 50 respectively
  • By 2050 only 10 of men and 15 of women will be
    in the healthy weight category

10
There is good evidence to suggest that a moderate
weight brings health benefits
11
Why NCMP data?
  • Provides population level data
  • Enables commissioners to target resource where
    needed most
  • Enables predictive trends to be determined
  • Will not impact on obesity directly NCMP
    collection has achieved nothing!!
  • Fact some children opt out is irrelevant in
    greater scheme of things!

12
WORK WITH PARENTS
PREVENTION early years
PREVENTION school age
DATA AND EVALUATION
COMMUNICATIONS

TRAINING
MANAGEMENT OF WEIGHT
WORK WITH FAMILIES
VISION AND STRATEGY

BUILT ENVIRONMENT
COMMISSIONING
13
Mixed Messages
  • Targeting overweight / obese children is
    stigmatising
  • Overweight children are the ones who do not
    participate
  • Ignores the underweight (averages 3)
  • Children will grow out of it
  • Nothing we can do its a societal problem

14
Realities
  • 12 obese children have obese mother
  • Quality of life of obese child is less than one
    with cancer
  • Targeting at population level on an industrial
    scale will make a difference
  • Addressing healthy eating and increasing physical
    activity in the workplace will make a positive
    impact

15
  • What can you do?

16
Vision and Strategy
  • Reframe obesity into healthy weight
  • Each PCT will have a healthy weight steering
    group join it?
  • Embed healthy eating and physical activity into
    every contact that you have with a child
  • Target the hard to reach
  • Ensure the steering group know what is going on
    in their community
  • Link with HVs and DNs and map what is available

17
Prevention and Early Years
  • Maternal obesity is a significant risk factor
  • Raise awareness in routine contacts with school
    aged children
  • Liaise with HVs and Midwives pregnant
    teenagers obese or parents of school age children
    more aware school gate!
  • Encourage breast feeding

18
Prevention School Years
  • Encourage FSM and ways to sign up
  • Link with schools extended services grant
  • Links with Healthy Schools Co-ordinators
  • Talk to Children YP eating habits/ lifestyle
    social marketing
  • Links with sports project leads
  • School Travel Plans

19
Work with Families / Management of Weight
  • MEND is not the only answer!
  • Identify local resources
  • Signpost to activities in community do not have
    to be sport or physical take them away from
    sedentary lifestyle
  • Ensure whole families can be involved in any
    programmes developed
  • Be involved in pathway development

20
Built Environment
  • Approach housing - new developments - sufficient
    safe areas for children to play Core Strategy
  • Work with CDRP in area to increase safety in
    communal spaces
  • Involve yourself in Building Schools for the
    Future dining space, play space, kitchen area
  • Involve in play builder initiatives
  • Lobby local shops and fast food outlets to
    provide healthy eating options? Raise issues with
    Council?
  • Lobby councillors to restrict licensing of fast
    food outlets outside schools and sports venues
    aimed at children

21
Data and Evaluation
  • NCMP Data
  • Ask for data to be evaluated against age, BME
    group, ward / MSOA, play areas, fast food
    outlets, schools, deprivation, employment, etc
  • Look for patterns identify where resources need
    to be targeted
  • Where reluctance make data collection fun part
    of another class
  • Target hard to reach

22
Communications
  • Your eyes and ears of school community
  • Sell yourself
  • You know the community probably better than
    anyone
  • Get a voice on strategic groups
  • Write a presentation / business case
  • Be heard!

23
Why are other staff brought in?
  • Stop seeing it as additional work
  • Signpost the majority to activities in the
    community
  • Set an example
  • Yes but, no but
  • Solution focused thinking does not necessarily
    mean you have to do it!

24
Education and Training
  • Influence core training
  • Ensure involved in any support events from NST
  • Identify training needs and what would help in a
    co-ordinated way
  • HENRY
  • Engagement with families, adolescents, hard to
    reach
  • Raise your profile

25
How to achieve and maintain weight loss across
such large numbers of our population is the
challenge for commissioners.Commissioning weight
management programmes is only the tip of the
iceberg
26
Commissioning
  • Need a needs assessment
  • Need mapping of current activity to make best use
    and avoid duplication
  • Need to know what community think and what they
    want?
  • Need a willing workforce
  • Need evaluation

27
Where are we now?
  • High profile
  • High regard
  • Too few of you
  • Increased demand HPV, swine flu etc
  • Danger will be overlooked strategic
  • Identify lead in your area spokesperson
  • This agenda is here to stay!
  • Make your voice heard!

28
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