Title: Complexity of Childhood Obesity Liz Plastow Public Health Nursing Advisor to NST Childhood Obesity H
1Complexity of Childhood ObesityLiz
PlastowPublic Health Nursing Advisor to NST
Childhood Obesity (Healthy Weight)
2Aim
- 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
3The 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)
4Obesity trends among children aged 2-15 years, by
sex, 1995-2006
5Future 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
-
6Health 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).
7Relative risks of health problems associated with
obesity
8The 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)
9Future 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
10There is good evidence to suggest that a moderate
weight brings health benefits
11Why 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!
12WORK 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
13Mixed 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
14Realities
- 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 16Vision 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
17Prevention 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
18Prevention 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
19Work 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
20Built 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
21Data 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
22Communications
- 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!
23Why 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!
24Education 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
25How 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
26Commissioning
- 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
27Where 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!
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