caroline cerny, alliance lead, obesity health alliance · 2019. 7. 19. · caroline cerny, alliance...
TRANSCRIPT
Tackling inequalities in childhood obesity:Influencing national policy
Caroline Cerny, Alliance Lead, Obesity Health Alliance
About Obesity Health Alliance
• 45 organisations
• Speak with one voice on obesity policy
Obesity prevalence by deprivation decileNational Child Measurement Programme 2017/18
3Patterns and trends in child obesity
Child obesity: BMI ≥ 95th centile of the UK90 growth reference
26.8%25.7%
23.8%
21.9%
20.0%18.5%
16.9%15.7%
14.0%
11.7%12.8%
12.0%11.0%
10.1%9.4%
8.5%7.8% 7.5%
6.8%5.7%
0%
5%
10%
15%
20%
25%
30%
Mostdeprived
Leastdeprived
Ob
es
ity p
reva
len
ce
Index of Multiple Deprivation 2015 decile
Year 6
Reception
Severe obesity prevalence by deprivation decileNational Child Measurement Programme 2017/18
4Patterns and trends in child obesity
Child severe obesity: BMI ≥ 99.6th centile of the UK90 growth reference
7.0%
6.2%
5.5%
4.7%
3.9%3.5%
2.8% 2.7%
2.0%1.6%
3.8%3.5%
3.0%
2.6%2.2%
1.9%1.6% 1.5%
1.3%1.0%
0%
1%
2%
3%
4%
5%
6%
7%
8%
Mostdeprived
Leastdeprived
Se
ve
re o
be
sit
y p
reva
len
ce
Index of Multiple Deprivation 2015 decile
Year 6
Reception
Role of national policy
• Population level interventions – likely to have most positive effect on health inequalities
• Universal interventions to restrict or modify choice – most effective behaviour change
AgenticIndividual
decision makingLikely increase
inequalities
Agento-structural
Environment + behaviour
Impact uncertain
StructuralChange
environmentCan reduce inequalities
Policy priorities
PROBLEM POLICY POLITICS
Needed Workable Wanted
Policy priorities
PROBLEM POLICY POLITICS
Needed Workable Wanted
Children’s excess sugar and calorie intake
Significant variation across categories
Some manufacturers leading the way on sugar reduction
83% of public support voluntary reformulation (73% regulation)
Structural: Lower income groups have highest level of sugar in their diets -potential to disproportionately impact inequalities
Policy priorities
PROBLEM POLICY POLITICS
Needed Workable Wanted
Voluntary action by some supermarkets show change is possible.
66% of public support supermarkets being made to promote healthier foods
Price promotions such as ‘buy one get one free’ and multi-buy offers more common on unhealthy food products.
Structural: Promotions generally cause people with less money to spend more, due to triggering impulse purchasing
Policy priorities
PROBLEM POLICY POLITICS
Needed Workable Wanted
The more junk food ads on TV young people see, the more they eat – 500 extra snacks per year
Limited restrictions already apply
Evidence based tools in place
72% of public support 9pm watershed / 70% support restrictions online
65% of MPs
Structural: Teens from more deprived backgrounds 40% more likely to recall seeing ads – potential to disproportionately impact inequalities
Looking ahead… a new narrative?
Child obesity is a problem heavily skewed to particular groups, demanding community-level solutions targeted at where the problem is to maximise effectiveness.
"If we want kids to lose weight we should encourage kids to walk and cycle to school and generally do more exercise. It’s calories in, and calories out.
“Taxes on treats hits those on lowest incomes. We should be #freetochoose.”