Tackling inequalities in childhood obesity:Influencing national policy

Caroline Cerny, Alliance Lead, Obesity Health Alliance

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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.”

Thank you

caroline.cerny@obesityhealthalliance.org.uk

@OHA_updates