hannah phaesant - ibehave presentation - c3 collaborating for health
TRANSCRIPT
Obesity in Tower Hamlets
Hannah Pheasant Manager of Tower Hamlets Weight Management Service at Barts Health NHS Trust
The Obesity Crisis
• Sta=s=cs on obesity, physical ac=vity and diet, England 2013
• 25% of adults are obese
• 31% boys + 28% girls overweight or obese
• 22% of men and 19% of women at increased risk of health problems
Tower Hamlets demography
• Tower Hamlets is a diverse Borough in East London
• BME communi=es make up 55% of the popula=on
• A young popula=on – one fiPh aged under 14 years
• 82% of under 14s from BME communi=es – the largest group are Bangladeshi (61%)
Challenges
• 55% of under 16s in Tower Hamlets are living in poverty – the highest in England (this rises to 69% in some wards)
• 33% of families live on an annual income of less than £20,000
• 52% of children en=tled to free school meals – the highest level in the country
• Rapid popula=on growth – 9% between 2009 and 2014
Source: www.towerhamlets.gov.uk Child Poverty JSNA 2012 and Tower Hamlets Annual Public Health Report 2010
• High levels of child poverty
• High density of fast food outlets
• Lack of availability of affordable healthy foods
• Loss of cooking skills and family meal =mes
• Low consump=on of fruit and vegetables
Challenges
• 5th most densely populated Borough in England
• High volume of traffic and conges=on
• Low ra=o of open space, including gardens
• Fear of crime
• Low use of some exis=ng facili=es
• Low par=cipa=on in physical ac=vity
Challenges
• Busy and =me poor
• Fast food is cheap and convenient and plen=ful!
• Poor food shopper/cook
• Unlikely to be ea=ng and playing together as a family
• Low understanding of por=on sizes, key foods, suitable snacking, etc.
• May not be English speaking/ children ac=ng as interpreters
Mums and Dads
• Boy aged 7 • Lives in an urban area of higher deprivation • Family access limited to local amenities with poor access to fresh food • Poor diet, with high intake of fizzy drinks, snacks and convenience food • Likes to play ‘Super Mario’ on the computer after school • Local area has low access to green space and the park is poorly lit at night • Sport and leisure facilities are the other side of town and are expensive • Parents have a poor understanding of nutrition and healthy food options • Struggles with concentration at school
Outlook: high risk of obesity, increased risk of type 2 diabetes, low educa=onal adainment, service user and co-‐morbidi=es later in life.
Recognise me?
Prevalence of obesity in Recep@on (4-‐5 year olds)
Prevalence of obesity in Year 6 (10-‐11 year olds)
Pre-‐birth and being born
Vitamin D Maternal obesity Diabetes in pregnancy Low Birth Weight Breasheeding ini=a=on
Early years
Breasheeding Weaning Dental Decay Physical Ac=vity and Ac=ve Play High obesity in 4-‐5 year olds
Growing up High obesity in 10-‐11 year olds Boys at higher risk Low par=cipa=on in physical ac=vity Low consump=on of fruit and veg
Adulthood Obesity increasing Higher risk for diabetes , CVD and cancers Low par=cipa=on in physical ac=vity Low consump=on of fruit and veg
Growing older Physical ac=vity key for independence and wellbeing Under nutri=on Osteoporosis
Physical Environment: Open Spaces, Congested roads, Community Safety Food Environment: Fast Food Outlets, Shops, Schools, Leisure Centres, Hospitals
The local picture – needs and priori@es
Pre-‐birth and being born
Antenatal paren=ng classes Healthy Start Vitamins Iden=fica=on of high risk families during pregnancy Baby Friendly Ini=a=ve
Early years
Early Years Accredita=on Scheme Ac=ve Play and Healthy Ea=ng Cook4Life Par=cipatory Appraisal training Breasheeding welcome standard Weight management
Growing up Healthy Schools Healthy Breakfast Clubs & School Meals Healthy Lives Champions Healthy Families and Parent Ambassadors Ac=ve Play Bike It! & Cycle Training Weight management
Ac=ve Play
Adulthood My Weigh Jump Start Cycling on Prescrip=on Women & Girls Swimming Can Do Grants All Ability Cycle Club Ability Bow Health Trainers
Growing older Link Age Plus Young at Heart (over 50s) Lunch Clubs
Physical Environment: LDF, Green Grid, Road Safety Plan HIA, Walking & Cycling strategies Food Environment: LDF, Food4Health Awards, Food Growing, Portas Bid, Food Policy
The local picture – services and interven@ons ‘Whole systems approach through the life course’