Big obesity gap between Southampton's most and least deprived children
A leading health boss in the city has warned it could increase further without action
An inequality in childhood obesity across Southampton could get even worse in the years ahead, a public health chief has warned.
The latest data for 2022/23 shows that 40.5 per cent of the city’s year six children are overweight and 26 per cent are obese.
This is above the national picture of 36.6 per cent having excess weight and 22.7 per cent obesity.
At a recent meeting of the city’s health and wellbeing board, a report showed there was a large disparity when analysing the data in terms of deprivation.
Senior public health practitioner and researcher Ravita Taheem said 44.3 per cent of children in the most deprived areas of Southampton were overweight or obese, compared to 23.8 per cent in the least deprived areas.
The board was told the gap had been present for some time but in recent years the inequality had been increasing.
Debbie Chase, director of public health, said: “The trends are going in opposite direction for most affluent and most deprived and we know from the census data over time we are becoming more deprived as a city, so this is going to get worse unless we focus on the drivers.”
Ms Taheem has been leading a team focused on developing a whole system approach to tackling childhood obesity.
This was one of the recommendations that came out of a scrutiny inquiry on the issue in 2020.
It has led to identifying four themes or drivers in the Southampton system for childhood obesity.
Ms Taheem told the health and wellbeing board: “Traditionally when we talk about childhood obesity it’s about healthy cook and eat sessions, information campaigns, free activities, weight management advice.
“What we’re doing is dealing with a symptom of the system and not the system itself.
“We have identified what the causes of the system are and what we are doing is dealing with something that comes out of the system, not trying to change the system.
“That is really what we need to start thinking about. It is not just obesity in and of itself, how are we addressing the drivers.”
The drivers identified were:
Time and resource-poor families
Mixed signals both nationally, locally and in the community
Public spaces perceived as being unsafe, unpleasant and off-limits
Local policies with competing priorities that don’t support a healthy weight environment
The board heard that university research carried out in Southampton found that a basket of food which cost £18 in a supermarket chain’s large store, was £20 more expensive for those items in one of the same company’s smaller shop.
On the subject of mixed messaging, board members brought up vending machines being in hospitals and leisure centres, and children being rewarded with doughnuts in schools.
Ms Taheem said that these themes operate in feedback loops or “vicious circles” as part of a complex system.
She said such systems cannot be controlled, but they can be designed and re-designed.
To address this the team had worked on developing a framework for intervention which had four levels:
Intent – the overall values which can only be changed by those in power and articulating what is wrong with the system
Design – the structures, such as policy and required data, to meet the intent
Feedback – looking at the feedback loops and working to slow them down by strengthening what works and weakening what does not work
Materials – the common interventions like campaigns and training, which are least likely to change the system
The report contained an intent or vision around each of the four drivers.
Ms Chase said the work on a whole system approach was “groundbreaking”.
She said: “For me, the key point Ravita has raised is as much as we have got a lot of groups working on this and focused on the indicators, recognition that as system leaders around this board, we need to support and get assurance that there is that focus on the drivers in anything and everything that we do.
“Where we work through our organisations, through other sectors, a continual focus on those drivers.”
The board supported the recommendations to:
Actively engage and communicate the drivers of childhood obesity, and embed the intents for system change within their plans
Request feedback from other sectors and departments on how the four drivers are being addressed
Monitor the progress on tackling the four drivers of childhood obesity.