Hull’s new approach to child obesity rests on the premise that unhealthy weight is not just a public health problem but cuts across all the council’s areas of responsibility.
With this in mind, hundreds of people have been brought together to discuss how it needs to be tackled, leading to the emergence of 12 themes.
The challenge
Obesity rates in Reception and Year 6 are higher than the England average and on an upward trajectory. About 8,000 four to 11-year-olds are currently overweight and obese in the city, a figure that has helped to contextualise the problem for elected members.
Deprivation and unhealthy weight are strongly linked and Hull is one of the most deprived cities in the country. Just over 17 per cent of children are overweight or obese in the fifth most deprived quintile, compared to 9 per cent in the least deprived quintile.
The approach
Increasing recognition of the complexity of the child obesity problem, and work from Leeds Beckett University on the need for a more holistic approach, has led to a rethink in Hull.
More than 80 council staff, elected members and partner and voluntary sector representatives were brought together at the city’s Guildhall for the first obesity mapping session. Twelve interlinked themes emerged; Active travel, early years, education and schools, places to be active, food environment, nutrition and cooking, family norms and parenting, community physical activity, campaigns and awareness, knowledge and experience of health professionals, mental health, poverty and technology.
Carrying out the exercise demonstrated how the issue of obesity related to all areas of council work.
Claire Farrow, Hull City Council’s Public Health Lead for Behaviour Change, said: “It helped people to understand it is not just about eating less and personal choices; it is about where people live and how much money they have in their pocket and how they are feeling about themselves.”
It has been a long and work intensive process. The fifth conversation is scheduled for January 2020. In the meantime, ongoing work to tackle child obesity is beginning to incorporate what has been learnt. Healthy eating and access to healthy food is one of the main focuses/opportunities for change.
The impact
Healthy cooking on a budget has been delivered by the healthy lifestyles team, paid for in part by public health money. Some 28 staff from the voluntary sector, children’s centres, which are based in some of the most deprived wards, youth centre staff, and volunteers have been trained to deliver a programme of practical sessions with the aim of “feeding a family for a fiver”.
Over the last two years nearly 400 parents have attended and developed their cooking skills.
A Healthy Holidays pilot project targeted at the four most deprived wards in the city, which also have the highest rates of obesity, has proved immensely popular. It provided positive activities for children during the summer holidays, along with a food offer. Some 60 per cent of participants were in receipt of Free School Meals.
Hull Food Partnership, made up of number of voluntary sector organisations and the city council, is working collaboratively to improve the food offer. It achieved the Bronze Sustainable Food cities award in 2019 and spearheaded the Soil Association’s Veg Cities campaign in the city to encourage children to eat more vegetables.
It also runs a popular campaign to promote soup. Local cafes and restaurants that provide fresh soup and shops which sell fresh vegetables are promoted through the Partnership website and via social media.
Lessons learned
The new approach moves away from the tendency to put child obesity in to a public health silo.
Strategic buy-in and support are essential for a WSA. The causal map helps stakeholders and politicians to appreciate the complexity of the problem and its long term nature.
Part of this work is to harness community action. A community consultation in priority wards where obesity is highest will ask residents what they want to see and what initiatives are the right ones.
With this in mind, a decision was taken to reframe “childhood obesity” as “childhood healthy weight”, to move away from a medicalised view of the issue.
How will the approach be sustained?
Tackling child obesity is a strategic priority and the plan is to keep it at the top of the agenda.
Momentum will be maintained by “telling the story in different way” and linking it to other issues and agendas, such as poverty, inequality and the council’s Fairness Hull Commission.
Cllr Gwen Lunn, Cabinet Member – Portfolio: Adult Services and Public Health, said: "Hull's whole systems approach ensures joined-up thinking and working across the council, with our partners and with businesses and communities. It gives us the opportunity to create an environment where our children are more likely to eat healthily and be active and give us the best chance of having an impact on childhood healthy weight."
Contact
Claire Farrow, Hull City Council’s Public Health Lead for Behaviour Change