What was the aim?
To give childhood obesity a voice and a platform to show that by tackling childhood obesity now, in the longer term, this reduces the demand on the social care system, reduces school absence, unemployment, bullying and stigma, low self-esteem, high blood pressure and pre-diabetes plus bone and joint problems in adult life. Health issues related to adult obesity costs the NHS millions each year.
Using a population health management approach, we have been able to improve the health and wellbeing of a high-risk group of patients identified by our linked datasets as needing more support.
By using the data to understand more about the group and contacting the patients individually we have been able to offer them a menu of support including:
- weight management support for young people
- counselling support for parents.
Using linked data to understand what people need
The linked data was an issue. The data the group did have access to was from primary and secondary care. There was no community data which limited the usefulness of the analysis for childhood obesity.
The group was fortunate that it had already completed insight work in the local population and knew the group of people they wanted to focus on. These analytics came from close working with the acute hospital trust, pharmacists, GP practices, public health experts, the voluntary sector and community/neighbourhood groups.
The collaboration in Medway and Swale is strong. Everyone in the partnership is passionate about focussing on childhood obesity and how the wider determinants of health impact upon a young person’s life and opportunities.
- High number of people attend the community-run activities.
- More professionals trained to discuss obesity in a sensitive and informed way – Make Every Contact Count.
- Reduction in sedentary behaviour.
- Improvement in child mental health and self-esteem.
- System-wide sign-up to an eight-year plan to halve obesity rates.
- Reduced prevalence of type 2 Diabetes, cancer, coronary heart disease and other long-term conditions.
Who did we engage with and why?
Children in Year 6 and their families – 36 per cent of Year 6 children in Medway and Swale have excess weight. If this pattern continues into teenage years and adulthood this will impact on the health system because they are more likely to have high blood pressure, low self-esteem, bone and joint problems and be at risk from type 2 diabetes and other long-term conditions.
What did we do and why?
- Medway Tier 3 Children’s Service was launched in August 2021.
- 57 referrals met the criteria – 21 young people active in the programme and one discharged.
- Pre-measurements included: Height, weight, BMI, physical activity, screen and sedentary time, wellbeing score, food and nutrition.
What were patients and residents offered?
A 12-month weight management programme to support the young people and their family make healthier choices, get advice from a personal trainer, mental health support and counselling support for parents. This was offered to families in Medway only.
How did we evaluate our impact and success and why?
The evidence and impact of this programme will be shown in 20-30 years, the aim being there will be a reduction in hospital waiting times and use of health services by this group of people.
In the shorter term, Medway families were offered a 12-month programme of intervention, funded by Medway Council’s Public Health Team. The results of this will be evaluated in spring 2023.
What were the challenges?
- Time – the programme is slow and requires a commitment from all the health and social care professionals involved.
- Funding – no budget for families in Swale to have similar intervention to families in Medway because funding route is different/more complicated.
- Lack of personal and demographic data – ideally wanted to link this to social and wider determinants of health but with the data available this was not possible. The group had to work around this obstacle.
- Children with obesity do not cost the system now and therefore are not recognised as a priority. However, when those children become adults, they do cost the system.
What were the learning points?
Good analytics are key – need granular data to find which communities need help.
No single intervention can halt the advance of the obesity epidemic.
Every child needs to grow up in an environment that supports their health and weight.
All stakeholders to recognise their responsibility to act on behalf of the child and reduce the risk of obesity when health policy doesn’t articulate wider determinants of health.
Next steps
The long-term ambition is to halve childhood obesity by 2030.
- An environment that encourages people to eat healthy food and minimises access to unhealthy food.
- Active travel being the normal.
- Cheap and accessible leisure options.
- Healthy weight discussed at all health appointments. Make every contact count.
- All education settings and workplaces are health promotion settings.
- Breastfeeding is normalised in public places.
- All greenspaces perceived as safe and accessible with residents regularly using them.
- Food mileage reduced with locally grown food.
- All residents know how to cook healthy foods and can afford to buy the raw ingredients.