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’