david herne public health specialist chorley & south ribble pct

David Herne

Public Health SpecialistChorley & South Ribble PCT

Purpose of this session- to promote an understanding of the

wider determinants of health andspecifically how they underpin patterns of obesity

and- to consider what actions would contribute to a reduction in obesity rates.

Obesity is a problem

But if you need any convincing look at the picture in America………………

Obesity Trends* Among U.S. AdultsBRFSS, 1985

Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

What is ObesityBody Mass Index (BMI) is a measure comparing weight to height and is often used as an indicator of body fat for adults.

Obesity is usually defined as a body mass index (BMI) of 30 or above.

BMI classification:

Source: Tackling Obesity in England. Report by the Comptroller and Auditor General HC 220. National Audit Office, 2001. London: The Stationery

BMI Classification

Less than 20 Underweight

Over 20 but under 25 Healthy

Over 25 but under 30 Overweight

Over 30 Obese

Why is obesity a problem ? - the costs

• In 1998 on conservative estimates, obesity treatment cost the NHS £0.5billion

• 1.5% of the total NHS expenditure in that year

• The bulk of this cost is attributable to treating the consequences of obesity

• £2billion was attributable to wider societal impacts such as sickness time off etc

• Over 18 million sick days and 6% of all deaths are attributed to obesity each year (compared to about 10% due to smoking)

• An obese person loses approximately 9 years of life

• If the prevalence of obesity continues to rise at the present rate until 2010, costs would increase by £1billion to around £3.6billion

Obesity in Young Children• Little change in overweight or obesity from 1974

to 1984.

• From 1984 to 1994 overweight increased from 5.4% to 9.0% in English boys9.3% to 13.5% for English girls.

• The prevalence of obesity increased correspondingly, reaching 1.7% boys and 2.6% girls

• Now 10% of 6 year olds are classified as obese

Among 3 to 4 year old English Children• 60% increase in the prevalence of being

overweight and

• 70% increase in the prevalence of obesity

• Increases in obesity in surprisingly young children.

• Furthermore, more than 60% of overweight children have at least one additional risk factor for cardiovascular disease, such as

raised blood pressure,hyperlipidaemia, orhyperinsulinaemia

• More than 20% have two or more risk factors.

• Type 2 diabetes, which was previously rare in children and adolescents, now accounts for over 30% of new cases in some parts of the United States;

• Most cases of type 2 diabetes in children and adolescents are attributable to obesity.

SourcesBMJ2001;322:313-4NWPHO 2002BMJ 2001;322:24-6

Task 1

In pairs consider…..

why are children getting fat?

Task 2In pairs considerWhat can schools alone do to address this broad agenda which underpins the Obesity epidemic?What more can they do if they work in partnership, and who else would they need to work with?

Public health is about…Surveillance & assessment of population health and well beingPromoting and protecting population health and well beingDeveloping health programmes & services and working to reduce health inequalities eg the LHSP

Public health is about…Developing & implementing policies and strategiesTaking a strategic lead in collaborative workingWorking with and for communitiesDeveloping high quality in our work & routinely evaluating its effectivenessCarrying out research and development

Obesity was just an example….

The public health approach applies for many topic and setting areas

david herne public health specialist chorley & south ribble pct

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