23rd March 2016

Welcome Promoting healthy weight : National policy to local action Wednesday 23rd March 2016 Blackburne House, Blackburne Place, Liverpool #foodactive wifi password: blackburne

Abdul Razzaq

Healthy Weight, National Policy and

Priorities (Government’s Childhood Obesity Strategy)

Healthy Weight: National Policy and Priorities

Abdul Razzaq, Director of Public Health, Trafford Council and Chair, Food Active

23rd March 2016

Prevalence of excess weight among children

National Child Measurement Programme 2014/15

4 Patterns and trends in child obesity

Child overweight (including obesity)/ excess weight: BMI ≥ 85th centile of the UK90 growth reference

One in five children in Reception is overweight or obese (boys 22.6%, girls 21.2%)

One in three children in Year 6 is overweight or obese (boys 34.9%, girls 31.5%)

Prevalence of obesity among children National Child Measurement Programme 2014/15

5 Patterns and trends in child obesity

Child obesity: BMI ≥ 95th centile of the UK90 growth reference

Around one in ten children in Reception is obese (boys 9.5%, girls 8.7%)

Around one in five children in Year 6 is obese (boys 20.7%, girls 17.4%)

Obesity prevalence by deprivation decile National Child Measurement Programme 2014/15

6 Patterns and trends in child obesity

Child obesity: BMI ≥ 95th centile of the UK90 growth reference

25.0% 24.2%22.7%

21.2%19.3%

17.8%16.0%

15.0%13.7%

11.5%12.0% 11.2%10.3% 9.7% 9.0% 8.3% 7.6% 7.0% 6.8%

5.7%

0%

5%

10%

15%

20%

25%

30%

Mostdeprived

Leastdeprived

Obe

sity

pre

vale

nce

Index of Multiple Deprivation 2010 decile

Year 6

Reception

Overweight and obesity among adults Health Survey for England 2011-2013

7 Patterns and trends in adult obesity

Adult (aged 16+) overweight and obesity: BMI ≥ 25kg/m2

More than 6 out of 10 men are overweight or obese (66.2%)

More than 5 out of 10 women are overweight or obese (57.6%)

Obesity among adults Health Survey for England 2011-2013

8 Patterns and trends in adult obesity

Adult (aged 16+) obesity: BMI ≥ 30kg/m2

One out of four men is obese (24.7%)

One out of four women is obese (24.9%)

Our Obesogenic Environment

↓ ↓ Costs ↑↑ Availability ↑Portion sizes

Junk Food Marketing: Aggressive, Relentless

Recommended diet vs the Advertised diet

if Obesity prevention was as easy as telling individuals to eat less & move more then we would not have an obesity epidemic

Our Obesogenic Environment ↓ ↓ Costs ↑↑ Availability ↑Portion sizes

North West Directors of Public Health In 2014, their ‘Top Ten for Number Ten’ public health manifesto included:

– a call for a sugar sweetened beverage duty at 20p per litre

– A ban on the marketing of HFSS foods before 9pm to reduce children’s exposure to unhealthy food marketing

– Introduce policies to encourage active travel and use of public transport to improve the quality of local environments and improve road safety, health and wellbeing.

WHO: Ending Childhood Obesity (2016)

Children’s Health Fund

• Set up by Jamie Oliver and Sustain. • Aims to get restaurants and cafes to

put a 10p sugary drinks levy on non-alcoholic soft drinks on their menu with added sugar.

• Revenues raised will be paid into the Children’s Health Fund which will then distribute grants to programmes and schemes aimed at improving children’s health and food education.

Simon Stevens promises levy on sugary foods and snacks as he urges ministers to force food firms to take action Guardian 17 Jan 2016

Eatwell Guide

Government Levy on High Sugar Drinks

“A levy or tax was 1 of 8 recommendations from PHE’s evidence review on sugar reduction and is a stunning early indication of the Government’s commitment to reducing child obesity……..the money raised will be used to boost funding for school based exercise and sport” Duncan Selbie, Chief Executive of Public Health England https://www.gov.uk/government/news/levy-on-high-sugar-drinks-phe-statement

Childhood Obesity Strategy…… what’s next? • strong measures to control marketing of junk food (including online) • increased powers for local authorities to control proliferation of fast food outlets

Thank you

Email: foodactive@hegroup.org.uk www.foodactive.org.uk

Professor Simon Capewell and Dr Martin

O’Flaherty

Evidence Based Food Policy and Equity: LILAC Research

Martin O’Flaherty & Simon Capewell

Department of Public Health and Policy University of Liverpool & LILAC

Liverpool and Lancaster Universities

Collaboration for Public Health Research

Evidence Based Food Policy and Equity:

LILAC Research

This Talk

• What to expect in the future? – Future inequalities in CHD

mortality

• How to create our future? – Exploring food policy options

to reduce CHD mortality and inequalities with a model.

• Summary & conclusions

What to expect How to create our future Conclusions

METHODS Forecast Bayesian Age-Period-Cohort Analysis to 2035 Socioeconomic measure: IMD Absolute inequalities: Variance of premature mortality probabilities Relative Inequalities Log odds of premature mortality probabilities

Allen et al International Journal of Cardiology, Vol. 203, p290–297

Future trends and inequalities in premature coronary deaths in England: Modelling study

Future trends and inequalities in premature coronary deaths in England: Modelling study

What to expect How to create our future Conclusions

METHODS Forecast Bayesian Age-Period-Cohort Analysis to 2035 Socioeconomic measure: IMD Absolute inequalities: Variance of premature mortality probabilities Relative Inequalities Log odds of premature mortality probabilities

Allen et al International Journal of Cardiology, Vol. 203, p290–297

Exploring the potential of food & smoking policies to reduce inequalities in CHD mortality

What to expect How to create our future Conclusions

Agentic (individuals) & Structural (environmental) policies: conceptual steps and effects on food intake

McLaren et al. (2010) Int. J. Epi Tugwell et al. (2006) The BMJ Diderichsen, Evans and Whitehead (2001) Ox. Uni Press

Efficacy • The largest potential effect

Coverage • The spread of the intervention through the

population

Impact • If the interventions reaches its target, the size of

outcome that results

What to expect How to create our future Conclusions

Salt Policy Options

Structural Agentic

LESS

INEQ

UA

LITY

MO

RE

INEQ

UA

LITY

What to expect How to create our future Conclusions

Structural

Salt Policy Options

Structural Agentic

LESS

INEQ

UA

LITY

MO

RE

INEQ

UA

LITY

What to expect How to create our future Conclusions

Structural

Are healthy eating interventions equally effective for all? Impact on socioeconomic inequalities- systematic review Rory McGill et al BMC Public Health 2015 15:457

Are healthy eating interventions equally effective for all? Impact on socioeconomic inequalities- systematic review Rory McGill et al BMC Public Health 2015 15:457

Smoking: Maximizing the Tobacco Control Scale for England

IMPACT Model methods – IMPACTsec – IMPACTfood policy – Moving mortality

baseline

Allen et al BMC Public Health (in press 2016)

Smoking: Maximizing the Tobacco Control Scale for England

IMPACT Model methods – IMPACTsec – IMPACTfood policy – Moving mortality baseline

KEY RESULTS:

Improving all smoking policies to achieve a maximum score on the TCS might reduce smoking prevalence in England by ~15% among adults aged 35 – 74 Bigger reductions in deprived quintiles ~3,000 fewer premature CHD deaths biggest benefits in most deprived groups.

Allen et al BMC Public Health (in press 2016)

The Health Equity and Effectiveness of Policy Options to Reduce Dietary Salt Intake in England: Policy Forecast

What to expect How to create our future Conclusions

Gillespie et al PLoS ONE 10(7): e0127927

IMPACT Model methods • IMPACTfood • IMPACT SEC • Moving mortality baseline Inputs Differential social effect of policy on salt intake

• Mason et al + McGill et al + Expert elicitation

Effect of Salt intake on CHD deaths

• Strazullo et al

The Health Equity and Effectiveness of Policy Options to Reduce Dietary Salt Intake in England: Policy Forecast

What to expect How to create our future Conclusions

Gillespie et al PLoS ONE 10(7): e0127927

IMPACT Model methods • IMPACTfood • IMPACT SEC • Moving mortality baseline Inputs Differential social effect of policy on salt intake Mason et al + McGill et al + Expert elicitation Effect of Salt intake on CHD deaths

• Strazullo et al

Relative reduction in CHD mortality attributable to a Trans Fat Ban in England

What to expect How to create our future Conclusions

IMPACT Model methods • IMPACTfood • IMPACT SEC • Moving mortality baseline

Inputs • Differential social on trans-

fats intake • Based on NDNS trans-

fats gradients • Effect of Trans fats intake

on CHD deaths • Mozzafarian et al

Health Economics • Societal perspective

Allen et al BMJ 2015;351:h4583

Costs : Transfats

13/02/2015 37

The Sugar Tax: Kcal and Health gains

13/02/2015 38

Reduction in Kcal per person per day Gains in QALYs

The Sugar Tax: Impact on diabetes, CVD and Cancer

13/02/2015 39

Modelling the Health Impact of an English Sugary Drinks Duty at National and Local Levels Brendan Collins Simon Capewell Martin O’Flaherty Hannah Timpson Abdul Razzaq Sylvia Cheater Robin Ireland Helen Bromley Plos ONE 2015 10(6):e0130770

Summary and Conclusions

• Reduction in CHD mortality inequalities will continue to be an issue: – Reduction in absolute terms but more effort is needed to

accelerate decline amongst more deprived.

– However, if current rate of decline persists, reducing excess deaths in the more deprived will require more effort (low mortality)

• “Structural” policies consistently deliver : – Reductions in mortality – Reductions in inequalities in mortality – Key question: Will the combination of population/structural with

individual level interventions also reduce inequalities?

What to expect How to create our future Conclusions

Summary & Conclusions

• Our work highlights the need to consider how policies work might affect inequalities: – Level: Differential exposure, differential vulnerability, differential

outcomes (Diderichesen-Whitehead model) – Place in the Structure-Agency/personal continuum (Mc Laren)

– Policies and decisions in the real world do not act in isolation!

• WE SHOULD EMBRACE COMPLEXITY • Modelling offers a useful perspective to explore

these issues in an explicit way to engage in a dialogue with researchers and policy makers

What to expect How to create our future Conclusions

THANK YOU!

Dr K Allen (Lancaster), Dr E Anwar (Liverpool), Dr P Bandosz (Liverpool), Prof. S Capewell (Liverpool), Prof. P Diggle (Lancaster), Dr D Gillespie (Liverpool, Sheffield), Dr M Guzman-Castillo (Liverpool), Dr R McGill (Liverpool) Dr M O’Flaherty (Liverpool), Prof J Popay (Lancaster), Prof M Whitehead (Liverpool), and many others…

Reserve Slides

Public Health Science Conference

Methods: Salt Modelling approach

Upstream Risk

Factor Change

Downstream Risk Factor

Change

Mortality Change

Policy

Intervention

⇓ salt intake ⇓[1 g/day]

⇓blood pressure

⇓4.6% stroke deaths

⇓3.4% CHD deaths

⇓salt in food

Strazzulo et al

BMJ 2009;339:b4567

He & Mcregor et al

Cochrane Database of Systematic

Reviews 2004;3.

McGill et All (BMC Public Health 2015)

Little on effect sizes for inequalities

What to expect How to create our future Conclusions

2025 Forecast effects on salt intake – all policy options

X-axis: Change to average daily salt intake (g/day) Y-axis: The differential (inequality) in this change by Index of Multiple Deprivation

Gillespie et al 2014 (in submission)

Ji & Capuccio BMJ Open 2014 14;4(8):e005683 Inequalities in salt intake are still there!!!!

What to expect How to create our future Conclusions

Experts What to expect How to create our future Conclusions

2025 Forecast effects on salt intake – all policy options

X-axis: Change to average daily salt intake (g/day) Y-axis: The differential (inequality) in this change by Index of Multiple Deprivation

Gillespie et al 2014 (in submission)

What to expect How to create our future Conclusions

Why Food and Smoking Policies?

• ~60-70% of CHD burden can be attributed to diet & smoking » GBD Lancet 2014. INTERHEART Circulation 2008

• Improving diets at the population level can results in massive reductions in mortality

» PREDIMED NEJM 2013, O’Flaherty et al WHO Bull 2012, Bibbins-Domingo et al NEJM 2012, Collins et al Value in Health 2014

• Improving diets can result in rapid changes in mortality » Bandoz et al BMJ 2012, O’Flaherty & Capewell

Lancet 2012/EHJ 2012 • And might reduce inequalities

» Graham & Capewell Plos Medicine 2010

What to expect How to create our future Conclusions

What policies should we use?

Structural policy approaches

Agentic policy approaches

Target the conditions in which behaviours occur

Work through legislative changes to our food-

environment

Potentially most effective and equitable

Potentially politically challenging to achieve

Target individual behaviour

Rely on providing information for healthy

choices

Might widen health

inequality

Capewell & Graham (2010) PLOS Med McLaren et al. (2010) Int. J. Epi Bromley et al. (2014) Euroheart II Work Package 5

What to expect How to create our future Conclusions

Salt Policy Options

Structural Agentic

LESS

INEQ

UA

LITY

MO

RE

INEQ

UA

LITY

What to expect How to create our future Conclusions

Modelling approach:

Upstream Risk

Factor Change

Downstream Risk Factor

Change

Mortality Change

Policy

Intervention

O’Flaherty WHO Bulletin 2012 O’Keefe BMJopen 2013

What to expect How to create our future Conclusions

What to Expect? Future inequalities in CHD mortality

• Forecasting future mortality – Bayesian Age-Period-Cohort model based forecast – Guzman Castillo M, Gillespie DO, Allen K, Bandosz P, Schmid V, Capewell S,

O'Flaherty M. PLoS One. 2014 Jun 11;9(6):e99482. doi: 10.1371/journal.pone.0099482

• SEC measure: IMD

• We investigated the annual changes in SEC inequality and the contributions of changes in each IMDQ to the overall annual changes, using both absolute (probability) and relative (logit) scales.

• We quantified SEC inequality using the statistical variance in the probability of premature death among deprivation quintiles.

What to expect How to create our future Conclusions

Diderichsen, Evans and Whitehead 2001. The Social Basis of Disparities in Health

What to expect How to create our future Conclusions

Structural-Agentic continuum R

educ

e In

equa

litie

s Increase Inequalities

Structural Agentic

Policy Layer : IMPACTSEC model

Diiferential SEC Effect on salt intake

Expert opinion

Other information

Effect on forecast CHD death rates

Policy Simulation Epidemiology Link

Smoking: Maximizing the TCS for England

POLICY TYPE UK STATUS (2013)

[Additional modelled policies]

MAXIMUM EFFECT ON SMOKING

PREVALENCE

SEC GRADIENT MODEL DECISION

Price 27 out of 30

[20% retail price increase]

3.5% reduction for 10% price increase

[19]

For each 10% price increase,

prevalence relative decreases by [18]:

Lowest SEC: 6.3%

Highest SEC: 1.2%

20% price increase. The effect on

prevalence was modelled from published

price elasticities by SEC.

Smoke-free places 21 out of 22

[Smoking in cars with minors

banned as of October 2015 and

extend ban to all public places]

Worksite total ban 6% reduction

compared to 2% for partial ban;

Restaurant total ban 1% reduction [21,

22]

Smoke-free workplaces generally favour

higher SEC [9, 12]. Mixed evidence for

other types smoke-free places [10, 12].

Additional 1% prevalence relative reduction

possible because little room for

improvement. Assume no SEC gradient.

Public information

campaigns

3 out of 15

[a five-fold increase to 2012

government budget spending of

~£20 million pounds]

Maximum annual effect 2% [26, 27] Often favour highest SEC [28] Additional 1% (average) prevalence relative

reduction possible because moderate

campaigns already in place. Assume

Highest SEC twice as responsive as

Lowest SEC.

Advertising bans 10 out of 13

[Point-of-sale and display ad ban

in small stores as of April 2015]

Comprehensive ban 5% prevalence

reduction; Total ban 3% reduction; Weak

ban 1% reduction [21, 29]

No evidence of gradient [9, 10] Additional 2% prevalence relative reduction

possible

Health Warnings

(including plain

packaging)

4 out of 10

[Plain packaging approved by

Parliament, larger health

warnings (>80% of the packet)]

Large bold graphic warnings reduce

prevalence by 2%; Weaker warnings 1%

reduction. Plain packaging has

maximum effect similar to health

warnings [33]

No evidence of gradient [9, 10, 35] Additional 3% prevalence relative reduction

possible (1% from larger health warnings

and 2% from plain packaging).

Treatment 9 out of 10

[Full reimbursement of

treatment]

4.75% reduction in prevalence (no

details on individual components of

treatment policy)

[21]

Low SEC may have lower success, but

programs can be targeted to eliminate

gradient [36]

Additional 0.5% prevalence relative

reduction possible because most elements

in place already. No SEC gradient

SEC denotes Socioeconomic circumstance

UK status for 2013 (2nd column) is based on Tobacco Control Scale [7]

The potential for further health gains from salt reduction is large

UNITED STATES: 3 g/day reduction in salt intake Save 194,000 to 392,000 QALYs annually Save 10 to 24 billion dollars in healthcare costs annually

CHD Policy Model. Bibbins-Domingo 2010 NEJM

How do you solve a problem like very busy experts? – design a very short questionnaire

For labelling and social marketing, we first anchored experts by asking them to assume, arbitrarily, that coverage was currently 10% in all deprivation quintiles We then asked them to estimate the future coverage in 2020.

Differential effects by Index of multiple deprivation quintiles If the value of your estimate was represented by 1.0 in the richest, what do you think would the value be in the poorest? (Putting “1.0” would mean no different, “0.2” would mean just 20% of that in the richest.)

For reformulation, we asked for the population-average values of coverage and impact that would be expected by 2020.

What did the experts’ estimates look like?

Our expert elicitation – a critique

Strengths • Prior definition of policy

model • Thorough treatment of

uncertainty • Brief exercise – good

response rate and rapid data

Limitations • Lack of qualitative data

showing experts’ reasoning

• Limited pool of experts – public health academics

• No consideration of interactions among policy options

TF Policies: Cost effectiveness Plane

Cost effectiveness of a legislative ban (1&2) or mandatory reformulation (3&4) on TFA, with equal (1&3) and unequal (2&4) intake across SEC quintiles.

Methods • Estimated the population benefits, and cost effectiveness from

2011-2020 of: – Legislative ban on TFA (0% intake) – Mandatory reformulation (0.4% intake)

• First modelling equal TF intake • Second modelling unequal TF intake

• Modelling approach • Mortality counterfactuals • Beta coefficient for risk factor intervention • Stratified by age, gender, SEC

Methods: Costs

• Govt costs - Initial legislation + Annual monitoring • Industry costs – reformulation + annual cost • Savings:

– Direct healthcare savings – reduction in hospital admissions

– Informal care savings – Averted productivity loss

• All outputs discounted at 3.5%

Methods: Outputs •Hospital admissions averted over 10 year period •Life Years Gained & QALYs •Total costs •Cost effectiveness

•Cost/LYG •Results tested in Probability Sensitivity Analysis

Results

• Legislative ban: – 27,200-29,000 life years – 17,700-19,300 QALYs – 68,000-72,000 hospital admissions averted

• Costs: – Govt: £22m - £27.2m – Industry: £0- - £140m

Cost Savings

• Savings: – Direct healthcare - £190m-£200m – Informal care - £560m-£730m – Averted productivity loss - £580m-£610m – Net Saving

• Mandatory reformulation would half health gains and economic savings

Results: Cost effective? • Cost effective:

– Cost saving + QALYs = dominant scenario – £1,400-£1,600/LYG (conservative cost only)

• Statins £27,000/LYG 1° prevention

– $0.7 - $7 per capita (PPP) • WHO ‘extremely cost effective’ < 1 x GDP per

capita = $16,000 PPP

Cost effectiveness Plane

Cost effectiveness of a legislative ban (1&2) or mandatory reformulation (3&4) on TFA, with equal (1&3) and unequal (2&4) intake across SEC quintiles.

Inequalities

• Unequal TFA intake yields even greater gains: – Five times as many LYGs

– One fifth cost per LYG

– In the most deprived, compared to most affluent

– Wider societal SEC effects could be greater still

Cost Effectiveness of TFA policies

• Cost per LYG of TFA ban (1&2), and mandatory reformulation (3&4) from 2011-2020. Stratified by SEC (equal intake 1&3, unequal intake 2&4)

Would a TFA ban be equally cost effective across SEC quintiles?

Cost per LYG in men, of a legislative ban on TFA achieving TFA intake of 0% daily energy. LYG stratified by age, and SEC over the period 2011-2020. (State costs only, no savings included)

Strengths & Limitations

• Consistent with previous estimates • Entire adult population + reliable datasets • Novel modelling and stratification of population level intervention But • Area level SEC categorisation • Assumes instantaneous effect • Implementation strategies? • Doesn’t account for community costs

Conclusions

• Reducing dietary Trans Fats consumption in UK could: – Yield substantial health gains – Be cost saving – Be ‘extremely cost effective’

• Further research outlining cost effects upon community prevalence required

• Case for population level, primary prevention policies has never been stronger

Cost Effectiveness of TFA policies

• Cost per LYG of TFA ban (1&2), and mandatory reformulation (3&4) from 2011-2020. Stratified by SEC (equal intake 1&3, unequal intake 2&4)

Ongoing work: Developing a policy decision space with equity at its centre

Kypridemos et al 2016 (submitted to BMJ) Funding: HeRC,In part supported by SPHR

Entry

CHD (1st episode)

Death from CHD (in the first 30

days)

Death from CHD (post 30 days)

Stroke (1st episode)

Death from stroke (in the first 30

days)

Death from stroke (post 30 days)

Age, sex, QIMD

Behavioural risk factors

Biological risk factors

Give birth

Death (all other causes)

Microsimulation model. Allows: taking into account differential exposure differential vulnerability (risk factor clustering)

Sugar Smart Cities - Ben Reynolds,

Deputy Coordinator, Sustain: the alliance for better food and farming and Jo Ralling,

Campaign Director, Jamie Oliver Food Foundation

Q&A

Refreshment Break

Robin Ireland

Food Active : A Regional Healthy Weight Campaign

Food Active: A Regional Healthy Weight campaign

Robin Ireland, CEO Health Equalities Group and

Director, Food Active Promoting Healthy Weight: National Policy to Local

Action 23rd March 2016

Learning from the battle against tobacco?

http://www.publications.parliament.uk/pa/cm201516/cmselect/cmhealth/465/465.pdf

Health Committee (Nov. 2015): “Childhood obesity – brave and bold action”

• Controls on price promotions of unhealthy food and drink • Tougher controls on marketing and advertising • Reformulation programme to reduce sugar • A sugary drinks tax • Labelling showing sugar content in teaspoons • Improved education and information • Universal school food standards • Greater powers for local authorities to tackle the obesogenic

environment • Early intervention to offer help to families

What can be done at Local Authority level? • Children and adults should have access to healthy

food in care settings including hospitals, schools, nurseries, residential care.

• Local authorities should procure food and drink intelligently (both in-house and in public venues)

• Town planning needs to encourage active travel and restrict fast food outlets wherever possible

• Local authorities should consider not accepting funding associated with industries that produce food and drinks high in sugar, salt and saturated fat.

Local Authority Declaration on Healthy Weight • Based upon the principle of the Local Authority

Declaration on Tobacco Control from ASH • Support and develop action locally on sugary

drinks and/or junk food / commercial determinants • The declaration will aim to support Local

Government to take action to prevent excess weight and secure the health and wellbeing of residents

• The declaration will require Local Government officers and politicians to support the implementation of policies that will encourage healthy weight.

Obesity Health Alliance

Coalition of over 26 leading national charities, Medical Royal Colleges and campaign groups: aims to share expertise and support Government in

tackling the complex issue of overweight and obesity in the UK, across the life course through population level policy interventions.

Thank you

Robin Ireland

Director, Food Active & CEO, Health Equalities

Group

@robinHEG

robin.Ireland@hegroup.org.uk

www.hegroup.org.uk

Dr Arif Rajpura

Adopting a Local Authority Declaration on Healthy Weight and Implementing a Local

Gulp Campaign

Turning the Tide of Obesity in Blackpool

Dr Arif Rajpura Director of Public Good Health 23 March 2016

Contents

• Size of the problem in Blackpool • Taking steps to healthy weight • Local Authority Declaration on Healthy Weight • #GULPChallenge

Blackpool Gazette

• Pupils tip scales as obesity levels rise • Town leads the way in fighting obesity crisis • New bid to tackle obesity • Shocking new figures reveal 83,000 Blackpool

adults are overweight • Poverty link to wellbeing • Health kick for new estate in fat-busting pilot

Size of the Problem in Blackpool

Blackpool “The Watering Hole of the Masses”

Overweight and Obesity in Blackpool • 25% 4-5 year olds

• 38% 10-11 year olds • 72% adults

• 4-5% adults morbidly obese

• 1 in 6 pregnant women obese

• 46% adults eat ‘five a day’ • One in six meals eaten outside the home • 14% adults have sugary drinks every day • Blackpool is the ‘fast food capital’ of the UK • Teens get 1/3rd of their daily calories from sugary

drinks • 25% of boys and 16% of girls 12-15 drink fizzy drinks

on most days

Diet and Eating Habits

Obesity Donuts

Blackpool England

NCMP : 2006/07 – 2013/14 Reception and Year 6 Excess Weight (Overweight and Obese)

0-19’s Tooth Extraction Pies

15.1%

41.5%

24.8%

18.6%

England

Age 0-4yrs

Age 5-9yrs

Age 10-14yrs

Age 15-19yrs

n=184,045 0.5% of 0-19 population

20.1%

54.6%

13.6%

11.6%

Blackpool

Age 0-4yrs

Age 5-9yrs

Age 10-14yrs

Age 15-19yrs

n=1,168 1.2% of 0-19 population

Source: Public Health England, Dental Public Health Intelligence Programme, HES Extractions Data 2011-2014

Taking Steps Towards Healthy Weight

Refreshing Blackpool’s Healthy Weight Strategy • Focus on children and young people • Build on existing schemes e.g. free school breakfast • Seek ways of reducing sugar consumption • Redesign and orientating environments to promote healthier

choices • Adopt a ‘whole systems approach’ • Secure a Council wide commitment to align policies and

actions to promote and support healthy weight -> LA Declaration on Healthy Weight

Signing the Local Authority Declaration on Healthy Weight

Local Authority Declaration on Healthy Weight

By signing the declaration the Council will be showing a commitment to reducing unhealthy weight in our communities, protect the health and wellbeing of staff and citizens and make an impact on health and social care • There are 12 broad statements which all Local Authorities sign

up to

• Plus a number of local priorities to be included within the declaration

The Journey So Far August 2015 Idea first floated September 2015 Corporate Leadership Team December 2015 Health and Wellbeing Board December 2015 Senior Leadership Team January 2016 Council Leadership January 2016 Full Council

Blackpool’s Local Priorities

• Consider weighted/financial support for ‘healthier’ retail (e.g. greengrocers, co-operatives etc.) in deprived areas

• Improve the quality of packed lunches by developing a local agreement with schools to implement guidance

• Work with schools to achieve Walk to School • Take a stepped approach to reduce sugary drinks available in

vending machines on locally controlled sites • To work with commercial outlets within all public sector premises

to develop a food and drink policy

Campaign Aims

• Reduce the number of sugary drinks consumed • Swap to drinking non-sugary drinks such as water

and semi-skimmed milk • Raise general awareness of the amount of sugar in

sugary drinks

What was Involved

• Interactive sessions in secondary schools and colleges

• Goody bag and branded water bottle – to stimulate interest and maintain brand presence

• #GulpChallenge – promoted via sessions and social media

• ‘Healthy selfies’ competition

Did it Work?

Emerging findings from the evaluation:

• The proportion of teens who think sugary drinks is a health problem increased from 53% to 70%

• Increase in proportion indicating preference for low sugar drinks, from 34% to 66%

• Decrease in proportion reporting they often buy drinks that have lots of sugar in, from 66% to 36%

• Increase in the proportion reporting that they think about how much sugar is in drinks they buy, from 21% to 43%

• Increase in the proportion who understand health risks of sugary drinks, from 63% to 82%

http://www.bbc.co.uk/news/health-35115476

Q&A

Round table discussions

“What can local authorities do to further

develop healthy weight plans/strategies in

response to national policy?”

Feedback from round table discussions and

session summary

Thank you for attending Please complete your evaluation

form The presentations can be accessed via

www.champspublichealth.com