The document discusses obesity rates in Broxbourne and England. It notes that Broxbourne has significantly higher rates of obese children and adults than the Hertfordshire average. Maintaining a healthy weight is complex, with multiple contributing factors including human biology, culture, food environment, physical environment, and sedentary lifestyles. A multifaceted, whole system approach is needed that addresses the social, biological, behavioral, environmental, and structural determinants of health across communities. The Broxbourne pilot aims to help achieve healthy weights through initiatives targeting children, families, schools, healthcare providers, food access, physical activity programs, and the built environment.

1. The whys and wherefores of
healthy weight
Broxbourne Obesity Summit, 22 October 2013
Jim McManus
Director of Public Health

2. Key points
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Keeping a healthy weight is difficult
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Many strands of scientific debate and argument
We are failing as a Country and a County
Broxbourne Significantly Worse than Herts
There are multiple reasons why so many people struggle
We need a multifaceted solution
The Broxbourne pilot gives us perhaps our best chance
at achieving this

3. Health Profiles for England 2013
Health Profiles 2013
indicators
Measure
Eng
Average
Herts
Broxb
Watford
9 Obese children (Year 6)
%
19.2
14.1
17.8
19.1
13 Increasing and higher risk drinking
%
22.3
22.9
22.1
22.5
14 Healthy eating adults
%
28.7
32.7
27.2
32.2
15 Physically active adults
%
56.0
58.2
55.4
58.9
16 Obese adults
%
24.2
21.4
26.4
17.3
26 Life expectancy - male
years
78.9
80.2
80.8
79.2
27 Life expectancy - female
years
82.9
83.8
85.1
82.5
per 100,000
60.9
51.8
53.6
58.7
30 Early deaths: heart disease &
stroke
Green: Significantly better than Hertfordshire average
Amber : Not significantly different from Hertfordshire average
Red: Significantly worse than Hertfordshire average

5. Broxbourne Wards
MSOA/ Ward
Rosedale
45.7%
27.1%
Goffs Oak
44.6%
18.9%
Bury Green
39.4%
16.9%
38.6%
15.7%
Wormley & Turnford
Year 6
(aged 1011)
Obese
Flamstead End
Reception
Year
(aged 4-5)
Excess Weight
37.1%
18.1%
MSOA/ Ward
Excess Weight
Obese
Wormley & Turnford
50.0%
24.2%
Flamstead End
44.7%
23.5%
Bury Green
41.2%
17.6%
Rosedale
40.4%
25.0%
Rye Park
38.1%
15.9%

6. Obesity is growing at an alarming rate, with a significant impact
UK Foresight report: By 2050, 60% of men and 50% of
women could be clinically obese

7. Health Impacts
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Health impact of obesity:
– 58% type-2 diabetes
– 21% of heart disease
– 10% of non-smoking related cancers
– 9,000 premature deaths a year in England
– Reduces life expectancy by, on average, 9 years.
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Costs of obesity:
– National Health Service - £4.2bn
– Wider economy - £15.8bn
– Foresight estimate costs to economy of £50bn by 2050

8. The Science
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Biology – “hormonal” response to foods
Medicine – treatment regimes of various levels
Psychology – intra and interpersonal
Built Environment – mitigates for being overweight
Social Sciences – family and social influences, advertising
THERE IS NO ONE ANSWER – THE ISSUE IS BUILDING A
WHOLE SYSTEM APPROACH

9. Multiple causes
Multiple challenges

10. Physical
Activity
is not the
answer to
Obesity,
but it is a
part of an
answer

11. Active Living is Seen as Essential to Good Health, but it is
ONE part, not the whole solution

12. Why maintaining a healthy weight is so complex
1)
Human biology - genetics plays a part
but does not pre-destine us to be obese
2)
Culture/Individual psychology - it is
difficult to break habituated unhealthy
eating patterns, especially when common
to those around us
3)
The food environment - there has also
been a huge increase in the quantity of
quick convenience foods, which tend to be
high in saturated fat, salt and sugar.
4) The physical environment - our lives have
become increasingly sedentary. For
example, the last 2 decades have seen a
10% drop in children walking to school
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Levels of public
health action needed
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Social
Biological
Environmental
Behavioural
Legislative
Structural

13. Systems thinking on getting to healthy weight
The wider determinants of Health and Local Government functions
(Must adopt a Lifecourse approach!)
The Lives people lead and whether LA functions help or
hinder healthy lifestyles (policy, service quality, access,
behavioural economics, behavioural sciences)
The services people access such as primary care
(high quality, easy access, good follow up,
behavioural and lifestyle pathways wrap around)

14. it is particularly important to engage parents
Prevalence of obese children by parental obesity
30
% of Obese Children
25
Boys
Girls
20
15
10
5
0
No obese parents
One parent obese
Both parents
obese

15. a new approach is needed, focus on shifting
weight distribution in the population
Underweight
Healthy weight
Overweight
Obese
Average BMI
Maximise proportion
at a healthy weight
Minimise proportion
at an unhealthy
weight
Fewer overweight
Fewer underweight
Average BMI
Fewer obese
Reduce average BMI
Underweight
Healthy weight
Overweight
Obese
Make more people a
healthy weight,
not just fewer
people obese

16. We all have a role to play

17. What we’re doing currently
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Children’s Centres promoting healthy weight in under-5s
Healthy Schools Programme, with subsidy to encourage
local schools to take part
Exercise on Referral Scheme Pilot with Council leisure
centres and 4 GP practices
Weight Management pilot (WeightWatchers and
Slimming World)
PlayRangers active play sessions for children, targeted
in locations where children most at risk
HealthWalks programme

19. Some Key Priorities for Broxbourne and
Hertfordshire
1.
Every child should start and
grow up with a healthy weight
2.
Our food environment should
make healthy choices easy
3.
Regular physical activity to
maintaining healthy weight
4.
Good education for all about
what keeps us a healthy weight
5.
Our physical environment needs
to support maintaining a healthy
weight
www.hertsdirect.org
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Remember those levels
of action? We need
them all
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Social
Biological
Behavioural
Environmental
Legislative
Structural