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Childhood Obesity in the United Kingdom: A Comprehensive Assessment and Path to Healthier Futures
  • 4

  • Course Code: PHE7452
  • University: Birmingham City University
  • Country: United Kingdom

Executive Summary

The report on childhood obesity in the UK points out some troubling trends. High rates of obesity, especially among poor areas and Black children, show that something needs to be done right away. There are still differences between regions, with the highest rates being found in the North East. Also, a small rise in the number of underweight children in year 6 shows how complicated the problem is.

As a matter of public health, childhood obesity is complicated. It is caused by biological, behavioural, social, and environmental factors. The Behaviour Change Wheel and the Socio-Ecological Model help shape interventions, stressing the need for multifaceted methods that target different levels.

Childhood obesity is caused by a mix of structural, social, economic, and cultural factors. Ethnicity, family behaviour, socioeconomic status, and the environment in which one lives are all very important. The Marmot framework emphasizes the need for assistance in several important areas, including early childhood development, education, economic stability, healthy communities, social inclusion and good governance.

Government Interventions and policies, such as Childhood Obesity: A Plan for Action and Tackling Obesity Government Strategy demonstrates how the awareness of the problem is increasing. These policies range from sugar tax to restrictions on advertising, all aimed at making it a bit easier for people to make the better choice for health.

They do not always work, and when used, they should be guided by ethics like avoiding victim blaming and equity.

Thus, addressing childhood obesity in the UK requires a multipronged, ethical approach. The stakeholders must keep working for healthier children and lower health disparities.

Introduction

Childhood obesity is a significant public health issue in the UK, and its impacts are felt significantly far and wide (Wickramasinghe et al., 2021). It is not just a health issue; it is also a social and economic one.

The aim of this report is to have a closer view of various public health policies and interventions that have been implemented for combating this epidemic, influenced by pertinent causal/contributory factors. It aims to add to the larger conversation about reducing childhood obesity and promoting healthier futures for children in the UK by looking into how well these strategies work and what ethical issues they raise.

Background

Public Health Concern

obesity increase in 6 year old children in uk

Figure 1: Obesity among year 6 children
(Source: UK Parliament, 2023)


Statistical data and trends show the severity of the situation. During the school year 2022-2023, a very large percentage of children in year 6 (10-11 years old), particularly in the poorest areas, were overweight or obese (Baker, 2023). This was also the case in children in reception where the rate of obesity was more than twice as high in deprived areas compared to that of rich areas (RCPCH, 2023). This difference indicates that socio economic factors played a big role on number of overweight and obese children.

childhood obesity in uk
Figure 2: Childhood obesity in England
(Source: UK Parliament, 2023)


The number of overweight or obese children living in different areas varied from place to place. For instance, children’s obesity in the reception and year 6 was highest in the North East, and lowest in South East, East of England, and South West (Baker, 2023). This regional variation implies that childhood obesity is being influenced by multiple factors that act together.

Race also affects how many overweight or obese children there are. 2022–2023 showed that black children are the most likely to be overweight both in reception and year 6 (Baker, 2023). Chinese children were the least likely to be overweight. This indicates that cultural, dietary, and lifestyle differences influence obesity rates among racial groups.

It was also discovered that the number of children that were considered underweight rose slightly in year 6 but remained the same in the first year of reception (Baker, 2023). The slight but observable increase of the number of underweight children can refer to the various issues with the nutrition that children from different groups of people encounter (Snowdon, 2023).

The statistics prove that there is a need to take specific steps to help children who are overweight or obese, as they contribute to public health problem. Overcoming the problem of childhood obesity requires a multi-dimensional approach acknowledging the cultural, geographical, and socioeconomic components that influence children’s health.

Public Health Perspective

Childhood obesity in the public health field is viewed not only as a personal health problem but also as a complex issue that cannot be solved completely but requires systemic solutions.

One of the public health perspectives about why children are overweight can be garnered through the socio-ecological model. This model highlights that childhood obesity is a result of complex interactions at various levels, namely, the individual including genetics and behaviour, the interpersonal including family and friends, the community encompassing school and neighbourhood, and the societal encompassing laws and cultural norms (Lang et al., 2021). So, obesity requires actions beyond one level.

Another model is the Behaviour Change Wheel, which is based on the COM-B system and looks at three important factors for behaviour change: ability, opportunity, and motivation (Chater et al., 2023). They use this way of thinking to design interventions to alter behavior by affecting one or more of these areas, such as eating well and being active.

To combat childhood obesity, public health strategies include promoting healthy eating and activity in children, implementing policies such as sugar taxes that decrease the likelihood of consuming unhealthy foods, and making modifications to the environment such as improving the safety of play areas (Dietz and Baur, 2022). Usually, these strategies are implemented in schools, health care facilities or programmes in the community. The bigger policy and law changes back them up.

The public health perspective on childhood obesity is a wide perspective, looking at many things and doing it in many ways to address such a complicated issue.

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Main causal/contributory factors

Structural

Social

UK childhood obesity is influenced heavily by multiple social factors. Social class is important; overweight children are usually from poor families (Iguacel et al., 2021). This is due to fewer opportunities for healthy food, physical activity, and unhealthy food advertisements. Family environment and behaviour are crucial. Children's lives are shaped by their parents' weight, diet, and fitness attitudes. Children from non-exercising or unhealthy homes are more likely to be overweight.

Stress and mental health are strongly linked to obesity. Children often eat poorly to cope with stress from family issues, peer pressure, or bullying (Mireku and Rodriguez, 2020). Overweight and depressed children create a vicious cycle of mental and physical health issues. Community and environmental factors like fast food restaurants and safe play areas also affect childhood obesity. Schools' rules and programmes encourage healthy eating and exercise, which shapes children' health habits.
All of these social factors must be considered and policies and programmes implemented to combat childhood obesity in the UK.

Economic

Economic factors are crucial in determining childhood obesity in the UK. Food insecurity is linked to obese children (Keenan et al., 2021). Poor children are almost twice as likely to be overweight as rich children. This difference in obesity rates between problem and non-problem areas has grown over the last decade (Baker, 2023). Public policies to combat obesity often change market signals and the choice environment to promote healthier choices. These policies aim to make healthy food more accessible and affordable. Examples include sugar taxes and junk food advertising bans.

Obesity treatment costs the NHS £6.5 billion annually. That number should reach £10 billion by 2050 (Bell and Deyes, 2023). Obesity affects the economy beyond healthcare. It lowers workplace productivity and raises social care costs.

Cultural

Multiple cultural factors affect UK children's obesity rates. A study found that English children were more likely to be overweight than French children because they were less active and spent more time watching TV and using the computer (Alghadir et al., 2021). Many people eat fast food, don't value traditional meals, and don't walk to school. Studies in Birmingham's Pakistani and Bangladeshi communities show ethnicity matters (Redclift et al., 2022). This shows the need for culturally appropriate obesity management programmes. Due to poverty, these children are more likely to be overweight.

Ethnic minorities have cultural practices for feeding children, eating, and getting healthy food. Traditional food preferences and cultural food rules are examples. Breastfeeding and trying new foods affect how people eat and their risk of obesity (Dietz and Baur, 2022).

Causes of the Causes 

The Marmot framework, which was created by Professor Sir Michael Marmot, looks at the social factors that affect health and how they affect health disparities, such as the high rate of childhood obesity in the UK (Griffin et al., 2021). The framework stresses that social, economic, and environmental factors have a big impact on health because they make up the conditions of daily life.
 marmot framework obesity children
Figure 3: Marmot Framework
(Source: Straatmann et al., 2020)


At the heart of the Marmot framework are a few important ideas about how to deal with childhood obesity:

Early Childhood Development: The framework stresses how important experiences in the first few years of life are for shaping health later on (Salm et al., 2023). Children can become overweight if their mothers aren't healthy, if they don't get enough to eat, or if they don't have a supportive environment when they are young. In communities that are struggling financially, these factors are especially noticeable.

Education and Lifelong Learning: Getting an education is a big part of staying healthy. The level of education has direct and indirect effects on health by affecting job opportunities, income, and the ease of accessing and understanding health information (Nobles et al., 2021). Often, having less education means having a greater rate of childhood obesity.

Work and Economic Stability: A family’s economic standing greatly influences the health of their children (Nobles et al., 2021). More children in poor, jobless, or fearful of losing their jobs families may not find it easy to get healthy foods and secure areas where they can be at ease to play.

Healthy and Sustainable Communities: The Marmot Review highlights the importance of the environment to health (Griffin et al., 2021). To prevent children from being overweight, they should have easy access to safe and green areas for play and physical activity, allowing them to receive nutritious food. Health disparities are often worsened by the absence of these resources in poor neighbourhoods.

Social Inclusion and Non-discrimination: Health disparities can result from discrimination against people due to their social status or background (Salm et al., 2023). For instance, it may be difficult for minority ethnic groups to reach educational and health promotion resources such as education and healthcare, thus they are at high risk of developing obesity in their childhoods.

Good Governance and Public Policy: Policies can play a very important role to identify the reasons of inferior health for some people compared to others (Straatmann et al., 2020). Children should not become overweight, so policies that address the issues of income inequality, making sure everyone can afford good schools and health care and that the children live in healthy places are needed.

Policy Support

The UK government has been actively tackling the issue of childhood obesity by addressing both personal actions and broader factors that contribute to these behaviours. This approach is shown by a number of important policies and plans:

Childhood Obesity: A Plan for Action: The goal of this project is to decrease sugar consumption, persuade people to eat more healthily, and regularly update nutrient profile models to assist people in eating better (Griffin et al., 2021). This involves targets for reducing calories in a number of foods, promoting innovations for healthier food; and putting in place in the public sector standards for healthier food options.

Tackling Obesity: Government Strategy: This strategy was created in response to the growing obesity crisis made worse by the COVID-19 pandemic (Dolezal and Spratt, 2023). It includes a wide range of steps that will help adults and children live healthier lives. It includes adding healthy weight coaching to primary care networks, speeding up the NHS Diabetes Prevention Programme, and expanding services for managing weight. A lot of focus is put on behavioural interventions to get people to live healthier lives.

Economic Benefits: The government's plan, especially the calorie labelling programmes, should have a big impact on health and save money for the NHS in the long run (Hand, 2023).These policies show that the government is acting in a way that is very similar to what research has shown about what causes children to be overweight.

A lot of attention is paid to changing society so that it supports behaviours that are good for health (Keenan et al., 2021). These steps address both the lifestyle choices of individuals and larger societal issues like food production and the power of the public sector.

But there are still problems, especially when it comes to making sure that these policies are implemented and evaluated correctly. Over time, the government's strategy has grown to include more areas and work better with others (Dietz and Baur, 2022). This shows that they are becoming more aware of how complicated childhood obesity is and how many different ways they need to help.

Public Health Interventions 

The UK has taken a number of public health measures to fight childhood obesity because they know that this is a complicated problem that is affected by genes, culture, behaviour, and the environment.

Important interventions are:

Healthier Weight and Nutrition Messages: Health professionals should be saying the same thing over and over again when it comes to promoting a healthier weight, diet and exercise. As such, the Eatwell Guide and the Chief Medical Officers' Physical Activity Guidelines are promoted (Snowdon, 2023).
Public Sector Initiatives: Over £2 billion a year is spent on food and catering services in the public sector (UK Parliament, 2021). This is aimed at facilitating individuals to make healthy food choices.

Behavioural and Lifestyle Interventions: Interventions based on diet and exercise have been demonstrated to reduce the risk of obesity in UK children (Bell and Deyes, 2023). But it is still not evident to what extent these interventions will work in the future.

Legislative Measures: The government wants to change the law to promote people to eat healthily by targeting such ads such as “Buy One, Get One Free” which represent foods that are highly unhealthy (Furey, 2022). This method aims to make healthier options not only more appealing but also easy to find.

Creative Education Programs: For instance, the Planet Munch Healthy Lifestyle Programme involves the families in activities aimed at educating them about nutrition, exercise, and changing their habits (UK Parliament, 2021). These types of programs are fitting with the NICE guidelines that say that people should discuss the lifestyle risk factors with their relatives and friends.

Support for Breastfeeding and Responsive Feeding: The health visitors provide support and recommendations regarding natural feeding and formula feeding, and they encourage concepts such as responsive feeding (Iguacel et al., 2021). This is a part of a bigger plan to get children to eat well from a young age.

Community and Population Level Interventions: Health visitors are very important for getting people in the community to eat and exercise in a healthy way. As part of this, they work with early years' services to put evidence-based programmes like HENRY (Health, Exercise, and Nutrition for the Really Young) and the UNICEF UK Baby Friendly Initiative into action (Bell et al., 2020).

An approach with many parts, these interventions aim to deal with the bigger reasons behind childhood obesity by using a mix of education, support, and legal actions. These interventions will only work if they are combined and people from different fields, like healthcare, education, community groups, and government agencies, work together.

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Analysis Of Interventions

It is possible to use the Ecological Model of Public Health to compare and contrast the UK's public health efforts to fight childhood obesity. This model looks at how interventions affect people on many levels, including the individual, the interpersonal, the organisational, the community, and the public policy level.

Individual Level: At this level, interventions are aimed at changing how people act. In the UK, resources and training for health care workers have been put in place to help families and children talk about nutrition and weight (Dietz and Baur, 2022). However, this depends on people taking initiative and being involved, which can vary considerably between the groups.

Interpersonal Level: This level is concerning family and social relationships that influence people’s behavior (Hu et al., 2021). The UK government's actions are such as the launches of campaigns to make parents and early year’s workers more conscious and such programs as Start4Life that provide parents and professionals with adult-based child health information. However, the effectiveness of these programmes relies on how involved and helpful family and social networks are, which is sometimes not the case.

Organizational Level: This level encompasses institutions such as hospitals and schools (Dietz and Baur, 2022). Such as the Change4Life School Zone or promoting active play in early years’ settings in the UK to help children eat and play well in schools. These interventions cover many people but the efficacy of each one may depend on how much money and time each institution has to implement them.

Community Level: These actions are aimed at the bigger community (Dolezal and Spratt, 2023). Things like the Healthy Start scheme have been done in the UK to make healthier foods easier to get and more affordable. But these kinds of interventions may not have the same effect on all communities, especially in places where it is hard to get healthy food.

Public Policy Level: These are the policies and laws that affect the whole country (Hu et al., 2021). To get people to eat healthier, the UK has put in place rules like the Soft Drinks Industry Levy and limits on food advertising. These policies could have a big effect on many people, but how well they work will depend on how the industry reacts and how well the public accepts them.

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Ethics

Intervention Ladder was made by the Nuffield Council on Bioethics to help evaluate public health interventions, especially in terms of how they might affect ethics. It has several rungs, and each one shows a different level of interference, from least to most (Leek and Afoakwah, 2023). Using this model to look at the UK's efforts to fight childhood obesity can bring up a number of ethical issues.

 intervention ladder
Figure 4: Intervention Ladder
(Source: Walls, 2015)


Do nothing or provide information (Least Intrusive): At this level, the UK's public health strategy includes campaigns to teach people how to eat and exercise in a healthy way. These interventions respect people's right to be left alone, but they depend on people acting on the information they are given (Snowdon, 2023). But it would not be enough to give the children information, especially where money is scarce, to combat childhood obesity.

Guide choices through changing the default policy: These actions include changing school menus and promoting breastfeeding (Leek and Afoakwah, 2023). It helps people decide through facilitating healthier choices but may look like controlling which may negatively affect public health authorities’ trust level.

Guide choices through incentives: For instance, the Healthy Start voucher scheme allocates vouchers to them to buy healthy foods. Although incentives can encourage people to make healthier choices, they are not able to solve structural issues such as food deserts or disparities in income (Chater et al., 2023).

Guide choices through disincentives: An example is the Soft Drinks Industry Levy (SDIL). It also wishes to reduce the consumption of unhealthy goods by levying a tax on sugary drinks (Hand, 2023). However, such policies can be criticised for harming low-income families higher than others.

Restrict choice: This involves taking a more hands on approach such as restrictions on food advertisements and promotions (Nobles et al., 2021). These steps may prevent people from doing wrong things but at the same time it can be argued as opposed to the rights of people and the rights of businesses.

Eliminate choice (Most Intrusive): UK has not widely used this level of intervention in order to address childhood obesity. People would have to make extreme steps like banning some types of foods, yet it would raise a serious moral question about people’s freedom and freedom of choice (Hand, 2023).

There are quite a number of ethical issues that need to be considered in looking at what the UK is doing about combating the level of childhood obesity through the Nuffield Ladder. For instance, there is a right balance between guiding and limiting choices and not blaming the victim and ensuring fair interventions while respecting people’s right to be alone.

Conclusion

Childhood obesity is a complex issue in the UK that is influenced by several factors. There are measures to enhance public health such as legislation that helps people to eat healthier and be more active. It is important to adopt a multidimensional view that considers how people behave, how society operates and the social dynamics that contribute to health.

The UK government’s actions demonstrate that these people are learning more about this problem. The fight against childhood obesity can be effectively addressed by improving interventions over the years and developing a balance between public health goals and individual liberties in dealing with the issue. This would ensure a healthier future for children and less health disparity.

 

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