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OBESITY HNA

OBESITY HNA. Karen Jackson Public Health 2012. AN OVERVIEW. Why HNA?- aim Headlines from obesity HNA Adults & children with learning disabilities Revised obesity strategy ‘framework for action’ Way forward for learning disabilities. THE CHANGING CONTEXT. -2005-2010.

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OBESITY HNA

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  1. OBESITY HNA Karen Jackson Public Health 2012

  2. AN OVERVIEW • Why HNA?- aim • Headlines from obesity HNA • Adults & children with learning disabilities • Revised obesity strategy ‘framework for action’ • Way forward for learning disabilities

  3. THE CHANGING CONTEXT -2005-2010 -Halt the rise in obesity

  4. OBESITY HNA –What It Involved • To inform refresh of Dudley’s obesity strategy • Includes reviews of: • national and local data –obesity & lifestyles • services and interventions currently in place • evidence on emerging interventions • stakeholder views, • progress of 2005-10 strategy • Makes recommendations, • Proposes a revised framework for action, strategic objectives, monitoring and outcomes measures

  5. THE OBESITY PICTURE FOR DUDLEY

  6. THE OBESITY PICTURE FOR DUDLEY 51,317 People Obese138,532 People Overweight and obese

  7. THE OBESITY PICTURE FOR DUDLEY • All of current increase due to obese category • At current rates: 24.9% obese by 2016 • Halt the rise by 2016- balance of 9400 less people moving into the obese category

  8. THE OBESITY PICTURE FOR DUDLEY

  9. THE OBESITY PICTURE FOR DUDLEY Reception Year Obesity Prevalence Year 6 Obesity Prevalence

  10. DUDLEY HEALTHY LIFESTYLES Adults: Increase in physical activity-46% to 49% (2004 to 2009,)- but more so in the least deprived than the most deprived areas.BME, women and girls, older people and overweight and obese people - lower activity levels. Children:70 % of year 5/6 year olds get enough exercise nationally, which declines to 62% by years 8/10 - more so for girls Less children cycle or walk to school than in previous years. Adults:5 a day F&V intake -remained constantat 25.6% (2009), -increased in deprived areas. Males, BME and deprived areas have a lower 5-day levels. 86.9% of the population eat a less than healthy diet Children: 5 a day F&V intake -increased slightly for childrensince 2004. Declines between school years 5/6 and 8/10. Children are consuming high levels of fatty and sugary snacks on a daily basis. Breast feeding: Initiation and duration rates are falling and lower than W.Mids and England . Year 8/10 children – 2/3rds would not consider breast-feeding

  11. HEALTH NEEDS/RISK VARIES There are specific groups that are more at risk of developing obesity- • Children from low income families • Children from families where at least one parent is obese • Looked after children • Young parents- <21 • Adults- unemployed or in routine/semi routine jobs • Older people • People of Asian origin • Ethnic groups with higher than average prevalence • People with physical and learning difficulties • People with mental health conditions

  12. CONCLUSIONS & GAPS • Robust initiatives and services in place, but impact on public health outcomes not yet realised. • Interventions - not yet at full implementation • takes longer than 5 years for the impacts of public health programmes to come to fruition • Some programmes have limited resources and are achieving only a small ‘reach’ • New action plan - build on these interventions • 2005 obesity strategy delivery framework still valid –to add life-course & at-risk population groups

  13. REVISED STRATEGIC DELIVERY FRAMEWORK Progressive universalism- universal and targeted in each section

  14. RECOMMENDATIONS Tier 1: Tackling the Obeseogenic Environment: • Expand reach and impact of programmes increasing access to healthy food , active travel, urban design and planning Tier 2: Lifestyles: Attitudes, Knowledge and Skills: • Public health campaign to raise the public’s consciousness • Early years & primary school age, breast-feeding & healthy workplace programmes Tier 3: Treatment Pathways for Adults and Children: • Increase referrals, Improve long-term weight loss outcomes

  15. SO WHAT ABOUT LEARNING DISABILITIES-why at higher risk? • Higher prevalence of overweight and obesity than the average population: 1 in 3 obese V 1in 5 • Less than 10% of adults with learning disabilities in supported accommodation eat a balanced diet, & sufficient intake of F&V • Carers generally have a poor knowledge about healthy diet • 80% of adults with learning disabilities not taking enough exercise • More likely than the general population to have avoidable, diet related ill health and a shortened life expectancy – type 2 diabetes is double

  16. LEARNING DIFFICULTIES- local prevalence and risk? • National prevalence rates: 25/1000 with mild and moderate learning difficulties, 3-4/1000 with severe learning disabilities • Locally: • Ω 6023 adults- mild/moderate LD , 2008 obese • Ω 722-963 adults – severed LD, 241-321 obese • QOF data: (Sept 2011) 53/54 practices • 1250 adults – mild/moderate & severe LD • 984 adults- on LD register (moderate/severe), • 805 (81.8%) also on obesity register • 59% male, 41% female • Obesity most prevalent for 35-54 year olds- as general population • Schools Health Behaviour Data: suggestion of less healthy lifestyle for children with LD

  17. WHAT DID THE SERVICE REVIEWS TELL US • Environmental changes are universal and will benefit all- healthy towns, food for health award • Many universal interventions will support people with learning difficulties (but need carer support or involvement, or need to be aimed at carers) • Targeted services also in existence- for weight management • Adults: slimmer’s kitchen for LD, • Children: Seekers (ages 8 to 18 with LD) • Data shortage • Systematic measurement and referral of children with learning disabilities is patchy • Outcomes from initiatives can be lower for LD clients:

  18. SLIMMER’S KITCHEN FOR LD

  19. SEEKERS- CHILDREN WITH LD * where monitoring data available

  20. FUTURE FOR LD • Making reducing obesity a priority for all- at both strategic and delivery levels - implementation of the learning disability obesity charter • Development and delivery of an obesity action plan for people with learning difficulties • Monitoring data

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