Obesity - an acknowledged public health challenge

As we face a difficult economic climate, in which inequalities may worsen, the PHA faces many challenges in its efforts to improve the health of the population. One such challenge is the issue of obesity. Recently, in the Draft Programme for Government and, again today, in anticipation of the publication of the Consultation on the Review of Health and Social Care Services in Northern Ireland, the specific issue of obesity has been highlighted in the media.The PHA is committed to playing a lead role in tackling this major health issue and has been systematically examining the evidence of best practice and effectiveness to ensure that investment and working in partnership will bring clear benefits. A welcome consequence of any success would be a reduction in the impact of the physical, and emotional costs of obesity related ill-health to individuals - and the financial costs to an overstretched healthcare system.A multi-facetted approach to tackling obesity is required for Northern Ireland. This will mean working across government departments, looking at relevant legislation, taxation, food standards and labelling, as well as supporting a raft of programmes within education, workplace, and at the local community level."The prevalence of overweight and obesity has risen dramatically in recent years in Northern Ireland and is now the norm to be overweight, rather than the exception. The Northern Ireland Health and Social Wellbeing Survey (2010-11) indicated that 36% of adults are overweight and a further 23% are obese; this means that approximately 3 in 5 adults in Northern Ireland carry excess weight. A similar proportion of males and females were obese (23%) however males were more likely to be overweight (44%) than females (30%).Data from the Northern Ireland Health and Wellbeing Survey (2010-11) reported that 27% of children aged 2-15 years are obese or overweight. The findings presented here are based on the guidelines put forward by the International Obesity Task Force. Using this approach, 8% of children were assessed as obese, with similar results for boys (8%) and girls (9%). Obesity has serious implications for health and wellbeing and is associated with an increased risk of heart disease and stroke, type 2 diabetes, some cancers, respiratory problems and joint pain.Evidence indicates that being obese can reduce life expectancy by up to 9 years; and it can impact on emotional and psychological well-being and self-esteem, especially among young people.Obesity also impacts on wider society through economic costs, loss of productivity and increased demands on our health and social care system. It is estimated that obesity in Northern Ireland is resulting in 260,000 working days lost each year with a cost to the local economy of £500 million.The good news is that the intentional loss of significant weight (approx 10kg) in overweight and obese adults has been shown to confer significant health benefits, decreased morbidity and may also reduce obesity-related mortality.Key programmes and interventions are undertaken by the PHA in order to prevent and reduce overweight and obesity. The programmes/interventions are supported by significant ongoing work at local level. Examples include:the promotion of breastfeeding; local programmes to increase awareness of good nutrition and develop cooking skills, for example 'Cook It!'; promotion of more active lifestyles, for example, Walking for Health' and 'Teenage Kicks'; development of community allotment schemes; programmes for primary school children, for example Skip2bfit and Eat, Taste and Grow; and sports and other recreation, for example 'Active Belfast'. The PHA's multi media campaign 'It all adds up!' to encourage children to become more active and understand the importance of keeping fit, in a fun and exciting way, ran until October 2011. It encouraged parents and carers to go to the website www.getalifegetactive.com and download the PHA logbook It all adds up! to plan activities as a family. The logbook helped children and parents plan and keep track of their participation in physical activity at school, home and in the community. PHA is currently developing a public information campaign and other supportive work to increase public awareness of obesity as well as to provide advice and support for those who want to make real changes. The campaign development is well underway and is anticipated for launch in late Spring 2012. Like many common health problems, people living in disadvantaged circumstances suffer most and the PHA is committed to tackling this aspect of health inequality. The good news is that even a modest weight loss, of 1-1 Â_ stones, can help to reduce the risk of many of the health problems resulting from being overweight or obese. Information on losing weight through healthier eating and being more active can be found on the PHA websites - www.enjoyhealthyeating.info and www.getalifegetactive.com . These websites provide help and advice for anyone who wants to improve their eating habits and fitness levels, by making small, sustainable, healthy changes to their lifestyle. The PHA leaflet, Small changes, big benefits is also available to download from the PHA website, 'Publications' section.

Public Health England Briefing Papers

-Social and economic inequalities in diet and physical activity - Obesity and disability - adults - Obesity and alcohol - an overview - A simple guide to classifying body mass index in children - Knowledge and attitudes towards healthy eating and physical activity - Brief intervetions for weight management - Data sources:environmental influences on physical activity and diet - Measuring diet and physical activity in weight management interventions - Obesity and Mental Health - Obesity and ethnicity - Variation in Childrens BMI by month of measurement - The economic burden of obesity - Bariatric surgery for obesity - Review of dietary assessment methods in public health - Obesity and life expectancy -

Public Health England Obesity

The Public Health England Obesity website provides a single point of contact for wide-ranging authoritative information on data, evaluation, evidence and research related to weight status and its determinants. They work closely with a wide range of organisations and provide support to policy makers and practitioners involved in obesity and related issues.

Director of Public Health Annual Report 2013

The fifth Director of Public Health Annual Report for Northern Ireland, launched on 16 June 2014, celebrates diversity in our population. Diversity is about people and how we value and appreciate those who are not like us. People differ in all sorts of ways which may not always be obvious or visible. These differences might include race and ethnicity, culture and belief, gender and sexuality, age and social status, ability, and use of health and social care services The report recognises the opportunities and challenges posed by population diversity and highlights some of the key programmes introduced to meet these needs.

Improving young people's health and wellbeing: a framework for public health

The Framework has been developed as a resource to enable local areas in the delivery of their public health role for young people. It poses questions for councillors, health and wellbeing boards, commissioners, providers and education and learning settings to help them support young people to be healthy and to improve outcomes for young people. This is a new framework, which has been developed with support from Association of Young People’s Health and with input from those across health, education, youth services and local and national government.

A Study of a Staff Alcohol Policy in a Large Public Health Organisation, Looking at the Policy Content, the Policy Development and the Implementation Process, and the Policy Impact

There are different approaches to dealing with alcohol related problems in the workplace. A literature review indicates that two of the models that underpin programmes to deal with alcohol related problems in the workplace are the disease model and the health promotion model. The disease model considers alcoholism as an illness and uses curative techniques to restore the individual to sobriety. The health promotion model looks at the determinants of health and promotes changes in the environment and structures, which would support healthy behaviour in relation to alcohol. Employee Assistance Programmes (EAPs) may have elements of both theses models. Dealing with alcohol problems at work involves a captive audience and the workplace as a setting can be used to influence healthier lifestyles. A workplace alcohol policy is a mechanism through which alcohol related issues might be dealt with, and the necessary resources and commitment of managers and staff channelled to this end. The policy aims should be clear and unambiguous, and specific plans put in place for implementing all aspects of the policy. In the case of the alcohol policy in the organisation under study, the policy was underpinned by a health promotion ethos and the policy document reflects broad aims and objectives to support this. The steering group that oversaw the development of the policy had particular needs of their own which they brought to the development process. The common theme in their needs was how to identify and support employees with alcohol related problems within an equitable staff welfare system. The role of the supervisor was recognised as crucial and training was provided to introduce the skills needed for an early intervention and constructive confrontation with employees who had alcohol related problems. Opportunities provided by this policy initiative to deal with broader issues around alcohol and to consider the determinants of health in relation to alcohol were not fully utilised. The policy formalised the procedures for dealing with people who have alcohol related problems in an equitable and supportive manner. The wider aspect of the health promotion approach does not appear to have been a priority in the development and implementation of the policy.This resource was contributed by The National Documentation Centre on Drug Use.

Behaviour change at population, community and individual levels: NICE Public Health Guidance 6

This guidance is aimed at those responsible for helping people to change their behaviour to improve their health. This includes policy makers and those working in local authorities and the community and voluntary sectors. It gives advice on how to plan and run relevant initiatives. The recommendations include the following advice: base interventions on a proper assessment of the target group, where they are located and the behaviour which is to be changed: careful planning is the cornerstone of success  work with other organisations and the community itself to decide on and develop initiatives build on the skills and knowledge that already exists in the community, for example, by encouraging networks of people who can support each other take account of and resolve problems that prevent people changing their behaviour (for example, the costs involved in taking part in exercise programmes or buying fresh fruit and vegetables, or lack of knowledge about how to make changes) base all interventions on evidence of what works train staff to help people change their behaviour evaluate all interventions.This resource was contributed by The National Documentation Centre on Drug Use.

Recognising diversity in Public Health NI

The fifth Director of Public Health Annual Report for Northern Ireland, launched on 16 June 2014, celebrates diversity in the population.��The report recognises the opportunities and challenges posed by population diversity and highlights some of the key programmes introduced to meet these needs.The presentation slides from key speakers from the launch event on 16 June 2014 and all parallel sessions will be��appended below.��Please note:��The PHA cannot be held responsible for any breach of copyright that may exist within individual presentations.Read more here>>

Smoking and Public Health: A Review of Reviews of Interventions to Increase Smoking Cessation, Reduce Smoking Initiation and Prevent Further Uptake of Smoking - Evidence Briefing

This evidence briefing collates review-level evidence of interventions including those targeted at pregnant women and evidence for tackling health inequalities in smoking.

Smoking and Public Health: A Review of Reviews of Interventions to Increase Smoking Cessation, Reduce Smoking Initiation and Prevent Further Uptake of Smoking - Summary

The briefing identifies gaps in primary and review-level research and makes a number of recommendations, including further measures to address health inequalities.

The Public Health Observatory Handbook of Health Inequalities Measurement (2005)

This SEPHO handbook primarily focuses on the measurement and interpretation of health inequalities. Written by Roy Carr-Hill and Paul Chalmers-Dixon of York University, it provides a comprehensive collection of material for those concerned to document and understand health inequalities.

Fully engaged: tackling health inequalities through public health interventions

The evolving role of Primary Care Trusts (PCTs) is currently centre stage, with fundamental debate emerging from Commissioning a patient-led NHS and Our health, our care, our say a new direction for community services. This paper argues that PCTs have a crucial role to play in the public health agenda, specifically tackling health inequalities. This responsibility will become even stronger as the present wave of reforms gains momentum. There is also a lively debate on whether these reforms will make inroads into the persistent problem of health inequality or will exacerbate them even further unless robust, additional intervention levers and mechanisms are introduced. This paper suggests that PCTs will be central to ensuring the balance of reforms is tilted towards a more rather than a less equitable NHS. One of the key responsibilities for PCTs outlined by the Department of Health1 will be to act as the anchor at local level to the increasingly diverse and potentially3fragmented NHS. By using their crucial commissioning role to provide overall coherence to the health system, acting as leading local champions of the NHS and continuing the drive for improvement in access and quality, PCTs will have to act as enforcer and guardian of the equity of the NHS at local level. There is widespread evidence of the tenacity of health inequalities in Great Britain. This report looks at the measures that a fully engaged۝3 PCT has taken to grapple with the issues and draws some conclusions as to their possible wider application.refer to the resource

Are We Choosing Health? Annual Public Health Report from Healthcare Commission and Audit Commission

A new report by the Healthcare Commission and Audit Commission assesses the impact government policy has had on: narrowing health inequalities; improving sexual and mental health; and reducing smoking, alcohol misuse and obesity.

Indications of Public Health in the English Regions 10: Drug Use

This tenth in a series of national reports produced for the Chief Medical Officer (CMO) by the Association of Public Health Observatories (APHO) is on drug use. The report contains 46 different indicators of drug use relating to the individual, community and population across all nine English regions; with additional analysis of sub-regional inequalities where possible. An Executive Summary is also available.

Indications of public health in the English regions 5: child health

This report, focusing on child health, is the fifth in a series of reports commissioned by the CMO and produced by the Association of Public Health Observatories. It examines geographical and socio-economic variations in indicators of child health in the English regions.