THE PROBLEMChildhood obesity is one of the most serious Globally, in 2010, thepublic health challenges of the 21st century. number of overweight children under the ageOverweight and obese children are likely to stay of five is estimated toobese into adulthood and more likely to develop be over 42 million.noncommunicable diseases like diabetes andcardiovascular diseases at a younger age. Close to 35 million of these are living in developing countries.
THE PROBLEMHigh Prevalence of Overweight and Obesity in Schoolchildren
THE PROBLEMIncreasing Number of Overweight Children Around the World
THE PROBLEMIncrease in Schoolchildren At Risk As Well
THE PROBLEMBoth Developed and Developing Countries Face the Challenge
THE PROBLEMFactors that Influence Risk• Obesity prevalence varies between ethnic groups within countries.• Gender differentials in obesity prevalence are also frequently observed and need to be considered in programme planning.• Evidence shows that television advertising influences children’s food preferences, purchase requests and consumption patterns and that increasingly children are being exposed to a wide range of other marketing techniques.• Peers can serve as remarkably powerful role models for children and may share their unhealthy eating or exercise habits with them.• Obesity is linked to socioeconomic deprivation• There is some evidence that parental and household behaviours shape the food and exercise habits of the child
THE CONTEXTEconomic Assessment of the Intervention at the Population Level(Average Effect per Year)
THE CONTEXTCost per Life Year Gained in Good Health of Interventions to Tackle Obesity
THE OPPORTUNITY SPACEHealthy Arkansas Initiative• Arkansas Act 1220 of 2003 requires that all public school students have an annual BMI screening• Recent initiatives that limited access to vending machines in schools, while at the same time providing healthier alternatives• Efforts to increase physical activity in schools
THE OPPORTUNITY SPACESingapore “Fighting Obesity”• Compulsory membership of Health Clubs for overweight schoolchildren• Monitor her height and weight every month• Teachers meet parents regularly to recommend healthier ways to prepare their meals at home
THE OPPORTUNITY SPACEThe big lesson on behaviour change is that environments and service designmatter more than individual treatments/intervention
How do we redesign ourapproach to tacklingchildhood obesity?
DRIVERS OF BEHAVIOUR Habits are repeated behaviours, often fairly automatic and Habits sometimes difficult to control, triggered by environmental cues. Habits can challenge motivations for behaviour change. Beliefs about consequences, social norms and relative costs and Beliefs benefits influence the behaviour changes that people are willing to make. Translating A perceived lack of time, reluctance toward short-term costs, Intention into distractions and stress can heighten a risk of failing to start or Action failing later on. Automatic vs. Automatic attitudes are those that people are unable or unwilling Self-Reported to retrieve from memory themselves. These often conflict with Attitudes explicit or ‘self-reported’ attitudes (e.g. “I don’t like cake.”). Moral Climate The effect that attitudes have on some behaviours is, in part, determined by moral norms.Adapted from UK Government Office for Science, Tackling Obesities: Future Choices, 2nd ed.
POSSIBLE ROUTES TO ACTION• Food regulation• Fat taxes• Public awareness• TV• Cycling lanes• Walking buses for children• Slow food• Personal health technologies