1. Obesity
in
Tower
Hamlets
Hannah
Pheasant
Manager
of
Tower
Hamlets
Weight
Management
Service
at
Barts
Health
NHS
Trust

2. The
Obesity
Crisis
• Sta=s=cs
on
obesity,
physical
ac=vity
and
diet,
England
2013
• 25%
of
adults
are
obese
• 31%
boys
+
28%
girls
overweight
or
obese
• 22%
of
men
and
19%
of
women
at
increased
risk
of
health
problems

3. Tower
Hamlets
demography
• Tower
Hamlets
is
a
diverse
Borough
in
East
London
• BME
communi=es
make
up
55%
of
the
popula=on
• A
young
popula=on
–
one
fiPh
aged
under
14
years
• 82%
of
under
14s
from
BME
communi=es
–
the
largest
group
are
Bangladeshi
(61%)

4. Challenges
• 55%
of
under
16s
in
Tower
Hamlets
are
living
in
poverty
–
the
highest
in
England
(this
rises
to
69%
in
some
wards)
• 33%
of
families
live
on
an
annual
income
of
less
than
£20,000
• 52%
of
children
en=tled
to
free
school
meals
–
the
highest
level
in
the
country
•
Rapid
popula=on
growth
–
9%
between
2009
and
2014
Source:
www.towerhamlets.gov.uk
Child
Poverty
JSNA
2012
and
Tower
Hamlets
Annual
Public
Health
Report
2010

5. • High
levels
of
child
poverty
• High
density
of
fast
food
outlets
• Lack
of
availability
of
affordable
healthy
foods
• Loss
of
cooking
skills
and
family
meal
=mes
• Low
consump=on
of
fruit
and
vegetables
Challenges

6. • 5th
most
densely
populated
Borough
in
England
• High
volume
of
traffic
and
conges=on
• Low
ra=o
of
open
space,
including
gardens
• Fear
of
crime
• Low
use
of
some
exis=ng
facili=es
• Low
par=cipa=on
in
physical
ac=vity
Challenges

7. • Busy
and
=me
poor
• Fast
food
is
cheap
and
convenient
and
plen=ful!
• Poor
food
shopper/cook
• Unlikely
to
be
ea=ng
and
playing
together
as
a
family
• Low
understanding
of
por=on
sizes,
key
foods,
suitable
snacking,
etc.
• May
not
be
English
speaking/
children
ac=ng
as
interpreters
Mums
and
Dads

8. • Boy aged 7
• Lives in an urban area of higher deprivation
• Family access limited to local amenities with
poor access to fresh food
• Poor diet, with high intake of fizzy drinks, snacks
and convenience food
• Likes to play ‘Super Mario’ on the computer after
school
• Local area has low access to green space and
the park is poorly lit at night
• Sport and leisure facilities are the other side of
town and are expensive
• Parents have a poor understanding of nutrition
and healthy food options
• Struggles with concentration at school
Outlook:
high
risk
of
obesity,
increased
risk
of
type
2
diabetes,
low
educa=onal
adainment,
service
user
and
co-­‐
morbidi=es
later
in
life.
Recognise
me?

9. Prevalence
of
obesity
in
Recep@on
(4-­‐5
year
olds)

10. Prevalence
of
obesity
in
Year
6
(10-­‐11
year
olds)

11.
Pre-­‐birth
and
being
born
Vitamin
D
Maternal
obesity
Diabetes
in
pregnancy
Low
Birth
Weight
Breasheeding
ini=a=on
Early
years
Breasheeding
Weaning
Dental
Decay
Physical
Ac=vity
and
Ac=ve
Play
High
obesity
in
4-­‐5
year
olds
Growing
up
High
obesity
in
10-­‐11
year
olds
Boys
at
higher
risk
Low
par=cipa=on
in
physical
ac=vity
Low
consump=on
of
fruit
and
veg
Adulthood
Obesity
increasing
Higher
risk
for
diabetes
,
CVD
and
cancers
Low
par=cipa=on
in
physical
ac=vity
Low
consump=on
of
fruit
and
veg
Growing
older
Physical
ac=vity
key
for
independence
and
wellbeing
Under
nutri=on
Osteoporosis
Physical Environment: Open Spaces, Congested roads, Community Safety
Food Environment: Fast Food Outlets, Shops, Schools, Leisure Centres,
Hospitals
The
local
picture
–
needs
and
priori@es

12.
Pre-­‐birth
and
being
born
Antenatal
paren=ng
classes
Healthy
Start
Vitamins
Iden=fica=on
of
high
risk
families
during
pregnancy
Baby
Friendly
Ini=a=ve
Early
years
Early
Years
Accredita=on
Scheme
Ac=ve
Play
and
Healthy
Ea=ng
Cook4Life
Par=cipatory
Appraisal
training
Breasheeding
welcome
standard
Weight
management
Growing
up
Healthy
Schools
Healthy
Breakfast
Clubs
&
School
Meals
Healthy
Lives
Champions
Healthy
Families
and
Parent
Ambassadors
Ac=ve
Play
Bike
It!
&
Cycle
Training
Weight
management
Ac=ve
Play
Adulthood
My
Weigh
Jump
Start
Cycling
on
Prescrip=on
Women
&
Girls
Swimming
Can
Do
Grants
All
Ability
Cycle
Club
Ability
Bow
Health
Trainers
Growing
older
Link
Age
Plus
Young
at
Heart
(over
50s)
Lunch
Clubs
Physical Environment: LDF, Green Grid, Road Safety Plan HIA, Walking & Cycling strategies
Food Environment: LDF, Food4Health Awards, Food Growing, Portas Bid, Food Policy
The
local
picture
–
services
and
interven@ons
‘Whole
systems
approach
through
the
life
course’