Childhood obesity in Southwark Findings from the National Child Measurement Programme

Southwark’s Joint Strategic Needs Assessment

People & Health Intelligence Section Public Health November 2017 GATEWAY INFORMATION

Report title: Childhood obesity in Southwark: Findings from the National Child Measurement Programme Status: Public Prepared by: M Chau & C Williamson Contributors: S Kwaa Approved by: K Fenton Suggested citation: Childhood obesity in Southwark. Southwark’s JSNA. Southwark Council: . 2017. Contact details: [email protected] Date of publication: 30 November 2017

Slide 2 Health Needs Assessments form part of Southwark’s Joint Strategic Needs Assessment process BACKGROUND The Joint Strategic Needs Assessment (JSNA) is the ongoing process through which we seek to identify the current and future health and wellbeing needs of our local population.

. The purpose of the JSNA is to inform and underpin the Joint Health and Wellbeing Strategy and other local plans that seek to improve the health of our residents.

. The JSNA is built from a range of resources that contribute to our understanding of need. In Southwark we have structured these resources around 4 tiers:

Tier I: The Annual Public Health Report provides an APHR overview of health and wellbeing in the borough.

JSNA Tier II: JSNA Factsheets provide a short overview of Factsheets health issues in the borough.

Health Needs Tier III: Health Needs Assessments provide an in- Assessments depth review of specific issues.

Other Intelligence Sources Tier IV: Other sources of intelligence include Local Health Profiles and national Outcome Frameworks.

. This document forms part of those resources. . All our resources are available via: www.southwark.gov.uk/JSNA

Slide 3 CONTENTS

Introduction

Policy Context

The Local Picture

The Local Response

Future Action & Next Steps

Slide 4 Approximately 6,000 children in Southwark are weighed and measured each year as part of the NCMP INTRODUCTION The National Child Measurement Programme (NCMP) measures the height and weight of children in Reception (aged 4-5 years) and Year 6 (aged 10-11 years) in state maintained primary schools across .

. Following the transfer of Public Health from the NHS to local government, Local Authorities have a statutory responsibility to deliver the NCMP.

. The NCMP has been running since 2005-06 and is designed to support population surveillance, local planning and the delivery of services.

. The participation rate in Southwark in 2016-17 was 94.3% compared to the England rate of 95%

. Southwark parents and carers receive a letter to inform them of the weight status of their child and are signposted to relevant services to support the achievement and maintenance of a healthy weight.

References 1. NHS Digital: https://digital.nhs.uk/catalogue/PUB30113 Slide 5 This report provides an overview of the latest NCMP results and outlines our local response to childhood obesity AIMS & OBJECTIVES This report forms part of the Joint Strategic Needs Assessment (JSNA) for Southwark and aims to provide an overview of childhood obesity in the borough and has the following objectives:

. To provide an understanding of the current policies relating to obesity and factors that may influence it

. To describe the extent of childhood obesity in Southwark

. To identify communities that may have a higher prevalence of childhood obesity in the borough

. To highlight the current actions being taken to reduce childhood obesity in Southwark

. To identify additional needs within our local population and offer recommendations to promote healthy weight among children and young people

Slide 6 CONTENTS

Introduction

Policy Context

The Local Picture

The Local Response

Future Action & Next Steps

Slide 7 The NCMP is a key element of the Government’s strategy to tackle childhood obesity POLICY CONTEXT The NCMP is a statutory public health function of local authorities . Introduced in 2005, the NCMP is a key element of the Government’s strategy to tackle childhood obesity . The NCMP measures the height and weight of children in Reception (aged 4-5 years) and Year 6 (aged 10-11 years) in state maintained primary schools across England.

Local authorities are responsible for data collection . School participation is not compulsory but for those that do partake, the required pupil participation rate is 85% . It is recommended results are communicated to parents within six weeks of measurement . Data are not shared with school staff or other pupils

This programme is a unique public health intelligence resource and has UK National Statistics status. The collected data are used to: . Inform local service planning and delivery . Provide robust surveillance data on the prevalence and trends in the weight of children . Engage with children and families about healthy lifestyles and weight issues

References 1. NHS Digital: https://digital.nhs.uk/catalogue/PUB30113 Slide 8 2. Public Health England (2016) National child measurement programme operational guidance. CONTENTS

Introduction

Policy Context

The Local Picture

The Local Response

Future Action & Next Steps

Slide 9 A significant number of children in Southwark are overweight or obese FINDINGS FROM 2016-17 PROGRAMME . Fewer than 3 in 10 children in Reception are overweight or obese (excess weight). By Year 6 this increases to more than 4 in 10 children.

. The increase in obesity between Reception and Year 6 is statistically significant, while there is only a marginal increase in the prevalence of children who are overweight. Percentage of Children Southwark London 90% England 80% 72.7% 70% 55.9% 60%

50% 43.0% 40% 30% 26.3% 27.2% 15.8% 20% 13.1% 13.3% 10% 1.1% 1.0% 0% Underweight Healthy Overweight Obese Excess Underweight Healthy Overweight Obese Excess Weight Weight Weight Weight Reception Year 6 References 1. NHS Digital: http://content.digital.nhs.uk/catalogue/PUB19109 Slide 10 Levels of obesity among children in Southwark are significantly above the London and national average TRENDS IN OBESITY . Levels of obesity among children in Southwark have been significantly above national levels since measuring began. . Trends indicate there has been no statistically significant change in the gap between Southwark and London since the start of the measurement programme, with the exception of children in Reception Year in 2011-12. . The Healthy Weight Strategy aims to reduce obesity by 2020-21 to 11.3% among children in Reception and 24.9% among Year 6 children.

50% Reception Southwark 50% Year 6 London 40% 40% England

27.8% 26.8% 27.8% 27.2% 30% 30% 26.5% 25.5% 25.7% 26.3% 26.0% 26.7%

23.6% 20% 20% 23.2% 20.0% 13.7% 13.8% 14.2% 13.4% 13.8% 13.3% 19.8% 11.9% 12.8% 12.9% 12.2% 10% 10.3% 10% 10.3% 9.6% 9.3% 0% 0%

References Slide 11 1. NHS Digital: http://content.digital.nhs.uk/catalogue/PUB19109 Excess weight among children in Southwark is significantly above London and national average TRENDS IN EXCESS WEIGHT . Levels of excess weight among children in Southwark have been significantly above London and national levels since measuring began. . Trends indicate there has been little change in the gap between Southwark and London since the start of the measurement programme. . The Health Weight Strategy aims to reduce excess weight by 2020-21 to 23.6% among children in Reception and 38.9% among Year 6 children.

Southwark 60% Reception 60% Year 6 London

50% England 50% 42.3% 42.8% 43.3% 43.6% 43.2% 43.0% 40.9% 40.9% 42.1% 39.0% 40% 40% 38.5% 38.1% 34.2% 27.9% 28.7% 27.8% 27.8% 27.1% 27.0% 26.4% 26.3% 30% 25.3% 25.2% 30% 34.2%

22.6% 20% 22.1% 22.3% 20% 22.0% 10% 10%

0% 0%

References Slide 12 1. NHS Digital: http://content.digital.nhs.uk/catalogue/PUB19109 Levels of obesity among children in Southwark are amongst the highest in London LONDON RANKING: OBESITY . Nationally, Southwark was among the top twenty local authorities with the highest prevalence of obesity in both Reception and Year 6 children. . Having been highest for obesity prevalence in Reception and Year 6 children in 2007-8, Southwark has fallen to 2nd and 5th highest respectively compared to other London boroughs. 2007-8 Reception 2016-17 2007-8 Year 6 2016-17 Southwark Barking and Southwark Brent Newham Brent Newham Southwark Hackney Barking and Dagenham Tower Hamlets Hackney Barking and Dagenham Barking and Dagenham Richmond upon Thames Tower Hamlets Southwark Newham Newham Enfield Tower Hamlets Tower Hamlets Kensington and Chelsea Greenwich Barking and Dagenham Hackney Westminster Redbridge Hackney Enfield and Enfield Islington Lambeth Havering Haringey Lambeth Redbridge Waltham Forest Waltham Forest Croydon Hounslow Hammersmith and Fulham Hounslow Islington Hounslow Richmond upon Thames Lambeth Greenwich Redbridge Brent Barking and Dagenham Brent Lewisham Lewisham Camden Enfield Croydon Waltham Forest Lewisham Camden Ealing Islington Haringey Merton Wandsworth Waltham Forest Croydon Camden Greenwich Hillingdon Ealing Havering Havering Hammersmith and Fulham Redbridge Hammersmith and Fulham Haringey Barnet Kensington and Chelsea Haringey Camden Merton Merton Bexley Harrow Hillingdon Harrow Harrow Ealing Havering Wandsworth Barnet Barnet Kensington and Chelsea Hillingdon Kensington and Chelsea Harrow Barnet Sutton Wandsworth Sutton Kingston upon Thames Sutton Sutton Bromley Bromley Richmond upon Thames Bromley Kingston upon Thames Richmond upon Thames Kingston upon Thames Richmond upon Thames Richmond upon Thames

References 1. NHS Digital: http://content.digital.nhs.uk/catalogue/PUB19109 Slide 13

Excess weight among children in Southwark is significantly above London and national average LONDON RANKING: EXCESS WEIGHT . Southwark has the 3rd highest prevalence of excess weight in both reception and year six children compared to London boroughs. . While the Southwark ranking has remained stable for children in Reception since 2007-08, the borough ranking has improved for those in Year 6.

2007-8 Reception 2016-17 2007-8 Year 6 2016-17

Hackney Brent Southwark Brent Barking and Dagenham Bexley Barking and Dagenham Bexley Southwark Southwark Newham Southwark Newham Barking and Dagenham Lewisham Barking and Dagenham Lambeth Havering Westminster Havering Hammersmith and Fulham Hackney Islington Hackney Kensington and Chelsea Enfield Tower Hamlets Enfield Lewisham Westminster Wandsworth Westminster Enfield Lambeth Hackney Lambeth Westminster Greenwich Camden Greenwich Tower Hamlets Croydon Lambeth Croydon Hounslow Newham Haringey Newham Croydon Tower Hamlets Greenwich Tower Hamlets Havering Redbridge Enfield Redbridge Merton Islington Hammersmith and Fulham Islington Islington Lewisham Hounslow Lewisham Redbridge Haringey Brent Haringey Ealing Waltham Forest Kensington and Chelsea Waltham Forest Brent Hammersmith and Fulham Waltham Forest Hammersmith and Fulham Haringey Hounslow Merton Hounslow Camden Merton Ealing Merton Waltham Forest Kensington and Chelsea Bexley Kensington and Chelsea Wandsworth Camden Croydon Camden Greenwich Hillingdon Redbridge Hillingdon Harrow Bromley Harrow Bromley Bexley Barnet Havering Barnet Barnet Ealing Barnet Ealing Sutton Harrow Hillingdon Harrow Hillingdon Wandsworth Kingston upon Thames Wandsworth Kingston upon Thames Sutton Sutton Sutton Richmond upon Thames Richmond upon Thames Bromley Richmond upon Thames Bromley Kingston upon Thames Richmond upon Thames Kingston upon Thames

References Southw 1. NHS Digital: http://content.digital.nhs.uk/catalogue/PUB19109 Statistical Neighbours London Boroughs Slide 14 Unlike Reception Year, there is little significant variation in excess weight across Southwark in Year 6 LOCAL HOTSPOTS: EXCESS WEIGHT Reception Year 6 . Excess weight in Reception is significantly higher than the Southwark average in Faraday, East , Livesey and Green wards.

. By Year 6 there is little significant difference across the borough.

References Slide 15 1. NHS Digital: http://content.digital.nhs.uk/catalogue/PUB19109 Children in more deprived communities are significantly more likely to be overweight or obese WEIGHT AND DEPRIVATION . National results from the 2016-17 measurement programme show that excess weight and obesity among children are strongly associated with socio-economic status.

. More deprived communities tend to have higher prevalence of excess weight and obesity, and the strength of association increases between Reception and Year 6. Excess Weight Obesity Percentage of Percentage of Children Reception Children Reception 45.0% 30.0% 40.9% Year 6 26.3% Year 6 40.0% 25.0% 35.0% 30.0% 26.8% 20.0% 24.2% 25.0% 15.0% 12.7% 20.0% 17.3% 11.4% 15.0% 10.0% 5.8% 10.0% 5.0% 5.0%

0.0% 0.0% 1 (Most 2 3 4 5 6 7 8 9 10 (Least 1 (Most 2 3 4 5 6 7 8 9 10 (Least deprived) deprived) deprived) deprived)

References 1. NHS Digital: http://content.digital.nhs.uk/catalogue/PUB19109 Slide 16 Children from Black or Black British ethnic groups are significantly more likely to be overweight or obese WEIGHT AND ETHNICITY . National results show that excess weight and obesity is highest among children from Black or Black British ethnic groups for both Reception and Year 6 cohorts. . Excess weight and obesity is lowest among children from Chinese ethnic background among both Reception and Year 6 cohorts. . By Year 6 all ethnic groups, except Chinese, have a significantly higher level of excess weight or obesity than children who have a White ethnic background. Excess Weight Obesity Percentage of Percentage of Children Reception Children Reception 50.0% 35.0% 45.5% Year 6 Year 6 45.0% 29.5% 30.0% 40.0% 33.9% 35.0% 25.0% 29.3% 19.8% 30.0% 20.0% 25.0% 14.8% 15.0% 20.0% 15.8% 15.0% 10.0% 10.0% 5.8% 5.0% 5.0% 0.0% 0.0% White Mixed Asian or Black or Chinese Any other Unknown White Mixed Asian or Black or Chinese Any other Unknown Asian British Black British ethnic group Asian British Black British ethnic group References 1. NHS Digital: http://content.digital.nhs.uk/catalogue/PUB19109 Slide 17 Levels of obesity and excess weight in Southwark are significantly higher than in London and England SUMMARY OF KEY FINDINGS . Southwark has the third highest level of excess weight out of the 32 London Boroughs for Reception and fourth highest for Year 6 children. The borough is ranked second for obesity among Reception age children and fifth among Year 6 (fifth for Reception age and sixth for Year 6 children in 2015-2016).

. There has been no significant change in the prevalence of excess weight or obesity in Southwark since measuring began.

. Excess weight and obesity in Reception is significantly higher than the Southwark average in Faraday, East Walworth and wards. By Year 6 there is little significant difference across the borough, indicating a whole population approach is required by this age.

. Excess weight and obesity is highest among children from Black/Black British ethnic backgrounds, and lowest among children from Chinese ethnic background.

. Excess weight and obesity is significantly higher among deprived communities, and the association increases with age. References 1. NHS Digital: http://content.digital.nhs.uk/catalogue/PUB19109 Slide 18

CONTENTS

Introduction

Policy Context

The Local Picture

The Local Response

Future Action & Next Steps

Slide 19 The Southwark Healthy Weight Strategy sets a framework for taking a whole systems approach to tackling obesity LOCAL RESPONSE The Southwark Healthy Weight Strategy 2016-2021: Everybody’s Business sets a framework for taking a whole systems approach to tackling obesity in the borough . This framework commits to both universal and targeted services that are evidence-based, family focused and across the life course

The Healthy Weight Strategy Action Plans identify key outcomes for people (maternity and early years, children and young people, adults) and places (the obesogenic environment) in Southwark . The Action plans guide the development, progress and support of initiatives toward the five year ambitions outlined in the strategy . Each action plan is reviewed and updated on a quarterly basis at implementation group meetings with key stakeholders

References 1. Southwark Council. Everybody’s Business: Southwark Healthy Weight Strategy 2016-2021. Available from: http://www.southwark.gov.uk/health-and-wellbeing/public-health/for- Slide 20 professionals?chapter=3 Already there have been significant achievements to support early years, children and young people into healthy weight LOCAL RESPONSE: PEOPLE The first year of the action plan has resulted in significant achievements to support early years, children and young people into healthy weight . The continued high NCMP participation in schools ensures parents and carers are informed of their child’s weight status and are supported by our healthy weight specialist nurse . Stage 1 accreditation of the Baby Friendly Initiative has allowed our hospitals, children’s centres and health visiting service to build a foundation for promoting breastfeeding and the best start in life . Implementation of food and nutrition policies, workshops and training in early years settings stimulates healthy weight from a young age . 93 Southwark schools are registered to the Healthy Schools Programme and 55% have achieved an award . Southwark is one of just six London boroughs to offer universal free, healthy school meals and free fruit to all primary school children.

References Slide 21 1. Healthy Schools London. Available from: http://www.healthyschools.london.gov.uk Southwark has implemented several initiatives to improve the obesogenic environment for young people LOCAL RESPONSE: PLACE The first year of the action plan has resulted in significant achievements to improve the obesogenic environment for early years, children and young people . Collaboration with Planning has resulted in the rejection of applications for new hot food takeaway shops falling within the 400m exclusion zones around secondary schools . Development of new or refreshed play areas and green flag parks ensures young people have facilities to be active in the environment . 59 Southwark schools are accredited with the TfL STARS programme and have developed School Travels Plans to aid and promote children’s engagement with active travel . Improved information sharing across departments and additional data collection opportunities have enriched the body of local evidence on the attitudes and behaviours of young people toward healthy eating and physical activity

Slide 22 CONTENTS

Introduction

Policy Context

The Local Picture

The Local Response

Future Action & Next Steps

Slide 23 Tackling childhood obesity continues to be a council priority in Southwark FUTURE ACTION & NEXT STEPS Southwark will continue to support exiting initiatives on the action plans in addition to further ways to promote healthy weight throughout the borough . Commissioning e-learning and training on raising the issue of weight to equip health and non-health professionals with brief intervention techniques, information about Southwark healthy weight referral pathways, and the latest data on local prevalence level and trends . Build a Food Poverty Alliance to support vulnerable children and families in accessing healthy and affordable food and cooking opportunities . Sign up to the Local Authority Declaration on Sugar Reduction and Healthier Food to minimise young people’s access to food and drink with excess sugar and promote healthier eating options . Commission the Breastfeeding Welcome Scheme to support mothers in the community wishing to breastfeed in public by offering businesses support to make their premises breastfeeding welcome . Continue to build up relationships with key local partners and stakeholders to align priorities and offer strategic support and guidance on healthy weight initiatives

Slide 24 Appendix 1 Excess Weight in Reception and Year 6 by school (2013/14 – 2015/16) Reception Year 6

Slide 25 Appendix 1 Excess Weight in Reception and Year 6 by school (2013/14 – 2015/16)

Map ID School name Postcode Map ID School name Postcode 1 Albion SE167JD 31 Phoenix SE15JT 2 Bellenden SE154PQ 32 Pilgrims Way SE151EF 3 Camelot SE151QP 33 Alfred Salter SE167LP 4 SE11AF 34 Oliver Goldsmith SE58UH 5 Cobourg SE50JD 35 Boutcher SE13BW 6 Comber Grove SE50LQ 36 Village Infants SE217AL 7 Crampton SE173QA 37 English Martyrs Roman SE171QD 8 Crawford SE59NF 38 St. James the Great Roman SE155LP 9 Dog Kennel Hill SE228AB 39 St Francis RC SE151RQ 10 Gloucester SE156FL 40 St Georges Cathedral SE17JB 11 Goodrich Community SE220EP 12 Grange SE14TP 41 St James SE164SU 13 Heber SE229LA 42 St Johns and St Clements Primary SE154DY 14 Hollydale SE152AR 43 St Johns Walworth SE171NQ 15 Ilderton SE151TL 44 St Josephs Roman SE164UP 16 Ivydale SE153DE 45 St Josephs SE162TY 17 John Ruskin SE50PQ 46 St Josephs the Borough SE11NJ 18 Keyworth Priamry SE173TR 47 St Judes SE16EZ 19 Lyndhurst SE58SN 48 St Mary Magdalene SE153RA 20 Dulwich Wood SE218NS 49 Peter Hills with St Marys and St Pauls SE165ED 21 Michael Faraday SE172HR 50 St Pauls Walworth SE173DT 22 Riverside SE164PS 51 St Peters SE172HH 23 Robert Browning SE172DH 52 The Cathedral of St Saviour and St Mary SE11HA 24 SE162PL 53 St Johns Roman SE166SD 25 Snowfields SE13TD 26 SE162JH 54 St Francesca Cabrini SE233LE 27 Tower SE12AE 55 St Anthonys SE220LA 28 Townsend SE14NU 56 St Josephs Junior SE50TS 29 Victory SE171PT 57 St Josephs Infants SE50TS 30 Charlotte Sharman SE114SN 58 Friars Foundation SE10RF

Slide 26 Appendix 1 Excess Weight in Reception and Year 6 by school (2013/14 – 2015/16)

Map ID School name Postcode 59 Haymerle SE156SH 60 Beormund SE13PS 61 Bessemer Grange SE58HP 62 Square SE172JY 63 SE57QH 64 Rye Oak SE153PD 65 ARK Globe SE16AG 66 Dulwich Hamlet Junior SE217AL 67 Harris Academy Park SE155TD 68 Redriff SE165LQ 69 Southwark Free SE151SH 70 Harris Free Peckham SE155DZ 71 Goose Green SE228HG 72 Judith Kerr SE249JE 73 John Donne SE152SW 74 Harris Academy SE228HA 75 Angel Oak Academy SE156FL 76 The Belham SE154DG

Slide 27

Find out more at southwark.gov.uk/JSNA

People & Health Intelligence Section Southwark Public Health