merton council tackling childhood obesity together
TRANSCRIPT
Tackling Childhood Obesity Together Annual Report of the Director of Public Health2016-17
MERTON COUNCIL
merton.gov.uk/health-social-care/publichealthPage 11
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Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
Ack
now
ledg
emen
tsCo
nten
ts
Fore
wor
d ....
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Key
Mes
sage
s ....
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.6
1. In
trod
ucti
on ...
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.8
2. In
flue
nces
on
child
hood
obe
sity
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.. 10
3. C
onse
quen
ces
and
cost
s ....
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.. 16
4. T
he p
atte
rn o
f chi
ldho
od o
verw
eigh
t and
obe
sity
in M
erto
n ...
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....1
9
5. W
hat d
o ch
ildre
n, y
oung
peo
ple,
fam
ilies
and
com
mun
itie
s th
ink?
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.....2
4
6. T
he n
eed
for a
fres
h ap
proa
ch ...
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.....2
8
7. M
erto
n’s
call
to a
ctio
n on
chi
ldho
od o
besi
ty ...
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.32
8. R
esou
rces
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8
Aut
hors
Dr
Dag
mar
Zeu
ner
Julia
Gro
omH
ilina
Asr
ress
Sam
ina
She
ikh
Ack
now
led
gem
ents
Aal
aa J
awad
Am
anda
Killo
ran
Ann
e-M
arie
Lie
wA
nnet
te B
unka
Bar
ry C
ause
rB
ronw
en P
icke
ring
Chr
is T
owns
end
Cla
rissa
Lar
sen
Chr
istin
e P
arsl
oeC
orin
ne G
arro
dD
avid
Tch
ilingi
rian
Ele
anor
Cur
tisE
lizab
eth
Fitz
patr
ick
Fran
cis
McP
arla
ndG
ary
Forb
esH
elen
Teb
bit
Lean
ne W
alld
erLi
zzie
Hud
son
Rac
hel T
ilfor
dR
ebec
ca S
penc
erS
helle
y H
effe
rnan
Zara
Bis
hop
Mer
ton’
s C
hild
ren’
s Tr
ust B
oard
Mer
ton’
s H
ealth
and
Wel
l-bei
ng B
oard
Mer
ton’
s C
hild
Hea
lthy
Wei
ght S
teer
ing
Gro
up
Page 12
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Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
Dr
Dag
mar
Zeu
ner,
Dir
ecto
r o
f P
ublic
Hea
lth
I am
del
ight
ed to
pre
sent
m
y fir
st in
depe
nden
t ann
ual
repo
rt o
n th
e he
alth
of t
he
popu
latio
n of
Mer
ton,
in
fulfi
lmen
t of m
y st
atut
ory
duty
as
Dire
ctor
of P
ublic
H
ealth
. I jo
ined
Mer
ton
in F
ebru
ary
2016
and
hav
e sp
ent m
y fir
st m
onth
s m
akin
g su
re I
fully
und
erst
and
the
big
publ
ic h
ealth
cha
lleng
es fa
cing
the
boro
ugh
and
wor
king
with
par
tner
s to
tack
le th
em to
geth
er.
This
repo
rt c
onsi
ders
one
of t
he m
ajor
pub
lic h
ealth
is
sues
in M
erto
n –
child
hood
obe
sity
– w
hich
is a
pr
iorit
y fo
r ou
r lo
cal H
ealth
and
Wel
lbei
ng B
oard
, as
it is
for
Lond
on a
nd n
atio
nally
.
We
all h
ave
a pa
rt to
pla
y in
tack
ling
the
influ
ence
s an
d ad
dres
sing
the
cons
eque
nces
of c
hild
hood
ob
esity
. Goo
d w
ork
is a
lread
y ta
king
pla
ce a
cros
s M
erto
n bu
t we
need
to d
o m
ore.
This
repo
rt g
athe
rs th
e fa
cts
and
figur
es a
bout
ch
ildho
od o
besi
ty in
Mer
ton
and
the
evid
ence
abo
ut
wha
t wor
ks a
s an
eas
y lo
cal r
efer
ence
and
reso
urce
to
sup
port
our
join
t effo
rt. T
he p
urpo
se o
f thi
s re
port
is
to c
ompl
emen
t the
Hea
lth a
nd W
ellb
eing
Boa
rd
child
hea
lthy
wei
ght a
ctio
n pl
an.
The
repo
rt b
egin
s w
ith lo
okin
g at
the
broa
d ra
nge
of fa
ctor
s th
at in
fluen
ce th
e lik
elih
ood
of c
hild
hood
ob
esity
, mov
ing
into
the
cons
eque
nces
and
cos
ts o
f ch
ildho
od o
besi
ty to
soc
iety
. Cha
pter
4 p
rovi
des
an
insi
ght i
nto
the
size
and
pat
tern
of c
hild
hood
obe
sity
lo
cally
and
cha
pter
5 re
view
s w
hat w
e kn
ow s
o fa
r ab
out t
he v
iew
s of
chi
ldre
n an
d yo
ung
peop
le a
nd
resi
dent
s on
the
topi
c. C
hapt
er 6
hig
hlig
hts
the
need
fo
r a
new
app
roac
h to
tack
ling
child
hood
obe
sity
in
Mer
ton
and
chap
ter
7 pr
ovid
es d
etai
ls o
f our
ap
proa
ch to
tack
ling
child
hood
obe
sity
thro
ugh
the
Mer
ton
child
hea
lthy
wei
ght a
ctio
n pl
an.
I am
gra
tefu
l to
my
team
and
man
y co
lleag
ues
from
the
coun
cil,
Mer
ton
Clin
ical
Com
mis
sion
ing
Gro
up a
nd o
ther
org
anis
atio
ns fo
r the
ir su
ppor
t and
co
ntrib
utio
ns. T
hese
effo
rts
are
muc
h ap
prec
iate
d –
on to
p of
eve
rybo
dy’s
bus
y da
ily w
ork
– an
d re
sult
in a
m
ore
info
rmed
and
col
labo
rativ
e ou
tput
. We
are
keen
to
mak
e ou
r ann
ual r
epor
t as
usef
ul fo
r par
tner
s as
po
ssib
le. P
leas
e em
ail p
ublic
.hea
lth@
mer
ton.
go
v.uk
w
ith a
ny fe
edba
ck y
ou m
ight
hav
e.
Co
unci
llor
Tob
in B
yers
, C
abin
et M
emb
er f
or
Ad
ult
So
cial
Car
e an
d H
ealt
h an
d C
oun
cillo
r K
aty
Nee
p,
Cab
inet
Mem
ber
fo
r C
hild
ren’
s S
ervi
ces
As
the
Cab
inet
Mem
bers
re
spon
sibl
e fo
r P
ublic
Hea
lth
and
Chi
ldre
n w
e co
mm
end
this
ann
ual r
epor
t of o
ur
Dire
ctor
of P
ublic
Hea
lth.
The
need
s of
chi
ldre
n ar
e at
th
e he
art o
f wha
t we
do a
nd
child
hood
obe
sity
is a
maj
or
publ
ic h
ealth
cha
lleng
e fo
r M
erto
n. A
s re
sour
ces
tight
en
it is
esp
ecia
lly im
port
ant t
o un
ders
tand
the
influ
ence
s an
d ca
uses
of c
hild
hood
obe
sity
and
reco
gnis
e th
at
it is
onl
y th
roug
h a
prev
enta
tive
appr
oach
that
we
will
be a
ble
to ta
ckle
them
in a
sus
tain
able
way
. If a
ctio
n is
not
take
n by
us
all n
ow w
e ris
k th
e ne
xt g
ener
atio
n ex
perie
ncin
g th
e bu
rden
of i
ncre
asin
g an
d m
ultip
le
long
-ter
m c
ondi
tions
.
The
repo
rt p
rovi
des
a w
elco
me
unde
rpin
ning
of t
he
Hea
lth a
nd W
ellb
eing
Boa
rd c
hild
hea
lthy
wei
ght a
ctio
n pl
an a
nd s
ets
out t
he im
port
ance
of p
lace
, com
mun
ity
and
fam
ily. T
he s
olut
ions
are
mul
tiple
and
wid
e-ra
ngin
g an
d th
e on
ly w
ay to
face
the
chal
leng
e is
to w
ork
in
part
ners
hip
for
and
with
the
resi
dent
s of
Mer
ton.
Dr
And
rew
Mur
ray,
C
hair
of
Mer
ton
Clin
ical
C
om
mis
sio
ning
Gro
up
As
the
Cha
ir of
Mer
ton
CC
G
and
a lo
cal G
P, I
see
first
ha
nd t
he c
onse
quen
ces
of c
hild
hood
obe
sity
and
kn
ow t
hat
we
need
to
wor
k to
geth
er t
o ta
ckle
the
com
plex
ran
ge o
f infl
uenc
es
on o
besi
ty in
a jo
ined
up
way
.
The
NH
S F
ive
Year
For
war
d V
iew
sta
tes
that
the
futu
re h
ealth
of m
illion
s of
chi
ldre
n w
ill de
pend
on
a ra
dica
l upg
rade
in p
reve
ntio
n an
d pu
blic
hea
lth,
and
high
light
s th
e ne
ed to
bac
k ac
tion
on o
besi
ty.
The
NH
S h
as a
n im
port
ant r
ole
to p
lay
and
we
mus
t w
ork
colla
bora
tivel
y w
ith c
omm
uniti
es a
nd p
artn
ers
acro
ss M
erto
n to
co-
crea
te s
usta
inab
le p
reve
ntat
ive
solu
tions
. Our
wor
k to
dev
elop
a n
ew m
odel
of h
ealth
an
d w
ellb
eing
in th
e ea
st o
f the
bor
ough
will
be a
key
fo
cus
in th
e co
min
g ye
ars.
I com
men
d th
e pu
blic
atio
n of
this
ann
ual p
ublic
he
alth
repo
rt. I
t is
a us
eful
reso
urce
and
pro
vide
s a
stro
ng fo
cus
on th
e ro
le w
e ca
n al
l pla
y in
tack
ling
this
m
ajor
pub
lic h
ealth
cha
lleng
e.
Fore
wor
d
Page 13
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Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
The
cha
lleng
e
Chi
ldho
od
ob
esity
is h
arm
ful t
o t
he
heal
th a
nd w
ellb
eing
of
Mer
ton’
s ch
ildre
n no
w a
nd in
the
ir f
utur
e:
Chi
ldho
od o
besi
ty in
crea
ses
the
risk
of d
evel
opin
g he
alth
con
ditio
ns in
clud
ing
asth
ma,
type
2 d
iabe
tes
and
card
iova
scul
ar r
isk
fact
ors
durin
g ch
ildho
od. I
t al
so in
crea
ses
the
risk
of lo
ng te
rm c
hron
ic c
ondi
tions
in
adu
lthoo
d an
d ca
n le
ad to
pre
mat
ure
deat
h.
Obe
sity
affe
cts
soci
al a
nd e
mot
iona
l wel
lbei
ng, w
ith
an in
crea
se in
chi
ldre
n ex
perie
ncin
g lo
w s
elf-
este
em,
anxi
ety
and
depr
essi
on. T
his
may
lead
to lo
wer
leve
ls
of e
duca
tiona
l att
ainm
ent w
hich
can
lim
it em
ploy
men
t op
port
uniti
es a
s ad
ults
.
Chi
ldho
od
ob
esity
is a
n ep
idem
ic:
Ther
e ha
s be
en a
sig
nific
ant i
ncre
ase
sinc
e th
e 19
80s
and
the
Wor
ld H
ealth
Org
aniz
atio
n (W
HO
) reg
ards
chi
ldho
od o
besi
ty a
s on
e of
the
mos
t se
rious
glo
bal p
ublic
hea
lth c
halle
nges
of t
he 2
1st
cent
ury.
Whe
n co
mpa
red
to s
imila
r gl
obal
citi
es,
incl
udin
g P
aris
, New
Yor
k an
d S
ydne
y, L
ondo
n ha
s th
e hi
ghes
t rat
es o
f chi
ldho
od o
besi
ty. I
f we
do
not r
ever
se th
e ep
idem
ic, t
hen
for
the
first
tim
e in
hu
ndre
ds o
f yea
rs o
ur c
hild
ren
mig
ht e
xper
ienc
e sh
orte
r lif
e ex
pect
ancy
than
thei
r pa
rent
s.
Ob
esity
aff
ects
lots
of
child
ren
and
fa
mili
es a
cro
ss M
erto
n:
Aro
und
4,50
0 pr
imar
y sc
hool
child
ren
(age
d be
twee
n 4
and
11 y
ears
) are
est
imat
ed to
be
over
wei
ght o
r obe
se –
this
is e
quiv
alen
t to
150
prim
ary
scho
ol c
lass
es. O
ne in
five
chi
ldre
n en
terin
g R
ecep
tion
are
over
wei
ght o
r obe
se a
nd th
is in
crea
ses
to o
ne in
th
ree
child
ren
leav
ing
prim
ary
scho
ol in
Yea
r 6. T
his
gain
in o
besi
ty a
s ch
ildre
n ge
t old
er is
hap
peni
ng
unde
r our
wat
ch in
sch
ools
and
com
mun
ities
. If w
e do
not
act
now
, the
num
ber o
f ove
rwei
ght a
nd o
bese
ch
ildre
n w
ill co
ntin
ue to
rise
in M
erto
n.
Chi
ldho
od
ob
esity
co
ntri
but
es t
o
wid
enin
g h
ealth
ineq
ualit
ies:
R
ates
of c
hild
hood
obe
sity
are
hig
her
in m
ore
depr
ived
com
mun
ities
in th
e ea
st o
f Mer
ton.
At a
ge
4-5
year
s, o
ne in
ten
child
ren
are
obes
e in
the
east
of
the
boro
ugh,
whe
reas
in th
e w
est,
one
in 2
0 ch
ildre
n ar
e ob
ese.
By
age
10-1
1 ye
ars,
one
in fi
ve c
hild
ren
are
obes
e in
the
east
com
pare
d to
one
in s
even
in
the
wes
t. Th
e ga
p be
twee
n th
e ea
st a
nd w
est i
s co
ntin
uing
to w
iden
. As
wel
l as
our
phys
ical
and
food
en
viro
nmen
ts, h
ealth
beh
avio
urs
are
influ
ence
d by
so
cioe
cono
mic
and
cul
tura
l fac
tors
. Hea
lthie
r ch
oice
s ar
e no
t alw
ays
the
easi
est o
nes
to m
ake
beca
use
of
all t
he a
ctor
s th
at in
fluen
ce o
ur c
hoic
es.
The
env
ironm
ent
that
we
live
in is
th
e un
der
lyin
g c
ause
of
ob
esity
: W
e ar
e liv
ing
in a
n ‘o
beso
geni
c’ e
nviro
nmen
t w
hich
enc
oura
ges
peop
le to
eat
mor
e un
heal
thily
an
d be
less
act
ive.
Peo
ple
have
not
bec
ome
lazi
er o
r gr
eedi
er –
inst
ead,
we
are
surr
ound
ed b
y m
ore
high
en
ergy
, hig
h fa
t, hi
gh s
ugar
, low
cos
t foo
ds. T
here
is
als
o in
crea
sing
car
use
, tra
ffic
cong
estio
n an
d re
duce
d tim
e an
d op
port
uniti
es to
be
activ
e.
Ob
esity
is b
eco
min
g u
naff
ord
able
: N
atio
nally
, obe
sity
cos
ts £
27 b
illion
ann
ually
to
the
wid
er e
cono
my,
incl
udin
g £6
.1 b
illion
to th
e N
HS
and
£35
2 m
illion
to s
ocia
l car
e. A
dditi
onal
ly th
ere
are
an e
stim
ated
16
milli
on o
besi
ty-a
ttrib
uted
day
s of
si
ckne
ss a
nnua
lly w
hich
is a
hug
e lo
ss o
f pro
duct
ivity
to
the
econ
omy.
The
est
imat
ed c
ost o
f ove
rwei
ght a
nd
obes
ity to
the
NH
S in
Mer
ton
is £
52 m
illion
ann
ually
. B
y 20
50, t
he w
ider
cos
ts o
f ove
rwei
ght a
nd o
besi
ty
are
pred
icte
d to
incr
ease
to n
early
£50
billi
on n
atio
nally
, w
hich
cou
ld b
ankr
upt t
he h
ealth
and
car
e sy
stem
.
We
may
no
t re
cog
nise
ove
rwei
ght
or
ob
esity
in o
urse
lves
or
our
chi
ldre
n:
Ther
e ha
s be
en a
shi
ft in
soc
iety
’s p
erce
ptio
n of
wha
t is
a he
alth
y bo
dy s
ize
and
shap
e. T
he m
edia
te
nd to
use
imag
es o
f ext
rem
e ob
esity
to il
lust
rate
ar
ticle
s ab
out o
besi
ty. I
n so
me
coun
trie
s an
d cu
lture
s ha
ving
a la
rger
bod
y si
ze m
ay b
e se
en a
s in
dica
tion
of w
ealth
and
hea
lth. I
f we
do n
ot re
cogn
ise
obes
ity,
we
are
less
like
ly to
prio
ritis
e ta
cklin
g it.
The
so
luti
on
We
mus
t ta
ke a
who
le-s
yste
m
pre
vent
ativ
e ap
pro
ach:
E
vide
nce
show
s th
at a
pre
vent
ativ
e, w
hole
sy
stem
s ap
proa
ch to
tack
ling
child
hood
obe
sity
is
nee
ded,
whi
ch re
cogn
ises
the
maj
or im
pact
of
the
plac
es w
here
we
live,
wor
k an
d pl
ay o
n he
alth
an
d w
ellb
eing
, as
wel
l as
indi
vidu
al b
ehav
iour
s an
d ch
oice
s. A
who
le s
yste
ms
appr
oach
add
ress
es
the
need
to ta
ke a
ctio
n at
diff
eren
t lev
els;
at t
he
popu
latio
n, c
omm
unity
and
indi
vidu
al le
vel i
n or
der
to m
axim
ise
oppo
rtun
ities
for
child
ren
and
fam
ilies
to a
dopt
and
mai
ntai
n he
alth
y lif
esty
les
as p
art o
f da
ily li
fe. P
opul
atio
n le
vel a
ctio
ns in
clud
e po
licy
and
regu
lato
ry m
easu
res;
com
mun
ity le
vel a
ctio
ns in
clud
e th
ose
in s
ettin
g su
ch a
s he
alth
y sc
hool
s an
d he
alth
y ca
terin
g; in
divi
dual
leve
l act
ions
incl
ude
supp
ort t
o ac
hiev
e an
d m
aint
ain
a he
alth
y w
eigh
t.
We
need
to
cre
ate
an e
nviro
nmen
t in
Mer
ton
whi
ch m
akes
the
hea
lthy
cho
ice
the
easy
and
pre
ferr
ed o
ne
for
our
chi
ldre
n an
d f
amili
es:
Evi
denc
e te
lls u
s th
at p
opul
atio
n w
ide
actio
ns
acro
ss a
spec
ts o
f the
phy
sica
l, fo
od a
nd c
ultu
ral
envi
ronm
ent a
re m
ost l
ikel
y to
be
succ
essf
ul a
nd
cost
effe
ctiv
e. H
ealth
pro
mot
ing
envi
ronm
ents
, tha
t is
thos
e w
here
the
heal
thie
r ch
oice
is b
oth
the
easi
er
and
pref
erre
d ch
oice
, are
als
o m
ore
econ
omic
ally
an
d en
viro
nmen
tally
sus
tain
able
. Acc
ess
to p
hysi
cal
activ
ity a
nd a
fford
able
hea
lthy
food
, and
goo
d ho
usin
g an
d co
okin
g fa
cilit
ies
are
all s
igni
fican
t. Im
prov
ing
acce
ss to
and
use
of M
erto
n’s
gree
n sp
aces
and
leis
ure
faci
litie
s al
l con
trib
ute
to im
prov
ed
phys
ical
act
ivity
. Ens
urin
g sc
hool
mea
ls a
nd c
ater
ing
busi
ness
es p
rovi
de h
ealth
y fo
od o
ptio
ns s
uppo
rts
peop
le to
mak
e he
alth
y ch
oice
s.
Pat
tern
s o
f b
ehav
iour
are
oft
en
esta
blis
hed
ear
ly in
life
and
in
terv
enin
g e
arly
is m
ore
ap
pro
pri
ate
and
co
st e
ffec
tive.
Th
ere
is s
tron
g ev
iden
ce th
at in
crea
sing
chi
ldre
n’s
posi
tive
early
exp
erie
nces
(inc
ludi
ng p
re-b
irth)
has
a
cum
ulat
ive
effe
ct a
s th
ey g
row
up.
Ear
ly y
ears
se
rvic
es h
ave
an e
ssen
tial r
ole
to p
lay
in p
rom
otin
g he
alth
y ch
oice
s an
d su
ppor
ting
mor
e vu
lner
able
fa
milie
s. M
axim
isin
g th
e ro
le o
f sch
ools
is im
port
ant
to m
ake
sure
chi
ldre
n an
d yo
ung
peop
le d
evel
op
heal
thy
lifes
tyle
s to
take
into
adu
lthoo
d. D
evel
opin
g cl
ear
path
way
s an
d su
ppor
t for
pro
fess
iona
ls w
orki
ng
with
par
ents
, chi
ldre
n an
d yo
ung
peop
le to
feel
co
nfide
nt a
bout
talk
ing
abou
t wei
ght a
nd s
ignp
ostin
g fa
milie
s ar
e pr
iorit
ies.
We
mus
t w
ork
to
get
her
to c
o-
pro
duc
e o
ur a
pp
roac
h lo
cally
: B
uild
ing
on th
e st
rong
rela
tions
hip
betw
een
volu
ntar
y, c
omm
unity
and
pub
lic s
ecto
rs a
nd
busi
ness
par
tner
s in
Mer
ton
and
good
wor
k al
read
y ta
king
pla
ce, w
e ne
ed a
sus
tain
ed jo
ined
up
app
roac
h to
influ
enci
ng a
t all
leve
ls if
we
are
to
addr
ess
the
chal
leng
e of
obe
sity
and
the
prof
ound
lo
ng te
rm c
onse
quen
ces
for
heal
th a
nd w
ellb
eing
of
child
ren
and
adul
ts.
Und
erst
and
ing
chi
ldre
n an
d y
oun
g
peo
ple
, par
ents
and
car
ers
and
co
mm
uniti
es’ p
ersp
ectiv
es in
M
erto
n w
ill s
tren
gth
en o
ur a
pp
roac
h.
The
conv
ersa
tion
with
our
resi
dent
s, fo
r ex
ampl
e th
roug
h th
e G
reat
Wei
ght D
ebat
e an
d on
-goi
ng
enga
gem
ent w
ith o
ur d
iver
se c
omm
uniti
es, w
ill in
crea
se a
war
enes
s of
the
issu
e of
chi
ldho
od o
besi
ty,
but m
ore
impo
rtan
tly h
elp
us c
o-cr
eate
sus
tain
able
so
lutio
ns a
nd a
ctio
n w
ith c
omm
uniti
es.
Key
Mes
sage
s
11 2
3 4 5
4 5 6 7
2 3
Page 14
89
Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
It br
ings
toge
ther
dat
a, re
sour
ces
and
info
rmat
ion
from
a r
ange
of s
ourc
es a
nd p
rovi
des
evid
ence
abo
ut
wha
t wor
ks a
s w
ell a
s ex
ampl
es o
f act
ion
to ta
ckle
ob
esity
, to
prov
ide
a lo
cal r
efer
ence
and
reso
urce
to
supp
ort o
ur jo
int e
ffort
. The
repo
rt c
ompl
emen
ts th
e H
ealth
and
Wel
lbei
ng B
oard
chi
ld h
ealth
wei
ght a
ctio
n pl
an, w
hich
set
s ou
t det
ails
of o
ur c
omm
itmen
ts o
n ch
ildho
od o
besi
ty.
As
we
cont
inue
to e
ngag
e w
ith s
take
hold
ers
and
resi
dent
s th
roug
h th
is re
port
and
sub
sequ
ent
conv
ersa
tions
, we
hope
to fu
rthe
r re
fine
our
appr
oach
es, c
reat
ing
colle
ctiv
e an
d su
stai
nabl
e ac
tions
to a
ddre
ss c
hild
hood
obe
sity
loca
lly.
The
child
hea
lthy
wei
ght a
ctio
n pl
an a
nd a
refe
renc
es
docu
men
t are
ava
ilabl
e on
the
follo
win
g lin
k:
ww
w.x
xxxx
xxxx
xxx.
go
v.uk
Why
chi
ldho
od o
besi
ty?
Chi
ldho
od o
besi
ty is
an
epid
emic
– th
ere
has
been
a
stee
p in
crea
se s
ince
the
1980
s an
d th
e W
orld
Hea
lth
Org
aniz
atio
n (W
HO
) reg
ards
chi
ldho
od o
besi
ty a
s on
e of
the
mos
t ser
ious
glo
bal p
ublic
hea
lth c
halle
nges
for
the
21st
cen
tury
.
Whe
n co
mpa
red
to s
imila
r gl
obal
citi
es L
ondo
n ha
s th
e hi
ghes
t ra
tes
of c
hild
hood
obe
sity
at
23%
–
com
pare
d w
ith P
aris
(5%
), S
ydne
y (1
0%) a
nd
even
New
Yor
k (2
1%).
In M
erto
n on
e in
five
of
our
child
ren
are
over
wei
ght
or o
bese
on
ente
ring
prim
ary
scho
ol a
t R
ecep
tion.
How
ever
by
the
time
child
ren
leav
e pr
imar
y sc
hool
in Y
ear
6 th
is r
ises
to
one
in t
hree
. If w
e do
n’t
take
act
ion
to r
ever
se
the
epid
emic
, the
n fo
r th
e fir
st t
ime
in h
undr
eds
of y
ears
our
chi
ldre
n m
ight
exp
erie
nce
shor
ter
life
expe
ctan
cy t
han
thei
r pa
rent
s.
Wha
t do
we
mea
n w
hen
we
say.
.. ?
Bo
dy
Mas
s In
dex
(BM
I) fo
r A
dul
tsTh
e bo
dy m
ass
inde
x (B
MI)
is a
mea
sure
that
pr
ovid
es a
n in
dica
tion
of w
heth
er s
omeo
ne is
a
heal
thy
wei
ght o
r no
t rel
ativ
e to
thei
r he
ight
. BM
I is
calc
ulat
ed a
s a
pers
on’s
wei
ght i
n ki
logr
ams
(kg)
di
vide
d by
his
or
her
heig
ht in
met
ers
squa
red.
The
B
MI s
core
is th
en re
view
ed a
gain
st a
BM
I ran
ge a
s sh
own
in ta
ble
1 fo
r ad
ults
.
Tab
le 1
: Ad
ult
BM
I cat
ego
ries
BM
I cen
tile
fo
r ch
ildre
nFo
r C
hild
ren,
wei
ght a
nd h
eigh
t cha
nges
qui
ckly,
m
akin
g de
finin
g th
eir
wei
ght c
ateg
orie
s m
ore
com
plex
. Gen
der
and
age
appr
opria
te re
fere
nces
al
low
mor
e ac
cura
te d
eter
min
ing
of w
eigh
t sta
tus
to u
se in
eva
luat
ing
child
ren’
s B
MI.
In E
ngla
nd, t
he
Brit
ish
1990
(UK
90) g
row
th re
fere
nce
char
ts a
re u
sed
to d
eter
min
e th
e w
eigh
t sta
tus
usin
g ce
ntile
clin
ical
cu
t off
poin
ts w
hich
are
as
follo
ws.
Tab
le 2
: Chi
ld B
MI c
ateg
ori
es
Exc
ess
wei
ght
Exc
ess
wei
ght i
s a
term
use
d to
des
crib
e a
com
bine
d po
pula
tion
abov
e th
e he
alth
y w
eigh
t ran
ge. F
or
exam
ple
exce
ss w
eigh
t in
child
ren
incl
udes
thos
e w
ho a
re id
entifi
ed a
s ‘c
linic
ally
ove
rwei
ght’,
‘clin
ical
ly
obes
e’ a
nd ‘c
linic
ally
ext
rem
ely
obes
e’. I
n th
e ad
ult
BM
I cat
egor
ies,
this
wou
ld b
e a
com
bina
tion
of th
ose
iden
tified
as
‘ove
rwei
ght a
nd o
bese
’.
Nat
iona
l Chi
ld M
easu
rem
ent
Pro
gra
mm
e (N
CM
P)
The
NC
MP
was
est
ablis
hed
in 2
005
and
invo
lves
m
easu
ring
the
heig
ht a
nd w
eigh
t of R
ecep
tion
and
Year
6 c
hild
ren
at s
tate
-mai
ntai
ned
scho
ols,
incl
udin
g ac
adem
ies,
in E
ngla
nd. T
his
is d
one
in s
choo
ls b
y sc
hool
nur
sing
or
othe
r he
alth
car
e pr
ofes
sion
als.
E
very
yea
r, m
ore
than
one
milli
on c
hild
ren
are
mea
sure
d an
d an
nual
par
ticip
atio
n ra
tes
are
cons
iste
ntly
hig
h. T
he N
CM
P h
as tw
o pu
rpos
es:
a) t
o p
rovi
de
rob
ust
pub
lic h
ealt
h su
rvei
llanc
e d
ata
on
child
wei
ght
sta
tus:
to u
nder
stan
d an
d m
onito
r ob
esity
pre
vale
nce
and
tren
ds a
t na
tiona
l and
loca
l lev
els,
to in
form
pla
nnin
g an
d co
mm
issi
onin
g of
ser
vice
s.
b) t
o p
rovi
de
par
ents
wit
h fe
edb
ack
on
thei
r ch
ild’s
wei
ght
sta
tus:
to h
elp
them
und
erst
and
thei
r ch
ild’s
hea
lth s
tatu
s an
d to
sup
port
and
en
cour
age
beha
viou
r ch
ange
whe
re it
will
help
a
child
ach
ieve
a h
ealth
y w
eigh
t. Th
is a
lso
prov
ides
a
mec
hani
sm fo
r di
rect
eng
agem
ent w
ith fa
milie
s.
Whe
n m
easu
ring
a po
pula
tion
of c
hild
ren
(for
exam
ple
repo
rtin
g N
CM
P fi
ndin
gs) w
eigh
t sta
tus
is d
efine
d us
ing
the
follo
win
g U
K90
pop
ulat
ion
cut
poin
ts. T
hese
cut
poi
nts
are
slig
htly
low
er th
an th
e cl
inic
al c
ut p
oint
s m
entio
ned
in th
e ‘B
MI f
or C
hild
ren’
se
ctio
n. T
his
is to
iden
tify
thos
e ch
ildre
n w
ith a
wei
ght
prob
lem
as
wel
l as
thos
e at
ris
k of
dev
elop
ing
a w
eigh
t pro
blem
(tha
t is
thos
e ch
ildre
n w
ho m
aybe
on
the
bord
er li
ne o
f the
clin
ical
defi
nitio
n). T
his
help
s en
sure
that
ade
quat
e se
rvic
es a
re p
lann
ed a
nd
deliv
ered
for
the
who
le p
opul
atio
n.
Tab
le 3
: NC
MP
Cat
ego
ries
The
NC
MP
is a
relia
ble
sour
ce o
f dat
a an
d is
ava
ilabl
e by
bot
h re
side
nt a
nd s
choo
l pop
ulat
ions
. Res
iden
t da
ta fo
r R
ecep
tion
clas
s an
d Ye
ar 6
has
bee
n us
ed in
th
is re
port
. As
mos
t chi
ldre
n at
tend
prim
ary
scho
ols
near
to th
eir
hom
es, t
he s
choo
l lev
el d
ata
clos
ely
refle
cts
the
resi
dent
chi
ldre
n’s
popu
latio
n.
Wei
ght
gai
n, w
eig
ht lo
ss a
nd w
eig
ht m
aint
enan
ceW
eigh
t gai
n oc
curs
as
a re
sult
of re
gula
rly e
atin
g m
ore
calo
ries
than
peo
ple
wou
ld u
se th
roug
h no
rmal
bo
dily
func
tions
and
phy
sica
l act
ivity
. Wei
ght i
s m
aint
aine
d th
roug
h en
surin
g th
e am
ount
of c
alor
ies
cons
umed
is e
qual
to c
alor
ies
used
(see
dia
gram
1).
1. In
trod
ucti
on
This
Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
set
s ou
t the
cha
lleng
e of
chi
ldho
od o
besi
ty in
Mer
ton
and
is a
cal
l to
actio
n to
par
tner
s to
wor
k to
geth
er o
n th
e so
lutio
ns.
Cal
ori
es In
Wei
ght
Mai
ntai
ned
Isoc
alor
ic B
alan
ceE
nerg
y In
= E
nerg
y O
ut
Wei
ght
Lo
ss
Neg
ativ
e C
alor
ic B
alan
ceE
nerg
y In
< E
nerg
y O
ut
Wei
ght
Gai
n
Pos
itive
Cal
oric
Bal
ance
Ene
rgy
In >
Ene
rgy
Out
Cal
ori
es O
ut
Exc
ept
for
wat
er, e
very
Fo
od
and
D
rink
item
con
tain
s ca
lorie
s.
BM
R is
yo
ur B
asal
Met
abo
lic R
ate.
Th
is is
the
amou
nt o
f ene
rgy
(cal
orie
s)
your
bod
y us
es w
hile
it is
at r
est o
r sl
eep
ing.
It a
ccou
nts
for
50-7
0 p
erce
nt
of y
our
calo
rie e
xpen
ditu
re e
ach
day
!
Dai
ly A
ctiv
ity in
clud
es a
ny ti
me
you
mov
e yo
ur m
uscl
es, w
heth
er it
is
wal
king
to c
lass
, cle
anin
g yo
ur h
ouse
or
run
ning
a m
arat
hon.
Ad
ult
Cla
ssifi
cati
on
BM
I ran
ge
(kg
/m2)
Und
erw
eigh
tU
nder
18.
5
Hea
lthy
Wei
ght
18.5
– 2
4.9
Ove
rwei
ght
25-2
9.9
Obe
se30
or
high
er
Po
pul
atio
n b
ased
cat
ego
ryC
enti
le r
ang
e)
Und
erw
eigh
t≤2
nd c
entil
e
Hea
lthy
wei
ght
>2
- <
85th
cen
tile
Ove
rwei
ght
≥ 85
th c
entil
e
Obe
se≥9
5th
cent
ile
Clin
ical
cat
ego
ryC
enti
le r
ang
e
Clin
ical
ly v
ery
unde
r w
eigh
t≤
0.4t
h ce
ntile
Clin
ical
ly lo
w w
eigh
t≤
2nd
cent
ile
Clin
ical
ly h
ealth
y w
eigh
t>
2 -
< 9
1st c
entil
e
Clin
ical
ly o
verw
eigh
t≥
91st
cen
tile
Clin
ical
ly o
bese
*≥
98th
cen
tile
Clin
ical
ly e
xtre
mel
y ob
ese
≥ 99
.6th
cen
tile
*Als
o ca
lled
‘ver
y ov
erw
eigh
t’ in
the
Nat
iona
l Chi
ld M
easu
rem
ent
Pro
gram
me
Dia
gra
m 1
: Cal
ori
e b
alan
cing
Page 15
1011
Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
2. In
flue
nces
on
Child
hood
Obe
sity
Chi
ldho
od o
besi
ty is
not
cau
sed
by o
ne d
istin
ct fa
ctor
but
a n
umbe
r of
w
ide-
rang
ing
fact
ors
all c
ombi
ning
to in
crea
se r
isk
of o
besi
ty.
Phys
ical
act
ivit
y P
hysi
cal a
ctiv
ity in
clud
es c
yclin
g, w
alki
ng, a
ctiv
e pl
ay,
goin
g to
the
gym
, sw
imm
ing,
gar
deni
ng, h
ouse
wor
k an
d ac
tive
trav
el. S
eden
tary
life
styl
es in
chi
ldre
n in
crea
se o
besi
ty r
ates
. Inc
reas
ed ‘s
cree
n tim
e’,
incl
udin
g pl
ayin
g co
mpu
ter
gam
es a
nd w
atch
ing
tele
visi
on, a
nd u
sing
touc
hscr
eens
and
sm
artp
hone
s,
is li
nked
to in
crea
sed
obes
ity r
ates
. Chi
ldre
n w
ho
wat
ch m
ore
than
eig
ht h
ours
of t
elev
isio
n pe
r w
eek
at
age
thre
e ar
e m
ore
likel
y to
be
obes
e. G
ood
phys
ical
ac
tivity
hab
its in
chi
ldho
od a
nd a
dole
scen
ce a
re li
kely
to
be
carr
ied
into
adu
lthoo
d.
Phys
ical
env
iron
men
tTh
e en
viro
nmen
ts th
at p
eopl
e liv
e in
may
hel
p or
bl
ock
how
phy
sica
lly a
ctiv
e ch
ildre
n an
d fa
milie
s ar
e.
Saf
ety,
road
traf
fic, e
ase
of w
alki
ng a
nd a
cces
s to
ph
ysic
al a
ctiv
ity fa
cilit
ies
and
gree
n sp
ace
all h
ave
an
impa
ct o
n th
e le
vel o
f phy
sica
l act
ivity
und
erta
ken.
W
ork
to c
reat
e en
viro
nmen
ts w
here
fam
ilies
chos
e to
wal
k an
d cy
cle
and
visi
t ope
n sp
ace
as p
art o
f ev
eryd
ay li
fe w
ill ha
ve a
pos
itive
impa
ct a
t ind
ivid
ual
and
popu
latio
n le
vels
.
Nat
iona
lly:
Aro
und
four
in t
en c
hild
ren
aged
bet
wee
n fiv
e an
d 15
yea
rs o
ld a
re p
hysi
cally
inac
tive
(39%
boy
s an
d 45
% g
irls)
(cla
ssifi
ed a
s fe
wer
than
30
min
utes
of m
oder
ate
to v
igor
ous
activ
ity o
n ea
ch d
ay o
r 60
min
utes
or
mor
e, o
n fe
wer
than
sev
en d
ays
in th
e la
st w
eek)
.
Onl
y o
ne in
ten
chi
ldre
n ag
ed b
etw
een
two
and
four
yea
rs o
ld m
eet t
he G
over
nmen
ts’ r
ecom
men
datio
ns
for
phys
ical
act
ivity
(cla
ssed
as
180
min
utes
(3 h
ours
) of p
hysi
cal a
ctiv
ity s
prea
d th
roug
hout
the
day
on a
ll se
ven
days
In th
e la
st w
eek)
.
The
per
cent
age
of tw
o to
15
year
old
s m
eetin
g th
e re
com
men
ded
leve
ls o
f phy
sica
l act
ivity
has
dro
pped
fro
m 2
5% in
200
8 to
18%
in 2
012.
Lo
w le
vels
of
phy
sica
l act
ivit
y ar
e re
late
d t
o h
ous
eho
ld in
com
e. M
ore
boys
and
girl
s in
the
low
est
inco
me
hous
ehol
ds w
ere
clas
sifie
d in
the
low
phy
sica
l act
ivity
gro
up th
an in
the
high
est i
ncom
e ho
useh
olds
.
In M
erto
n:
In M
erto
n:
In M
erto
n, a
nat
iona
l sur
vey
of
15 y
ear
old
s sh
ow
s:
Onl
y 11
.8%
of
15 y
ear
old
s in
Mer
ton
mee
t the
Wor
ld H
ealth
Org
aniz
atio
n’s
guid
elin
e of
an
hour
of
mod
erat
e-to
-vig
orou
s ph
ysic
al a
ctiv
ity p
er d
ay.
71.
2% o
f 15
yea
r o
lds
spen
d an
ave
rage
of s
even
hou
rs a
day
on
sede
ntar
y ac
tiviti
es, i
nclu
ding
tim
e w
atch
ing
tele
visi
on a
nd u
sing
com
pute
rs.
Bot
h of
thes
e ar
e si
mila
r le
vels
to L
ondo
n an
d E
ngla
nd.
Par
ks a
nd o
pen
spac
es a
re a
n as
set.
Mer
ton
is
one
of th
e gr
eene
st b
orou
ghs
in L
ondo
n. T
here
m
ore
than
60
park
s an
d 18
% o
f the
bor
ough
is
open
spa
ce, c
ompa
red
to 1
0% L
ondo
n av
erag
e.
How
ever
, onl
y on
e in
10
resi
dent
s us
e ou
tdoo
r sp
ace
to e
xerc
ise,
the
fifth
low
est l
evel
in L
ondo
n.
A s
igni
fican
t par
t of t
he b
orou
gh’s
ope
n sp
ace
is
mad
e up
of W
imbl
edon
Com
mon
and
Mitc
ham
C
omm
on.
Mor
e th
an h
alf (
57.8
%) o
f hou
seho
lds
have
acc
ess
to o
pen
spac
es (w
ithin
400
met
res)
, mor
e th
an a
th
ird (3
8.8%
) of h
ouse
hold
s ha
ve a
cces
s to
loca
l pa
rks
(with
in 4
00 m
etre
s) a
nd tw
o th
irds
(66.
9%)
have
acc
ess
to re
gion
al p
arks
(with
in 5
km).
In
term
s of
util
isat
ion
of o
utdo
or s
pace
, onl
y 11
.1%
of t
he p
opul
atio
n in
Mer
ton
use
outd
oor
spac
e fo
r ex
erci
se p
urpo
ses
(low
er th
an
Lond
on-1
2.3%
and
Eng
land
-17.
9%).
Infl
uenc
es o
nCh
ildho
odO
besi
ty
Food
Envi
ronm
ent
Food
Cons
umpt
ion
Phys
ical
Envi
ronm
ent
Soci
oeco
nom
icFa
ctor
sPh
ysic
alA
ctiv
ity
Earl
y Li
fean
dIn
divi
dual
Fact
ors
Page 16
1213
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ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
Food
con
sum
ptio
n
Poo
r di
et is
a m
ajor
ris
k fa
ctor
for
child
hood
obe
sity
, ill-
heal
th a
nd p
rem
atur
e de
ath.
Con
sum
ptio
n of
ex
cess
cal
orie
s is
ofte
n du
e to
con
sum
ptio
n of
hig
h en
ergy
food
s an
d dr
inks
or
larg
e po
rtio
n si
zes.
Eat
ing
habi
ts a
re p
erpe
tuat
ed th
roug
h fa
milie
s, c
omm
uniti
es,
cultu
res
and
envi
ronm
ents
and
are
ofte
n m
aint
aine
d fro
m c
hild
thro
ugh
to a
dulth
ood.
In g
ener
al, c
hild
ren
who
eat
a s
choo
l lun
ch m
eal
tend
to c
onsu
me
a he
alth
ier
mea
l tha
n th
ose
who
ea
t pac
ked
lunc
hes
or ta
keaw
ay m
eals
at l
unch
tim
e.
Upt
ake
of s
choo
l mea
ls te
nds
to d
ecre
ase
whe
n ch
ildre
n m
ove
from
prim
ary
to s
econ
dary
sch
ool
and
som
e sc
hool
s al
so a
llow
chi
ldre
n to
leav
e sc
hool
pr
emis
es a
t lun
ch ti
mes
, whi
ch c
an in
crea
se c
hild
ren’
s co
nsum
ptio
n of
fast
food
.
Food
env
iron
men
t
Ther
e ar
e st
rong
link
s be
twee
n ob
esity
and
th
e co
mm
unity
food
env
ironm
ent.
Fas
t fo
od is
ge
nera
lly h
ighe
r in
sug
ar, s
alt
and
satu
rate
d fa
t co
nten
t th
eref
ore
high
er c
onsu
mpt
ion
of fa
st fo
od
cont
ribut
es to
hig
her
risk
of o
besi
ty. T
here
is a
str
ong
asso
ciat
ion
betw
een
depr
ivat
ion
and
the
dens
ity o
f fa
st fo
od o
utle
ts.
Fast
food
is a
n af
ford
able
and
read
ily a
vaila
ble
sour
ce
of fo
od in
som
e ar
eas
whe
reas
hea
lthy
food
opt
ions
m
ay b
e lim
ited
or u
naffo
rdab
le. I
t is
also
a p
opul
ar
choi
ce fo
r ch
ildre
n an
d yo
ung
peop
le, w
hich
pro
vide
s a
sign
ifica
nt p
ropo
rtio
n of
thei
r fa
t, sa
lt an
d su
gar
inta
ke. T
he p
roxi
mity
of f
ast f
ood
outle
ts to
sch
ools
m
akes
it h
arde
r to
mak
e he
alth
y lif
esty
le c
hoic
es.
Nat
iona
lly:
Fru
it an
d ve
geta
ble
cons
umpt
ion
decr
ease
s as
chi
ldre
n ge
t old
er.
Fru
it an
d ve
geta
ble
cons
umpt
ion
is re
late
d to
hou
seho
ld in
com
e. F
amilie
s fro
m th
e hi
ghes
t inc
ome
hous
ehol
ds c
onsu
me
mor
e th
an th
ose
in a
ll ot
her
cate
gorie
s of
hou
seho
ld in
com
e.
Eng
land
’s y
oung
peo
ple
have
the
high
est c
onsu
mpt
ion
of s
ugar
y so
ft dr
inks
in E
urop
e.
In M
erto
n:
Jus
t ove
r ha
lf (5
2.8%
) of 1
5-ye
ar-o
ld c
hild
ren
repo
rted
that
they
ate
at l
east
five
por
tions
of f
ruit
and
vege
tabl
es e
ach
day
(the
reco
mm
ende
d am
ount
). Th
is c
ompa
res
to 5
6.2%
in L
ondo
n an
d 52
.4%
in E
ngla
nd.
In
the
Aut
umn
and
Spr
ing
term
(201
5/16
aca
dem
ic y
ear)
60%
of c
hild
ren
in a
Mer
ton
prim
ary
scho
ol a
te a
sc
hool
mea
l. Th
eref
ore
arou
nd 4
0% o
f pup
ils a
re h
avin
g a
pack
ed lu
nch,
whi
ch a
re o
ften
less
hea
lthy.
Per
cent
age
of
11-1
5 ye
ar o
lds
who
dri
nk s
ugar
y d
rink
s at
leas
t o
nce
a d
ay
In M
erto
n:
The
re a
re 8
2.1
fast
food
out
lets
per
100
,000
pop
ulat
ion
(four
th lo
wes
t in
Lond
on a
nd 1
49th
hig
hest
in
Eng
land
(out
of 3
25).
In
2015
ther
e w
ere
302
rest
aura
nts
and
171
take
away
s.
The
war
ds w
ith th
e hi
ghes
t num
ber
of fa
st fo
od ta
keaw
ays
are
Trin
ity, A
bbey
and
Col
liers
Woo
d.
Map
1: L
ond
on
bo
roug
hs f
ast
foo
d o
utle
t d
ensi
ty (2
014)
Eng
land
40%
Po
land
27%
Ger
man
y18
.5%
Sw
eden
6.3%
Fin
land
5%
Mer
ton
Mer
ton
Fas
t fo
od
out
lets
by
lo
cal a
utho
rity
Rat
e p
er 1
00,0
00 p
op
ulat
ion
24.1
– 5
7.0
57.1
– 7
2.1
72.2
– 8
6.4
86.5
– 1
04.3
104.
4 –
198.
98
Page 17
1415
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ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
Earl
y lif
e, in
divi
dual
and
fam
ily fa
ctor
s
A c
hild
’s n
utrit
ion
early
in li
fe h
as c
onse
quen
ces
for
futu
re o
besi
ty ri
sk. B
reas
tfeed
ing
has
been
sho
wn
to c
onfe
r sig
nific
ant p
rote
ctio
n ag
ains
t obe
sity
in
child
ren.
Evi
denc
e al
so s
ugge
sts
the
long
er th
e du
ratio
n of
bre
astfe
edin
g, th
e lo
wer
the
asso
ciat
ed ri
sk
of c
hild
hood
obe
sity
. Hig
h B
ody
Mas
s in
dex
(BM
I) in
pr
esch
ool y
ears
lead
s to
a s
igni
fican
tly h
ighe
r ris
k of
be
ing
obes
e la
ter i
n ch
ildho
od.
Par
enta
l beh
avio
urs
are
an in
tegr
al a
nd in
fluen
tial
part
of a
chi
ld’s
dev
elop
men
t and
beh
avio
ur, w
hich
in
clud
es e
atin
g ha
bits
and
phy
sica
l act
ivity
.
Par
enta
l obe
sity
is a
n im
port
ant i
nflue
nce
on
child
hood
obe
sity
. The
chi
ldre
n of
obe
se p
aren
ts a
re
mor
e lik
ely
to b
e ob
ese
than
thos
e bo
rn to
par
ents
of
a he
alth
y w
eigh
t.
Evi
denc
e al
so s
how
s th
at e
xces
sive
wei
ght
gain
du
ring
preg
nanc
y (re
gard
less
of m
othe
rs w
eigh
t pr
e-pr
egna
ncy)
, can
lead
to
an in
crea
sed
likel
ihoo
d of
hig
her
obes
ity r
ates
in c
hild
ren.
Thi
nk F
amily
Act
ion
to ta
ckle
chi
ldho
od o
besi
ty a
t an
envi
ronm
enta
l lev
el w
ill ha
ve b
enefi
ts fo
r w
hole
fa
milie
s an
d w
ider
com
mun
ities
, and
enc
oura
ging
pa
rent
s an
d ca
rers
to ta
ke a
who
le fa
mily
app
roac
h in
clud
ing
adul
ts a
nd s
iblin
gs is
effe
ctiv
e.
The
fam
ily c
ont
ext
in M
erto
n
3 in
5 a
dul
ts
are
eith
er o
verw
eigh
t or
obes
e
In M
erto
n:
Ethn
icit
y an
d O
besi
tyTh
ere
are
ethn
ic v
aria
tions
in o
besi
ty p
reva
lenc
e.
Nat
iona
lly, e
vide
nce
indi
cate
s th
at a
chi
ld is
mor
e lik
ely
to h
ave
exce
ss w
eigh
t if t
hey
are
from
a b
lack
B
ritis
h, b
lack
Afri
can,
bla
ck C
arib
bean
or
Asi
an e
thni
c ba
ckgr
ound
. Thi
s is
sig
nific
ant b
ecau
se 4
6% o
f ch
ildre
n an
d yo
ung
peop
le in
Mer
ton
are
from
Bla
ck,
Asi
an a
nd M
inor
ity E
thni
c gr
oups
and
the
rang
e ac
ross
chi
ldre
n an
d yo
ung
peop
le in
our
sch
ools
in
Mer
ton
is b
etw
een
32%
to 9
1%.
How
ever
, the
re is
no
stra
ight
forw
ard
rela
tions
hip
betw
een
obes
ity a
nd e
thni
city
, with
a c
ompl
ex
inte
rpla
y of
fact
ors.
Hea
lth b
ehav
iour
diff
ers
acco
rdin
g to
diff
eren
t soc
ioec
onom
ic, r
elig
ious
and
cul
tura
l fa
ctor
s, a
nd e
vide
nce
sugg
ests
that
it is
the
impa
ct
of h
ighe
r le
vels
of d
epriv
atio
n an
d its
ass
ocia
tion
with
gr
eate
r ris
k of
obe
sity
that
is a
lead
ing
fact
or.
Nat
iona
lly:
NC
MP
dat
a fo
r 20
15/1
6 sh
ow
s:
For
4-5
yea
r o
lds
in R
ecep
tion,
obe
sity
pr
eval
ence
was
:
– 15
.2%
in B
lack
or
Bla
ck B
ritis
h et
hnic
gro
up
com
pare
d to
8.8
% in
the
Whi
te g
roup
– a
gap
of
ove
r 6%
.
– 9
.7%
in M
ixed
eth
nic
grou
p co
mpa
red
to
8.8%
in th
e w
hite
gro
up.
For
10-
11 y
ear
old
s in
Yea
r 6,
obe
sity
pr
eval
ence
was
:
– 2
8.6%
in th
e B
lack
or
Bla
ck B
ritis
h et
hnic
gr
oup
com
pare
d to
18.
1% in
the
Whi
te g
roup
–
a ga
p of
ove
r 10
%.
– 2
4.5%
in A
sian
or
Asi
an B
ritis
h et
hnic
gro
up
com
pare
d to
18.
1% in
the
whi
te g
roup
.
50%
of
Mer
ton
resi
den
ts
are
livin
g in
fam
ily h
ouse
hold
s
Soci
oeco
nom
ic fa
ctor
sD
epriv
atio
n is
one
of t
he m
ost
strik
ing
influ
ence
s on
ob
esity
. Evi
denc
e sh
ows
that
a c
hild
is m
ore
likel
y to
ha
ve e
xces
s w
eigh
t if
they
are
from
a lo
wer
inco
me
hous
ehol
d. C
hild
hood
obe
sity
pre
vale
nce
incr
ease
s w
ith in
crea
sing
dep
rivat
ion.
Nat
iona
lly, c
hild
ren
from
the
mos
t dep
rived
ba
ckgr
ound
s ha
ve a
lmos
t dou
ble
the
leve
l of o
besi
ty
com
pare
d to
thos
e in
the
leas
t dep
rived
bac
kgro
unds
.
Ris
ing
food
pric
es, l
ow w
ages
, cha
nges
to
wel
fare
be
nefit
s an
d la
ck o
f loc
al r
etai
lers
sel
ling
affo
rdab
le
heal
thy
food
all
cont
ribut
e to
hig
her
rate
s of
obe
sity
.
Cos
t-of
livi
ng p
ress
ures
mea
n th
at lo
w in
com
e fa
milie
s ha
ve fe
wer
cho
ices
, spe
nd m
ore
of t
heir
budg
et o
n fo
od c
ompa
red
to t
he n
atio
nal a
vera
ge,
and
are
eatin
g un
heal
thie
r fo
od, p
riorit
isin
g ca
lorie
s ov
er n
utrie
nts
whe
n m
oney
is t
ight
.
War
ds in
Eas
t Mer
ton
have
a h
ighe
r In
dex
of
Dep
rivat
ion
Affe
ctin
g C
hild
ren
Inde
x (ID
AC
I). T
his
corr
elat
es w
ith th
e pa
tter
n of
exc
ess
wei
ght s
een
whe
re w
ards
in th
e E
ast h
ave
a hi
gher
pre
vale
nce
of
exce
ss w
eigh
t tha
n w
ards
in th
e W
est.
IDA
CI 2
015
Mer
ton
War
ds
0.24
1 to
0.3
03 m
ore
depr
ived
0.16
4 to
0.2
41
0.11
1 to
0.1
64
0.07
9 to
0.1
11
0.02
8 to
0.0
79 le
ss d
epriv
ed
Exc
ess
wei
ght
in Y
ear
6 (%
)
42.8
– 3
6.2
36.1
– 2
6.6
26.5
– 2
0.0
*Lar
ge g
reen
circ
les
sign
ify h
ighe
r pr
eval
ence
of e
xces
s w
eigh
t in
Yea
r 6
in t
he w
ard
Ray
nes
Par
kVill
age
Wim
ble
do
nP
ark
Co
llier
s W
oo
d
St
Hel
ier
Rav
ensb
uryC
rick
etG
reen
Fig
ges
Mar
sh
Long
tho
rnto
n
Gra
vene
y
Lave
nder
Fiel
ds
Ab
bey
Trin
ity
Dun
do
nald
Hill
sid
e
Po
llard
s H
illW
est
Bar
nes Lo
wer
Mo
rden
Can
non
HillM
erto
n P
ark
Ray
nes
Par
kVill
age
Wim
ble
do
nP
ark
Co
llier
s W
oo
d
St
Hel
ier
Rav
ensb
uryC
rick
etG
reen
Fig
ges
Mar
sh
Long
tho
rnto
n
Gra
vene
y
Lave
nder
Fiel
ds
Ab
bey
Trin
ity
Dun
do
nald
Hill
sid
e
Po
llard
s H
illW
est
Bar
nes Lo
wer
Mo
rden
Can
non
HillM
erto
n P
ark
In M
erto
n:
Map
2: I
ndex
of
Dep
riva
tion
Aff
ectin
g C
hild
ren
Ind
ex (I
DA
CI)
in M
erto
n an
d e
xces
s w
eig
ht in
Yea
r 6
by
war
d
Page 18
1617
Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
Phys
ical
and
men
tal h
ealt
h co
nseq
uenc
es in
chi
ldho
od
Obe
sity
incr
ease
s th
e ris
k of
the
follo
win
g ph
ysic
al, e
mot
iona
l and
men
tal h
ealth
pro
blem
s de
velo
ping
dur
ing
child
hood
and
ado
lesc
ence
(See
Fig
ure
A).
3. C
onse
quen
ces
and
Cost
s
The
cons
eque
nces
of c
hild
hood
obe
sity
are
wid
e ra
ngin
g an
d in
clud
e im
pact
on
futu
re h
ealth
, bot
h ph
ysic
al a
nd p
sych
olog
ical
, as
wel
l as
havi
ng
long
-last
ing
impa
cts
on e
mpl
oym
ent a
nd re
latio
nshi
ps.
Fig
ure
A: N
egat
ive
cons
eque
nces
of
bei
ng o
verw
eig
ht o
r o
bes
e in
chi
ldho
od
Fig
ure
B: I
mp
act
of
ob
esity
on
adul
t he
alth
By
2020
...
Long
term
con
sequ
ence
s
Bei
ng o
bese
in c
hild
hood
can
lead
to p
rem
atur
e de
ath.
Chi
ldre
n w
ith w
eigh
t in
the
high
est B
MI q
uart
ile
are
over
twic
e as
like
ly to
die
bef
ore
the
age
of 5
5 th
an th
ose
with
BM
Is in
the
low
est q
uart
ile.
Chi
ldho
od o
besi
ty is
als
o si
gnifi
cant
ly li
nked
to
incr
ease
d m
orbi
dity
. Obe
sity
affe
cts
alm
ost a
ll of
the
body
’s s
yste
ms,
and
ther
e ar
e a
huge
num
ber
of
adul
t chr
onic
long
term
con
ditio
ns th
at a
re li
nked
to
child
hood
obe
sity
(See
Fig
ure
B o
ppos
ite).
The
cost
s of
chi
ldho
od o
besi
ty
The
impa
ct o
f chi
ld o
besi
ty h
as lo
ng te
rm
cons
eque
nces
for
adul
t ill
heal
th. A
s w
ell a
s th
e ef
fect
s on
the
indi
vidu
al, i
t is
a bu
rden
on
the
heal
thca
re s
yste
m c
ausi
ng in
crea
sed
finan
cial
cos
ts.
Obe
sity
and
its
asso
ciat
ed h
ealth
pro
blem
s ha
ve
a si
gnifi
cant
eco
nom
ic im
pact
on
the
NH
S. D
irect
m
edic
al c
osts
incl
ude
prev
entiv
e, d
iagn
ostic
, and
tr
eatm
ent s
ervi
ces
such
as
the
cost
of m
edic
atio
n re
late
d to
obe
sity
. Ind
irect
cos
ts re
late
to re
duce
d
prod
uctiv
ity fr
om b
eing
abs
ent f
rom
wor
k du
e to
si
ckne
ss a
nd d
ecre
ased
pro
duct
ivity
whi
lst a
t wor
k,
as w
ell a
s di
sabi
lity
and
prem
atur
e m
orta
lity.
The
lost
ear
ning
s at
trib
utab
le to
obe
sity
hav
e be
en
estim
ated
bet
wee
n £2
.3–3
.6 b
illion
. The
ann
ual s
ocia
l ca
re c
osts
of o
besi
ty to
loca
l aut
horit
ies
are
estim
ated
at
£35
2m, w
ith th
e co
sts
to th
e w
ider
eco
nom
y of
£2
7 bi
llion.
In M
erto
n:
Rep
rod
uctiv
eC
om
plic
atio
ns
Live
rd
isea
se
Hea
rtd
isea
seS
tro
ke
Can
cer
Sle
epap
noea
Typ
e 2
dia
bet
es
Ost
eoar
thri
tisB
ack
pai
n
Ast
hma
Dep
ress
ion
and
anxi
ety
Em
otio
nal a
nd b
ehav
iour
al
• S
choo
l abs
ence
• S
tigm
atis
m•
Bul
lyin
g•
Low
-sel
f est
eem
• H
igh
chol
este
rol
• H
igh
bloo
d pr
essu
re•
Pre
-dia
bete
s•
Bon
e &
join
t pro
blem
s•
Bre
athi
ng d
iffic
ultie
s•
Ast
hma
• O
bstr
uctiv
e sl
eep
apno
ea (O
SA
)
• To
oth
deca
y
SC
HO
OL
• In
crea
sed
risk
of b
ecom
ing
over
wei
ght a
dults
• R
isk
of il
l-hea
lth a
nd p
rem
atur
e
m
orta
lity
in a
dult
life
49,5
00 p
eop
le in
Mer
ton
will
have
hi
gh b
lood
pre
ssur
e co
mpa
red
to
44,0
00 in
201
0.
9,00
0 p
eop
le in
Mer
ton
will
have
ca
rdiv
ascu
lar
dise
ase
com
pare
d to
8,
000
peop
le in
201
0.
13,7
00 p
eop
le in
Mer
ton
will
have
dia
bete
s co
mpa
red
to
11,2
00 in
201
0.
2010
Page 19
1819
Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
Fig
ure
C: T
he a
nnua
l fina
ncia
l co
st o
f o
bes
ity t
o s
oci
ety
In M
erto
n:
The
ann
ual c
ost
s to
the
NH
S o
f:
Dis
ease
s re
late
d to
bei
ng o
verw
eig
ht a
nd
ob
ese
is e
stim
ated
at £
52 m
illio
n.
Dis
ease
s re
late
d to
ob
esit
y al
one
is e
stim
ated
at
£30
mill
ion.
By
2025
it is
est
imat
ed th
at th
e co
sts
of b
eing
ov
erw
eigh
t or
obes
e to
the
NH
S w
ill ris
e to
£8.
3 b
illio
n, w
ith th
e w
ider
cos
t to
soci
ety
of £
37.2
b
illio
n. B
y 20
50, t
he N
HS
cos
ts c
ould
ris
e to
£9
.7 b
illio
n, w
ith th
e w
ider
cos
t to
soci
ety
bein
g in
crea
sing
to n
early
£50
bill
ion
(at t
oday
’s p
rices
).
4. T
he p
atte
rn o
f chi
ldho
od o
verw
eigh
t and
obe
sity
in
Mer
ton
Mer
ton’
s po
siti
on in
Lon
don
In L
ondo
n, fo
r R
ecep
tion
year
, Mer
ton
had
the
fifth
lo
wes
t pre
vale
nce
of e
xces
s w
eigh
t (ov
erw
eigh
t and
ob
esity
) for
201
5/16
(out
of 3
2 bo
roug
hs).
How
ever
fo
r Ye
ar 6
, Mer
ton’
s hi
gher
pre
vale
nce
of e
xces
s w
eigh
t mov
es o
ur p
ositi
on in
to th
e ni
nth
low
est o
ut o
f 32
bor
ough
s.
Lond
on’s
pre
vale
nce
of e
xces
s w
eigh
t is
sim
ilar
to E
ngla
nd fo
r R
ecep
tion,
how
ever
, Yea
r 6
exce
ss
wei
ght i
n Lo
ndon
is h
ighe
r th
an E
ngla
nd. T
he to
p 3
Lond
on b
orou
ghs
for
exce
ss w
eigh
t at R
ecep
tion
are
Gre
enw
ich,
Bex
ley
and
Bar
king
and
Dag
enha
m.
For
Year
6, t
he to
p 3
boro
ughs
with
the
high
est
prev
alen
ce o
f exc
ess
wei
ght a
re B
arki
ng a
nd
Dag
enha
m, H
ackn
ey a
nd N
ewha
m.
Focu
s on
exc
ess
wei
ght (
BMI >
91s
t ce
ntile
)
Mer
ton’
s go
od r
anki
ng w
hen
com
pare
d to
Lon
don
can
mas
k th
e re
ality
that
the
num
bers
of c
hild
ren
with
ex
cess
wei
ght a
re s
ubst
antia
l.
Ove
rall,
ther
e ar
e ov
er 4
,500
prim
ary
scho
olch
ildre
n,
betw
een
4 an
d 11
yea
rs o
ld in
Mer
ton
that
are
es
timat
ed to
hav
e ex
cess
wei
ght –
equ
ival
ent t
o 15
0 pr
imar
y sc
hool
cla
sses
.
Nea
rly o
ne in
eve
ry fi
ve c
hild
ren
in M
erto
n en
terin
g R
ecep
tion
has
exce
ss w
eigh
t (18
.8%
) whi
ch is
low
er
than
Lon
don
(22%
) and
Eng
land
(22.
1%).
By
the
time
child
ren
leav
e pr
imar
y sc
hool
in Y
ear
6, th
e pr
opor
tion
of th
ose
who
hav
e ex
cess
wei
ght
incr
ease
s to
ove
r o
ne in
eve
ry t
hree
chi
ldre
n (3
4.7%
), w
hich
is s
imila
r to
Eng
land
(34.
2%) b
ut lo
wer
th
an L
ondo
n (3
8.1%
).
It is
impo
rtan
t to
unde
rsta
nd th
e pa
tter
n of
chi
ldho
od o
besi
ty lo
cally
to
supp
ort t
he d
evel
opm
ent o
f act
ions
and
inte
rven
tions
to re
duce
chi
ldho
od
obes
ity. T
he d
ata
belo
w fo
cuse
s on
the
Nat
iona
l Chi
ld M
easu
rem
ent
Pro
gram
me
(NC
MP
), w
hich
invo
lves
mea
surin
g th
e he
ight
and
wei
ght o
f ch
ildre
n in
Rec
eptio
n (4
-5 y
ear
olds
) and
Yea
r 6
(10-
11 y
ear
olds
) at s
tate
-m
aint
aine
d sc
hool
s, in
clud
ing
acad
emie
s.
Co
st t
o w
ider
ec
ono
my
£27b
nC
ost
to
NH
S
£6.1
bn
So
cial
car
e
£352
m
Ob
esit
y at
trib
uted
da
ys s
ickn
ess
16m
Ob
esit
y m
edic
atio
n
£13.
3m
Page 20
2021
Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
Tren
ds
in e
xces
s w
eig
ht (o
verw
eig
ht a
nd o
bes
e)
Ove
r the
pas
t eig
ht y
ears
ther
e ha
s be
en a
gen
eral
de
clin
e in
the
prop
ortio
n of
4-5
yea
r old
s th
at a
re o
f ex
cess
wei
ght a
nd in
10-
11 y
ear o
lds
the
sign
s ar
e th
at
the
leve
l of e
xces
s w
eigh
t is
also
beg
inni
ng to
dec
reas
e.
Ther
efor
e th
e ov
eral
l gai
n in
exc
ess
wei
ght b
etw
een
4-5
year
old
s an
d 10
-11
year
old
s in
Mer
ton
is s
low
ly
decr
easi
ng (c
ompa
red
to in
crea
ses
seen
in L
ondo
n an
d En
glan
d) a
nd is
cur
rent
ly 1
5.9%
(dow
n fro
m 1
6.6%
in
2014
/15)
. How
ever
, with
a g
row
ing
scho
ol p
opul
atio
n in
Mer
ton
the
actu
al n
umbe
r of c
hild
ren
iden
tified
with
ex
cess
wei
ght h
as s
tead
ily in
crea
sed.
Focu
s on
obe
sity
(BM
I ≥ 9
8th
cent
ile)
One
in e
very
13
(7.8
%) c
hild
ren
in M
erto
n en
terin
g R
ecep
tion
clas
s ar
e ob
ese.
By
the
time
child
ren
leav
e pr
imar
y sc
hool
in Y
ear
6, th
is in
crea
ses
to o
ne in
five
(1
9.9%
) chi
ldre
n.
Tren
ds
in o
bes
ity
Ove
r th
e pa
st s
ix y
ears
ther
e ha
s be
en a
gen
eral
de
clin
e in
4-5
yea
r ol
ds w
ho a
re o
bese
. How
ever
, th
ere
has
been
a s
light
incr
ease
in 1
0-11
yea
r ol
ds
who
are
obe
se. T
here
fore
the
over
all g
ain
in o
besi
ty
betw
een
4-5
year
old
s an
d 10
-11
year
old
s in
Mer
ton
is s
low
ly in
crea
sing
and
is c
urre
ntly
12.
1%.
Gap
in o
bes
ity
bet
wee
n ea
st a
nd w
est
Mer
ton
Ther
e ar
e m
arke
d ge
ogra
phic
al in
equa
litie
s w
ith a
hi
gher
pre
vale
nce
of o
besi
ty in
eas
t Mer
ton
(als
o se
e p.
14
geog
raph
ical
var
iatio
n of
exc
ess
wei
ght b
y w
ard)
:
Look
ing
ahea
d...
If w
e do
not
take
mor
e ac
tion
to ta
ckle
chi
ldho
od o
besi
ty a
nd th
e cu
rren
t tre
nds
cont
inue
:
Gra
ph
A: P
erce
ntag
e o
f ch
ildre
n in
Mer
ton
with
exc
ess
wei
ght
200
7/08
to
201
5/16
Gra
ph
B: T
rend
in o
bes
ity p
reva
lenc
e in
eas
t an
d w
est
Mer
ton
ove
r tim
e (R
ecep
tion
and
Yea
r 6)
Rec
epti
on
child
ren
One
in 1
0 ch
ildre
n ar
e ob
ese
in e
ast M
erto
n
One
in 2
0 ch
ildre
n ar
e ob
ese
in w
est M
erto
n
The
re is
a w
iden
ing
gap
in o
besi
ty b
etw
een
east
and
wes
t Mer
ton
as o
besi
ty is
incr
easi
ng
in th
e ea
st b
ut d
ecre
asin
g in
the
wes
t of t
he
boro
ugh
over
tim
e (s
ee g
raph
B).
The
gap
is
curr
ently
6.2
%.
Year
6 c
hild
ren
One
in f
our
chi
ldre
n ar
e ob
ese
in e
ast M
erto
n
One
in s
ix c
hild
ren
are
obes
e in
wes
t Mer
ton
The
re is
a w
iden
ing
gap
in o
besi
ty b
etw
een
east
an
d w
est M
erto
n as
obe
sity
is in
crea
sing
in th
e ea
st b
ut d
ecre
asin
g in
the
wes
t of t
he b
orou
gh
over
tim
e (s
ee g
raph
B).
The
gap
is c
urre
ntly
9.2
%.
The
ineq
ualit
ies
gap
in o
besi
ty
betw
een
the
east
and
wes
t of t
he
boro
ugh
in R
ecep
tion
will
incr
ease
from
6.
2% to
10.
7% –
that
’s a
n ad
ditio
nal 4
30
mor
e ob
ese
child
ren
in e
ast M
erto
n.
The
ineq
ualit
ies
gap
bet
wee
n ea
st a
nd
wes
t in
Year
6 w
ill in
crea
se fr
om 7
.8%
to
10.
3% –
that
’s a
n ad
ditio
nal 5
80 m
ore
obes
e ch
ildre
n in
eas
t Mer
ton.
Ther
e w
ill be
an
ove
rall
gai
n ac
ross
M
erto
n in
the
num
ber
of R
ecep
tion
and
Year
6 c
hild
ren
who
are
ov
erw
eigh
t or
obes
e (e
xces
s w
eigh
t) as
sho
wn
in g
raph
C o
verle
af.
By 2
018.
..By
202
1...
2016
2017
2018
2019
2020
2021
Percentage (%)
25 20 1015 5 008
/09-
10/1
109
/10-
11/1
210
/11-
12/1
311
/12-
13/1
412
/13-
14/1
5Year
6 –
Eas
t Mer
ton
Year
6 –
Wes
t Mer
ton
9.2%
Gap
Rece
ptio
n –
East
Mer
ton
Rece
ptio
n –
Wes
t Mer
ton
6.2%
Gap
Percentage (%)
40 36 32 28 24 20 16 12 8 4 020
07/0
820
08/0
920
09/1
020
10/1
120
11/1
220
12/1
320
13/1
420
14/1
520
15/1
6
4-5
year
old
s10
-11
year
old
s
15.9
%
Year
6
Rec
eptio
nR
ecep
tion
Page 21
2223
Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
Gra
ph
C: C
urre
nt a
nd p
roje
cted
tre
nds
in n
umb
er o
f ch
ildre
n w
ith e
xces
s w
eig
ht in
R
ecep
tion
and
Yea
r 6
The
proj
ecte
d in
crea
sing
num
bers
sho
w th
at b
y 20
21
in R
ecep
tion
and
Year
6 a
lone
the
num
ber
of c
hild
ren
with
exc
ess
wei
ght w
ill ha
ve in
crea
sed,
with
:
90
mo
re R
ecep
tio
n ch
ildre
n w
ho h
ave
exce
ss
wei
ght t
han
in 2
015/
16 –
equ
ival
ent t
o 3
mor
e sc
hool
cla
sses
.
60
mo
re Y
ear
6 ch
ildre
n w
ho h
ave
exce
ss
wei
ght t
han
in 2
015/
16 –
equ
ival
ent t
o 2
mor
e sc
hool
cla
sses
.
Thes
e in
crea
sing
num
bers
wou
ld b
e re
plic
ated
in
the
othe
r sc
hool
yea
r gr
oups
, the
refo
re a
hig
her
num
ber
of c
hild
ren
are
expe
cted
to b
e ov
erw
eigh
t or
obes
e ac
ross
the
boro
ugh.
Geog
raph
ical
Sch
ool c
lust
ers
Prim
ary
scho
ols
in M
erto
n ar
e gr
oupe
d in
to
geog
raph
ical
are
as k
now
n as
sch
ool c
lust
ers.
The
fo
llow
ing
prov
ides
an
anal
ysis
of N
CM
P d
ata
by th
ese
scho
ol c
lust
ers:
Exc
ess
wei
ght
in o
ur s
cho
ol c
lust
ers
At R
ecep
tion,
mor
e th
an a
fifth
of p
upils
from
sc
hool
s in
the
Mitc
ham
Tow
n an
d E
ast M
itcha
m
clus
ters
hav
e ex
cess
wei
ght c
ompa
red
to o
ne in
te
n ch
ildre
n in
Wes
t Wim
bled
on
In
Year
6, o
ver
four
in 1
0 ch
ildre
n in
sch
ools
in
Mitc
ham
Tow
n an
d E
ast M
itcha
m c
lust
ers
have
ex
cess
wei
ght c
ompa
red
to th
ree
in 1
0 pu
pils
in
Wes
t Wim
bled
on c
lust
er
The
re a
re a
num
ber
of p
rimar
y sc
hool
s in
Mer
ton
whe
re o
ver
50%
of p
upils
in Y
ear
6 ha
ve e
xces
s w
eigh
t.
Gra
ph
D: P
rop
ort
ion
of
pup
ils w
ith e
xces
s w
eig
ht, h
ealth
y w
eig
ht a
nd u
nder
wei
ght
in
Mer
ton
geo
gra
phi
cal s
cho
ol c
lust
ers
Percentage (%)800
700
500
300
600
400
200
100 0
2007
/8
2008
/9 2009
/10
2010
/11
2011
/12
2012
/13
2013
/14
2014
/15
2015
/16
2016
/17
2017
/18
2018
/19
2019
/20
2020
/21
By
2021
...
expe
cted
exc
ess
wei
ght n
umbe
rs
Cur
rent
tren
dPr
ojec
ted
trend
690
child
ren
510
child
ren
Year
6
Rec
eptio
n
Proportion of pupils with a valid BMI100% 90%
70%
80%
50%
30%
60%
40%
20%
10%
Unde
rwei
ght
0
Mitcham Town
East Mitcham
Morden
Central Wimbledon
West Wimbledon
Mitcham Town
East Mitcham
Morden
Central Wimbledon
West Wimbledon
Year
6R
ecep
tion
23%
75%
2%2%
2%1%
1%
75%
75%
83%
86%
56%
56%
65%
68%
68%
23%
23%
16%
12%
42%
42%
34%
30%
29%
1%2%
1%2%
3%
Hea
lthy
wei
ght
Exce
ss w
eigh
t
Sou
rce:
Nat
iona
l Chi
ld M
easu
rem
ent P
rogr
amm
e (N
CM
P),
Hea
lth &
Soc
ial C
are
Info
rmat
ion
Cen
tre
(HS
CIC
)
Page 22
2425
Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
Child
ren
and
youn
g pe
ople
’s b
ehav
iour
s an
d pe
rcep
tion
s
Per
cep
tions
on
wei
ght
/bo
dy
size
(12-
18 y
ear
old
s)Th
ere
are
high
leve
ls o
f con
cern
abo
ut b
ody
size
am
ong
youn
g pe
ople
in th
e U
K. I
n a
larg
e st
udy
of 1
5-17
-yea
r-ol
ds, o
besi
ty w
as a
ssoc
iate
d w
ith
depr
essi
on a
nd fe
elin
gs o
f sha
me.
Con
cern
s ar
ound
he
avie
r w
eigh
t or
a la
rger
bod
y si
ze s
tem
from
mor
e so
cial
rat
her
than
hea
lth re
late
d re
ason
s, fo
r ex
ampl
e,
nega
tive
impa
ct o
n so
cial
act
iviti
es, h
avin
g fe
wer
fri
ends
, not
bei
ng a
ttra
ctiv
e to
oth
ers,
and
bei
ng
unab
le to
find
fash
iona
ble
clot
hes
to w
ear.
Find
ings
su
gges
t tha
t you
ng w
omen
mig
ht n
ot a
lway
s be
m
ore
conc
erne
d ab
out t
heir
own
size
than
you
ng
men
. The
re a
re p
ress
ures
for
girls
to b
e ‘s
lim’ o
r ‘s
kinn
y’ a
nd fo
r bo
ys to
be
mor
e m
uscu
lar.
Ove
rwei
ght y
oung
peo
ple
repo
rt a
num
ber o
f bar
riers
in
thei
r way
of s
ucce
ss in
losi
ng w
eigh
t. Th
ey d
escr
ibe
stig
ma
and
abus
e w
hile
exe
rcis
ing
or a
ttem
ptin
g to
ea
t hea
lthily
, unh
elpf
ul fo
od e
nviro
nmen
ts a
t hom
e an
d un
help
ful a
dvic
e an
d cr
itici
sm fr
om o
ther
s. A
s a
resu
lt, y
oung
peo
ple
ofte
n w
ithdr
aw fr
om s
ocia
lisin
g,
avoi
d sc
hool
-bas
ed p
hysi
cal a
ctiv
ity a
nd e
at fo
r co
mfo
rt. G
ood
men
tal h
ealth
is s
een
as k
ey fo
r su
bsta
ntia
l wei
ght-
loss
and
hav
ing
take
n ac
tive
step
s to
redu
ce w
eigh
t can
be
a so
urce
of c
onsi
dera
ble
prid
e, e
spec
ially
whe
n su
cces
sful
.
Whe
n as
ked
wha
t w
oul
d h
elp
the
m, y
oun
g
peo
ple
sai
d…
Youn
g p
eop
le t
end
ed t
o em
pha
sise
thi
ngs
that
th
ey,
or o
ther
ove
rwei
ght
youn
g p
eop
le s
houl
d d
o to
hel
p t
hem
selv
es,
such
as
eatin
g he
alth
ily
and
exe
rcis
ing,
lear
ning
mor
e ab
out
nutr
ition
and
ac
cess
ing
thei
r ow
n p
sych
olog
ical
res
ourc
es.
Ther
e w
as le
ss m
entio
ned
abou
t the
wid
er p
hysi
cal
and
food
env
ironm
ents
that
impa
ct o
n th
eir
food
ch
oice
s an
d ph
ysic
al a
ctiv
ity le
vels
. Thi
s m
ay b
e du
e to
lack
of a
war
enes
s ab
out h
ow th
e w
ider
en
viro
nmen
t is
impa
ctin
g on
thei
r w
eigh
t.
Adu
lts’
beh
avio
urs
and
perc
epti
ons
Mos
t adu
lts h
ave
an u
nder
stan
ding
of t
he d
iffer
ent
com
pone
nts
of a
hea
lthy
diet
, for
exa
mpl
e, e
atin
g fiv
e po
rtio
ns o
f fru
it an
d ve
geta
bles
eac
h da
y an
d re
duci
ng th
eir
salt
and
fat i
ntak
e. T
hey
cons
ider
he
alth
y ea
ting
to b
e im
port
ant a
nd w
ould
like
to m
ake
impr
ovem
ents
to th
eir
own
diet
s. H
owev
er, p
erce
ived
ba
rrie
rs to
mak
ing
impr
ovem
ents
to d
iet i
nclu
de: l
ack
of ti
me
and
the
cost
of h
ealth
y fo
ods.
For
thos
e in
lo
wer
inco
me
hous
ehol
ds, a
fford
abilit
y w
as c
ited
as a
si
gnifi
cant
bar
rier
to e
atin
g m
ore
heal
thy
food
s.
Mos
t adu
lts a
re a
war
e th
at p
hysi
cal a
ctiv
ity
reco
mm
enda
tions
exi
st, b
ut fe
w k
now
wha
t the
y ar
e an
d co
nsid
er th
e m
ain
barr
iers
to b
e tim
e pr
essu
res
and
lack
of m
otiv
atio
n to
be
phys
ical
ly a
ctiv
e.
Not
all
pare
nts
perc
eive
they
hav
e th
e sa
me
degr
ee
of c
ontr
ol o
ver
thei
r ch
ild’s
die
tary
beh
avio
ur. F
igur
e D
illu
stra
tes
fact
ors
that
influ
ence
par
enta
l per
cept
ions
of
a c
hild
’s d
ieta
ry b
ehav
iour
s an
d ho
w th
is s
hape
s th
e qu
ality
of a
chi
ld’s
die
t.
5. W
hat d
o ch
ildre
n, y
oung
peo
ple,
fam
ilies
and
co
mm
unit
ies
thin
k?U
nder
stan
ding
kno
wle
dge
and
attit
udes
tow
ards
wei
ght,
diet
and
phy
sica
l ac
tivity
is im
port
ant i
n pr
ovid
ing
an in
sigh
t int
o fa
ctor
s th
at m
ay m
otiv
ate
and
enab
le c
hang
e. T
his
sect
ion
iden
tifies
insi
ghts
from
stu
dies
that
hel
p un
ders
tand
the
pers
pect
ives
of c
hild
ren,
you
ng p
eopl
e an
d ad
ults
.
Fig
ure
D: I
nflue
nces
on
par
enta
l per
cep
tions
on
the
qua
lity
of
child
ren’
s d
iet
We
may
no
t se
e o
urse
lves
or
our
chi
ldre
n as
ob
ese.
..
Rec
ogni
sing
obe
sity
and
ove
rwei
ght
Man
y pe
ople
may
not
reco
gnis
e a
child
is o
verw
eigh
t or
obe
se a
s so
ciet
y’s
unde
rsta
ndin
g of
wha
t is
a he
alth
y bo
dy s
ize
and
shap
e ha
s sh
ifted
as
mor
e pe
ople
(adu
lts a
nd c
hild
ren)
bec
ome
over
wei
ght o
r ob
ese.
In s
ome
cultu
res
havi
ng a
larg
er b
ody
size
m
ay b
e se
en a
s an
indi
catio
n of
wea
lth a
nd h
igh
stat
us. T
he m
edia
has
con
trib
uted
to p
eopl
e ha
ving
a
dist
orte
d pe
rcep
tion
of o
besi
ty a
s th
ey te
nd to
use
pict
ures
of e
xtre
mel
y ob
ese
peop
le w
hen
illust
ratin
g st
orie
s ab
out t
he d
ange
rs o
f bei
ng o
verw
eigh
t or
obe
se. T
here
fore
, effo
rts
to ta
ckle
obe
sity
and
ov
erw
eigh
t are
like
ly to
be
ham
pere
d by
a la
ck o
f re
cogn
ition
of w
hat a
hea
lthy
wei
ght l
ooks
like
. We
need
to lo
ok a
t how
we
can
rais
e aw
aren
ess,
pro
mot
e re
cogn
ition
and
und
erst
andi
ng o
f a h
ealth
y w
eigh
t.
Adu
lts te
nd to
und
eres
timat
e th
eir
own
wei
ght
Hal
f of p
aren
ts d
o no
t re
cogn
ise
thei
r ch
ildre
n ar
e ov
erw
eigh
t or
obes
e
The
med
ia te
nd to
use
im
ages
of e
xtre
me
obes
ity
to il
lust
rate
art
icle
s ab
out
obes
ity
GP
s m
ay u
nder
estim
ate
thei
r pa
tient
s’ B
MI
If w
e d
o n
ot
reco
gni
se
ob
esit
y w
e ar
e le
ss li
kely
to
p
rio
riti
se t
ackl
ing
it
Par
enta
l p
erce
pti
ons
Chi
ld d
iet
qua
lity
Sch
oo
ls
Med
ia
Med
ia
Bio
log
ical
Bio
log
ical
So
cio
-ec
ono
mic
stat
us
Kno
wle
dg
e
Cul
ture
Cul
tura
l
Psy
cho
-so
cial
Foo
dav
aila
bili
ty
Beh
avio
urs
& a
ttit
udes
Beh
avio
urs
& a
ttit
udes
So
cial
pre
ssur
es
So
cial
pre
ssur
es
Page 23
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ual R
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Ann
ual R
epor
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he D
irect
or o
f Pub
lic H
ealth
201
6-17
Lond
oner
s’ p
erce
ptio
ns a
nd a
war
enes
s
The
Gre
at W
eigh
t Deb
ate
(GW
D) i
s a
Lond
on w
ide
initi
ativ
e to
sta
rt a
con
vers
atio
n w
ith L
ondo
ners
so
they
are
fully
eng
aged
in th
e ch
ange
s th
at n
eed
to b
e m
ade
acro
ss th
e ci
ty to
sup
port
redu
cing
ch
ildho
od o
besi
ty.
So
far
a pa
nel o
f Lon
done
rs h
ave
cont
ribut
ed to
th
e de
bate
and
this
has
hig
hlig
hted
that
Lon
done
rs
wer
e le
ss a
war
e of
the
scal
e of
chi
ldho
od o
besi
ty
for
the
coun
try
and
did
not i
dent
ify it
as
a pa
rtic
ular
ch
alle
nge
for
Lond
on. W
hen
pres
ente
d w
ith th
e da
ta, p
eopl
e w
ere
amaz
ed th
at th
ere
is n
ot m
ore
awar
enes
s of
this
issu
e.
Cha
lleng
es o
f liv
ing
in L
ond
on
The
pace
of l
ife w
as id
entifi
ed a
s a
part
icul
ar
chal
leng
e fo
r he
alth
whi
ch re
sults
in le
ss ti
me
for
hom
e co
okin
g, le
ss ti
me
for
exer
cise
and
fam
ily
activ
ities
and
less
tim
e to
thin
k ab
out h
ealth
. Lon
don
can
be a
diffi
cult
plac
e fo
r ch
ildre
n to
be
activ
e an
d so
me
pare
nts
are
conc
erne
d ab
out w
heth
er it
is
safe
to a
llow
chi
ldre
n to
wal
k or
cyc
le to
sch
ool.
Res
pond
ents
iden
tified
fact
ors
such
as
over
crow
ding
, po
llutio
n, lo
ng w
orki
ng h
ours
, com
mut
ing
and
the
cost
of h
ealth
y fo
od a
nd e
xerc
ise
as re
ason
s be
hind
Lo
ndon
bei
ng a
diffi
cult
city
in w
hich
to b
e he
alth
y as
w
ell a
s a
stre
ssfu
l pla
ce to
live
.
Con
stan
t ava
ilabi
lity
of u
nhea
lthy
food
s w
as fe
lt to
po
se a
maj
or c
halle
nge.
Avo
idin
g un
heal
thy
food
w
as fe
lt to
be
part
icul
arly
diffi
cult
for
child
ren
and
youn
g pe
ople
as
they
wer
e be
ing
targ
eted
thro
ugh
fast
food
out
lets
clu
ster
ing
arou
nd s
choo
ls. F
ast f
ood
outle
ts a
re s
een
by c
hild
ren
and
youn
g pe
ople
as
an
impo
rtan
t and
affo
rdab
le s
ocia
l hub
.
Wha
t Mer
ton
resi
dent
s sa
y
Find
ings
from
insi
ght r
esea
rch
on a
war
enes
s an
d at
titud
es to
war
ds h
ealth
y ea
ting
(par
ents
and
car
ers
of c
hild
ren
aged
five
or
unde
r) hi
ghlig
hted
: B
arri
ers
to h
ealt
hy e
atin
g…
Lac
k of
kno
wle
dge,
und
erst
andi
ng a
nd c
onfid
ence
by
par
ents
aro
und
cook
ing
and
heal
thy
eatin
g gu
idel
ines
was
iden
tified
, for
exa
mpl
e, u
nder
stan
ding
fo
od la
bellin
g, c
onfid
ence
in c
ooki
ng fr
esh
heal
thy
food
s, a
nd c
onfu
sion
ove
r po
rtio
n si
zes.
Cos
t of h
ealth
y fo
od a
nd a
lack
of t
ime
to p
repa
re
it m
ake
it m
ore
diffi
cult
to e
at h
ealth
ily.
Whe
n as
ked
wha
t w
oul
d h
elp
the
m, M
erto
n p
aren
ts s
aid
…P
aren
ts a
nd c
arer
s ar
e pr
epar
ed to
mak
e ch
ange
s fo
r th
eir
child
ren.
How
ever
, som
e he
alth
y be
havi
ours
feel
lik
e th
ey w
ould
be
hard
wor
k an
d pa
rent
s an
d ca
rers
w
ould
like
it to
be
mad
e ea
sier
for
them
to m
ake
chan
ges.
The
y w
ant i
nfor
mat
ion
and
supp
ort b
ut th
is
need
s to
be
rele
vant
, con
cise
and
eas
y to
find
. The
y w
ould
like
to k
now
abo
ut th
e im
med
iate
ben
efits
and
ta
ngib
le re
war
ds o
f mak
ing
chan
ges.
The
y w
ould
like
pr
actic
al to
ols
to u
se fo
r da
ily li
ving
to m
ake
chan
ges.
Furt
her
conv
ersa
tio
ns w
ith
Mer
ton’
s re
sid
ents
The
sec
ond
phas
e of
the
Gre
at W
eigh
t Deb
ate
invo
lved
a p
an L
ondo
n su
rvey
to s
tart
con
vers
atio
ns
with
resi
dent
s. M
erto
n ha
d th
e hi
ghes
t num
ber
of
resp
onse
s of
any
Lon
don
boro
ugh
and
the
resu
lts
will
info
rm M
erto
n’s
child
hea
lthy
wei
ght a
ctio
n pl
an.
Add
ition
ally,
furt
her w
ork
is p
lann
ed to
com
mun
icat
e an
d en
gage
with
you
ng p
eopl
e an
d ad
ults
to
rais
e aw
aren
ess,
gal
vani
se a
ctio
n an
d ga
ther
id
eas
for
how
Mer
ton
can
best
sup
port
chi
ldre
n,
youn
g pe
ople
and
fam
ilies
to m
aint
ain
or a
chie
ve
a he
alth
y w
eigh
t. W
e w
ill pr
iorit
ise
enga
ging
with
B
AM
E g
roup
s an
d re
side
nts
livin
g in
the
east
of
the
boro
ugh
whe
re th
e ris
k of
obe
sity
is h
ighe
r.
“[Yo
ung
peop
le] g
o an
d ha
ng o
ut in
the
chic
ken
shop
s. It
’s a
big
par
t of t
he
cult
ure.”
“My
daug
hter
had
to c
hang
e sc
hool
s sh
e w
as g
etti
ng b
ullie
d so
muc
h. A
PE
teac
her o
nce
told
her
it w
as h
er o
wn
faul
t for
eat
ing
so m
any
burg
ers.”
“Som
etim
es y
ou ju
st d
on’t
have
tim
e to
coo
k –
it’s
eas
ier j
ust t
o ge
t ata
keaw
ay o
r sti
ck s
omet
hing
in th
e ov
en.”
“How
muc
h sh
ould
my
two–
year
-old
be
eat
ing,
how
muc
h sh
ould
my
six
year
old
be
eati
ng?
They
wou
ldn’
t hav
e th
e sa
me
as I
have
, but
I’m
sti
ll no
t su
re h
ow m
uch
they
sho
uld
be e
atin
g.”
“It w
ould
be
real
ly h
elpf
ul to
kno
w
exac
tly
how
muc
h su
gar
and
salt
is
in th
ings
. The
cur
rent
info
rmat
ion
does
n’t m
ean
anyt
hing
. The
y ar
e hi
ding
info
rmat
ion.
”
“It’s
unb
elie
vabl
y ch
eap,
isn’
t it?
£1.
99
for a
chi
cken
bur
ger i
s w
ay c
heap
er
than
pay
ing
for f
ruit
and
veg
etab
les.”
Sti
gm
aP
erce
ptio
ns th
at c
hild
hood
obe
sity
is th
e re
sult
of la
x pa
rent
ing
and
a la
ck o
f sel
f-co
ntro
l mea
n th
at th
ere
is a
con
side
rabl
e st
igm
a at
tach
ed to
this
issu
e. T
he
wor
d ‘o
besi
ty’ p
uts
pare
nts
on th
e de
fens
ive,
and
m
akes
them
less
like
ly to
acc
ept t
hat t
heir
child
has
a
prob
lem
. Bec
ause
of t
he s
tigm
a ar
ound
obe
sity
, the
re
are
conc
erns
that
obe
se c
hild
ren
are
bein
g bu
llied
and
moc
ked.
Par
ents
feel
this
stig
ma
need
s to
be
addr
esse
d if
child
hood
obe
sity
is to
be
tack
led.
Page 24
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ual R
epor
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he D
irect
or o
f Pub
lic H
ealth
201
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Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
6. T
he N
eed
for a
Fre
sh A
ppro
ach
Chi
ldho
od o
besi
ty is
a c
ompl
ex p
robl
em a
nd th
ere
is n
o si
ngle
sol
utio
n.
The
evid
ence
is c
lear
that
a p
reve
ntat
ive,
who
le s
yste
ms
appr
oach
to
tack
ling
obes
ity is
nee
ded.
Thi
s ap
proa
ch re
cogn
ises
the
maj
or in
fluen
ce
of ‘p
lace
’ (w
here
we
live,
wor
k an
d pl
ay) o
n he
alth
and
wel
lbei
ng, a
s w
ell
as in
divi
dual
beh
avio
urs
and
choi
ces.
It in
volv
es ta
king
act
ion
at d
iffer
ent l
evel
s: a
t pop
ulat
ion,
co
mm
unity
and
indi
vidu
al le
vels
, in
orde
r to
max
imis
e op
port
uniti
es fo
r ch
ildre
n an
d fa
milie
s to
ado
pt a
nd
mai
ntai
n he
alth
y lif
esty
les
as p
art o
f dai
ly li
fe.
Po
pul
atio
n le
vel a
ctio
ns in
clud
e re
gula
tory
and
po
licy
mea
sure
s, s
uch
as th
e na
tiona
l sug
ar le
vy,
and
the
plan
ning
pro
cess
hel
ping
cre
ate
heal
thy
food
and
phy
sica
l env
ironm
ents
.
Co
mm
unit
y le
vel a
ctio
ns a
cros
s a
rang
e of
se
ttin
gs a
nd o
rgan
isat
ions
incl
ude
initi
ativ
es s
uch
as h
ealth
y sc
hool
s, h
ealth
y ca
terin
g an
d ac
tive
trav
el p
lans
cre
atin
g op
port
uniti
es fo
r he
alth
y ea
ting
and
phys
ical
act
ivity
.
Ind
ivid
ual l
evel
act
ions
incl
ude
supp
ort t
o fa
milie
s to
ach
ieve
and
mai
ntai
n a
heal
thy
wei
ght,
incl
udin
g ad
vice
and
sup
port
from
hea
lthca
re a
nd o
ther
pr
ofes
sion
als
and
on-li
ne d
igita
l too
ls.
Evid
ence
tells
us
that
pop
ulat
ion
wid
e ac
tions
acr
oss
aspe
cts
of th
e ph
ysic
al, f
ood
and
cultu
ral e
nviro
nmen
t ar
e m
ost l
ikel
y to
be
succ
essf
ul a
nd c
ost e
ffect
ive.
H
ealth
pro
mot
ing
envi
ronm
ents
, tha
t is,
thos
e w
here
the
heal
thie
r cho
ice
is b
oth
the
easi
er a
nd
pref
erre
d ch
oice
, are
als
o m
ore
econ
omic
ally
and
en
viro
nmen
tally
sus
tain
able
.
Focu
sing
on
prev
entio
n ea
rlier
in li
fe w
ill ac
cum
ulat
e gr
eate
r ben
efits
and
is m
ore
acce
ptab
le a
nd m
ore
cost
effe
ctiv
e. E
arly
yea
rs s
ervi
ces
have
an
impo
rtan
t rol
e to
pl
ay in
pro
mot
ing
heal
thy
choi
ces
and
supp
ortin
g m
ore
vuln
erab
le fa
milie
s. M
axim
isin
g th
e ro
le o
f sch
ools
an
d de
velo
ping
cle
ar p
athw
ays
and
supp
ort f
or h
ealth
an
d ot
her
prof
essi
onal
s w
orki
ng w
ith p
aren
ts/c
arer
s,
child
ren
and
youn
g pe
ople
is im
port
ant.
A w
hole
sys
tem
s ap
proa
ch is
the
mos
t effe
ctiv
e fo
r ac
hiev
ing
chan
ge a
t a la
rge
scal
e ne
cess
ary
to
addr
ess
child
hood
obe
sity
. Bui
ldin
g on
the
good
wor
k al
read
y ta
king
pla
ce in
Mer
ton,
we
need
to c
o-pr
oduc
e a
shar
ed a
ppro
ach
with
peo
ple
who
live
in th
e bo
roug
h an
d ac
ross
org
anis
atio
ns in
the
volu
ntar
y, c
omm
unity
an
d pu
blic
sec
tors
, and
with
bus
ines
s pa
rtne
rs.
This
will
enab
le u
s to
resp
ond
to th
e ch
alle
nge
of
child
hood
obe
sity
thro
ugh
solu
tions
that
are
effe
ctiv
e an
d su
stai
nabl
e.
Act
ion
to ta
ckle
chi
ldho
od o
besi
ty s
houl
d be
info
rmed
by
evi
denc
e of
effe
ctiv
enes
s an
d co
st e
ffect
iven
ess
whe
re a
vaila
ble.
Nat
iona
lly, P
ublic
Hea
lth E
ngla
nd
have
revi
ewed
evi
denc
e an
d us
ed th
is to
adv
ise
on
the
deve
lopm
ent o
f the
nat
iona
l chi
ldho
od o
besi
ty
plan
(see
bel
ow) a
nd p
rovi
de s
uppo
rt to
loca
l are
as.
The
Wor
ld H
ealth
Org
anis
atio
ns’ (
WH
O) r
epor
t on
‘The
C
ase
for I
nves
ting
in P
ublic
Hea
lth’ h
ighl
ight
that
ther
e is
a s
trong
eco
nom
ic c
ase
for p
reve
ntat
ive
solu
tions
. P
reve
ntio
n is
cos
t-ef
fect
ive,
pro
vide
s va
lue
for m
oney
an
d gi
ves
retu
rn o
n in
vest
men
t in
both
the
shor
t and
lo
nger
term
.
Fig
ure
E: H
ow
par
tner
s co
ntri
but
e to
a w
hole
sys
tem
ap
pro
ach
to t
ackl
ing
ob
esity
Com
mis
sion
ers
Long
ter
m v
isio
nP
lann
ing
&
envi
ronm
ent
Des
ign
for
activ
ity
and
hea
lthy
food
Leis
ure/
fit
ness
p
rovi
der
sA
cces
sib
le,
affo
rdab
le Tran
spo
rtW
alki
ng a
nd
cycl
ing,
net
wor
ks,
activ
e tr
avel
So
cial
car
eP
reve
ntio
n,
trea
tmen
t, a
dvi
ce
and
car
e
Par
ks a
nd
gre
en s
pac
esLo
cally
acc
essi
ble
, sa
fe
Ed
ucat
ion
&
Lear
ning
A h
ealth
y le
arni
ng
envi
ronm
ent
Ho
usin
gA
pp
rop
riate
ho
usin
g
Thi
rd s
ecto
rA
ctiv
ity a
nd fo
od
rela
ted
Ele
cted
M
emb
ers
Dire
ct, o
vers
ee,
scru
tinis
e
Loca
l au
tho
riti
esC
o-or
din
ate
Pub
lic h
ealt
hA
naly
se, e
vid
ence
b
ase,
com
mis
sion
Hea
lth &
W
ellb
eing
Boa
rdFo
rmal
par
tner
ship
re
spon
sib
ilitie
sCC
GC
omm
issi
on fo
r he
alth
Pri
mar
y ca
reId
entif
y, a
dvi
se,
refe
r, tr
eat
Sou
rce:
PH
E
Ret
urn
on
inve
stm
ent
exam
ple
s fr
om
the
UK
in
clud
e:
Stu
dies
hav
e de
mon
stra
ted
that
the
retu
rn
on in
vest
men
t for
ena
blin
g on
e m
ore
child
to
wal
k o
r cy
cle
to s
cho
ol c
ould
be
as m
uch
as
£768
for
wal
king
and
£53
9 fo
r cy
clin
g in
hea
lth
bene
fits,
NH
S c
osts
, pro
duct
ivity
gai
ns a
nd
redu
ctio
n in
air
pollu
tion
and
cong
estio
n.
C
omm
unity
Wal
king
gro
ups
have
bee
n es
timat
ed
to re
turn
£3
for e
very
£1
inve
sted
ove
r 2 y
ears
.
Lo
cal a
utho
rity
inve
stin
g an
ext
ra £
71,0
00 o
n he
alth
y, u
npro
cess
ed, l
ocal
ly s
ourc
ed s
choo
l m
eals
(com
pare
d w
ith ‘n
orm
al’ s
choo
l mea
ls),
was
est
imat
ed to
cre
ate
over
£50
0,00
0 of
ec
onom
ic, s
ocia
l and
env
ironm
enta
l ben
efit.
Lei
sure
ser
vice
s: F
or e
very
£1
spen
t on
free
leis
ure
serv
ices
for
resi
dent
s av
aila
ble
at
cert
ain
times
, £21
.30
was
est
imat
ed to
hav
e be
en re
coup
ed in
hea
lth b
enefi
ts in
clud
ing
an
incr
ease
in p
artic
ipat
ion
rate
s.
Ther
e is
als
o gr
owin
g ev
iden
ce o
n th
e re
turn
on
inve
stm
ent o
f loc
al s
olut
ions
to ta
ckle
chi
ldho
od
obes
ity.
WH
O c
ost
-eff
ecti
ve in
terv
enti
ons
:
Red
uce
salt
in fo
ods
Pro
mot
e he
alth
y di
ets
and
phys
ical
act
ivity
Res
tric
t mar
ketin
g of
unh
ealth
y fo
od a
nd
beve
rage
s to
chi
ldre
n
Rep
lace
tran
s fa
t and
sat
urat
ed fa
t with
po
lyun
satu
rate
d or
uns
atur
ated
fat
Sup
port
act
ive
tran
spor
t str
ateg
ies
Pro
mot
ing
safe
gre
en s
pace
s
Offe
r co
unse
lling
in p
rimar
y ca
re o
n un
heal
thy
diet
and
phy
sica
l ina
ctiv
ity
Pro
mot
e he
alth
y di
ets
and
phys
ical
act
ivity
in
wor
kpla
ces
and
scho
ols
Page 25
3031
Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
The
Nat
iona
l Chi
ldho
od O
besi
ty
Plan
201
6
The
Nat
iona
l Chi
ldho
od O
besi
ty P
lan
aim
s to
redu
ce
Eng
land
’s r
ate
of c
hild
hood
obe
sity
with
in th
e ne
xt
deca
de, a
nd s
tate
s it
will
do th
is w
hile
resp
ectin
g co
nsum
er c
hoic
e an
d ec
onom
ic re
aliti
es. A
lthou
gh
mor
e lim
ited
in s
cope
than
exp
ecte
d, th
e na
tiona
l pl
an w
ill su
ppor
t loc
al b
orou
gh a
ppro
ache
s to
ta
cklin
g ch
ildho
od o
besi
ty b
y ta
king
act
ions
that
can
on
ly b
e dr
iven
at a
nat
iona
l lev
el s
uch
as in
fluen
cing
legi
slat
ion.
For
exa
mpl
e, w
e kn
ow th
at te
enag
ers
in E
ngla
nd a
re th
e bi
gges
t con
sum
ers
of s
ugar
-sw
eete
ned
drin
ks in
Eur
ope,
ther
efor
e in
trod
ucin
g a
soft
drin
ks in
dust
ry le
vy a
nd s
ettin
g ta
rget
s to
redu
ce
the
amou
nt o
f sug
ar in
food
and
drin
k pr
oduc
ts b
y 20
% w
ill m
ake
a po
sitiv
e di
ffere
nce.
We
mus
t mak
e su
re th
at w
e ge
t max
imum
loca
l ben
efits
from
the
polic
ies
and
initi
ativ
es s
et o
ut in
the
natio
nal p
lan.
Exam
ples
of g
ood
prac
tice
, opp
ortu
niti
es a
nd e
mer
ging
sol
utio
ns
Exa
mpl
es o
f goo
d pr
actic
e, o
ppor
tuni
ties
and
emer
ging
sol
utio
ns th
at c
an s
uppo
rt ta
cklin
g ch
ildho
od o
besi
ty
loca
lly in
clud
e:
Com
mun
icat
ion
and
enga
gem
ent
Pro
mot
ing
nati
onal
reso
urce
s su
ch a
s St
art
4 Li
fe, C
hang
e 4
Life
, 5 a
day
, Sug
ar S
wap
s
Com
mun
ity
cham
pion
s
You
th P
arlia
men
t, Sc
hool
Cou
ncil
You
th in
spec
tors
/ hea
lth
cham
pion
s
Com
mun
ity
and
Vol
unta
ry o
rgan
isat
ions
Loc
al re
sour
ces
and
onlin
e su
ppor
t
Phys
ical
env
iron
men
t
Cyc
le la
nes
and
segr
egat
ed c
ycle
rout
es
Enc
oura
ging
act
ive
trav
el
Spe
ed re
stri
ctio
ns a
nd tr
affic
cal
min
g to
im
prov
e sa
fety
Wid
ened
pav
emen
ts
Saf
e op
en g
reen
spa
ces
Wid
enin
g st
airw
ays,
nar
row
ing
esca
lato
rs
Sch
ool a
nd c
omm
unit
y cy
cle
trai
ning
Cyc
le p
arki
ng a
nd s
tora
ge fa
cilit
ies
Saf
e at
trac
tive
env
iron
men
ts
Gre
en G
yms
and
Leis
ure
faci
litie
s
Com
mun
ity
infr
astr
uctu
re le
vy m
onie
s fr
om n
ew d
evel
opm
ents
con
trib
utin
g to
im
prov
ing
loca
l com
mun
itie
s
Food
env
iron
men
t
Hea
lthi
er C
ater
ing
Com
mit
men
t
Sug
ar ta
x
Sal
t red
ucti
on
Sug
ar d
ecla
rati
on a
nd s
ugar
redu
ctio
n
Hea
lthy
ven
ding
mac
hine
ava
ilabi
lity
Bre
astf
eedi
ng a
nd b
aby
feed
ing
frie
ndly
sp
aces
Reg
ulat
ion
of fa
st fo
od o
utle
ts fo
r exa
mpl
e ta
cklin
g fa
st fo
od o
utle
ts n
ear s
choo
ls
Pro
mot
ion
of a
ffor
dabl
e fr
uit a
nd v
eget
able
s
Earl
y ye
ars,
sch
ool s
etti
ngs
and
path
way
s
Hea
lthy
Sch
ools
Lon
don
Spo
rt a
nd p
lay
in s
choo
l and
ear
ly y
ears
se
ttin
gs
Int
rodu
cing
the
‘Dai
ly m
ile’
Par
enti
ng p
rogr
amm
es
‘M
akin
g ev
ery
cont
act c
ount
’ for
hea
lth
and
othe
r pro
fess
iona
ls
Hea
lth
visi
ting
, sch
ool n
ursi
ng a
nd
child
ren’
s ce
ntre
ser
vice
s su
ppor
t
Sch
ool t
rave
l pla
ns
PH
SE a
nd c
urri
culu
m ti
me
on h
ealt
hy
eati
ng a
nd a
ctiv
ity
Hea
lthy
Ear
ly Y
ears
Lon
don
Hea
lthy
Sta
rt V
ouch
ers
Sch
ool m
eals
and
hea
lthy
pac
ked
lunc
hes
Com
mun
ity
and
scho
ol c
ooki
ng s
essi
ons
Com
mun
ity
and
scho
ol g
arde
ning
Bul
lyin
g pr
even
tion
/sel
f-es
teem
em
otio
nal
wel
lbei
ng
Fig
ure
F: K
ey a
ctio
ns f
rom
the
Nat
iona
l Chi
ldho
od
Ob
esity
Pla
n 20
16
1)
Intr
oduc
ing
a so
ft d
rink
s in
dust
ry le
vy
2)
Red
ucin
g su
gar i
n fo
od a
nd d
rink
pro
duct
s by
20%
3)
Supp
orti
ng in
nova
tion
to h
elp
busi
ness
es to
mak
e th
eir p
rodu
cts
heal
thie
r
4)
Upd
atin
g N
utri
ent p
rofil
e M
odel
refle
ctin
g la
test
gov
ernm
ent d
ieta
ry g
uide
lines
to s
uppo
rt li
mit
s on
ch
ildre
n’s
expo
sure
to a
dver
ts fo
r les
s he
alth
y fo
od a
nd d
rink
pro
duct
s.
5)
Mak
ing
heal
thy
opti
ons
avai
labl
e in
the
publ
ic s
ecto
r
6)
Cont
inui
ng to
pro
vide
sup
port
wit
h th
e co
st o
f hea
lthy
food
for t
hose
who
nee
d it
mos
t
7)
Hel
ping
all
child
ren
to e
njoy
an
hour
of p
hysi
cal a
ctiv
ity
ever
y da
y
8)
Impr
ovin
g th
e co
-ord
inat
ion
of q
ualit
y sp
ort a
nd p
hysi
cal a
ctiv
ity
prog
ram
mes
for s
choo
ls
9)
Crea
ting
a n
ew h
ealt
hy ra
ting
sch
eme
for p
rim
ary
scho
ols
10) M
akin
g sc
hool
food
hea
lthi
er
11) C
lear
er fo
od la
belli
ng
12) S
uppo
rtin
g ea
rly
year
s se
ttin
gs
13) H
arne
ssin
g th
e be
st n
ew te
chno
logy
14) E
nabl
ing
heal
th p
rofe
ssio
nals
to s
uppo
rt fa
mili
es
Page 26
3233
Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
7. M
erto
n’s
Call
to A
ctio
n on
Chi
ldho
od O
besi
ty
Dur
ing
the
last
yea
r w
e ha
ve b
een
wor
king
to d
evel
op o
ur w
hole
sys
tem
s ap
proa
ch to
tack
ing
child
hood
obe
sity
toge
ther
.
The
star
ting
poin
t was
taki
ng p
art i
n a
‘Chi
ldho
od
Obe
sity
Pee
r R
evie
w’ w
ith o
ther
bor
ough
s ac
ross
Lo
ndon
. Thi
s as
sess
ed o
ur p
rogr
ess
agai
nst a
n ev
iden
ce b
ased
fram
ewor
k on
wor
k to
tack
le
child
hood
obe
sity
loca
lly. I
t als
o pr
ovid
ed a
be
nchm
ark
for
Mer
ton’
s po
sitio
n ag
ains
t 13
key
area
s, h
ighl
ight
ing
area
s w
here
goo
d pr
ogre
ss h
ad
been
mad
e an
d ar
eas
requ
iring
furt
her
actio
n. T
he
diag
ram
bel
ow s
how
s M
erto
n’s
posi
tion
at th
e tim
e of
th
e re
view
in F
ebru
ary
2016
.
Mer
ton’
s ch
ild h
ealt
hy w
eigh
t act
ion
plan
for p
reve
ntin
g an
d re
duci
ng
child
hood
obe
sity
A p
artn
ersh
ip c
hild
hea
lthy
wei
ght a
ctio
n pl
an h
as
been
dev
elop
ed b
ased
on
the
findi
ngs
of th
e pe
er
revi
ew. T
he p
lan
prov
ides
a fr
amew
ork
for
enab
ling
diffe
rent
sta
keho
lder
s ac
ross
the
coun
cil (
incl
udin
g pu
blic
hea
lth, c
hild
ren’
s se
rvic
es, e
duca
tion,
en
viro
nmen
t and
tran
spor
t and
pla
nnin
g), N
HS
or
gani
satio
ns, s
choo
ls, c
omm
unity
and
vol
unta
ry
sect
or a
nd b
usin
ess
orga
nisa
tions
, to
wor
k w
ith o
ur
com
mun
ities
to ta
ckle
chi
ldho
od o
besi
ty to
geth
er.
The
actio
n pl
an is
spl
it in
to 4
key
are
as s
et o
ut b
elow
. Th
e fu
ll ac
tion
plan
is a
vaila
ble
on th
e fo
llow
ing
link:
xx
xxxx
xxxx
xxx.
com
Mer
ton
doin
g w
ell o
n: P
ublic
and
Com
mun
ity
sett
ing
Sch
ools
Mer
ton
is m
akin
g pr
ogre
ss o
n: P
hysi
cal e
nvir
onm
ent
Hea
lth
serv
ices
Jou
rney
s by
foot
or b
ike
Wor
kpla
ces
Eva
luat
ion
of p
rogr
amm
es a
nd in
itia
tive
s
Mer
ton
can
mak
e im
prov
emen
ts o
n: E
ngag
emen
t and
com
mit
men
t A
cces
sibi
lity
of h
ealt
hy fo
od B
reas
tfee
ding
and
wea
ning
Sup
port
ing
peop
le to
be
acti
ve K
now
ledg
e an
d aw
aren
ess
1. L
eade
rshi
p, c
omm
unic
atio
n an
d en
gage
men
t
Lea
ders
hip
– In
crea
se e
ngag
emen
t and
com
mit
men
t to
tack
ling
child
hood
obe
sity
am
ong
part
ners
in a
ll se
ctor
s, fo
r exa
mpl
e th
roug
h ad
opti
ng a
Hea
lth
in A
ll Po
licie
s ap
proa
ch.
Kno
wle
dge
and
awar
enes
s –
Impr
ove
child
ren
and
fam
ilies
’ und
erst
andi
ng o
f, an
d fe
elin
g of
con
trol
ove
r th
eir o
wn
heal
th a
nd w
ell-
bein
g.
Pro
mot
e th
e us
e of
dig
ital
tech
nolo
gy a
nd s
uppo
rt to
ols
- Im
prov
e ac
cess
to e
vide
nce
base
d ad
vice
and
in
form
atio
n to
sup
port
hea
lthi
er li
fest
yles
, for
exa
mpl
e St
art4
Life
, Cha
nge4
Life
and
NH
S G
o.
Eng
age
wit
h fa
mili
es, c
hild
ren
and
youn
g pe
ople
to p
rom
ote
heal
thy
eati
ng a
nd p
hysi
cal a
ctiv
ity
and
conv
ersa
tion
s on
obe
sity
and
hea
lthy
wei
ght.
Lis
ten
to re
side
nts
and
child
ren
and
youn
g pe
ople
incl
udin
g BA
ME
grou
ps a
nd re
side
nts
in e
ast M
erto
n, to
en
sure
act
ions
are
co-
prod
uced
and
mak
e a
posi
tive
impa
ct.
Ide
ntif
y op
port
unit
ies
to b
ring
in a
ddit
iona
l res
ourc
es to
sup
port
tack
ling
child
hood
obe
sity
in M
erto
n.
2. F
ood
envi
ronm
ent –
incr
easi
ng a
vaila
bilit
y of
hea
lthy
food
Inc
reas
e th
e re
ach
of M
erto
n Fo
od C
hart
er to
mai
ntai
n an
d gr
ow th
e lo
cal f
ood
part
ners
hip
and
roll
out t
he
Hea
lthy
Cat
erin
g Co
mm
itm
ent.
Inc
reas
e av
aila
bilit
y of
aff
orda
ble
heal
thie
r foo
d an
d dr
inks
in M
erto
n to
hel
p m
ake
the
heal
thie
r cho
ice
the
easi
er c
hoic
e.
Ens
ure
that
all
food
and
dri
nk a
vaila
ble
wit
hin
loca
l aut
hori
ty m
aint
aine
d es
tabl
ishm
ents
is in
line
wit
h re
leva
nt g
over
nmen
t sta
ndar
ds/g
uide
lines
for g
ood
nutr
itio
n.
Dev
elop
eff
ecti
ve w
ays
to m
onit
or a
nd re
duce
the
num
ber o
f foo
d ou
tlet
s se
lling
pre
dom
inat
ely
food
s hi
gh
in fa
t, sa
lt a
nd s
ugar
thro
ugh
part
ners
hip
betw
een
plan
ning
, reg
ulat
ory
serv
ices
, pub
lic h
ealt
h, s
choo
ls,
child
ren’
s ce
ntre
s an
d co
mm
unit
y ve
nues
.
3. P
hysi
cal e
nvir
onm
ent –
incr
easi
ng le
vels
of p
hysi
cal a
ctiv
ity
and
heal
th p
rom
otin
g ph
ysic
al
envi
ronm
ent
Inc
reas
e op
port
unit
ies
for a
ctiv
e tr
avel
and
phy
sica
l act
ivit
y th
roug
h th
e us
e of
exi
stin
g be
st p
ract
ice
and
guid
ance
.
Max
imis
e op
port
unit
ies
to p
rom
ote
phys
ical
act
ivit
y an
d so
cial
eng
agem
ent i
n es
tate
s re
gene
rati
on
incl
udin
g ac
cess
to a
ctiv
e tr
avel
opp
ortu
niti
es a
nd o
pen
spac
es.
Inc
reas
e nu
mbe
r of c
hild
ren
and
youn
g pe
ople
that
trav
el to
and
from
sch
ool o
n fo
ot a
nd o
n bi
ke.
Inc
reas
e th
e nu
mbe
r of c
hild
ren
and
youn
g pe
ople
, and
thei
r fam
ilies
, who
are
regu
lar u
sers
of p
arks
, ope
n sp
aces
, inf
orm
al re
crea
tion
spa
ce a
nd a
llotm
ents
.
Im
prov
e th
e sc
hool
spo
rt o
ffer
, to
ensu
re th
at c
hild
ren
and
youn
g pe
ople
are
ent
huse
d an
d ha
ve th
e re
sour
ces
to b
e ab
le to
lead
act
ive
lifes
tyle
s la
ter i
n lif
e.
Inc
reas
e up
take
of f
ood
grow
ing,
gar
deni
ng a
nd o
utdo
or a
ctiv
itie
s.
4. E
arly
yea
rs a
nd s
choo
l age
d se
ttin
gs a
nd p
athw
ays
Inc
reas
e th
e nu
mbe
r of b
abie
s th
at a
re b
reas
tfed
.
Sup
port
par
ents
and
car
ers
to e
stab
lish
a he
alth
y di
et fo
r the
ir c
hild
ren
from
a v
ery
earl
y ag
e th
roug
h Ch
ildre
n’s
Cent
res
and
othe
r Ear
ly Y
ears
ser
vice
s.
Max
imis
e th
e ro
le o
f sch
ools
as
sett
ings
pro
mot
ing
heal
thy
wei
ght,
for e
xam
ple
thro
ugh
prom
otio
n of
H
ealt
hy S
choo
ls L
ondo
n (H
SL) p
rogr
amm
e an
d sc
hool
s ac
hiev
ing
bron
ze, s
ilver
and
gol
d aw
ards
.
Ens
ure
the
deliv
ery
of th
e ne
w s
choo
ls m
eals
con
trac
t whi
ch a
chie
ves
the
requ
ired
nut
riti
on s
tand
ards
and
he
alth
y ch
oice
s.
Use
loca
l dat
a an
d in
telli
genc
e on
chi
ldho
od o
besi
ty to
info
rm s
ervi
ces
and
supp
ort t
o ch
ildre
n an
d fa
mili
es
iden
tifie
d as
obe
se to
hel
p th
em a
chie
ve a
nd m
aint
ain
a he
alth
y w
eigh
t.
Dev
elop
cle
ar p
athw
ays
for s
ervi
ce p
rovi
ders
and
sup
port
for p
rofe
ssio
nals
to m
ake
ever
y co
ntac
t cou
nt
and
feel
con
fiden
t abo
ut ta
lkin
g ab
out w
eigh
t and
sup
port
ing
and
sign
post
ing
fam
ilies
.
Page 27
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ual R
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lic H
ealth
201
6-17
Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
Hea
lthi
er C
ater
ing
Com
mit
men
t
The
Hea
lthie
r C
ater
ing
Com
mitm
ent i
s a
Lond
on w
ide
volu
ntar
y sc
hem
e ba
sed
on th
e pr
inci
ple
that
sm
all c
hang
es
can
mak
e a
big
diffe
renc
e.
It re
cogn
ises
thos
e fo
od
busi
ness
es th
at d
emon
stra
te
a co
mm
itmen
t to
offe
ring
heal
thie
r op
tions
, suc
h as
us
ing
heal
thie
r oi
ls a
nd fa
ts, u
sing
less
sal
t, pr
omot
ing
heal
thie
r al
tern
ativ
es to
sug
ary
drin
ks a
nd m
akin
g sm
alle
r po
rtio
ns a
vaila
ble.
Sin
ce J
uly
2015
a H
ealth
Impr
ovem
ent O
ffice
r ha
s be
en w
orki
ng w
ith fo
od b
usin
esse
s ac
ross
the
boro
ugh
and
so fa
r 28
bus
ines
ses
have
sig
ned
up
and
been
aw
arde
d a
cert
ifica
te o
f ach
ieve
men
t. Th
ese
busi
ness
es in
clud
e ta
keaw
ays,
caf
és,
rest
aura
nts
and
volu
ntar
y or
gani
satio
ns fr
om a
cros
s th
e bo
roug
h.
Look
ing
forw
ard,
the
aim
is to
sup
port
bus
ines
ses
to
not o
nly
prov
ide
heal
thie
r fo
od, b
ut a
lso
redu
ce th
eir
food
was
te, r
aise
food
hyg
iene
leve
ls a
nd b
ecom
e re
spon
sibl
e re
taile
rs if
they
als
o se
ll al
coho
l.
HEN
RY T
rain
ing
The
Hea
lthy
Eatin
g an
d N
utrit
ion
for
the
Rea
lly
Youn
g (H
EN
RY
) pro
gram
me
is a
n ev
iden
ce-b
ased
pr
ogra
mm
e w
hich
pro
mot
es a
hea
lthy
star
t in
life
to p
reve
nt c
hild
obe
sity
. The
pro
gram
me
equi
ps
heal
th a
nd e
arly
yea
rs p
ract
ition
ers
with
the
skills
, kn
owle
dge
and
confi
denc
e to
tack
le s
ensi
tive
lifes
tyle
is
sues
taki
ng a
hol
istic
app
roac
h, fo
cusi
ng o
n ba
bies
an
d ch
ildre
n ag
ed u
p to
five
yea
rs o
ld a
nd th
eir
fam
ilies.
In 2
016,
24
child
ren’
s ce
ntre
sta
ff in
Mer
ton
unde
rtoo
k th
e H
EN
RY
trai
ning
. The
con
fiden
ce
of p
artic
ipan
ts to
tack
le c
hild
obe
sity
and
sup
port
fa
milie
s to
dev
elop
a h
ealth
y lif
esty
le ro
se fr
om 1
3%
to 9
2%.
Hea
lthy
Sch
ools
The
Hea
lthy
Sch
ools
Lon
don
(HS
L) p
rogr
amm
e ha
s be
en a
dopt
ed in
Mer
ton
and
scho
ols
are
bein
g su
ppor
ted
to a
chie
ve b
ronz
e, a
nd s
ilver
and
gol
d st
atus
. HS
L pr
ovid
es a
fram
ewor
k to
del
iver
a ‘w
hole
sc
hool
app
roac
h’ to
hea
lth a
nd w
ell-b
eing
.
This
follo
wed
the
succ
ess
of a
two
year
targ
eted
M
erto
n H
ealth
y S
choo
ls p
rogr
amm
e fo
cuss
ing
in
the
east
of t
he b
orou
gh w
hich
enc
oura
ged
scho
ols
to u
nder
take
pra
ctic
al in
itiat
ives
to s
uppo
rt c
hild
ren,
fa
milie
s an
d te
ache
rs. P
roje
cts
incl
uded
: gar
deni
ng
and
food
gro
win
g, h
ealth
y ea
ting,
die
t and
nut
ritio
n,
prom
otin
g he
alth
y w
eigh
t and
phy
sica
l fitn
ess,
bui
ldin
g co
nfide
nce
and
resi
lienc
e fo
r pup
ils a
nd in
volv
ed 2
0 sc
hool
s fro
m a
cros
s th
e ea
st o
f the
bor
ough
.
Eva
luat
ion
has
show
n po
sitiv
e im
pact
, for
exa
mpl
e,
one
gard
enin
g an
d fo
od g
row
ing
proj
ect s
how
ed
that
initi
ally
70%
of c
hild
ren
said
they
wou
ld n
ot tr
y at
le
ast o
ne o
f the
thre
e in
gred
ient
s in
hea
lthy
cole
slaw
. Fo
llow
ing
the
food
gro
win
g ed
ucat
ion
and
cook
ing
sess
ions
95%
of p
upils
sai
d th
ey w
ould
gla
dly
mak
e an
d ea
t hea
lthy
cole
slaw
.
Spor
ts B
last
The
Lond
on B
orou
gh o
f Mer
ton
was
aw
arde
d ov
er £
120,
000
fund
ing
from
Spo
rt E
ngla
nd
and
the
Nat
iona
l Lot
tery
ove
r th
ree
year
s, to
del
iver
spo
rtin
g ac
tiviti
es w
ith s
peci
fic fo
cus
in
the
east
of t
he b
orou
gh. O
ver t
he la
st tw
o an
d a
half
year
s, th
e pr
ogra
mm
e ha
s en
gage
d w
ith o
ver 8
,000
pe
ople
and
has
bee
n ru
nnin
g fre
e sp
orts
cou
rses
for
14 –
25
year
old
s an
d fa
milie
s.
The
year
roun
d in
clus
ive
phys
ical
act
ivity
and
wel
l-be
ing
prog
ram
me
is b
eing
del
iver
ed w
ith p
artn
ers,
in
clud
ing:
Spo
rt E
ngla
nd, C
ircle
Hou
sing
Mer
ton
Prio
ry, F
ulha
m F
ootb
all C
lub,
Too
ting
and
Mitc
ham
U
nite
d, Y
MC
A L
ondo
n S
outh
Wes
t, En
glan
d N
etba
ll,
Moa
t, Lo
ndon
Spo
rt, S
t Mar
k’s
Aca
dem
y an
d M
VSC
. Tog
ethe
r the
se p
artn
ers
have
bee
n ab
le to
m
ake
addi
tiona
l con
trib
utio
ns o
f £18
0,00
0 to
the
prog
ram
me.
The
par
tner
s ar
e no
w lo
okin
g in
to h
ow
the
prog
ram
me
can
beco
me
mor
e su
stai
nabl
e on
ce
the
Spo
rts
Eng
land
and
Nat
iona
l Lot
tery
fund
ing
ends
.
Dai
ly M
ile
Lone
som
e P
rimar
y S
choo
l is
one
if th
e fir
st s
choo
ls
in M
erto
n to
hav
e ta
ken
up th
e ch
alle
nge
of r
unni
ng
The
Dai
ly M
ile. T
he a
im o
f The
Dai
ly M
ile is
to
impr
ove
the
phys
ical
, em
otio
nal a
nd s
ocia
l hea
lth
and
wel
lbei
ng o
f our
chi
ldre
n. H
avin
g st
arte
d as
a
tria
l with
Yea
r 1
child
ren
in th
e S
umm
er T
erm
, it h
as
gain
ed m
omen
tum
and
has
bec
ome
a re
gula
r pa
rt
of th
e sc
hool
day
for
all y
ear
grou
ps. T
hey
are
usin
g w
alki
ng o
r ru
nnin
g fo
r 15
min
utes
eac
h da
y as
a w
ay
of in
crea
sing
the
phys
ical
act
ivity
of t
heir
child
ren
on a
re
gula
r ba
sis
as w
ell a
s pr
ovid
ing
child
ren
with
a b
rain
br
eak
whe
n ne
eded
. “V
ery
usef
ul to
bui
ld c
onfid
ence
in a
n ar
ea th
at m
any
lack
exp
erie
nce.”
“Ver
y be
nefic
ial f
or b
oth
mys
elf a
nd
fam
ilies
I w
ork
wit
h.”
Exam
ples
of a
ctio
ns in
Mer
ton
to ta
ckle
chi
ldho
od o
besi
ty
“We
wan
ted
to e
nsur
e th
at m
ore
child
ren
wou
ld b
enefi
t fro
m th
e th
rill
and
fun
of g
etti
ng a
ctiv
e ev
ery
day.
We
have
not
iced
that
chi
ldre
n ar
e ge
ttin
g fit
ter –
they
can
wal
k or
run
furt
her i
n th
e ti
me
give
n th
an a
t the
beg
inni
ng
of te
rm. T
hey
also
love
the
brea
k fr
om
less
ons
and
are
enjo
ying
dev
elop
ing
thei
r fri
ends
hips
thro
ugh
jogg
ing
and
wal
king
toge
ther
.”
Hea
dtea
cher
Lone
som
e Pr
imar
y Sc
hool
Page 28
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lic H
ealth
201
6-17
Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
Hea
lthy
ven
ding
mac
hine
s in
Lei
sure
Ce
ntre
s
The
Lond
on B
orou
gh o
f Mer
ton
and
Gre
enw
ich
Leis
ure
Lim
ited
(GLL
) hav
e w
orke
d in
par
tner
ship
to
impr
ove
the
qual
ity o
f lei
sure
cen
tre
vend
ing
mac
hine
s in
the
boro
ugh.
Thi
s is
to m
ake
sure
that
af
ford
able
hea
lthie
r sn
acks
and
drin
k op
tions
are
av
aila
ble
for
peop
le u
sing
leis
ure
cent
res.
Sna
ck o
ptio
ns a
vaila
ble
have
bee
n re
plac
ing
trad
ition
al c
hoco
late
bar
s w
ith lo
wer
sug
ar, l
ower
ca
lorie
mor
e na
tura
l opt
ions
and
trad
ition
al h
igh
suga
r fiz
zy d
rinks
hav
e be
en re
plac
ed w
ith lo
w s
ugar
, low
ca
lorie
s m
ore
natu
ral o
ptio
ns.
Hea
lthy
vend
ing
mac
hine
s ha
ve n
ow b
een
intr
oduc
ed
in tw
o ou
t of t
he th
ree
leis
ure
cent
res
(Wim
bled
on
and
Mor
den
Par
k), h
elpi
ng m
ake
the
heal
thie
r op
tion
the
easi
est c
hoic
e.
Mer
ton
Coun
cil’s
Wor
kpla
ce H
ealt
h Ch
ampi
ons
As
part
of t
he M
erto
n C
ounc
il’s w
orkp
lace
hea
lth
prog
ram
me,
whi
ch h
as ‘c
omm
itmen
t’ le
vel
reco
gniti
on fr
om th
e G
LA’s
Hea
lthy
Wor
kpla
ce
Cha
rter
, Pub
lic H
ealth
and
Hum
an R
esou
rces
hav
e de
velo
ped
a ne
twor
k of
hea
lth c
ham
pion
s. T
hese
he
alth
cha
mpi
ons
help
thei
r co
lleag
ues
lead
hea
lthy
lifes
tyle
s by
rai
sing
aw
aren
ess
of a
ctiv
ities
that
are
av
aila
ble
to s
uppo
rt h
ealth
y liv
ing.
The
wor
kpla
ce h
ealth
cha
mpi
ons
have
bee
n es
sent
ial
part
ners
whe
n en
gagi
ng a
nd in
vitin
g co
lleag
ues
and
resi
dent
s to
com
plet
e th
e G
reat
Wei
ght D
ebat
e su
rvey
, whi
ch a
ims
to r
aise
aw
aren
ess
and
gath
er
idea
s fro
m L
ondo
ners
abo
ut h
ow o
ur c
hild
ren
can
be
help
ed to
lead
hea
lthie
r liv
es.
Cha
mpi
ons
took
on
resp
onsi
bilit
y to
pro
mot
e th
e G
reat
Wei
ght D
ebat
e, fo
r ex
ampl
e, li
brar
ies
desi
gnat
ed z
ones
with
com
pute
rs s
et u
p fo
r th
e su
rvey
as
wel
l as
floor
wal
kers
and
sta
ff re
ady
to
invi
te u
sers
to th
e su
rvey
.
Scho
ol M
eals
Con
trac
t
Mer
ton
Pub
lic H
ealth
team
hav
e be
en w
orki
ng in
pa
rtne
rshi
p w
ith th
e C
hild
ren’
s S
choo
ls a
nd F
amilie
s D
irect
orat
e ov
er th
e pa
st y
ear t
o ad
d va
lue
to th
e ne
w s
choo
l mea
ls c
ontr
act t
hat c
ame
in to
effe
ct
in S
epte
mbe
r 201
6. A
s a
resu
lt th
e ne
w p
rovi
der,
Cha
rtw
ell’s
, has
com
mitt
ed to
und
erta
king
a v
arie
ty o
f pr
ojec
ts a
nd in
itiat
ives
that
aim
to b
oth
incr
ease
upt
ake
of s
choo
l mea
ls a
nd s
uppo
rt w
ider
pub
lic h
ealth
ob
ject
ives
aro
und
child
hood
obe
sity
and
food
pov
erty
.
Ove
r th
e ne
xt th
ree
year
s, s
taff
wor
king
in s
choo
l ki
tche
ns a
cros
s M
erto
n pr
imar
y sc
hool
s w
ill ha
ve
the
oppo
rtun
ity to
att
end
nutr
ition
and
hea
lthy
eatin
g tr
aini
ng to
incr
ease
thei
r co
nfide
nce
and
com
pete
ncy
to s
uppo
rt c
hild
ren
to e
at m
ore
heal
thily
. We
will
also
se
e a
sust
aina
ble
redu
ctio
n in
the
suga
r co
nten
t of
scho
ol m
eals
of u
p to
20%
by
2019
, so
child
ren
will
be re
ceiv
ing
few
er c
alor
ies
from
sug
ar b
ut w
ill st
ill be
ab
le to
enj
oy a
tast
y ho
t sch
ool m
eal.
A h
olid
ay h
unge
r pr
ogra
mm
e w
ill ai
m to
add
ress
the
gap
in n
utrit
iona
lly b
alan
ced
food
pro
visi
on fo
r th
ose
child
ren
elig
ible
for
scho
ol m
eals
dur
ing
the
scho
ol
holid
ays.
Sch
ools
will
also
hav
e th
e op
port
unity
to
part
icip
ate
in a
var
iety
of p
rogr
amm
es th
at e
duca
te
child
ren
abou
t the
impo
rtan
ce o
f hav
ing
a ba
lanc
ed
diet
, whe
re th
eir
food
com
es fr
om, a
nd im
prov
ing
thei
r co
okin
g sk
ills.
Stud
ent d
ieti
cian
pro
ject
– n
utri
tion
al
qual
ity
of s
choo
ls m
eals
and
pac
ked
lunc
hes
Stu
dent
die
ticia
ns fr
om K
ings
Col
lege
Lon
don
Uni
vers
ity re
gula
rly u
nder
take
wor
k ex
perie
nce
plac
emen
ts w
ith t
he P
ublic
Hea
lth t
eam
in M
erto
n.
In S
epte
mbe
r 201
6 th
e st
uden
ts in
vest
igat
ed w
heth
er
pack
ed lu
nche
s ar
e nu
triti
onal
ly d
iffer
ent t
o sc
hool
m
eals
, and
if th
ere
is a
ny d
iffer
ence
bet
wee
n pr
imar
y sc
hool
s in
the
wes
t or
east
of t
he b
orou
gh.
Bas
ed o
n vi
sits
to n
ine
scho
ols
and
133
pack
ed
lunc
hes
surv
eyed
, the
resu
lts s
how
ed th
at o
nly
4%
of p
acke
d lu
nche
s su
rvey
ed m
et th
e fo
od b
ased
st
anda
rds
for
scho
ol m
eals
, with
50%
of c
hild
ren
brin
ging
in re
stric
ted
item
s hi
gh in
fat,
salt
or s
ugar
. S
ugar
sw
eete
ned
drin
ks w
ere
a po
pula
r co
mpo
nent
, w
ith 2
5% o
f chi
ldre
n ha
ving
them
for
pack
ed
lunc
h, c
ompa
red
to n
o ch
ildre
n ha
ving
a s
choo
l m
eal.
Pac
ked
lunc
hes
in th
e ea
st o
f the
bor
ough
w
ere
nutr
ition
ally
less
bal
ance
d, w
ith le
ss fr
uit a
nd
vege
tabl
es a
nd m
ore
food
s hi
gh in
fat,
salt
and
suga
r.
Nex
t ste
ps a
re to
offe
r rec
omm
enda
tions
to s
choo
ls
to im
plem
ent r
obus
t who
le s
choo
l foo
d po
licie
s th
at
enco
urag
e ch
ildre
n to
cho
ose
a he
alth
y ho
t sch
ool m
eal.
Juni
or h
ealt
h an
d fit
ness
– W
imbl
edon
le
isur
e ce
ntre
To p
rom
ote
bett
er u
se o
f lei
sure
cen
tres
by
youn
g pe
ople
und
er 1
6 ye
ars
and
to in
crea
se p
hysi
cal
activ
ity in
thi
s gr
oup,
GLL
and
the
cou
ncil’s
Lei
sure
Te
am in
trod
uced
an
‘enh
ance
d ju
nior
offe
r’. T
his
incr
ease
d th
e nu
mbe
r of
act
iviti
es a
vaila
ble
as p
art
of m
embe
rshi
p fo
r a
mon
thly
fee,
incl
udin
g th
e gy
m, t
akin
g pa
rt in
gro
up t
rain
ing
sess
ions
, fitn
ess
clas
ses,
lane
sw
imm
ing
in t
he p
ool a
nd t
he p
ool
infla
tabl
e se
ssio
ns. I
n cr
eatin
g a
mem
bers
hip
offe
r of
var
ied
activ
ities
, the
cen
tre
aim
s to
cul
tivat
e a
mor
e po
sitiv
e tr
aini
ng e
nviro
nmen
t. T
he e
nhan
ced
juni
or o
ffer
was
mar
kete
d th
roug
h m
embe
r sc
hool
s/co
llege
s, w
ebsi
te a
nd o
ther
par
tner
s an
d a
juni
or
‘Wel
com
e D
esk’
was
put
up
on th
e gy
m fl
oor.
A h
olid
ay
prog
ram
me
was
als
o im
plem
ente
d in
ord
er t
o ke
ep
juni
or m
embe
rs e
ngag
ed.
The
All
Engl
and
Law
n Te
nnis
Cl
ub (A
ELTC
)
The
All
Engl
and
Law
n Te
nnis
Clu
b (A
ELTC
) is
pilo
ting
thei
r Ear
ly Y
ears
A
ctiv
atio
n P
rogr
amm
e at
prim
ary
scho
ols
acro
ss
the
east
of t
he b
orou
gh. T
he e
arly
yea
rs p
rogr
amm
e se
eks
to e
nthu
se v
ery
youn
g ch
ildre
n to
be
activ
e fo
r sh
ort t
en m
inut
e bu
rsts
eve
ry d
ay. L
ed in
itial
ly b
y th
e A
ELTC
hea
d co
ach,
the
trai
n th
e tr
aine
r app
roac
h gi
ves
teac
hers
the
confi
denc
e to
bui
ld th
e ac
tivity
in
to th
e ev
eryd
ay c
urric
ulum
. The
exc
iting
pro
ject
will
be e
valu
ated
to s
how
how
ear
ly y
ears
act
ivat
ion
can
posi
tivel
y en
hanc
e th
e sc
hool
day
.
Page 29
3839
Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
Ann
ual R
epor
t of t
he D
irect
or o
f Pub
lic H
ealth
201
6-17
Inte
llige
nce
and
evid
ence
:
PH
E N
atio
nal O
bes
ity
Ob
serv
ato
ry (N
OO
) res
our
ces
– A
libr
ary
of re
port
s w
hich
form
s a
deta
iled
evid
ence
bas
e an
d da
ta re
posi
tory
for
child
obe
sity
. w
ww
.no
o.o
rg.u
k/R
eso
urce
s/D
H_P
ublic
atio
ns
PH
E P
ublic
Hea
lth
out
com
es f
ram
ewo
rk a
nd p
rofi
les
– B
row
se in
dica
tors
for
trac
king
pro
gres
s in
he
lpin
g pe
ople
to li
ve h
ealth
y lif
esty
les
and
mak
e he
alth
y ch
oice
s.
ww
w.p
hout
com
es.in
fo
Mer
ton
Join
t S
trat
egic
Nee
ds
Ass
essm
ent
– A
n ov
ervi
ew o
f the
hea
lth a
nd w
ellb
eing
nee
ds o
f Mer
ton
resi
dent
s. It
hig
hlig
hts
tren
ds a
nd c
hang
es in
the
heal
th a
nd w
ell-b
eing
of M
erto
n re
side
nts.
w
ww
.mer
ton.
go
v.uk
/hea
lth-
soci
al-c
are/
pub
liche
alth
/jsn
a.ht
m
Phy
sica
l Act
ivit
y –
Chi
ef M
edic
al O
ffice
rs re
port
on
phys
ical
act
ivity
for
heal
th fr
om th
e fo
ur h
ome
coun
trie
s.
ww
w.g
ov.
uk/g
ove
rnm
ent/
uplo
ads/
syst
em/u
plo
ads/
atta
chm
ent_
dat
a/fi
le/2
1637
0/d
h_12
8210
.pd
f
Guid
ance
and
sta
ndar
ds:
NIC
E g
uid
ance
– T
he N
atio
nal I
nstit
ute
for
Hea
lth a
nd C
are
Exc
elle
nce
(NIC
E) p
rovi
des
a ra
nge
of n
atio
nal
guid
ance
and
adv
ice
to im
prov
e he
alth
and
soc
ial c
are.
w
ww
.nic
e.o
rg.u
k
Rel
evan
t gui
danc
e pr
oduc
ed re
latin
g to
chi
ldho
od o
besi
ty in
clud
e •
QS
127
– O
besi
ty: c
linic
al a
sses
smen
t and
man
agem
ent (
2016
)•
CG
43 –
Obe
sity
pre
vent
ion
(201
5)•
QS
94 –
Obe
sity
in c
hild
ren
and
youn
g pe
ople
: pre
vent
ion
and
lifest
yle
wei
ght m
anag
emen
t pro
gram
mes
(201
5)•
NG
7 –
Pre
vent
ing
exce
ss w
eigh
t gai
n (2
015)
• P
H11
– M
ater
nal a
nd c
hild
nut
ritio
n (2
014)
• P
H47
– W
eigh
t man
agem
ent:
lifes
tyle
ser
vice
s fo
r ov
erw
eigh
t or
obes
e ch
ildre
n an
d yo
ung
peop
le (2
013)
• P
H42
– O
besi
ty: w
orki
ng w
ith lo
cal c
omm
uniti
es (2
012)
• P
H41
– P
hysi
cal a
ctiv
ity: w
alki
ng a
nd c
yclin
g (2
012)
• P
H17
– P
hysi
cal a
ctiv
ity fo
r ch
ildre
n an
d yo
ung
peop
le (2
009)
Hea
lthy
Sch
oo
ls L
ond
on
– B
ronz
e, S
ilver
and
Gol
d aw
ards
sch
eme
for
scho
ols
to re
cogn
ise
thei
r ac
hiev
emen
ts in
sup
port
ing
the
heal
th a
nd w
ellb
eing
of t
heir
pupi
ls, p
aren
ts a
nd s
taff.
w
ww
.hea
lthy
scho
ols
.lond
on.
go
v.uk
Chi
ldre
n’s
Foo
d T
rust
– A
cha
rity
shar
ing
the
skills
, kno
wle
dge
and
confi
denc
e to
coo
k fro
m s
crat
ch,
help
ing
anyo
ne w
ho p
rovi
des
food
for
child
ren
enco
urag
ing
indu
stry
to h
elp
fam
ilies
mak
e be
tter
food
cho
ices
w
ww
.chi
ldre
nsfo
od
trus
t.o
rg.u
k
Hea
lthy
Cat
erin
g C
om
mit
men
t –
A v
olun
tary
sch
eme
for
food
out
lets
in L
ondo
n ba
sed
on th
e pr
inci
ple
that
sm
all c
hang
es to
the
food
offe
r an
d nu
triti
onal
qua
lity
can
mak
e a
big
diffe
renc
e.
ww
w.c
ieh.
org
/hea
lthi
er-c
ater
ing
-co
mm
itm
ent.
htm
l
All
Our
Hea
lth
– P
ublic
Hea
lth E
ngla
nd g
uida
nce
on c
hild
hood
obe
sity
for
heal
thca
re p
rofe
ssio
nals
. w
ww
.go
v.uk
/go
vern
men
t/...
/chi
ldho
od
-ob
esit
y-ap
ply
ing
-all-
our
-hea
lth
Child
ren,
You
ng P
eopl
e an
d Fa
mili
es:
Hea
lth
Mat
ters
– A
loca
l dig
ital h
ub th
at s
uppo
rts
pare
nts/
care
rs a
nd c
hild
ren
and
youn
g pe
ople
to a
cces
s th
e he
alth
vis
iting
and
sch
ool n
ursi
ng s
ervi
ces
and
age
appr
opria
te a
dvic
e an
d su
ppor
t del
iver
ed b
y C
entr
al
Lond
on C
omm
unity
Hea
lthca
re N
HS
Tru
st.
ww
w.h
ealt
hmat
ters
.clc
h.nh
s.uk
Mer
ton
Fam
ily S
ervi
ces
Dir
ecto
ry –
For
info
rmat
ion
on s
ervi
ces
for
child
ren,
you
ng p
eopl
e, p
aren
ts,
care
rs, p
rofe
ssio
nals
and
pra
ctiti
oner
s ac
ross
Mer
ton
incl
udin
g in
form
atio
n on
edu
catio
n, c
hild
care
, act
iviti
es
and
leis
ure,
hea
lth a
nd w
ell-b
eing
, thi
ngs
to d
o, a
dvic
e, h
elp
and
supp
ort.
w
ww
.fsd
.mer
ton.
go
v.uk
/kb
5/m
erto
n/d
irec
tory
/ho
me.
pag
e
Sta
rt4L
ife –
Idea
s an
d su
ppor
t to
give
you
r ba
by th
e be
st s
tart
in li
fe fo
r m
ums,
dad
s, fa
mily
and
frie
nds.
w
ww
.nhs
.uk/
star
t4lif
e
Cha
nge4
Life
– Id
eas,
reci
pes
and
gam
es to
hel
p fa
milie
s ge
t the
mos
t out
of d
aily
life
.
ww
w.n
hs.u
k/C
hang
e4Li
fe/P
ages
/cha
nge-
for-
life.
asp
x
NH
S G
o –
Mob
ile A
pp fo
r yo
ung
peop
le to
incr
ease
acc
ess
and
rem
ove
barr
iers
to h
ealth
ser
vice
s.
ww
w.n
hsg
o.u
k
One
You
– S
uppo
rtin
g ad
ults
to m
ake
sim
ple
chan
ges
tow
ards
a lo
nger
and
hap
pier
life
. It p
rovi
des
tool
s,
supp
ort a
nd e
ncou
rage
men
t eve
ry s
tep
of th
e w
ay, t
o he
lp im
prov
e yo
ur h
ealth
rig
ht a
way
w
ww
.nhs
.uk/
one
you
NH
S C
hoic
es –
Pro
vide
s co
mpr
ehen
sive
hea
lth in
form
atio
n se
rvic
e w
ith th
ousa
nds
of a
rtic
les,
vid
eos
and
tool
s, h
elpi
ng p
eopl
e m
ake
the
best
cho
ices
abo
ut th
eir
heal
th a
nd li
fest
yle,
but
als
o ab
out m
akin
g th
e m
ost
of N
HS
and
soc
ial c
are
serv
ices
in E
ngla
nd.
ww
w.n
hs.u
k/p
ages
/ho
me.
asp
x
Ref
eren
ces
to th
is re
port
are
ava
ilabl
e se
para
tely
on
the
follo
win
g lin
k X
XX
XX
XX
XX
XX
X.c
om
Co
ntac
t d
etai
ls:
Mer
ton
Pub
lic H
ealth
Tea
mLo
ndon
Bor
ough
of M
erto
nC
ivic
Cen
tre
Lond
on R
oad
SM
4 5D
X
020
8545
483
6p
ublic
.hea
lth@
mer
ton.
go
v.uk
w
ww
.mer
ton.
go
v.uk
/hea
lth-
soci
al-c
are/
pub
liche
alth
8. R
esou
rces
Link
s to
evi
denc
e, g
uida
nce
and
stan
dard
s an
d di
gita
l res
ourc
es fo
r ch
ildre
n, y
oung
peo
ple
and
fam
ilies:
Page 30
40 Annual Report of the Director of Public Health 2016-17
Contact details:Merton Public Health TeamLondon Borough of MertonCivic CentreLondon RoadSM4 5DX
020 8545 [email protected] www.merton.gov.uk/health-social-care/publichealth
Page 31
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