obesity hna
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OBESITY HNA. Karen Jackson Public Health 2012. AN OVERVIEW. Why HNA?- aim Headlines from obesity HNA Adults & children with learning disabilities Revised obesity strategy ‘framework for action’ Way forward for learning disabilities. THE CHANGING CONTEXT. -2005-2010. - PowerPoint PPT PresentationTRANSCRIPT
Karen JacksonPublic Health
2012
Why HNA?- aim Headlines from obesity HNA Adults & children with learning disabilities Revised obesity strategy ‘framework for
action’ Way forward for learning disabilities
• Tackling Obesity Strategy
• Uses evidence – based interventions to produce a
framework for action
• Monitoring via 6 monthly Task Group meetings and annual report to LSP, PCT Board, LA Corporate Board and Cabinet
• All areas contribute to demand management
Targeted interventions
at the overweight and obese
Primary Prevention through encouraging healthy lifestyle
Targeted interventions
at the overweight and obese
Primary Prevention through encouraging healthy lifestyle
Action on the obeseogenic environmentand health inequalities
-2005-2010
-Halt the rise in obesity
To inform refresh of Dudley’s obesity strategy
Includes reviews of: national and local data –obesity & lifestyles services and interventions currently in
place evidence on emerging interventions stakeholder views, progress of 2005-10 strategy
Makes recommendations, Proposes a revised framework for
action, strategic objectives, monitoring and outcomes measures
51,317 People Obese138,532 People Overweight and obese
All of current increase due to obese category At current rates: 24.9% obese by 2016 Halt the rise by 2016- balance of 9400 less people moving into the obese category
YEARLY RATES OF INCREASE
2004 2009
Obese: 0.7 0.8Overweight: 0.3 0.0Overweight & obese: 1.0 0.8
2006/07(%)
2007/08(%)
2008/09 (%)
2009/10 (%)
2010/11 (%)
% point av yrly change
Dudley 11.4% 11.4% 9% 10.2% 10.7% -0.18
W.Mids 10.4% 10.0% 10.1% 10.5% _ +0.03
England 9.9% 9.6% 9.6% 9.8% _ -0.03
2006/07(%)
2007/08(%)
2008/09 (%)
2009/10 (%)
2010/11 (%)
% point av yrly change
Dudley 23.4% 20.1% 21.0% 23.8% 22.4% -0.25W Mids 19.1% 19.6% 19.8% 20.5% _ +0.47England 17.5% 18.3% 18.3% 18.7% _ +0.4
Reception Year Obesity Prevalence
Year 6 Obesity Prevalence
Adults: Increase in physical activity-46% to 49% (2004 to 2009,)- but more so in the least deprived than the most deprived areas. BME, women and girls, older people and overweight and obese people - lower activity levels.
Children: 70 % of year 5/6 year olds get enough exercise nationally, which declines to 62% by years 8/10 - more so for girls Less children cycle or walk to school than in previous years.
Adults:5 a day F&V intake -remained constant at 25.6% (2009), -increased in deprived areas. Males, BME and deprived areas have a lower 5-day levels. 86.9% of the population eat a less than healthy diet
Children: 5 a day F&V intake -increased slightly for children since 2004. Declines between school years 5/6 and 8/10. Children are consuming high levels of fatty and sugary snacks on a daily basis.
Breast feeding: Initiation and duration rates are falling and lower than W.Mids and England . Year 8/10 children – 2/3rds would not consider breast-feeding
There are specific groups that are more at risk of developing obesity-
Children from low income families Children from families where at least one
parent is obese Looked after children Young parents- <21 Adults- unemployed or in routine/semi routine
jobs Older people People of Asian origin Ethnic groups with higher than average
prevalence People with physical and learning difficulties People with mental health conditions
Robust initiatives and services in place, but impact on public health outcomes not yet realised. Interventions - not yet at full implementation takes longer than 5 years for the impacts of public
health programmes to come to fruition Some programmes have limited resources and are
achieving only a small ‘reach’ New action plan - build on these
interventions 2005 obesity strategy delivery framework still
valid –to add life-course & at-risk population groups
Progressive universalism- universal and targeted in each section
Tier 1: Tackling the Obeseogenic Environment: Expand reach and impact of programmes
increasing access to healthy food , active travel, urban design and planning
Tier 2: Lifestyles: Attitudes, Knowledge and
Skills: Public health campaign to raise the public’s
consciousness Early years & primary school age, breast-feeding &
healthy workplace programmes Tier 3: Treatment Pathways for Adults and
Children: Increase referrals, Improve long-term weight loss
outcomes
Higher prevalence of overweight and obesity than the average population: 1 in 3 obese V 1in 5
Less than 10% of adults with learning disabilities in supported accommodation eat a balanced diet, & sufficient intake of F&V
Carers generally have a poor knowledge about healthy diet
80% of adults with learning disabilities not taking enough exercise
More likely than the general population to have avoidable, diet related ill health and a shortened life expectancy – type 2 diabetes is double
National prevalence rates: 25/1000 with mild and moderate learning difficulties, 3-4/1000 with severe learning disabilities
Locally: Ω 6023 adults- mild/moderate LD , 2008 obese Ω 722-963 adults – severed LD, 241-321 obese
QOF data: (Sept 2011) 53/54 practices 1250 adults – mild/moderate & severe LD 984 adults- on LD register (moderate/severe),
805 (81.8%) also on obesity register 59% male, 41% female Obesity most prevalent for 35-54 year olds- as
general population
Schools Health Behaviour Data: suggestion of less healthy lifestyle for children with LD
Environmental changes are universal and will benefit all- healthy towns, food for health award
Many universal interventions will support people with learning difficulties (but need carer support or involvement, or need to be aimed at carers)
Targeted services also in existence- for weight management Adults: slimmer’s kitchen for LD, Children: Seekers (ages 8 to 18 with LD)
Data shortage Systematic measurement and referral of
children with learning disabilities is patchy Outcomes from initiatives can be lower for LD
clients:
Referral Status Number %
% Universal services
Total referrals 16Did not attend (DNA) 1 6%
Dropped out 1 6%Completed course 14 88%Weight loss 0-2.5%
(completers) 8 57%Weight loss 2.5-4.9% 4 29%
Weight loss 5%+ 1 7% 27%-55%No weight loss/gained 1 7%
2009/10 Seekers (8-18 YRS)
ALL PROGRAMMES*
Accepted a place 8 261Attended (rate %) 8 (100%) 245 (67%)DNA rate % 0 87 (33%)Completed (rate %) 6 (75%) 145 (83%)Drop out rate% 2 (25%) 29 (17%)% maintained or reduced BMI
1/8 (17%) 84 (71%)
% reduced/maintained waist size
3(50%) 67/80 (84%)
Programmes 1 31* where monitoring data available
Making reducing obesity a priority for all- at both strategic and delivery levels - implementation of the learning disability obesity charter
Development and delivery of an obesity action plan for people with learning difficulties
Monitoring data