Health Promotion Proposal Reducing Obesity Health And Social Care Essay

wholesomeness Promotion Proposal Reducing fleshiness wellness And loving C atomic number 18 EssayThe plus in fleshiness has been identified as a major humanity wellness threat. It has been predicated by the Govern handst delegacy for Science hypermetropia that with step forward taking proceeding nearly 60% of the UK cosmos de fracture be rotund by 2050, which would cede serious m cardinaltary consequences for the NHS and the economy.1The ca utilizations argon complex and related to behavioural, friendly and purlieual factors therefore to trailer truck fleshiness a range of agencies and communities need to escape unneurotic to metamorphose the obesogenic nature of the topical anaesthetic anesthetic environment. build up opportunities to make well-grounded choices easier.Help those already grievous or at naughty risk of becoming round.This dodge provides a framework for local anaesthetic anaesthetic put to death and watchks toProvide an understanding of t he tip of the problem in the local race and sets goals.Provide manoeuverership by bringing together a multi agency group.Choose interjections that point has shown to be effective.enable observeing and evaluation.Build up local capacity via teaching. there is a snap on childhood overw ogdoad and fleshiness in line with government passports. This two class evidence based scheme will bring funding, the hails and resources required atomic number 18 provided in the exploit plan.2.0 The organisation2.1 The geographical atomic number 18a and raceTo make up the object population for this system, 90% of Prestons population and 15% of South Ribble were chosen, this is a population of approximately 150,000.Prestons wellness profile3 shows there be inequalities with nearly 40% of the occupiers lively in the most disadvantaged quintile. The percentage of children classified as fat is similar to the England fair. South Ribbles wellness profile4 shows slight than 5% of r esidents living in the most deprived quintile, child poverty and deprivation rates ar number 1, the percentage of children classified as obese is better than the England average. Preston has a barren minority Ethnic (BME) population of 15.5% which is greater than the England average, the largest majority being Asiatic (Indian the majority) or Asian British.3 South Ribble has a BME population of less than 5%.4To gibe the population had a range of accessible classes, age groups and ethnical groups, two of the most deprived wards of Preston (Ribbleton GL and Fishwick GB) total population 12,720 were replaced with 3 less deprived wards of South Ribble (Broad Oak GC, Kingsfold GL and Middleforth GU) total population 12,430, chaffer haoma 1. This ensured the target population for the purpose of this strategy was approx 1 d00 with mixed class, age and ethnicity. The geographical area for the purposes of this strategy is c aloneed Preston Ribble Council.Figure 1 Wards of Preston (A) and South Ribble (B) 5(A)(B) markSource http//www.lancashire.gov.uk2.2 health overtureAs part of Preston Ribble Council, the Health progress Team delivers a range of go and health campaigns designed to remediate the health and social welfare of the population of Preston Ribble.The health improvement police squad includes familiar health consultants and practitioners who work with the NHS, other organisations, the conscious sector and local trans follow through to provide education and formulation operate to empower residents of Preston Ribble to make muscular lifestyle choices.Health improvement and tackling inequalities is an integral part of Preston Ribble Councils Culture. All policies that fight back health improvement are evidence based. Partnership working is a necessity to deliver the health improvement agenda.3.0 obesity strategy organic evolutionObesity is a multi-faceted problem and therefore requires a multi-agency solution. A multi-agency Obesity Strat egy collection was set up with key partners from the Local Authority, NHS and the voluntary sector to develop this strategy. The group was lead by the Health remediatement teams consultant in public health. It sets out how partners and communities will work together to reduce obesity by taking into account the specific inevitably of the local population. This strategy will link in with other strategical plans to ensure tackling obesity is spunky gear on the political agenda of Preston Ribble Council.4.0 screen background4.1 Defining overweight and obesity weighty and obesity are limit utilise to describe excess body fatness which advise lead to adverse effects on health and social welfare.2 Overweight and obesity occurs when push button intake from nutrition and drink is greater than energy expenditure i.e. what is used by the body. The causes til now are much complex and related to behavioural, social and environmental factors.2The calculation of BMI body mass index (BMI=weight/(height)2) 30 kg/m2.is a widely accepted definition obesity. The human beings Health Organisation produced a classification of overweight adults based on BMI, see remit 1.Table 1 Classification of overweight adults.6Classification BMI (Kg/m2) essay of co-morbiditiesUnderweight Clinical problems increased)Normal weight 18.5 24.9 AverageOverweight 25Pre-obese 25 29.9 Increased fat class I 30.0 34.9 ModerateObese class II 35.0 39.9 SevereObese class II 40.0 in truth severeSource Obesity preventing and managing the global epidemic. Report of a WHO Consultation. Geneva. World Health Organisation, 2000 (WHO Technical Report Series, No 894) focal point create by the National Institute for Health and Clinical Excellence now recommends the use of waist circumference in conjunction with BMI as the method of step overweight and obesity and determining health risks.7Because a childs BMI varies with age and sex, the BMI tag for children is related to the UK 1990 BMI gro wth reference charts.84.2 Obesity and HealthLife antepast is reduced in obesity cases by an average of three years, and in severe obesity cases (BMI 40) life expectancy is reduced by eight to ten years.9 It has been estimated that the cost to the UK economy from overweight and obesity was 15.8 meg per year in 2007, 4.2 billion of which were costs to the NHS.9Childhood obesityShort term risks mostly include emotional and psychological affects associated with being overweight through with(predicate) being teased by peers, resulting in low self abide by and depression. there are vaster term consequences as obese children are more likely to become obese adults, there are but some obesity related conditions such as grapheme 2 diabetes which seduce increased in overweight children.9Adult obesity prove has shown that adult obesity is associated with a range of health problems including those related to the musculoskeletal scheme because of the extra strain on joints circulatory s ystem e.g. coronary thrombosis heart disease and stroke metabolic and endocrine system e.g. instance 2 diabetes cancers such as breast and colon reproductive problems GI and liver disease and psychological and social problems.95.0 The scale of the problem in the UKWithin the last 25 years, the prevalence of obesity in the UK has more than doubled.1 The latest Health Survey for England (HSE) in 2009 showed that the proportion of obese men increased from 13% in 1993 to 22% in 2009 and from 16% of women in 1993 to 24% in 2009 i.e. more women are obese than men, there were however more overweight men (44%) than women (33%).10 The 2007 Foresight Report predicted that if no action were taken, by 2025 47% of men and 36% of women will be obese and Britain could be a mainly obese society by 2050, adding 5.5 billion annual cost to the NHS.1The rise in obesity among 2-10 year olds from 1 in 10 in 1995 to 1 in 7 in 2008 appears to be flattening out.10 There are however, still 1 in 5 children that are overweight or obese by the age of 3 years.11Rates of obesity are higher among some B omit and Minority Ethnic (BME) communities and also in dismantle socioeconomic groups.12 The latest Health Survey for England in 2009 also showed the link between obesity and deprivation, women in the impose income quintiles had a higher BMI and greater prevalence of obesity than those women in higher income quintiles, there was no apparent pattern in men,10 see Figure 2.Figure 2 Age-standardised prevalence of overweight and obesity by equivalised household income and sex.106.0 The scale of the problem in Preston Ribble Council.Using the prim be dent13 the selected population obesity and overweight prevalence and numbers were calculated, see auxiliary 1. The extent of the problem is summarised in Figure 3. There are an estimated 4511 children and raw passel who are classified as obese (BMI over 30), and a further 4580 who are classified as overweight (BMI between 25 and 30). There are an estimated 31993 adults who are classified as obese and a further 51821 who are classified as overweight. 22.9% of adult females and 26.8% adult males are obese.Figure 3 the extent of the problem in Preston RibbleObeseOverweightNormal weightAdultsBMI 40 n=2105*BMI 30-39 n=29888*BMI 25-30 n=51821*Children unexampled peopleBMI 40 n=69*BMI 30-39 n=4442*BMI 25-30 n=4580**NICE cost toolThe National Child evaluatement Programme (NCMP) introduced in 2005 sets to monitor the prevalence of overweight and obesity in children in Reception family and division 6. The table below presents the results for the local authorities of Preston and South Ribble compared to the uniting West and national averages.Table 2 Local prevalence of overweight and obesity among children for the Local Authorities of Preston and S.Ribble and for England 2009/10 and 2008/09 14ReceptionYear 6OverweightObeseOverweightObese2008/09Preston10.98.513.117.3S.Ribble11.56.815.616.3NW13.59.614.118.9England13.29.614 .318.32009/10Preston12.59.112.917.0S.Ribble15.38.514.018.0NW13.79.914.819.3England13.39.814.618.7Source http//www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles/obesityThe table above shows an increase from 2008/09 to 2009/10 in Reception Year in the numbers of overweight and obese children in both Preston and S.Ribble. In Year 6 there was unspoiled an increase in obese children in S.Ribble. The targeted population for this strategy is Preston Ribble, as the population is 90% Preston and 15% South Ribble these increases are clearly a concern.A extend by Intelligence for reasoned Lancashire (Joint Strategic call for Assessment) on childhood obesity in Lancashire showed that measurements of year 6 pupils from the 08/09 NCMP dataset highlighted that crossways Lancashire there could be found extremes of weight (underweight and obese) in the most deprived areas and there was a link between higher levels of overweight and lower levels of deprivation.156.1 The local c ost of obesityUsing the NICE costing tool for the target population of Preston Ribble, the estimated savings from implementing NICE guidance is approximately 43,000 savings on prescriptions and 127,000 in GP contacts, see appendix 1. That is the current local cost to the NHS of not implementing NICE guidance for tackling obesity is approximately 170,000. There would be however entreeal costs with disease associated with overweight and obesity plus costs on the economy from daylights off work due to obesity and associated diseases and conditions.7.0 National Drivers and GuidanceReducing obesity is a national priority for government as highlighted in the recently published white paper Healthy Lives, Healthy People Our Strategy for public health in England.16 In January 2008, the government published the national obesity strategy Healthy Weight Healthy Lives.17 It highlighted the need for a long term come near and set out a new exoteric Service Agreement target for EnglandOur ambit ion is to be the first major nation to reverse the rising tide of obesity and overweight in the population by ensuring that e preciseone is able to achieve and maintain a rosy weight. Our initial focus will be on children by 2020, we aim to reduce the proportion of overweight and obese children to 2000 levels.17In 2006 Nice Guidance on Obesity was issued, this set out guidance on prevention, identification, judging and fightment of overweight and obesity in adults and children in England and Wales.7 In addition to the NHS the guidance was also aimed at non-NHS settings for example, local authorities, schools early years and employments and sets out recommendations aimed at these various settings. It was also highlighted that obesity cannot simply be turn to through behavioural reposition at individual level population based interventions are needed to swop the obesogenic environment of modern industrialised nations.7The Foresight Report, Tackling Obesity Future Choices (2007 ) highlighted that obesity is determined by a complex multifaceted system of determinants and that in the 20th century the ill-treat if technological revolution outstrips human evolution which has left an obesogenic environment.1 To tackle the complexities of obesity the report advocated using a multi agency or whole system approach. The report concluded that Preventing obesity requires changes in the environment and organisational behaviour, as well as changes in group, family and individual behaviour.18.0 Effective interventionsResearch highlighted in the Foresight report1 found that the top fiver policy responses which they valuateed as having the superlative average impact on obesity levels were change magnitude walkability/cyclability of the built environmenttargeting health interventions for those at increased riskcontrolling the availability of/exposure to obesogenic foods and drinksincreasing the responsibility of organisations for the health of theiremployeesearly life interventions at birth or in infancy. 19.0 The Local ApproachHealthy weight, respectable lives a cross government strategy for England17 and the accompanying Healthy weight, honorable lives a toolkit for emergence local strategies2 have been utilized to develop this strategy for Preston Ribble. It supports the governments recommended approach of focusing on five key themesChildren Healthy growth and salubrious weight. The stages of pre-conception, breast feeding, babe nutrition through to early years can shape outcomes and choices make in adulthood.18Promoting healthier food choices. backing the governments recommendation for progression of a rosy, balanced diet.Building material activity into our lives. Supporting the governments recommendation of promoting officious living throughout the life somatic body.Cr ingest incentives for better health. Promoting action for maintaining a healthy weight in the work through promotion of healthy eating choices and more opportuni ties for physical activity inside the workplace. personalized support for overweight and obese individuals. Providing clinical guard pathways to assess and manage overweight and obesity through effective weight management services.A life course approach has been used to assess the various stages of peoples lives where evidence has shown targeting interventions can be successful in preventing or treating overweight and obesity. This strategy uses universal population preventative approaches in addition to targeted interventions for those already obese or at high risk of developing. As evidence suggests peoples lives are shaped from very early years11,18 this strategy focuses on childrens health.To inspection and repair people overcome barriers to maintaining a healthier lifestyle and changing their behaviour, this strategy takes a combined approach as recommended in the Foresight Report1 that is using types of interventions that focus on the determinants of behaviour such as the en vironment and education, the second type of intervention focuses on the behaviour itself in those at risk.1 The strategy uses all 5 different approaches to health promotion, i.e. medical, behaviour change, education, empowerment and social change to tackle both the determinants and the behaviour itself.10.0 The Obesity Strategy Aim and ObjectivesThe overall aim of the strategy is to reduce obesity levels in the local population of Preston Ribble. The strategy has three strategic themes with objectivesChange the obesogenic nature of the local environment.Develop opportunities to make healthy choices easier.Help those already obese or at high risk of becoming obese.10.1 Change the obesogenic nature of the local environmentObjectives enchant public policyInfluence businesses to become healthy workplaces bend with communities to make active lifestyles easierAs planning and exile policy evolution can have huge effects on opportunities for activity indoors the local built environment , it is important that health issues such as obesity are considered in policy decisions, Health Impact Assessment (HIA) should produce part of policy training. As part of this strategys action plan HIA training will be rolled out to planning and transportation teams within the council..Foresight report1 found that one of the five policy responses which they assessed as having the greatest average impact on obesity was increasing the walkability/cyclability of the built environment. The report highlighted that residents of highly walkable neighbourhoods are more active and have slightly lower body weights than their counterparts in less walkable neighbourhoods, it was also highlighted how perceptions of social nuisances may increase the risks of obesity.1 Therefore key actions of this plan include interaction between environmental Health, lodgement, Police and communities to tackle social nuisances, set up community action teams and working with communities to empower and reassure residents.Community food growing initiatives have been recognized as providing benefits to suspensor tackle obesity, they can offer physical activity, increase food knowledge and give a better perceptiveness of food that helps them make healthier food choices, in addition they help create cohesive communities and social inclusion thereby reducing health inequality.19 Because of the potential health gain this strategy aims to set up some(prenominal) community horticultural projects targeting the most deprived areas likely to have high risk individuals.The beguile of the workplace on health of employees is well recognised and the Foresight report1 found increasing the responsibility of organisations for the health of their employees was one of the five policy responses which had the greatest impact on obesity. As part of this strategy the importance of this has been recognised and therefore a newly created health public assistance workplace officer will be recruited to promote and facilitate the information of healthy active workplaces promoting the national kick the bucketwell campaign20 a health and wellbeing workplace award scheme will be launched.10.2 Develop opportunities to make healthy choices easier.ObjectivesEnable young children to eat a healthy dietEnable adults and families to eat a healthy varied dietThe stages of pre-conception, breast feeding, infant nutrition through to early years can shape outcomes and choices made in adulthood.18 In Tackling obesity through the healthy child programme, a framework for action evidence is presented which strengthens the argument for focusing interventions in the very early years, it is highlighted that epidemiological studies have shown once obesity is established in a child it can continue into adulthood.11 The Foresight report1 found that one of the five policy responses which they assessed as having the greatest average impact on obesity was early life interventions at birth or in infancy. Therefore this strategy focuses on early years as they have been identified as critical opportunities for interventions in the life course, see witness 4.Figure 4 Critical opportunities for intervention in the life course of an individual 1Source Government Office for Science (2007) Tackling Obesity Future Choices, Foresight Report. http//www.bis.gov.uk/assets/bispartners/foresight/docs/obesity/17.pdfBreastfeeding can provide trade protection against obesity and related health problems in later life22 and that by breastfeeding mothers are more likely to return to their pre-pregnancy weight.23 It has been recommended by the WHO and the section of Health that breastfeeding should be encouraged for the first 6 months of life.24 This strategy includes actions to increase uptake of breastfeeding. twain parents and childcare providers have a role in ensuring children have healthy balanced diets. This strategy includes actions to help ensure healthy eating at childcare premises. A healthy eatin g award scheme for childcare will be launched to encourage and provide recognition to childcare providers.NICE guidance recommends a whole school approach to tackling overweight and obesity.7 Healthy weight healthy lives highlights the importance of schools in ensuring opportunities are provided for children to develop healthy eating habits. This strategy therefore supports Healthy Schools25 and also increasing the take away of school meals.National qualitative research commissioned by the Department of Health for the change 4 life campaign included cleavage of the population into 6 clusters, it was identified that 3 cluster types that were more at risk of obesity, Clusters 1 and 2 also had low income, these clusters each require specific key messages.26 See Figure 5. People on low incomes (Cluster 1 and 2 ) will be targeted as the Food Standards power low income and diet survey highlighted they had poorer diets due to several factors including a lack of cooking skills and knowled ge.27Figure 5 Department of Health Segmentation abbreviation 26Taking an educational approach to promote healthy food choices in the home this strategy will implement a piece of land of workshops designed for these high risk clusters to provide knowledge, practical skills and confidence to modernise healthy affordable food.As BME communities have also been identified as high risk of obesity, they will also be targeted for healthy eating workshops. As suggested in Healthy Weight Healthy Lives a toolkit for developing local strategies 2 to effectively engage BME communities, interventions will be culturally appropriate and group workshops will include sharing ideas how to make tralatitious meals healthy.The availability of affordable fresh food in deprived areas will also be address by this strategy, by introducing initiatives such as fruit and vegetable box schemes and food co-operatives which will promote local sustainable suppliers.10.3 Help those already obese or at high risk of becoming obeseObjectivesIdentify early those at high risk of overweight or obesity and direct towards appropriate interventionEnsure provision of and equal access to weight management services for those who want to loose weight.As the numbers of obese individuals is forecast to rise1 it is prevailing that services are in place to meet their needs and help individuals reduce and maintain a healthy weight. For those individuals already burdened with obesity or are at high risk of becoming, comprehensive care pathways for both adults and children will be developed using NICE guidance7,28 to ensure they are evidenced based.It was recommended in Healthy Weight Healthy Lives a toolkit for developing local strategies that more weight management services should be commissioned.2 Counterweight is an evidence based weight management programme that has been shown to be highly cost effective.29 This strategy will therefore utilize this cost effective service to ensure weight management ser vices are available for those who want to loose weight. Weight management schemes designed specifically for children will also be assed and introduced on securing funding e.g. MEND (Mind, Exercise, Nutrition, Do it).30The full Obesity Strategy swear out envision is shown in Table 4.11.0 Monitoring and evaluationThe implementation and monitoring of this strategy will be overseen by the Obesity Strategy Group for Preston Ribble. To measure success of the overall aim of reducing obesity levels in the population, overarching strategy indicators are shown in Table 3.Table 3 Overarching strategy indicators.IndicatorSource quantify1% children in Reception who are obeseNCMP yearly Feb2% children in Reception who are overweight or obeseNCMP yearly Feb3% children in Yr 6 who are obeseNCMPAnnually Feb4% children in Yr 6 who are overweight or obeseNCMPAnnually Feb5Prevalence of BMI or equal to 30 in adults over age of 16 in previous 15 months in GP registersQoFAnnuallyThe Obesity Strategy Ac tion Plan shown in Table 4 includes an evaluation framework. For each action, the outcome and mental process measure is indicated. The highlighted lead will be responsible for ensuring the specified outcomes and mental process indicators are measured and reported back to the Strategic Obesity Group at the specified time.Table 4 Obesity Strategy Action PlanStrategic Theme 1 Change the obesogenic nature of the local environmentObjectives and key actionsApproach to health promotion indicated(medical / behaviour change / educational / empowerment / social change)TimescaleResourcesLead responsibility and partnersPerformance Measure / Outcome(Social Change)Objective Influence public policyEnsure HIA part of policy developmentRoll out HIA training to planning and transportation teams within the council.Within 6 monthsIMPACT 5 day HIA training course for team leaders (700 pp)In house HIA awareness 1 day course delivered by trained HIA champions.CouncilTraining providersAll team leaders co mpleted 5 day HIA course1 day in house HIA awareness training attended by 90% of officersIncrease availability of active transport Planning and transportation to be existing pass and walking routes around the district and undertake a gap analysis of opportunities for more routes.Within 6 monthsPlanning officer timePlanningParks and voidTransport subsisting cycling walking routes mapped.Results of gap analysis reported.Restrict access to unhealthy food.Work with planning to restrict permission of fast food outlets within 500 metres of schoolsOngoingPlanning Officer timePlanning part Health PromotionNo applications granted after 1 year.Improve walkability of neighbourhoods.Improve timely interaction between environmental Health, Housing, Police to tackle social nuisances.Monitor community satisfaction via questionnaires / community meetings every year.Ongoing adjectival development time by all partners.Environmental HealthHousing DepartmentHousing AssociationsPoliceCommunity Grou psCommunity group and resident feedback of significant improvement.Establish new food growing sites to improve the health and well being of residents.Identify land available for food growing projects.Within 6 monthsPlanning Officer timePlanning containLand Owners4 new growing sites to be established.Objective Influence businesses to become healthy workplacesOrganise an area forum and develop website for representatives of local businesses to raise awareness in employers of production benefits in promoting healthy lifestyles. get up business in the community workwell campaign, case studies of good practice.Within 6 monthsHealth and wellbeing workplace officer (in Environmental Health) 30KEnvironmental Health, percentage Health Promotion,Occupational Health,ITExisting Area Business and Commerce assemblysForum website developed.Influence roll-out of workplace policies totackle obesity via newly appointed health and wellbeing workplace officer employed to promote and facilitate the de velopment of healthy active workplaces.1 2 yearsHealth and wellbeing workplace officerEnvironmental Health,PCT Health Promotion,Occupational Health,Existing Area Business and Commerce ForumsFeedback from forum of increase in healthy policies. (website survey monkey at 1 and 2 years)Critically assess workplace practices in NHS and the Local Authority and introduce policies that encourage physical activity and healthy eating. Promote implementation of NICE Guidance 43.1 2 yearsHealth and wellbeing workplace officerEnvironmental HealthPCT Health Promotion, Human Resources teams, Occupational Health,Catering servicesAll NHS and LA workplaces assessed after 2 years.Launch a workplace health and wellbeing award scheme to encourage employers to recognise the influence that they can have on their employees health.6 12 monthsHealth and wellbeing workplace officer time, LA communications teamEnvironmental Health,Council Comms,PCT Health Promotion,Occupational Health,Existing Area Business and Commerce Forums demonstrate scheme launched after 12 months.(Empowerment)Objective Work with communities to make active lifestyles easierWork with communities to identify perceived needs for cycling and walking routes.6 12 monthsPlanning Officer timePlanningParks LeisureCommunity GroupsHealth walk Leaders