Health Needs Assessment Report on Childhood Obesity in the London Borough of Barking & Dagenham

A HEALTH NEEDS ASSESSMENT REPORT ON CHILDHOOD OBESITY IN THE LONDON BOROUGH OF   BARKING & DAGENHAM
Table of contents Introduction. 2 PART 1: 3 Population Demographics. 3 Characteristics of the Borough. 4 Local Authority & Commissioners. 6 PART 2: 6 The Related Health Needs. 6 Determinants. 10 Health Inequalities. 12 PART 3: 12 Current Interventions. 12 PART 4: 14 Local Priorities for Services Provisions, Effective Utilization, and Futures. 14 Conclusion. 16 Key Resources. 18  Abbreviations;
WHO: World Health Organisation
BMI: Body mass index
OHID: Office for Health Improvement and Disparities
H.C.: House of Common
JSNA: Joint Strategic Needs Assessment
OHA: Obesity Health Alliance
HSE: Health Survey England
ONS: Office of National Statistics
PHE: Public Health England
Introduction
Health is a condition of total physical, mental, and social well-being, not just illness or disability. (WHO, 2020). The ratio of overweight elementary school children in England is 1:3, while that of obese elementary school children is 1:5 (Department of Health and Social Care, 2020). Prevention of obesity before its development is imperative since treatment of obesity after its development is extremely challenging and time-consuming (Blackpool Council, 2022). Based on the report of WHO, since child obesity is a crucial global health issue, eradication of this problem is a highly complex task faced by global healthcare officials (DHSC, 2020). Only in 2019, the proportion of obese children in London and England was 23.2% and 20.2%, respectively (Trust for London, 2022). The prevalence of childhood obesity in the Barking and Dagenham Borough of London was recorded at 44.2% in 2022, which was the second highest in the metropolis. (Baker, 2022). It was critical to assess the healthcare problem in the target population, which comprises ethnic minorities (British, Black, and Asian) enjoying lesser social privilege, making them prone to obesity (PHE, 2021). The Health Care Act is one of the steps that the government has taken to improve the healthcare status of this ethnic entity. The Joint Health and Well-being Strategy, a part of the Health Care Act of 2012, aims to identify core plans of Health and Well-being Board partners to promote population health. (LBBD, 2019). Despite these efforts, the problem of healthcare inequalities is still pronounced in this region.
The above information reveals a greater need to access healthcare resources in the given locality to implement effective remedial measures addressing the issue. This access will enable authorities to create a health needs assessment which can be used to address issues healthcare issues in this locality. To design and provide healthcare services at various levels, strategies, such as Health Need Assessment, have been implemented. This assessment serves as a foundation to undertake various phases, including planning, implementation, and evaluation of the delivery of healthcare services. This assessment report aims to provide an overview of the demographic profile of the target population to facilitate an understanding of barriers and provisions. İn this way, it suggests recommendations for using evidence-based research (Public et al., 2021)
PART 1:
Population Demographics
The approximate population of this locality is 218869, out of which 63512 are children falling in the age bracket of 0 to 17 years. The proportion of females is 51.3%, while that of males is 48.7%, respectively (Census, 2021). Young adults and adults make up the largest proportion of the target population (approximately 62.3%), while teenagers make up 29% of the total population (Office of National Statistics, 2021). Most of the population of Barking and Dagenham is young, as the average age of the population is 33 years (Barking and Dagenham, n.d).
The number of households in Barking and Dagenham is 73,900 in comparison with a total number of 3423900 households present in London (Anonymous, 2023). This proportion of households represents a clear picture of the population density of Barking and Dagenham in comparison with the rest of London. Another significant aspect of the demographic profile of Barking and Dagenham is the prominent proportion of non-native people living in these localities. According to most recent estimates, 41.3% of people living in Barking and Dagenham are not born in the U.K.; the non-native profile of these people also reveals the role of ethnicity in the development of healthcare problems such as obesity and overweight children (Anonymous, 2023). The higher population density is a significant indicator of the higher poverty level in these regions; in this regard, recent estimates indicate that 34.9% of households have four or more people; moreover, 37.1% of the total households of Barking and Dagenham are at least deprived in one dimension (Anonymous, 2023).
İn terms of healthcare, 3.7% of the population suffer from bad health, and this proportion also indicates the potential occurrence of adverse health outcomes in families, especially children of these people (Anonymous, 2023). Another significant demographic indicator that provides information about the general health scenario of the target population is the rapid increase in the population of these regions. According to official estimates of the U.K. government, between 2011 and 2021, the population of Barking and Dagenham increased by 17.7% (Office for National Statistics, 2022). This increase in population further aggravates the healthcare issue as population growth is linked with poverty, and childhood obesity is directly proportional to poverty.
The region’s demographic profile indicates that white people still dominate the locality with a 45.7% proportion; on the other hand, with a 25.7% ratio, Asian stand at the second position. The proportion of blacks is even lower as their number makes up 20.3% of the entire population. Other minor demographic groups include Arabs and other ethnic minorities. Within the boundaries of Barking and Dagenham regions, the average life expectancy of people living in the poorest regions shows shocking orientation. For males, it is 3.8 years less than the national average, and for females, this number is 3.4 years (Public Health England, 2020). As a result, the average life for males is 82.7 years, and for females, it is 78 years (Trust for London, 2022). Since it is one of the most impoverished localities of London, issues like childhood trauma and domestic abuse are common and serve as additional risk factors for health (Joint Strategic Needs Assessment, 2020).
The region of Barking and Dagenham holds enough potential which keeps inviting visitors and entrepreneurs; a collaboration between council leaders and private investors is creating new economic opportunities. The locality has received massive investments in different projects, including road construction, drainage system, and environmental spacing (Barking and Dagenham, 2020). The authorities plan to establish 50,000 new houses to accommodate the growing population (Barking and Dagenham, 2020). This is a highly ambitious project, as its completion would resolve most of the housing problems faced by the residents of this locality. These housing schemes will be equipped with shopping malls and other centers, which contribute to the improvement of people’s social life. Barking and Dagenham also have a vast sports complex covering an area of 125,000 square feet. İt is the largest sports arena in the state, and for the same reason, it attracts sportsmen from all over the country (Barking and Dagenham, 2020).
When this project hits the completion mark, the housing problem will resolve considerably; however, due to a spike in the influx of people, shopping centers and amenities will increase. Since this region also has a 125,000-square-foot-long sports complex, it provides support to the proliferation of sporting activities (Barking and Dagenham, 2020).
Characteristics of the Borough
İn comparison with the other parts of London, the demographic profile of this region indicates a higher number of younger people, and this feature adds to the uniqueness of this region. Furthermore, within this locality, the number of pre-schoolers is much higher in comparison with the rest of London (JSNA, 2020). The average age of this locality lies between 32 and 33 years (Office for National Statistics, 2021).
Figure 1: Population age profile (ONS, 2020)
The chances of obesity are higher in Black and Asian children as their lower socioeconomic status makes them more susceptible to obesity due to different degrees of deprivation in these ethnic minorities (ONS, 2021). Children of white families face half chance of living in a lower socioeconomic stratum of society in comparison with children of the Asian population. İn numbers 37% of Asian and black children live under these conditions. With the increase in number of people suffering from poverty, the rate of obesity is more than likely to increase (NHS Digital, 2020).
The poverty rate of this region is the highest in London, as 37.1% of the population has lower socioeconomic status (ONS, 2021). This proportion provides a clue to understanding the causes of the high rate of obesity in this region. As people of lower socioeconomic status struggle to get a square meal, they are encouraged to buy sub-standard, unhygienic, and harmful diets, enhancing the chances of obesity and healthcare complications (Noonan, 2018).
Local Authority & Commissioners
In order to accomplish the goal of removing health inequalities by providing equal healthcare access to all people, the greatest responsibility lies on the shoulders of Clinical Commissioning Groups (CCGs) and local authorities. The priorities of CCGs include redesigning and improving healthcare services and actively engaging in healthcare services to improve healthcare quality. (NHS, 2015). For this purpose, CCGs make a clear and accurate assessment of local healthcare needs, choose healthcare priorities and strategies and purchase healthcare services from the appropriate providers. The CCGs’ healthcare providers include hospitals, clinics, and community health services. Furthermore, it is the responsibility of CCGs to remain flexible in their policy and adapt to the changing healthcare scenarios as they occur with the change in local social, economic, or cultural circumstances (NHS Confederation, 2021).
It is a fact that CCGs and health commissioners do not prioritize obesity as a healthcare issue to be addressed; however, this issue is more related to public health priority. Nevertheless, this responsibility also lies with CCGs to a greater extent. As per the official manifesto of CCGs, addressing socioeconomic issues which affect life expectancy and issues that can deteriorate the quality of life are their top priorities (NHS Leeds Clinical Commissioning Group, 2020).
However, the Healthcare Act is designed with the sole purpose of eradicating legal barriers, which makes integration and replacement of CCGs with integrated care systems (ICSs) (NHS Confederation, 2022).
PART 2:
The Related Health Needs
Access to the best healthcare facilities and availability of opportunity is the fundamental right of all the people living in Barking and Dagenham, and this right is in line with the universal right of equal access to healthcare facilities for all humans. Without fulfilling this fundamental requirement, one cannot anticipate healthy growth and economic and social prosperity in the people of this region (Barking and Dagenham, n.d). Obesity and overweight are one of the most prominent factors which have caused the deterioration of the healthcare system since these problems cause severe healthcare issues, including cardiovascular diseases, hypertension, and cancer (Barking and Dagenham, n.d). People having a risk of developing these healthcare complications tend to suffer from obesity. As a result, they also suffer from psychological and social problems such as bullying, lower self-esteem, and lower academic performance. Most of them belong to ethnic minorities belonging having lower socioeconomic status. (Department of Health and Social Care, 2018).
One crucial aspect of obesity is that even though it is often triggered by living in poverty in childhood, it persists throughout life and causes severe to moderate healthcare complications (LBBD, 2021). Another crucial aspect of childhood obesity and overweight is that it is not easy to get rid of these problems, for eating only healthy meals is not the ultimate solution to resolve the obesity problem. On the contrary, to resolve the issue of childhood obesity, authorities, and locals need to adopt a holistic approach involving all the measures available to help children overcome this problem (LBBD, 2021).
Despite their apparent harmless nature, obesity and overweight are strongly linked with the development of moderate to severe healthcare illnesses, including higher chances of a stroke, blood pressure, diabetes, and evince. At a milder level, obesity and overweight can weaken the natural immune system, and this weakness develops mild illnesses such as flu, cough, and cold. According to one estimate, obesity and overweight will result in 44000 additional healthcare complications by the year 2035. This projection shows that obesity and overweight is a significant healthcare concerns as the increase in this healthcare challenge may lead to a significant decline in the average lifespan of people in this community. Accordingly, even a minor change in healthcare characteristics may result in a crucial improvement or deterioration of the healthcare status of this population (OHA, 2016).
According to one estimate, only a one percent reduction in the number of cases of obesity per year may result in preventing the occurrence of 77,000 cases of lethal diseases by the year 2035. One of the most prominent of these diseases is type 2 diabetes (OHA, 2016). According to some other estimates, the future impact of obesity and overweight could be even greater as, based on their calculation, the healthcare issues generated by obesity and overweight may be as many as 7.6 million by the year 2035 (OHA, 2016). Resultantly, healthcare authorities must launch immediate initiatives to reduce the negative impacts of obesity. A crucial impact on the growing cases of obesity in Barking and Dagenham was the COVID-19 pandemic; the onset of the pandemic increased the proportion of families living indoors and children playing indoor games. Resultantly, the ratio of obesity in children and adults increased significantly during and even after the pandemic (LBBD, 2021).
To understand the problem of obesity in the target population, one has to consider the proportion of male and female children in the population of Barking and Dagenham. Accordingly, the population comprises 35848 male children and 33209 female children (PHE, 2020). According to an estimate made by NCMP 2019-2020, 12.9% of children in their reception years and 28.4 % of children within six years of age suffer from obesity. Furthermore, 4.2% of children of reception years and 7.9% of children within six years of age suffer from severe and life-threatening obesity (NHS Digital, 2020). As mentioned above, the core factor behind this shockingly high rate of obesity in children of this locality is their lower socioeconomic status.
The changes in lifestyle in the modern era have produced a deleterious impact on the health of the general populace; however, children are the most prominent target of these changes. In the previous era, obesity was common among adults; however, in modern times, the ratio of obesity in children, with specific reference to those living in Barking and Dagenham, has increased disproportionately. According to figures, one out of every ten children in the locality experiences obesity by the age of 5; likewise, when they reach 11 years, 1 in every two children suffers from obesity (LBBD, 2021). One additional factor which contributes to childhood obesity and overweight in the region is the lack of family support or healthy and supporting home life for children of the impoverished communities. Lack of healthy and supportive family care is one of the crucial aspects of adverse childhood experiences, which increases the chances of obesity and overweight (LBBD, 2021). According to one estimate, 75.43 per 1000 children aged 0-4 years have to live in a family having domestic issues such as abuse and discord (Barking and Dagenham, n.d). This fact also reflects the gravity and complexity of the situations, which lead to an increase in the rate of childhood obesity.
Obesity is the most common healthcare problem of the Black and Minority Ethnic (BME) population living in these regions, and it is more common in boys than in girls. Obesity affects the Black and Minority Ethnic (BME) population the greatest in Barking and Dagenham. Obesity is rising more among minority ethnic and Black boys than those of white British boys. A contrary trend is observed in White British children as in this group, and the white girls experience a surge in obesity and overweight. At the same time, this problem is negligible in white British male children (Knower, 2019). Adults suffering from diseases like hypertension and diabetes become a victim of obesity; therefore, these healthcare issues are the top priorities and need of these people (Barking & Dagenham, 2021). This problem has significantly increased the mortality rate in these localities.
The following aspects provide a glimpse into aspects that make a living in these regions valuable (Figure 2), and these figures also highlight these regions’ future plans (Figure...