Generating evidence to inform policies to prevent childhood obesity

UPDATE 21-04-22
WP1 will use National Child Measurement Programme data, adjusted for deprivation and ethnicity, to identify outlier local authorities (n=343) with respect to trends in and absolute levels of mean body mass index (BMI). I will also identify outliers with respect to the change in the gradient of BMI with deprivation. I will use a mixed methods case study analysis to understand the events and processes that may contribute to that case being an outlier. The work will be informed by a conceptual systems map for childhood obesity at the local level, co-developed with stakeholders.
WP2 will use public health modelling to quantify the impact on childhood obesity (and inequalities in childhood obesity) of different regulatory options for takeaway outlets, focusing on those that could be implemented at a local level. I will build a new module, to simulate the impact of changes in energy intake from takeaway food, for the existing PRIMEtime model. Interventions studied will be informed by stakeholder and public consultation. I will use data from empirical trials, observational studies, the National Diet and Nutrition Survey and the Food Environment Assessment Tool to parameterise the model.
WP3 is a natural experimental study, comparing Sainsbury's supermarket (which restricted its use of price promotions in 2016), with other supermarkets that did not. I will use a difference-in-difference approach to estimate the impact of the policy on annual purchases and expenditure of foods linked to childhood obesity (e.g. confectionary, crisps). I will use Kantar Worldpanel data for the UK (c. 30,000 representative households) from 2014-2018. I will undertake analysis for all households and by socio-economic group.
Impact and Dissemination
The findings from WP3, concerned with barriers to and opportunities for reducing childhood obesity, will inform local practice and influence policy nationally. WP2 will enable policy makers to better understand and compare the potential impacts of different regulatory options. The findings from WP1 will help policy makers to make informed decisions about the regulation of price promotions, an evolving area of national policy. Being part based in local government, I will work with colleagues in practice and policy to ensure the findings are understood and appropriately disseminated to achieve maximum impact.

My research will benefit children (and adults); policy makers and public health practitioners; UK business; and other researchers.

Whilst the primary focus is the UK, the UK is ahead of many countries in terms of commitment to tackling childhood obesity, and the challenges faced in other countries are similar, meaning there will be significant potential for the work to be applied and have impacts globally.

Children and Adults

The primary intended beneficiaries of the work are children. The work will support the introduction of better informed policies that are more likely to successfully create healthy environments that can allow children to grow up healthy. This will benefit not only children's health during childhood, but also their subsequent health in adult life. Tackling childhood obesity will improve future children's chances of achieving their full potential and reduce the risk of intergenerational inequalities caused by the increasing burden being placed on them by obesity.

Whilst not the direct focus of my fellowship, the interventions introduced to improve children's health can be expected to have a positive impact on adult's health. Adults and children share many of the same environments, so creating healthy environments for children will create healthy environments for adults.

Policy Makers and Public Health Practitioners

By working with policy makers (e.g. colleagues at Public Health England and Department for Health and Social Care) and public health practitioners (e.g. public health professionals in local government), I will produce new knowledge that will directly inform how these professionals work to prevent childhood obesity.

The model produced in WP2 could be converted into a tool (or emulator) to provide information directly relevant to local government departments concerned the health and other impacts of interventions to regulate takeaway food outlets.

Knowledge will be disseminated to these professionals either directly by me, e.g. through written briefings, meetings and presentations, and formal evidence submissions to government inquiries, as well as indirectly, i.e. by others (in civil society organisations and the media) picking up and using the evidence I produce to disseminate to these groups. As a result, part of my dissemination strategy will target the people who do this dissemination (i.e. charities, think tanks, the media).

UK Business

Obesity is a significant drag on UK economic growth - it costs the country more than 3% of GDP, with much of this cost being borne by business through reductions in productivity and employment. Obesity has a disproportionate effect on morbidity and disease in early and mid-life (e.g. type 2 diabetes, back pain, other musculoskeletal problems, depression) and thus has a negative impact on future productivity. Preventing obesity needs to start in childhood to enable the healthy workforce that UK business needs in the future.

The benefits to business accrue through the implementation of policies that allow children and adults to be healthier. Preventing obesity and the morbidity associated with it can reduce demands on (and costs of) both health and social care.

Many parts of the food industry recognise that the industry needs to change to tackle the rise in obesity (and prevent or mitigate climate change). The findings may be able to assist parts of the food industry to respond in a positive way for health.

Other Researchers

The work will be of interest to the community of public health and obesity researchers in the UK and worldwide. It will be used as part of formal evidence synthesis, to inform research ideas, and may contribute new tools/methods for future research (primarily through the public health modelling in WP2). I will also directly train and mentor two post-doctoral researchers and one PhD student, developing research capacity in this area of public health research.