A Superzone pilot in one of the most deprived ward’s in Portsmouth will focus on the environmental drivers of obesity and bring together work across the council, from housing, transport and education to planning and public health.
Following the Director of Public Health’s 2017 Annual Report which focused childhood obesity, the Health and Wellbeing Board requested an action plan on obesity.
A review of current activity to tackle excess weight indicated that substantial efforts were being made by the council, NHS and community groups. Much of the work focused on individuals and families, with less concentration on environmental factors which evidence shows can have a bigger impact on obesity at a population level.
The council decided to adopt a place-based approach to coordinate public policy and community action. It aims to reduce childhood obesity in one defined area, roughly a ten minute walk around Arundel Court Primary School in Charles Dickens ward, one of two areas in the city with the highest rates of child excess weight.
To help inform the council’s approach, children at Arundel Court were surveyed about what makes them healthy and unhealthy.
Pupils said they loved living in Pompey, and enjoyed playing outside and visiting the beach and the park. But they also highlighted a series of negatives such as; the unpleasant environment (particularly dog poo, litter, cigarette smoke offensive graffiti); not feeling safe (aggressive behaviour in the street); a lack of healthy food near their homes (too many fast food outlets in a small area that can be tempting for families).
The superzone takes a whole systems approach with four work streams– active places, healthy food environment, cleaner air and community and safety.
Dominique Le Touze, a Public Health Consultant for Portsmouth City Council, said: “The dramatic improvements we are looking for in reduced childhood obesity, cleaner air and safer communities are going to take longer than one year. But we will be looking at a number of outputs that indicate we are moving in the right direction.”
Interventions are taking place at all levels, from public policy to community action and individual behaviour change.
Improving nutrition in packed lunches with a lunch box audit is a priority, as well as improving the uptake of school meals and free school meals. At the same time there will be increased engagement with parents and the wider community through food events and a community festival.
Action on the active places work stream includes looking at incidental physical activity, such as getting to school and active play, and exploring the use of Play Streets.
Reduced exposure to unhealthy foods around the school day is one of the ideas being looked at, inspired by small successes in other parts of the city; a fastfood outlet has reduced and standardized chip portions and a shop near a school limits sales of fizzy drinks to children in the period directly before and after school.
“Much of this is happening across the city anyway to a larger or lesser extent,” said Le Touze. “This brings it together in a coordinated fashion in a hyperlocal area. Combining that with the insights and support of people living there is what I’m excited about as this will make the work more meaningful and sustainable.”
Progress against baselines and in key outputs will be measured in 12 months time.
It is hoped the pilot and its results will encourage more city wide endeavours but council officers are aware that a one-size fits all approach would be a mistake.
“We are looking at including a comparator baseline from another school in a different part of the city that has equally high levels of childhood obesity,” said Le Touze. “It has a very different location and demographic. Approaches in Charles Dickens may well be different to the approaches we take there.”
The evidence provided by the children’s survey was a “game changer”. It provided a different perspective and highlighted elements in the environment that matter to them. Their testimony has proved very powerful in garnering support across department and among elected members.
How will the approach be sustained?
There is no budget attached to the pilot, other than officer time. Funding will be sought for specific initiatives. However it is a coordinated approach, building on work that is already happening and that is part of officers’ core business.
Cultural and community buy-in will be vital to sustain the approach at a local level. The pilot will put in place the structures and the infrastructures to make positive behaviours the easier option for residents.
Cllr Matthew Winnington, Cabinet Member for Health, Wellbeing and Social Care at Portsmouth City Council, said; "By joining together different council departments and working with other organisations in a defined area we've got a real chance to see what activity might make the biggest difference to childhood weight.”
Dominique Le Touze, a Public Health Consultant for Portsmouth City Council