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Robin Ireland, Director of Research, Food Active (part of the Health Equalities Group), discusses how elected members can be powerful levers for change to champion and promote healthy weight.
We know society faces major health concerns because of the high prevalence of overweight and obesity which impacts on our poorest communities the most severely. Of course there is no single solution. We agree that more attention and resources should be given to prevention, but expensive healthcare treatments such as weight loss drugs and bariatric surgery grab the headlines in the media.
We find it hard to even find the right words to describe our interventions. We are aware of the terrible stigmatisation those who live with overweight and obesity experience. We need to take a compassionate approach to individuals but at the same time we need to describe the health consequences across the population if we do not take action.
Whole systems approaches provide an important and helpful direction of travel. We can’t leave everything to public health to fix. Planning decisions impact on the number of fast-food outlets in our neighbourhoods and outside our schools. Prioritising walking, cycling and wheeling infrastructure enables all of us to be more active. Promoting the health and wellbeing of our staff in the NHS has benefits both for them and their patients.
The part we are able to play in taking whole systems approaches is determined by the access we have to power and resources. For example, we have to address upstream measures to enable people to be able to afford and find healthier food. Cooking lessons, although admirable, help only those who are able to attend (and hopefully their families).
Whilst supporting individuals to change their behaviours, improve skills and confidence, we also need to consider much more impactful interventions across whole populations, where we can make affordable and good quality fruit and vegetables more available to all, and fast food outlets, which provide only unhealthy choices, made less attractive.
This requires system leadership. Whether in national or local government, in the NHS or in the third sector. We need to be braver in our policy choices if we are to support and work with our communities to be healthier.
The Local Authority Declaration on Health Weight, first launched in 2015, presents an opportunity for councils to lead local action and demonstrate good practice in adopting a systems approach to healthy weight.
Elected members can be powerful levers for change to champion and promote healthy weight. The Local Authority Declaration on Health Weight provides a mechanism to engage members and provide visibility and accountability. It is a statement owned by each adoptive authority, signalling a strategic commitment made across all council departments.
The Declaration includes 16 standard commitments whereby councils pledge to achieve action on improving policy and healthy weight outcomes in relation to specific areas of the council’s work. Within the Declaration there is also the opportunity for councils to add local commitments relevant to their community health needs and priorities. These local priorities are primarily determined through a wider consultation process which may include stakeholders such as the Health and Wellbeing Board, (or, increasingly, ICS and Primary Care Networks), third sector, and wider public consultation.
Over 32 councils across England have adopted the declaration; these range from metropolitan to unitary authorities, and county to district councils. The Healthy Weight Declaration is used to support healthy weight strategies, place-based approaches, diet and physical activity programmes, and whole systems approaches to overweight and obesity. Evidence emerging from adoption of the Declaration is starting to demonstrate that a ‘local authority declaration’ on healthy weight is an effective tool in bringing together a range of stakeholders and raising the profile of, as well as setting the agenda on, policies and practices promoting improved diet and physical activity. Case studies from local councils who have adopted the declaration are available in the New Healthy Weight Declaration Impact and Influence report (Food Active).
