Child obesity is linked to deprivation, so why do poor parents still cop the blame?

World Obesity Federation., CC BY

Robert Noonan, Edge Hill University

Childhood obesity has risen ten-fold over the past 40 years. In the UK, roughly 30% of children are overweight or obese. Obesity rates are much higher among children living in deprived communities. In England, there is a clear trend: the wealthier a child’s family is, the more likely the child is to be a healthy weight. And those who are a healthy weight during childhood are much more likely to be a healthy weight in adolescence.

In 2006, then Labour leader and prime minister Tony Blair argued that many public health problems, including obesity, can be solved by getting people to change their lifestyles. But strong evidence from behavioural economics research and weight-loss trials shows that advocating personal responsibility is destined to fail in the long-term.

The fact remains that behavioural interventions alone – such as the NHS five a day and Change4Life campaigns – do little to address child obesity across society, because healthy food is not always easily accessible. In fact, these types of approaches widen socioeconomic health inequalities. Findings from my latest research drive this home: childhood obesity rates in Liverpool – one of England’s most deprived cities – increased by up to 3% between 2006 and 2012.

Lessons from Liverpool

For our study, we analysed data from the National Child Measurement Program (NCMP), which measures the height and weight of children within state schools across England. We examined the data of 25,905 children aged four to five years and 24,220 children aged ten to 11 years, recorded between 2006 and 2012, in order to track changes in childhood obesity and socioeconomic health inequalities over time.

Liverpool is the sixth largest city in England, and up until 2016 it was ranked as the nation’s most deprived, with over 90% of Liverpool’s 470,000 population living in areas of high deprivation. Across the six-year duration of the study, children who lived in deprived communities became overweight or obese at a greater rate than children living in less deprived communities.

As public health and other services across England continue to have their funding cut by central government, it’s more important than ever that the nation takes a new approach to tackling child obesity, and reduce inequalities linked with poor health.

A better way

For too long, behavioural interventions have been used to prompt people – especially parents – to take responsibility for individual instances of child obesity. For example, the national social marketing campaign Change4Life aims to prevent child obesity, by educating and informing families about the benefits of being physically active and eating healthily. And the NCMP informs parents if their child is overweight by means of a letter, reinforcing the idea that it’s the parent’s responsibility to address their child’s weight.

Meanwhile, little attention is paid to the policies or the social and environmental conditions which also shape healthy (or unhealthy) behaviours. Research points to inequality as a primary factor which prevents people from making healthy choices. For example, many deprived communities are “food deserts”, where affordable or high-quality fresh food is hard to come by.

Deprived communities also have few opportunities for physical activity, and typically live in areas where there are lots of fast food outlets. If we take Liverpool as an example, the city now houses over 600 fast food outlets – a figure which has risen by roughly 10% since 2014.

Too great a temptation. Shutterstock.

There is quite a lot of evidence showing that children are more likely to be overweight or obese if there are fast food outlets near their home or school. To reduce access and remove temptation, some councils in England have suggested banning fast food outlets within 400 m etres of schools. But councils’ hands are tied, as they dont’t have the powers to stop new takeaway outlets being built.

People are the product of their environment, and in modern society, the default choice for many people is the unhealthy choice – and for some, the only choice as eating healthy has been shown to be more expensive. To address this major problem, government policies need to address public health priorities. The healthy choice needs to be just as easy as the unhealthy choice, and there needs to be a level playing field, in terms of the accessibility and pricing of decent food.

Placing the responsibility on children and families, without changing their economic and physical environment, will do little to tackle health inequality and reduce weight-related health problems in society. Instead, the government needs to step in and, through policy, create communities which promote and enhance healthy choices and lifestyles. Only this will ensure that the default choice for most people is the healthy choice.The Conversation

Robert Noonan, Senior Lecturer in Physical Education and Children’s Physical Activity, Edge Hill University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Everything you need to know about the legal high ban

serpeblu/Shutterstock

New laws to introduce a blanket ban on the sale, production, distribution and supply of legal highs have now come into force across the UK. The Psychoactive Substances Act attempts to close a loophole that has allowed legal high manufacturers to flourish by banning all psychoactive substances. All previously legal highs, including laughing gas, are now considered illegal, except for those with “specific exemptions” such as food, alcohol, nicotine, caffeine and medical products.

The effects of legal highs are often similar to prohibited stimulant drugs such as ecstasy and amphetamines. This explains why they belong to a group of drugs known more technically as psychoactive substances. Coffee, cigarettes, beer and sleeping pills all contain psychoactive substances, as do cannabis, ecstasy and LSD.

The reason for some substances with psychoactive properties being legal and some illegal pretty much comes down to a hark back to the good old days. History set a precedent with alcohol and tobacco, firmly established in society before any thought of legal prohibition emerged. And it would be just about impossible to try and make them illegal now – just look at the failure of alcohol prohibition in the US in the 1930s.

The loophole

Before now it was not possible to effectively prohibit “legal highs” in the UK because the law required that a substance first be defined by its chemical structure before a ban could be imposed. This provided a loophole for “black market chemists” who responded by making small but significant changes to the chemical structure of a substance to create a “new” drug which was not prohibited. When mephedrone became illegal in 2010, for example, it gave rise to the “now familiar cycle of new (legal) products appearing almost immediately after one was banned.”

It is never easy to predict the likely consequences of a new law like this and there has been ample criticism already, with suggestions it could push people to use harder drugs and that this change could even see more deaths by drugs as people move onto harder substances in the wake of the ban. There had also been calls for regulation rather than an outright ban, with many believing it will be hard to enforce, and could end up being another “war on drugs” disaster.

Reports show that similar legislation in Ireland has resulted in the closure of some shops selling legal highs – which are often known as “head shops” – but that’s not the end of the story. It is thought many former “head shop” customers are now using black market dealers, or the dark web to buy their drug of choice.

And the growth is legal highs is showing “no signs of a slowdown”,
according to a recent report, Ireland has the highest number of legal high users in Europe with over 20% of 15-24 year olds surveyed saying that they had used legal highs at some point.

The progress of prosecutions for dealing and possessing “legal highs” in Ireland has also been limited by difficulties in determining and demonstrating that a substance actually is “psychoactive”. The term “psychoactive” is essentially vague, which makes it difficult to prove under law that a specific effect comes directly from a specific new substance.

Drug of choice

Another factor to consider is that many legal high users are already taking “harder” substances and often consume illegal and so-called legal drugs together. A recent study of legal high users in New York showed people often use both ecstasy and cannabis at the same time as legal highs, and within the same drug taking session. So the introduction of the Psychoactive Substances Act is unlikely to do anything to stop this. Instead, the change in law will just mean that users will now get all their drugs from illegal sources.

Critics have suggested the legal highs ban will increase drug-related deaths by moving sales underground.

However, the new law may not fail entirely in its aim of encouraging abstinence from legal highs. Research from New Zealand – where a number of legal highs were banned in 2014 – shows that the legal status of drugs is taken by some users to indicate the “relative safety” and “social acceptability” of the drug. For legal high users in the UK who think this way, there is some possibility then that the new law may actually work.

Ironically however, accounts from some New Zealand drug users also indicated that the perceptions of greater safety and social acceptability of legal highs led to them not using, or using less of, illegal drugs such as ecstasy. And with so many legal high users already using illegal drugs to begin with, it follows that an unintended consequence of the new law may see higher consumption of already illegal drugs with known dangers.

It’s clear then that while the introduction of the new laws banning legal highs are seen as a step in the right direction for anti-drug campaigners there is still a long way to go when it comes to implementing these new laws and regulating drug use across the UK. Looking to other countries as an example, we know that if people want to get high, they are going to get high whether policy likes it or not – and only time will tell how this change in law will truly impact drug use across the UK.The Conversation

Philip Murphy, Professor of Psychology, Edge Hill University

This article was originally published on The Conversation. Read the original article.