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.

Liverpool judge’s decision recognises that ‘home’ still exists for the homeless

File 20180621 137717 2f8ym8.jpg?ixlib=rb 1.1
Shutterstock

Clare Kinsella, Edge Hill University

Stephen Gibney, a Liverpool man, has been sentenced to eight weeks imprisonment for urinating on homeless man Richard Stanley, while he slept rough in Liverpool City Centre. District Judge Wendy Lloyd handed down the sentence not just for degrading Stanley as a person, but also for attacking his home. Justice Lloyd condemned the offence, calling it:

A deliberate act of degradation of a homeless person … it was his home, his little pitch where he was trying to establish himself as a human being … apparently, to you and your companion this was just a joke.

By recognising that a homeless person can have something akin to a home, the judge acknowledges that home is an abstract, nebulous and subjective idea – that the meaning of home can differ between people and contexts. People who are homeless in the legal sense often feel as if they have a home, whether that be a city, a particular neighbourhood, a family or a friendship group. Some even understand their home in connection to the land, or as a content state of mind.

By making these comments, Justice Lloyd affords Stanley the dignity of having a recognisable defensible space, marked out by his possessions, which to all intents and purposes is his home – and should be respected as such.

A changing city

Since the early 1980s, Liverpool has been undergoing economic, physical, social, political, reputational and cultural regeneration. These processes have picked up pace since 2003, when Liverpool was announced as the 2008 European Capital of Culture. This accolade proved to be the catalyst for a range of initiatives to “clean up” the city, ready for its big year.

Like many other cities across the globe – New York, during its 1990s drive to shake off its title of “murder capital of the world”; Sydney, in the run up to the 2000 Olympics; and Glasgow in its preparations for its own European Capital of Culture year in 1990 – Liverpool’s authorities turned their attention to the city centre.

Mathew Street, Liverpool: drinkers with houses, welcome. littlenySTOCK/Shutterstock

In Liverpool, rough sleepers, street drinkers and any other groups identified as “uncivilised” impediments to regeneration were singled out and subjected to a range of punitive measures, including the criminalisation of street drinking and begging, designed to clear them from view. It was all part of the bid to present the city as prosperous and cultured, and to free it of its previous reputation for poverty, crime and post-industrial decline.

Scorned, not supported

Views of rough sleepers as anathema to prosperity and progress stem from the false belief that they must, by definition, perform all bodily functions – from urination and defecation to sleep and sex – in public spaces rather than a private home. Because of this, rough sleepers are seen as uncivilised – and consequently unwelcome – by authorities determined to attract business and tourism.

This has led, in some quarters, to the vilification of “visible” homeless people – particularly where their homelessness is seen as a “lifestyle choice” – on the basis that they wilfully stand in the way of social, economic and cultural progress. They are a social element to be scorned, rather than supported: a view which may have led Gibney – a man with a home in the conventional sense – to perform the kind of bodily function on Stanley, which is more often unfairly attributed to rough sleepers.

Once it is recognised that the idea of “home” applies beyond a formal abode of bricks and mortar, many more violations come to light: from the clearance of informal settlements, to the enforced displacement of whole populations.

For example, consider the forced removal of the population of Diego Garcia, an atoll in the Indian Ocean, to nearby Mauritius because the US military needed a refuelling base. The phenomenon is so widespread that it has even been given a name – domicide. The “-cide” suffix connotes murder: the deliberate, calculated and wilful killing of a home.

The ConversationBy thinking of the destruction of “home” as an act of killing, we recognise the its true value – home means so much more than simply a place or a building. And, although the meaning of home varies from person to person, those who lose their home – for whatever reason – almost universally experience shock, grief and bereavement. Justice Lloyd’s comments on handing down Gibney’s sentence reflect two vital but overlooked truths: that home has meaning beyond bricks and mortar and that being homeless does not necessarily mean having no home at all.

Clare Kinsella, Senior Lecturer in Criminology, Edge Hill University

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