Child of the North: Physical activity, obesity and food insecurity

By Dr Marie Bryant, University of York; Dr Alison Fildes and Professor Jason Halford, University of Leeds; Professor Caroyln Summerbell, Durham University; Dr Calum Webb, The University of Sheffield.

Examining physical activity levels, food intake, and levels of food insecurity, and the prevalence of obesity in children living in the North of England since the beginning of the COVID-19 pandemic.

Before the pandemic, these outcomes in children were generally worse in the North compared with the South of England (except for some inner parts of London).
These geographical differences can, in part, be explained by relative levels of deprivation. But that’s not the full picture. Even after adjusting these outcomes for deprivation, a substantial divide remains, suggesting more deep-seated structural issues. The COVID-19 pandemic has had a profound impact on the daily lives of children. Among the most significant changes were opportunities to be physically active, and access to food and different types of food.

Given that these factors determine growth and body fatness, it is important to ascertain whether the pandemic has also had an impact on levels of childhood obesity. Sadly, the evidence suggests that the pandemic has exacerbated North-South inequalities in physical activity levels, food insecurity, and obesity, for children.

While the legacy of these changes is yet to play out, there is real risk of short-term impacts translating to longer-term effects on health, and widening inequalities. There is some good news from initiatives tackling physical activity and food insecurity, helping to ‘level up’ children in the North, but there is little confidence in the sustainability of these efforts. If no child is to be left behind, plans must be upscaled and sustained.

Policy response and the need for whole system actions

The North-South variation in the prevalence of childhood obesity in England is certainly fuelled by poverty. Policies that aim to reduce food poverty and food insecurity, as outlined above, and investment in early years services are key to realising the Government’s ambition to halve the prevalence of childhood obesity by 2030, whilst also reducing health inequalities. It isn’t that the existing Government Obesity Plan is wrong – all of the strategies within it are sensible, evidence-based, and theoretically effective. However, they rely on an individual’s ability and will to make healthier lifestyle choices – including what food and drink they buy and consume – and on their access to appropriate health services in their local area.

A recent study sampling local authority obesity programmes found that the overwhelming focus was on changing individual behaviours rather than changing the environments in which people live. Alone, therefore, the Obesity Plan is likely to have limited impact.

The research suggests that reducing child poverty is a pre requisite to reversing and reducing the overall prevalence of, and inequalities in, childhood obesity across England. Beyond this, we need a whole system approach, with a broader set of initiatives targeting, in particular, educational settings, town planning and industry. Strategies must ensure access to health services according to need, with an appropriate balance of prevention and management of childhood obesity within emerging integrated care systems.

The elephant in the room is what this would cost. In the challenges of operating in a pandemic recovery economy, will local authorities and industry have the financial resource and political will to invest in tackling inequalities in childhood obesity in England, above other pressing priorities?

This Blog post is taken as an extract from the N8 Research Partnership Report – Child of the North: Building a fairer future after Covid.

Share this blog!