How local innovation, applied with a whole systems approach, could hold the key to solving this ‘wicked’ problem.
Over the past decade, statistics on childhood obesity in England have illustrated the rise of a growing health problem. Latest data from the National Child Measurement Programme shows that almost a fifth of all children in reception are overweight, obese or severely obese, increasing to over a third in Year 6. This trend is more extreme in the most deprived areas in the country, doubling in many areas, bringing into sharp focus the relationship between deprivation and health inequality.
“Childhood obesity is one of the most serious global public health challenges of the 21st century, affecting every country in the world. In just 40 years, the number of school-age children and adolescents with obesity has risen more than 10-fold, from 11 million to 124 million (2016 estimates). In addition, an estimated 216 million were classified as overweight but not obese in 2016.”
Childhood obesity is a complex, systemic problem, perpetuated by many different ‘actors’ in the system. From food producers and advertisers, to local high street businesses and societal norms.
With so many influencing factors, we need to take a systemic approach to solutions.
Taking the first steps
Last June, the UK Government published the second chapter of their Childhood Obesity: Plan for Action, recognising the complexity of this challenge and setting high ambitions to achieve by 2030. The Government also recognised the vital role local authorities can play, announcing a three-year trailblazer programme underpinned by Public Health England’s Whole Systems Approach. Aiming to address childhood obesity on a local level, the programme hopes to produce learnings and replicable frameworks other councils can follow and adapt to their own childhood obesity challenges.
This year, we started working with the Local Government Association (LGA), Department for Health and Social Care (DHSC) and Public Health England (PHE) to support 13 councils through a discovery phase to identify the root causes and influential actors in childhood obesity within their local system. Five councils were selected to continue in the programme, receiving funding to develop the interventions they believe can action real, systemic, positive change locally.
Building whole systems and design capabilities
Bringing all 13 councils together for workshops, we supported the councils to build their design research capabilities. By mapping local systems, compiling insights around the causes of obesity in their local area, we identified people in the system with high levels of influence that could be incentivised to work together, affecting greater positive change.
Throughout, we focused on the importance of taking a person-centred and whole systems approach to identify the components that were ‘keeping the problem’ in place. Part of this was helping identify the policy ‘levers’ for change that they, as local authorities, could test to further stretch local government’s powers in solving this problem.
By the end of discovery, each council had identified an area in their local system which potentially holds the answer to making truly positive change. For some councils, this meant leveraging the TFL advertising ban on foods high in salt, sugar and fat to expand the restriction across other advertising channels and reduce the unhealthy food messages residents are surrounded by. While other councils found that religious settings could be a pivotal platform for championing healthier behaviours within local community life.
What happens next?
Five councils have been selected for phase 2: Lewisham, Pennine and Lancashire, Nottinghamshire, Birmingham and Bradford. These councils have developed plans to test scalable interventions that would solve the problem of childhood obesity. We’ll be supporting the councils to test their solutions through prototyping, exploring if and how the proposed interventions will solve problems identified in the discovery and the potential impact on the wider system.
We’re currently travelling around the country, spending time with each council to learn as much as we can about their proposed intervention, the context of their local system and assess where best we can support. Together, they’ll continue to develop and deliver their plans over the next year through a test and learn approach.
Take a look at the programme overview for more details about their exciting plans and stay tuned as we share stories of the council’s system-wide achievements and learnings along the way.