22 Feb 2023 Blog: Healthier weight and cancer – the role of Cancer Alliances in addressing overweight and obesity
To mark Cancer Prevention Action Week (20th-26th February), we heard from Matthew Philpott, Executive Director of Health Equalities Group (HEG), about the overweight and obesity prevention project HEG are delivering for the Cheshire and Merseyside Cancer Alliance (CMCA).
The NHS is facing an obesity epidemic with 63% of adults in England living with overweight or obesity. The NHS Long Term Plan sets out new commitments for action the NHS will take to support individuals to achieve and maintain a healthy weight. It does so while recognising that a comprehensive approach to preventing and tackling obesity also depends on action that spans individuals, companies, communities and national government. This blog will look at the early stages of a project addressing overweight and obesity at a systems level commissioned by the NHS Cancer Alliance for Cheshire and Merseyside in North West England.
The Royal College of Physicians state that a large number of socio-economic factors such as where we live and our income and education levels help to determine the access we have to healthy food and thus our risk of obesity. There are inequalities both in adult and childhood obesity. In 2018/19, the prevalence of obesity in children aged 10–11 was 27% in the most deprived areas and 13% in the least deprived areas, data that is particularly pertinent to certain local authority areas in Merseyside and, to a lesser extent, Cheshire.
The association between overweight, obesity and cancer outcomes is less well recognised by the public than the influence of smoking, although there is wider understanding of the links between overweight, obesity and both CVD and Type 2 Diabetes. However, Cancer Research UK states that overweight and obesity is the second biggest cause of cancer in the UK, with more than 1 in 20 cancer cases caused by excess weight, whilst over 40% of specific types of cancers (e.g. breast, bowel, kidney) can be specifically attributable to obesity:
Health Equalities Group (parent charity for Food Active), is currently delivering a long-term project for the Cheshire and Merseyside Cancer Alliance (hereon CMCA) to develop a ‘hub’ of connectivity, bringing together system leaders and stakeholders, including non-health stakeholders such as housing, transport, employers and VCFSE organisations, to increase the overall volume and reach of initiatives designed to improve rates of overweight and obesity within the sub-region. Cancer Alliances are NHS organisations that were established in 2016 and bring together clinical and managerial leaders from different hospital trusts and other health and social care organisations, to transform the diagnosis, treatment and care for cancer patients in their local area. Find out more about the Cancer Alliances here.
Whilst a number of Cancer Alliances in England are starting to incorporate upstream prevention into their programmes, in particular treating tobacco dependency, the Cheshire and Merseyside Cancer Alliance is the first to commission a specific project addressing overweight and obesity, the benefits of which will exceed cancer outcomes alone. Speaking about this pioneering approach for a Cancer Alliance, Steve Jones, Senior Project Manager at CMCA said:
“As a Cancer Alliance we are aware that a project addressing overweight and obesity is something of a departure from our traditional core focus, but we are committed to taking an upstream, preventative approach to a significant and modifiable risk factor for certain cancers. As a sub-region Cheshire and Merseyside has above average rates of overweight and obesity in child and adult populations, whilst we also have higher than average rates of cancer prevalence. Not only will this project seek to stimulate connectivity across the system amongst traditional health and non-health stakeholders, but this emerging area of preventative work will link with existing screening services and CMCA projects around early diagnosis.”
Year 1 of the programme has had a strong focus on scoping and insight from across the sub-region, including stakeholder engagement and interviews from the health and non-health sectors, public engagement and insight from groups with protected characteristics, and a new set of geo-demographic data correlating obesity and cancer prevalence. A workplace weight-loss programme is also currently being delivered as part of Year 1 activity. Read more about the project launch here.
A key work package for Year 1 was a stakeholder insight exercise conducted in two phases gaining valuable perspectives and guidance from 26 representatives from national and local health organisations (NHS and local authority), transport, housing, economic development, VCFSE organisations, large employers, emergency services and DWP. Findings from this exercise showed that the interviewees recognise the complexity behind the levels of overweight and obesity in Cheshire and Merseyside and the determinants of health leading to these figures. In order to address overweight and obesity, the balance needs to be shifted from treatment to prevention and to encompass health and well-being.
A majority of interviewees also wanted to see a focus on young people with regarding solutions to overweight and obesity, whilst there was also a consensus amongst stakeholders across all backgrounds to use and share data at sub-regional level to drive interventions more effectively. Interviewees from the second phase of interviews recognised the role their own organisations (e.g. a Fire and Rescue Service) could play in addressing healthy weight, whether in the community or in the workplace, or through supporting the objectives of local public health teams. Finally, and perhaps most importantly, stakeholders also highlighted how communications about overweight and obesity had to be consistent and avoid victim-blaming and the use of stigmatising language and imagery. A report on Phase 1 of the research is available now, with the report from Phase 2 available w/c 6th March.
The different strands of research and initial scoping work across 2022-23 will be used to inform priority areas and key objectives for future work undertaken as part of the Cheshire and Merseyside Cancer Strategic Obesity Project, with a programme plan for work across 2023-24 developed and submitted to commissioners at CMCA.
Find out more about Cancer Prevention Action Week here.
For further information about the project, please contact Matthew Philpott from Health Equalities Group: info@hegroup.org.uk
