05 Nov 2019 Blog: The role of system leadership in tackling the obesity crisis
Ahead of the #FoodActive2019 conference ‘Healthy Weight in all Policies: Two Years On’ on Tuesday 12th November, we hear from Lead Director for Public Health at Food Active, Matthew Ashton to discuss one of the key themes of the conference – the role of system leadership in promoting healthy weight.
The Government has committed to halving childhood obesity by 2030. Yet, the latest round of National Child Measurement Programme results suggests achieving this will be very difficult – with the prevalence of obesity in reception children (aged 4-5) increasing from 9.5% in 2017/18 to 9.7% in 2018/19. Three childhood obesity strategies in and with little signs of the rising tide of obesity slowing down, signals that our current approach to tackling obesity simply isn’t working.
From my experience in local government and public health, I believe that taking a whole systems leadership approach to the obesity crisis, among other public health issues, is key to driving change.
System leadership
The Foresight report ‘Tackling obesities’, published in 2007 showed us the complexities surrounding the obesogenic environments in which we now live. It is clear that being overweight or obese is caused by a multitude of factors whether they be legislative, biological, environmental, economic or social. Why then, is tackling obesity all too often left to public health alone?
System leadership needs to be multi-level and multi-organisational, and is key in establishing a joint vision, shared by all partners in the whole system[i]. So, what would this look like when considering an approach to tackling obesity?
Adopting a system leadership approach involves building and managing effective partnerships to ensure that clear and consistent messages and action are delivered across the board. In my role as a Director of Public Health we have engaged the whole council to consider healthy weight as a priority and in doing so work closely with planners, transport agencies, education, digital and media, and others. This approach also needs to be taken at a sub regional and national level, with a consistent and clear vision across sectors. This is the only way we will turn the tide on obesity. One area from which we can take learning is Amsterdam, where the city’s healthy weight programme views a healthy life for children not just as a responsibility of the parents, but as a responsibility shared by everyone who plays a part in the life of children, be it close by like neighbours and teachers, or from afar like policy makers and the food industry. Whilst it is still early days, recent surveillance data suggests that there has been a drop in the prevalence in obesity in children, particularly in disadvantaged areas[ii].
Getting the narrative right
The need for a joined-up vision at national government level became evidently clear recently. On 10th September The Treasury tweeted to suggest that one of the benefits of Great Britain leaving the European Union without a deal would mean a return to duty-free shopping on tobacco, beers, wines and spirits. What kind of message is this for a government department to be sharing to millions of people, given the well-evidenced impact alcohol and smoking have on the health and wellbeing of our population? Less than a month later we then see the Department of Health and Social Care tweeting about the health harms associated with smoking or consuming too much alcohol, as well as the publication of the Prevention Green Paper which to commits to making the next generations smoke free by 2030 and reducing alcohol abuse. Two government departments…two very different messages!
Such messages from the Treasury are certainly not helpful to the aspirations of the Department of Health and Social Care. There was indeed a significant backlash from this tweet, and quite rightly so. You can read my response to the tweet after I challenged the Health Secretary Matt Hancock at the Public Health England conference last month here.
So, what is key in driving change? Well I think it is about system leaders and policy makers leading from the front and setting the standard. This has been a key factor in local authorities experience of adopting the Local Government Declaration on Healthy Weight – high level buy in is essential, and now this needs to happen at national level as well.
Only once we are all signing from the same hymn sheet will be finally start to tackle the rising tide of obesity. Public health simply cannot do it alone.
The #FoodActive2019 Conference will be held on Tuesday 12th November in Manchester. Click here to find out more.
References:
[i] http://eprints.chi.ac.uk/1231/1/Kings%20Fund%20Whole%20Systems%20Leadership.pdf
[ii] https://www.ucl.ac.uk/obesity-policy-research-unit/sites/obesity-policy-research-unit/files/what-learned-from-amsterdam-healthy-weight-programme-inform-policy-response-obesity-england.pdf
