Cheshire and Merseyside Cancer Alliance Strategic Obesity Project: Year 1 Findings and Next Steps

18 May 2023 Cheshire and Merseyside Cancer Alliance Strategic Obesity Project: Year 1 Findings and Next Steps

Health Equalities Group is currently delivering a long-term project for the Cheshire and Merseyside Cancer Alliance (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.

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. As such, this project is stimulating connectivity across the system amongst traditional health and non-health stakeholders, whilst this emerging area of preventative work is also linking with existing screening services and CMCA projects around early diagnosis.

Scoping and Insight work

Year 1 of the programme had a strong focus on scoping and insight from across the sub-region. This has included: two sets of stakeholder interviews from 27 leaders across the health and non-health sectors; insight from 6 focus groups including people with protected characteristics; responses from 327 people to a public facing insight survey; and, a new set of geo-demographic data correlating obesity, cancer prevalence and deprivation. In addition, a workplace weight-loss programme with a large call centre based in Cheshire has also been piloted as part of Year 1 activity. Please see reports on the scoping and insight phase of the project to download below.

Key findings and recommendations from this phase have included the following:

• The causes and solutions to lowering prevalence of overweight and obesity within C&M are complex, but there is a unanimous opinion from both public and professional stakeholders across the system that this is an issue that needs greater visibility and prioritisation.
• There is also a strong willingness to work in partnership to make this happen from local and national stakeholders, but strong leadership is needed across the system to enable policy change.
• Taking a preventative approach to addressing overweight and obesity is paramount, with a shift towards the wider determinants of health. All stakeholders, including the NHS, need to play a stronger role in moving from a culture of downstream treatment to upstream prevention, including a stronger focus on preventative policies and actions for children and young people from pre-natal up to late teenage years.
• In line with national data, quantitative and qualitative data evidenced that overweight and obesity are inextricably linked to deprivation, in particular unemployment and low income, and there should be greater recognition of the interplay between economic growth and sustainable, healthier communities at systems level.
• Obesogenic environments with a high prevalence of hot food takeaways, HFSS advertising, and convenience stores with little access to fresh fruit and vegetables were also cited by public and professional stakeholders as key drivers for overconsumption of calorie dense, ultra-processed foods. The prevalence of obesogenic environments and ‘food deserts’ in areas of higher deprivation was also noted as a point for intervention.
• The role of the VCFSE sector and community hubs was identified by the public and by multiple stakeholders as ‘trusted voices’ to engage local populations who do not readily access primary care. VCFSE organisations flagged up the requirement for capacity building and knowledge transfer within the sector concerning overweight and obesity, nutritional and weight management advice, and the need to co-create interventions with local populations.
• Public sector and statutory partners outside of public health were also cited as playing a key role in taking a preventative approach to addressing overweight and obesity as part of a multi-agency approach, in particular housing, transport providers, leisure services, emergency services, DWP and schools.
• The private sector, in particular large employers and business support organisations, also has a role to play in promoting healthier weight through their business practices, including provision of real living wage, health and wellbeing programmes, and creation of active work environments with a healthier catering offer for staff.
• Communicating on the subject of overweight and obesity is fraught with difficulties with a wide spectrum of opinions on how key messages should be delivered, whilst recognition of the association with some cancers was much lower than other NCDs.

• The related issues of weight stigma and the need to take a compassionate approach to obesity were particularly prevalent with regard to NHS services and staff, with training on weight stigma and further use of the MECC / brief intervention approach as two potential actions to develop further.

Key activity for 2023-24

In response to the findings from Year 1 scoping and insight, the project will focus on specific sectors and key themes across 2023-24, some of which will stretch into 2024-25 as specific work packages. This will include work packages on:

• Capacity building for the VCFSE sector
• Using planning levers to address obesogenic environments
• Policy work to limit/prohibit advertising of HFSS products on public transport and council assets
• Development and piloting of weight stigma training for NHS settings
• Building greater connectivity across the system through: sector specific briefings and events, a public facing communications campaign; a C&M specific declaration on healthy weight to promote senior leadership

For more information about the project please see the project website:

www.cm-strategicobesity.org

Or contact Health Equalities Group at:

info@hegroup.org.uk

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