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CHILDHOOD
OBESITY

[innovation session]
THE PROBLEM
Childhood obesity is one of the most serious        Globally, in 2010, the
public health challenges of the 21st century.      number of overweight
                                                   children under the age
Overweight and obese children are likely to stay    of five is estimated to
obese into adulthood and more likely to develop
                                                        be over 42 million.
noncommunicable diseases like diabetes and
cardiovascular diseases at a younger age.
                                                    Close to 35 million of
                                                       these are living in
                                                    developing countries.
THE PROBLEM
High Prevalence of Overweight and Obesity in Schoolchildren
THE PROBLEM
Increasing Number of Overweight Children Around the World
THE PROBLEM
Increase in Schoolchildren At Risk As Well
THE PROBLEM
Both Developed and Developing Countries Face the Challenge
THE PROBLEM
Factors that Influence Risk


• Obesity prevalence varies between ethnic groups within countries.
• Gender differentials in obesity prevalence are also frequently observed and need to
  be considered in programme planning.
• Evidence shows that television advertising influences children’s food preferences,
  purchase requests and consumption patterns and that increasingly children are being
  exposed to a wide range of other marketing techniques.
• Peers can serve as remarkably powerful role models for children and may share their
  unhealthy eating or exercise habits with them.
• Obesity is linked to socioeconomic deprivation
• There is some evidence that parental and household behaviours shape the food
  and exercise habits of the child
THE CONTEXT
Economic Assessment of the Intervention at the Population Level
(Average Effect per Year)
THE CONTEXT
Cost per Life Year Gained in Good Health of Interventions to Tackle Obesity
THE OPPORTUNITY SPACE
Healthy Arkansas Initiative


• Arkansas Act 1220 of 2003 requires that
  all public school students have an annual
  BMI screening
• Recent initiatives that limited access to
  vending machines in schools, while at the
  same time providing healthier alternatives
• Efforts to increase physical activity in
  schools
THE OPPORTUNITY SPACE
Singapore “Fighting Obesity”


• Compulsory membership of
  Health Clubs for overweight
  schoolchildren
• Monitor her height and weight
  every month
• Teachers meet parents
  regularly to recommend
  healthier ways to prepare their
  meals at home
THE OPPORTUNITY SPACE
The big lesson on behaviour change is that environments and service design
matter more than individual treatments/intervention
How do we redesign our
approach to tackling
childhood obesity?
DRIVERS OF BEHAVIOUR
                           Habits are repeated behaviours, often fairly automatic and
 Habits                    sometimes difficult to control, triggered by environmental cues.
                           Habits can challenge motivations for behaviour change.
                           Beliefs about consequences, social norms and relative costs and
 Beliefs                   benefits influence the behaviour changes that people are willing
                           to make.
 Translating               A perceived lack of time, reluctance toward short-term costs,
 Intention into            distractions and stress can heighten a risk of failing to start or
 Action                    failing later on.
 Automatic vs.             Automatic attitudes are those that people are unable or unwilling
 Self-Reported             to retrieve from memory themselves. These often conflict with
 Attitudes                 explicit or ‘self-reported’ attitudes (e.g. “I don’t like cake.”).

 Moral Climate             The effect that attitudes have on some behaviours is, in part,
                           determined by moral norms.
Adapted from UK Government Office for Science, Tackling Obesities: Future Choices, 2nd ed.
POSSIBLE ROUTES TO ACTION

•   Food regulation
•   Fat taxes
•   Public awareness
•   TV
•   Cycling lanes
•   Walking buses for children
•   Slow food
•   Personal health technologies
POSSIBLE ROUTES TO ACTION
Impact




                      Risk

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GIA Singapore - Childhood obesity (Mulgan)

  • 2. THE PROBLEM Childhood obesity is one of the most serious Globally, in 2010, the public health challenges of the 21st century. number of overweight children under the age Overweight and obese children are likely to stay of five is estimated to obese into adulthood and more likely to develop be over 42 million. noncommunicable diseases like diabetes and cardiovascular diseases at a younger age. Close to 35 million of these are living in developing countries.
  • 3. THE PROBLEM High Prevalence of Overweight and Obesity in Schoolchildren
  • 4. THE PROBLEM Increasing Number of Overweight Children Around the World
  • 5. THE PROBLEM Increase in Schoolchildren At Risk As Well
  • 6. THE PROBLEM Both Developed and Developing Countries Face the Challenge
  • 7. THE PROBLEM Factors that Influence Risk • Obesity prevalence varies between ethnic groups within countries. • Gender differentials in obesity prevalence are also frequently observed and need to be considered in programme planning. • Evidence shows that television advertising influences children’s food preferences, purchase requests and consumption patterns and that increasingly children are being exposed to a wide range of other marketing techniques. • Peers can serve as remarkably powerful role models for children and may share their unhealthy eating or exercise habits with them. • Obesity is linked to socioeconomic deprivation • There is some evidence that parental and household behaviours shape the food and exercise habits of the child
  • 8. THE CONTEXT Economic Assessment of the Intervention at the Population Level (Average Effect per Year)
  • 9. THE CONTEXT Cost per Life Year Gained in Good Health of Interventions to Tackle Obesity
  • 10. THE OPPORTUNITY SPACE Healthy Arkansas Initiative • Arkansas Act 1220 of 2003 requires that all public school students have an annual BMI screening • Recent initiatives that limited access to vending machines in schools, while at the same time providing healthier alternatives • Efforts to increase physical activity in schools
  • 11. THE OPPORTUNITY SPACE Singapore “Fighting Obesity” • Compulsory membership of Health Clubs for overweight schoolchildren • Monitor her height and weight every month • Teachers meet parents regularly to recommend healthier ways to prepare their meals at home
  • 12. THE OPPORTUNITY SPACE The big lesson on behaviour change is that environments and service design matter more than individual treatments/intervention
  • 13. How do we redesign our approach to tackling childhood obesity?
  • 14. DRIVERS OF BEHAVIOUR Habits are repeated behaviours, often fairly automatic and Habits sometimes difficult to control, triggered by environmental cues. Habits can challenge motivations for behaviour change. Beliefs about consequences, social norms and relative costs and Beliefs benefits influence the behaviour changes that people are willing to make. Translating A perceived lack of time, reluctance toward short-term costs, Intention into distractions and stress can heighten a risk of failing to start or Action failing later on. Automatic vs. Automatic attitudes are those that people are unable or unwilling Self-Reported to retrieve from memory themselves. These often conflict with Attitudes explicit or ‘self-reported’ attitudes (e.g. “I don’t like cake.”). Moral Climate The effect that attitudes have on some behaviours is, in part, determined by moral norms. Adapted from UK Government Office for Science, Tackling Obesities: Future Choices, 2nd ed.
  • 15. POSSIBLE ROUTES TO ACTION • Food regulation • Fat taxes • Public awareness • TV • Cycling lanes • Walking buses for children • Slow food • Personal health technologies
  • 16. POSSIBLE ROUTES TO ACTION Impact Risk