Obesity Case Study – EDPHiS

SUMMARY
Background
Childhood obesity is already epidemic in some countries and on the rise in others
including both industrialised and increasingly developing nations. It is associated
with substantial co-morbidity during childhood and adulthood. In Scotland for
example, adult obesity is associated with nearly 500,000 cases of high blood
pressure, 30,000 cases of type 2 diabetes, and similar numbers of cases of
osteoarthritis and gout, and its consequences cost the NHS in Scotland an estimated
£171 million in 2001.
In the UK, childhood obesity continues to be a major concern with 13.7% of 2-10 year
olds currently being classified as obese. In Scotland, there has been an increase in
overweight (including obesity) (defined as above the 85th BMI percentiles of the U.K
reference curves) from 28.8% (boys) and 31.1% (girls) in 1998 to 37.3% (boys) and
32.8% (girls) in 2003.
Reviews have concluded repeatedly that obesity prevention and control in children
have produced modest results. One aspect of this is that people find it difficult to
operate in environments which increasingly promote a high energy intake and
sedentary behaviours (“obesogenic” environment). Thus the success of obesity
prevention at the population level is not likely to occur until environmental influences
are identified and modified.
According to the Foresight report (2007), children are a critical area of policy overlap,
and intervention in early life is likely to generate the highest average impact on
obesity prevention. Therefore the scope of the measures taken to secure healthy
children will be a key test, not only for any obesity strategy but also for child-specific
policies.
This scoping report looks at the strength of evidence of the EDPHiS DPSEEA chains
in childhood (≤10 years) obesity, from major reports and reviews.
DPSEEA chains
At the start of the project workshops were held with stakeholders to identify chains of
Drivers, Pressures, States, Exposures, Effects and Actions according to the DPSEEA
MODEL. Sixteen chains were produced for diet and 15 for physical activity. These
chains were reviewed by four members of the EDPHiS team in Aberdeen and a
revised list circulated to all members for further comments and modifications. Four
chains for diet and four for physical activity were removed, all but one because they
were not relevant to children. Three new chains were added for diet, three for
physical activity and three for both diet and physical activity.