Agenda item

Report of the Corporate Director of Adult and Health Services and the Director of Public Health, DCC.

The Board received an update presentation from the Public Health Strategic Manager, Mick Shannon on the review of healthy weight approaches in County Durham (for copy see file of minutes).

The Public Health Strategic Manager noted the importance of people moving and considering how much they eat.  He acknowledged the impact of the pandemic on people’s behaviours.  He asked the Board for their thoughts on what they felt were key contributors to obesity.  Responses from the Board included: lifestyle choices; mental health issues; temptation from junk food; impact or side effects from medication or accidents; busy lifestyles; sedentary work and hobbies, such as working at a computer, playing computer games; cost of living impact; cost of access to some exercise; environment; and lack of cheap healthy food options.

The Public Health Strategic Manager noted issues that impacted included mental health and explained as regards food architecture and marketing and explained as regards evidence of pre-natal health issues, such as being overweight or smoking, having an impact on.  He explained as regards the change from the early part of the twentieth century, where the focus had been on tackling malnutrition, most often associated with poverty and the establishment of the welfare state.  He noted that now, those deprived areas were those suffering with the higher prevalence of obesity, with links to cheaper foods often being unhealthy and less nutritious.

The Public Health Strategic Manager noted the Healthy Weight Alliance met four times a year, with a significant amount of work having been carried out with local assets and key collaborators.  He noted mapping exercises and agreement to act across key partners.  He noted the example of the impact of hot foot takeaways, with 40 percent of children in County Durham leaving primary school overweight, and with 75 percent of adults being overweight.  He noted the impact of salt, with reduction in salt helping to reduce high blood pressure and associated impacts such as coronary heart disease.

The Public Health Strategic Manager explained noted that assessment of the impact of any work was evidence based, looking at key areas: systems leadership; long term systems approach; health promoting environment; community engagement; focus on inequalities; life course approach; monitoring, evidence, evaluation and innovation.

The Public Health Strategic Manager asked how the Board could help support healthy weight key priorities.

The Director of Public Health noted the Healthy Weight Declaration, with the Board signing up to the declaration.  The Head of Integrated Commissioning, Sarah Burns noted that continuing to work together in partnership was important, so each organisation can influence where it can, for example the Council being able to look at issues such as planning and leisure provision.  She noted the excellent work of School Sports Champions in encouraging young people to move more.  The Senior Policy Officer, Steph Rich noted the importance of recognising that working across County Durham meant working in many different types of areas, noting that for example, those living in rural areas were more reliant on private motor vehicles and would need to travel further to access facilities.  She added it was important to use local knowledge of communities within the County and asked what metrics were used to measure healthy weight, such as BMI or calorific intake.  The Public Health Strategic Manager noted that there was positive engagement within our local communities and that BMI was used as a metric, although other data, such as waist size were important.

The Corporate Director of Adult and Health Services asked if there was a checklist associated with the Healthy Weight Declaration, in terms of organisations signing up.  The Public Health Strategic Manager noted this would be discussed at an upcoming meeting of County Durham Together, with the key being in providing impact.  He added that the NHS had done a lot of work in County Durham in this regard, and actions included taking breaks, fresh air and nutritious food.

M Graham noted that Childrens and Young People’s Services operated different models in different areas and asked if other Local Authorities’ approaches had been looked at.  The Public Health Strategic Manager noted that the Office for Health Improvement and Disparities had shared ideas such as healthy activity strategy.

The Head of Partnerships and Community Engagement noted the work in terms of a “healthy start to life” what is included in the school curriculum and activities such as after school cooking clubs.  He noted that the ‘healthy weight lens’ should be applied to what we do, for example where warms spaces are being provided for those in need, is the food provision healthy and appropriate.  The Public Health Strategic Manager noted that working together to promote healthy weight was a challenge and included promotion of what was healthy in terms of levels of salt, fat and sugar.  The Senior Policy Officer noted that it was important to educate children in terms of being more active, however, there were factors to consider such as safety, especially when exercising outside in winter months.

Councillor R Bell asked as regards national policies in relation to volume promotions of foods high in salt and sugar.  The Public Health Strategic Manager noted the ban on the promotion of food high in fat, salt and sugar had been due to come into effect from October 2023, however, that had been pushed back to October 2025.

Councillor T Henderson asked as regards the links between poor mental health and unhealthy weight.  The Public Health Strategic Manager noted that unhealthy weight could impact upon mental health and vice-versa.  He noted a lot of work with colleagues from Primary Care in developing a toolkit in relation to help identify and have conversations with those individuals where there could be those links.  Councillor T Henderson asked as regards the provision of healthy school meals.  The Public Health Strategic Manager noted discussions in relation to supporting schools in terms of linking with suppliers of nutritious foods, and in encouraging healthy options.  Councillor R Bell asked if there were any differences in terms of Local Authority controlled schools and those that had become Academies.  The Public Health Strategic Manager noted he could find out.

M Pearson, County Durham and Darlington Fire and Rescue Service noted that it was important to look at physical exercise and living a balanced lifestyle.  He noted that viewing unhealthy food as a treat, taken in moderation, was important and noted the impact and influence that sports stars could have in terms of being role models for young people and that there could be opportunities to link in with schools in that regard.  The Public Health Strategic Manager noted that exercise was very important, and that Government had allocated £320 million for sports within schools.  He agreed that it could be beneficial for County Durham to utilise its sports personalities, noted that Firefighters from the County Durham and Darlington Fire and Rescue Service were very fit and represented good role models in that regard.  He noted the “Active 30” for children, with children to have 30 minutes of physical activity at school, 30 minutes “at home”.

The Director of Public Health noted that there were no easy answers and that it was important to look to partners to see if anyone was being missed.  She added it was important to embed healthy approaches internally and the commitment of the Health and Wellbeing Board was important in tackling this complex issue.

Resolved:

(i)       That the findings of the review be noted;

(ii)      That the Board endorse the recommendations for action and approve       progress to the delivery stage.