Elsevier

Public Health

Volume 158, May 2018, Pages 9-14
Public Health

Original Research
Increasing inequality in childhood obesity in primary schools in a northern English town

https://doi.org/10.1016/j.puhe.2018.01.033Get rights and content

Highlights

  • There is inequality in relation to obesity prevalence in primary school children in Doncaster.

  • The obesity prevalence gap between children in the most and least deprived quintile of schools is increasing over time.

  • Small area analysis of national epidemiological data can be used to inform local action.

  • Local public health policy and practice should focus weight management initiatives on schools in deprived areas.

Abstract

Objective

To undertake an analysis of National Child Measurement Programme (NCMP) data to quantify the obesity prevalence gap over time between children in primary schools in the most and least deprived areas of Doncaster.

Study design

The research design for this study was retrospective quantitative analysis of secondary data.

Methods

The study undertook secondary analysis of NCMP data on obesity prevalence in children in Reception Year and Year 6 in primary schools in Doncaster for the period 2006–2007 to 2014–2015. Data were combined into three 3-year periods (2006–2007 to 2008–2009; 2009–2010 to 2011–2012; and 2012–2013 to 2014–2015), and schools were grouped by deprivation based on the national Indices of Multiple Deprivation 2015. Analysis was undertaken to assess whether there is a difference in obesity prevalence for Reception Year and Year 6 children in schools in the most deprived areas compared with the least deprived (prevalence gap), over time.

Results

The difference in obesity prevalence between children attending schools in the most and least deprived areas has increased over time. For Reception Year children, the prevalence gap has widened from a difference of 1.01% higher in the most deprived schools in 2006–2007 to 2008–2009 to 3.64% higher in 2012–2013 to 2014–2015. In the same time periods, for Year 6 children, the obesity prevalence gap has also increased over time from 2.82% to 5.08%.

Conclusions

There is inequality in relation to obesity in primary school children in Doncaster with those in schools in the most deprived areas carrying the greatest burden. Research is needed to understand why the plateau seen nationally is not reaching the most deprived children.

Introduction

Childhood obesity is a high-priority public health area across the UK, with a quarter of 2- to 10-year-olds and a third of 11- to 15-year-olds overweight or obese.1 The adverse impact on the health, social care and economy are well documented; obesity increases the risk of type 2 diabetes, coronary heart disease, stroke, many cancers and reduces life expectancy.2, 3 Adverse social consequences include social isolation and discrimination.4 The direct cost to the National Health Service (NHS) in 2006–2007 was estimated to be £5.1 billion,5 which was 6% of the NHS budget that year. This is expected to double to £10 billion per year by 2050, with wider economic costs, such as loss of productivity, modelled at almost £50 billion per year by 2050.6

The prevalence of childhood obesity in England has trebled since the 1980s,7 reaching a peak of 19% in 2- to 15-year-olds in 2005.8 Since then prevalence has plateaued. However, this plateau is not uniform across society. National reports in England, using data sourced from the National Child Measurement Programme (NCMP), highlight that the obesity burden is increasing for children from the most deprived areas, and this is increasing over time.9 This emerging and increasing obesity prevalence gap highlights the growing disparity between the most and least deprived children in society.10, 11

The NCMP is the national epidemiological tool for monitoring weight in children in England. The programme is not in place in the rest of the UK. It involves all primary school children being measured (weight and height) on starting school at age 4–5 years and leaving school at age 10–11 years to assess whether they are underweight, of normal weight, overweight or obese. The NCMP started in 2006, and this research aimed to analyse 9 years of the data for Doncaster, a northern English town, to assess whether there was a local obesity prevalence gap between the most and least deprived children and to determine what the gap was, using this to inform local policy and practice. This was performed retrospectively, undertaking quantitative analysis of the Health and Social Care Information Centre (HSCIC) data. The HSCIC is the national information, data and IT system provider to the health and care system in England and is now known as NHS Digital.

Doncaster is a metropolitan borough council located in the north of England. It is coterminous with the area Clinical Commissioning Group, the body responsible for commissioning health services. The 2011 national census in the UK recorded the population of Doncaster at 302,400. Doncaster is considered a deprived area, and it ranked 48th most deprived local authority in England (out of a total of 326), according to the English Index of Multiple Deprivation (IMD; 2015).12

The objective of this study was to undertake an analysis of NCMP data to quantify the obesity prevalence gap over time between children in primary schools in the most and least deprived areas of Doncaster.

Section snippets

Methods

The research design for this study was retrospective quantitative analysis of secondary data. At the time of the study, there were 9 years of NCMP data available for analysis, from the initial year of the NCMP programme in 2006–2007 to 2014–2015.

Results

There were 104 primary schools in Doncaster in 2016. Data were analysed for 124 primary schools over the study period. This difference reflects changes to schools in terms of closures, mergers and the evolution of academy schools over this time.

The total number of children measured over the time period was 57,510, 52% pertaining to Reception Year children and 48% pertaining to Year 6 children. Participation in the NCMP in the town is similar to the national participation rate and has gradually

Discussion

The findings of this study show a modest decrease in obesity prevalence overall, for both year groups, from 2006–2007 to 2014–2015.

Of note, the most recent NCMP national report for the 2016–2017 school year (released after this study) highlights that the decline seen nationally may be changing with an increase in obesity prevalence for Reception Year children, in England, for the last 2 years, whereas for Year 6, obesity prevalence is stable.14

The results highlight a widening obesity prevalence

Acknowledgements

No patient identifiable data was used in this project. Permission was sought from HSCIC (NHS Digital), as the owner of the NCMP data, to access the datasets for the relevant years.

Ethical approval

Ethical approval for analysis of secondary data was received from the University of Sheffield.

Funding

None declared.

Competing interests

None declared.

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