Read: Obesity – more than just a health issue
Like most other health indicators, the issue of obesity impacts disadvantaged communities the most. Poor life expectancy, a higher incidence of serious diseases, poor neonatal health and maternal outcomes are just some of the other ways in which health inequality impedes access to opportunity for those who live there. That affects their economic prospects and life chances. New research shows the extent of the link between deprivation and obesity, as well as the wider economic impact that results from a loss of productivity, work absence and premature mortality.
The rates of people who have obesity or are overweight in England have tripled since 1975 and today almost two-thirds of the population live with it. It’s one of the top five causes of premature death in England alongside smoking, poor diet, high blood pressure and alcohol and drug use. New analysis from the Future Health Research Centre[1], led by a former government special adviser on health, Richard Sloggett, shows the rising impact of a crisis in which the most deprived parts of England have obesity rates one and a half times higher than the least deprived areas.
It also demonstrates a much clearer link between obesity and productivity, highlighting that local authorities with the highest rates of obesity also have the lowest rates of GDP per head at £24,214. Conversely, those with the lowest rates of obesity outside London have the highest rates of GDP at £33,979. That’s a difference of £9,765 a head. None of the 24 local authorities where obesity rates were highest had a GDP above the national average. The average rate of overweight and obesity in the ten places with the lowest GDP is 69.4% - eight in the north of England, one in the West Midlands and just one – Torbay in Devon – in the south. In the ten areas where personal productivity is highest, there is a much lower percentage of 62.6% overweight people. Five are in Berkshire, two in the Midlands, one in Buckinghamshire, one in Gloucestershire and just one in the north in Manchester.
That negative impact also affects employment with places like Hartlepool, Blackpool, Wirral and Kingston upon Hull all in the top 20 local authorities for both obesity rates and workless households.
As with other inequality indicators, there can be significant variation within areas. Thurrock in Essex has the highest recorded local authority rate of people having overweight or obesity at 76%. Seventeen local authorities (all in London) have overweight or obesity rates of below 55%. Islington has the lowest at 44%, nearly a quarter below the rate in Thurrock, despite the two places being just 25 miles apart.
The research also demonstrates the impact of obesity on health outcomes and health inequalities which will inevitably demand increasing amounts of spending on direct and indirect healthcare. At a local level, higher levels of deprivation map onto higher obesity rates, higher numbers of hospital admissions and higher numbers of patients undergoing surgery. Hospital admissions related to obesity, for example, are three times higher in the most deprived areas than the least deprived. There has been an accelerated increase in the number of admissions with a primary and secondary diagnosis of obesity, with a seven-fold increase in the ten years from 2009/10 to 2019/20. All four Integrated Care Systems (ICSs) with the highest rates of obesity are in the Midlands, whereas all five with the lowest rates are in London. There is also an inevitable rise in demand for GP appointments in the worst affected areas.
Purpose Health Coalition members are meeting the problem head on, tailoring action to where they consider it will be most effective and working in partnership with other local organisations who are familiar with their communities. In Warwickshire, for example, where there is evidence that obesity is greater in the more deprived areas of the county, two different trusts are both targeting children. Obese children are likely to become obese adults so the South Warwickshire NHS Foundation Trust is running a health education and nutrition programme for young children as a more general focus on health rather than illness and on helping people to help themselves. George Eliot Hospital NHS Trust is part of a local partnership, North Warwickshire Place, which is running a programme aimed at Year 6 pupils but which also engages with their parents and carers to increase its take up.
The problem of obesity is complex and there’s no doubt that it will require societal change to make a difference. Meanwhile, the OECD estimates that by 2050 overweight and obesity will reduce GDP by 3.3% in the UK. It’s clear that addressing the issue effectively is not just a health imperative but an economic one.
