Category: Nutrition

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cost-effective economic evaluation Nutrition Obesity

Economic evaluations of system‐based obesity interventions – the case for a new approach

Sonntag. D.  et al. Obesity Reviews, 2018; 19(5)

System‐based interventions are of increasing interest as they seek to modify environments (e.g. socio‐cultural system, transport system or policy system) that promote development of conditions such as obesity and its related risk factors. In our commentary, we draw attention to features of the system‐based approach that may explain the relative absence of economic evaluations of the cost‐effectiveness of these interventions, needed to guide decision‐making on which to deploy. We present and discuss potentially applicable methods and alternative approaches based on our experiences in two major system‐based interventions currently underway (in Melbourne, Australia and Gaggenau, Germany) that begin to fill this gap. We feel the issues and potential solutions outlined in this commentary are important for a broad range of stakeholders (e.g. clinicians, interventionalists, policy makers) to consider as they seek to address the issue of obesity.

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Alcohol cost-effective economic evaluation Nutrition Obesity Oral Health Physical Activity Smoking STPs Tobacco & Drugs

A systematic review of economic evaluations of local authority commissioned preventative public health interventions in overweight and obesity, physical inactivity, alcohol and illicit drugs use and smoking cessation in the United Kingdom

White, P. et al. Journal of Public Health, 2018, doi.org/10.1093/pubmed/fdy026

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Abstract
Background
Since 2013, local authorities in England have been responsible for commissioning preventative public health interventions. The aim of this systematic review was to support commissioning by collating published data on economic evaluations and modelling of local authority commissioned public health preventative interventions in the UK.

Methods
Following the PRISMA protocol, we searched for economic evaluations of preventative intervention studies in four different areas: overweight and obesity, physical inactivity, alcohol and illicit drugs use and smoking cessation. The systematic review identified studies between January 1994 and February 2015, using five databases. We synthesized the studies to identify the key methods and examined results of the economic evaluations.

Results
The majority of the evaluations related to cost-effectiveness, rather than cost-benefit analyses or cost-utility analyses. These analyses found preventative interventions to be cost effective, though the context of the interventions differed between the studies.

Conclusions
Preventative public health interventions in general are cost-effective. There is a need for further studies to support justification of continued and/or increased funding for public health interventions. There is much variation between the types of economically evaluated preventative interventions in our review. Broader studies incorporating different contexts may help support funding for local authority-sponsored public health initiatives.

Categories
Accident Prevention Alcohol behaviour change Community Safety Health Protection (Emergency planning Healthy Settings Long-Term Conditions Mortality Nutrition Obesity Oral Health Physical Activity seasonal mortality) Tobacco & Drugs

Tackling multiple unhealthy risk factors: emerging lessons from practice

By The King’s Fund (2018)

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  • Previous research by The King’s Fund has shown that unhealthy behaviours cluster in the population. Around seven in ten adults do not follow guidelines on tobacco use, alcohol consumption, healthy diet or physical activity, yet most behaviour change services address these behaviours separately, not reflecting the reality of people’s lives.
  • This report shares learning and insight from services that are using innovative ways to address the problem of multiple unhealthy risk factors in their populations. It draws on interviews and information from eight case studies in local authorities and the NHS and updates the evidence base on tackling multiple unhealthy risk factors.
  • Most services included in the report are local authority led and are integrated health and wellbeing services. These provide behavioural advice and support to people across a range of different behaviours, including smoking, weight management and physical activity.
  • The NHS is also addressing multiple unhealthy behaviours. We set out learning from two hospitals supporting individuals with multiple risk factors.
  • The evidence for these behaviour change services to draw on, in the context of multiple unhealthy risk factors, remains limited. These services are in a position to develop the evidence base on how best to address multiple unhealthy behaviours.
  • The report makes recommendations on how services can develop and share evidence, and for how the Department of Health and Social Care and Public Health England can support further innovation in such services.
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Nutrition Obesity

Making obesity everyone's business: a whole systems approach to obesity

By Local Government Association (2017)

This briefing, written in partnership with Public Health England and the Association of Directors of Public Health, focuses on the Whole Systems Obesity programme, which will provide local authorities with a different approach to tackling obesity. The programme is exploring the evidence and local practice to develop guidance and tools to help councils set up a whole systems approach to obesity in their local area.

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Categories
Health Improvement Healthy Settings Licensing Nutrition Obesity Oral Health Physical Activity Planning

Green space and health

By Parliamentary Office of Science and Technology (POST) (2016)

A range of bodies, including government agencies, have promoted the possible physical and mental health benefits of access to green space. This briefing summarises the evidence for physical and mental health benefits from contact with nature, such as reducing rates of non-communicable diseases, and the challenges for urban green spaces.

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Health Promotion Licensing Nutrition Obesity Planning

Building the foundations: tackling obesity through planning and development

By Local Government Association (2016)

This report outlines the actions and role that councils can take in helping to prevent and reduce the prevalence of obesity. It examines the role of town planning in contributing to the public health agenda and includes examples from various local authorities around the country. 

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CYP Healthcare Health Improvement Healthy Settings Licensing Nutrition Obesity Planning

Tipping the scale: case studies on the use of planning powers to limit hot food takeaways

By Local Government Association (2016)

This report contains seven case studies to illustrate how the use of planning powers could be utilised as part of public health policy locally. It highlights the balance to strike between supporting growth of local businesses and promoting healthier choices and options for the population.

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Children CYP Healthcare Healthy Settings Nutrition Obesity

Child obesity cut-offs as derived from parental perceptions: cross-sectional questionnaire

Black, J.A (2015) British Journal of General Practice, DOI: 10.3399/bjgp15X684385 Published 1 April 2015

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Abstract

Background Overweight children are at an increased risk of premature mortality and disease in adulthood. Parental perceptions and clinical definitions of child obesity differ, which may lessen the effectiveness of interventions to address obesity in the home setting. The extent to which parental and objective weight status cut-offs diverge has not been documented.

Aim To compare parental perceived and objectively derived assessment of underweight, healthy weight, and overweight in English children, and to identify sociodemographic characteristics that predict parental under- or overestimation of a child’s weight status.

Design and setting Cross-sectional questionnaire completed by parents linked with objective measurement of height and weight by school nurses, in English children from five regions aged 4–5 and 10–11 years old.

Method Parental derived cut-offs for under- and overweight were derived from a multinomial model of parental classification of their own child’s weight status against school nurse measured body mass index (BMI) centile.

Results Measured BMI centile was matched with parent classification of weight status in 2976 children. Parents become more likely to classify their children as underweight when they are at the 0.8th centile or below, and overweight at the 99.7th centile or above. Parents were more likely to underestimate a child’s weight if the child was black or South Asian, male, more deprived, or the child was older. These values differ greatly from the BMI centile cut-offs for underweight (2nd centile) and overweight (85th).

Conclusion Clinical and parental classifications of obesity are divergent at extremes of the weight spectrum

Categories
CYP Healthcare Nutrition Obesity Oral Health Physical Activity

What works in schools and colleges to increase physical activity?

By Public Health England (2015)

This briefing provides an overview from the evidence about what works in schools and colleges to increase levels of physical activity among children and young people. It is aimed at head teachers, college principals, staff working in education settings, directors of public health and wider partners.

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Nutrition Obesity Statistics

Obesity statistics

By House of Commons Library (2015)

This briefing gives statistics on obesity for England, Scotland, Wales and Northern Ireland with international comparisons. Breakdowns by age, gender, local authority and deprivation are given where possible, and data for both adult and child obesity is covered. In addition to statistics on the prevalence of obesity, this briefing gives statistics on prescriptions of drugs for obesity, trends in bariatric surgery, and the detrimental effect of obesity on health.

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