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I have been asked to produce a report on a health related problem within the UK. The problem that I have chosen to research is obesity.

I am going to research obesity within all generations, how the government proposes to tackle the problem within the UK and how successful government policy is now.

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In a recent broadsheet newspaper, it has been said that Government policy to halt childhood obesity is, “poorly co-ordinated, confused and lack of clarity and forcefulness.”

In 2004 the Government set a target of 2010 to halt the year-on-year rise in obesity in children under 11, but there are still no ring-fenced funds nor any specific programme to bring this about, the Public Accounts Committee says in a scathing report.

http://www.timesonline.co.uk/article/0,,2-2564349.html

This shows that policy isn’t too successful at the minute. If it continues like this who knows where the UK will end up in its fight against obesity?

B – Policy Issue or problem

Obesity is a growing problem in the UK, particularly within the younger generation. Some people are more susceptible to weight gain for genetic reasons, but the main cause of obesity is consuming more calories than are expended in everyday life. Obesity has grown by almost 400% in the last 25 years and on present trends will soon enough become the UK’s greatest cause of premature loss of life.

* Recent estimates for England show that some 8.5% of 6 year olds and 15% of 15 year olds are obese.

* Between 1995 to 2000 the proportion of overweight boys in England aged 2 to 19 years increased by 2 per cent. The increase for girls was by 3 per cent, so that by 2000, 20 percent of boys and 27 per cent of girls were overweight.

* 1 in 5 adults are obese. This contributes to 18 million sick days a year.

With obesity comes a range of health problems that are likely to cause premature mortality. Some of these include:

* Heart disease

* Type 2 diabetes

* High blood pressure

* Osteoarthritis

* Respiratory problems

* Some cancers

* Stress, anxiety and depression

The most common cause of premature mortality amongst the obese population is coronary heart disease. In women, obesity is the third most likely to cause cardiovascular disease.

Type 2 diabetes probably has the strongest link with obesity. The metabolic problems which give rise to this problem most commonly occur of as a result of excess weight. Having diabetes may put a person at more risk of developing high blood pressure and heart disease.

Although the link between obesity and cancer is less well-defined, research suggests that the risk of a range of cancers is increased by obesity including breast cancer, ovarian cancer, cervix, gallbladder, rectum and prostate. The cancer that has probably the most association with obesity is colon cancer.

Osteoarthritis is a common complication with obesity. It is a disease of the weight bearing joints that causes a great deal of disability. With so much weight bearing down on joints such as the knee, it is likely that the excess weight alone is the cause of these problems.

The most serious respiratory problem related to obesity is that of obstructive sleep apnoea. Sufferers experience the feeling of not being able to breath and therefore waking themselves up. This can cause broken sleep patterns contributing to heart disease, high blood pressure and maybe even depression.

Studies by the National Audit Office suggest that the UK treating overweight/obese people costs them �500 million a year and possibly costing the wider economy �2 billion in lost productivity.

One celebrity that takes an active role in children’s health and what they eat is Jamie Oliver. Jamie’s School Dinners was a four-part documentary broadcast on Channel 4. Oliver worked at a typical British school attempting to improve the quality and nutritional value of school meals. Disgusted by the use of unhealthy food within British schools Oliver took it upon himself to raise awareness and to fight for healthier school dinners. Within this time, Oliver set up a website campaign called “Feed Me Better”. His aim was to collect 10,000 signatures and present it to the Prime Minister. He had over 25,000 signatures in the first week. There where 5 main points that Oliver wanted the Government to change. So he wrote a manifesto asking for five things.

* Guarantee that children receive a nutritionally balanced meal at school everyday

* Ban junk food from school meals and introduce nutritional standards

* Invest in dinner ladies: better kitchens, more hours and support and training for them to be motivated when cooking for the children

* Teach children about food and introduce cookery back into the curriculum

* Commit long term funding to improve school food

Subsequent to Oliver’s efforts the Government set up a School Trust Fund and pledged to spend �280 million on school dinners over the course of 3 years.

C – Policy Solutions

The Government believes that part of the solution lies in preventing people from becoming overweight and also helping people that already are overweight. They feel that they can’t cure the situation on their own and therefore have prioritised certain factors in the strategy to tackle obesity within the UK. The prioritisations that have been outlined by the Department of Health are the reduction of coronary heart disease and cancers. They are also producing preventive strategies to improve diet and physical activity. Because the Government cannot deal with obesity alone they have delegated certain services within the NHS. The NHS provides management of obesity, ranging from general advice on diet and exercise and if needed onward referral for specialist help.

When Jamie Oliver started his campaign about healthy eating in school, the School Trust Fund was given �280 million to spend on keeping children healthy while at school. Since then many schools offer salads, fruit and many other nutritious foods during the day. Also taking part in the School Fruit and Vegetable scheme is a local school in Liverpool. They offer children fruit and vegetables throughout the day and they also give the children water bottles with their names on while in class. These are filled with water and left on the children’s desks. This has proven to be beneficial to the children and 96 percent of schools are already taking part.

It is important that the public fully know the damaging effects that obesity can have on their children and themselves. By lowering their children’s intake of fats and junk food, they are in the long term prolonging the children’s lives.

The Government have been working with industry to lower the salt content of many foods. Many fast food restaurants have stopped putting salt onto their fries and let people do it themselves. Food stores like McDonalds have lowered the amount of salt they put into kid’s favourites chicken nuggets. They have also introduced salad-up campaigns and 10,000 steps a day.

In Liverpool, most people use the bus when travelling to work or when taking their children to school. Some people have cars therefore lowering the amount of physical exercise they receive. Nationally people aren’t active enough to benefit their health. More so in Liverpool fewer people are active than the national average. Because of this the Liverpool Physical Activity Strategy has been set up to make physical activity an easier choice for people. It aims to do this by providing a variety of activity opportunities that people can choose to suit themselves and their daily lifestyles.

* In Liverpool only two in ten adults are active enough to benefit their health, but eight in ten people in Liverpool think that they are

* In the last 25 years the distance people walk or cycle has fallen by a quarter

* Nearly one in four boys and one in three girls in Year 5 (aged 10-11 years) in Liverpool are overweight.

* By 2020, at current rates, nearly one third of adults will be seriously overweight (obese) compared with 6% in 1980. Obese people have twice the risk of dying early as people of a normal weight.

* The financial and social costs of this inactivity are very high. There are costs to employers in lost days off work, costs to the NHS in treatment and the cost to individuals and families in illness and disability.

D – Research and Analysis

Here I will present some research within my 2 reports that I chose to include in my assignment.

The table above from the National Audit Office (NAO) shows the amount of fatalities that occurred due to obesity in 1998.

The chart above shows the estimated cost to the Health Service, due to being obese. As you can see it shows that the top 3 disorders that cost the NHS the most are high blood pressure, heart disease and type 2 diabetes.

How do we work out if people are obese? It’s not a case of just looking at them. We use a chart called Body Mass Index (BMI). This takes into consideration your height and weight and gives you an outcome that is either good or bad. A normal BMI should be between the ranges of 18.5-24.9. This is any normal BMI for a normal healthy adult.

The chart above shows what BMI is classed as underweight, normal, overweight, obese, and morbidly obese.

Not only does England have some of the worst figures in Europe but it also demonstrates some of the worst trends in the acceleration of obesity: in the majority of European countries the prevalence of obesity has increased between 10-40% in the last ten years, but in England it has more than doubled.

As I mentioned earlier, Liverpool has one of the worst obesity rates in the UK. There are currently a number of physical activity programme that are being used everyday in Liverpool and there is much to show for good practice and services that are already making a difference in people’s lives. Here is a list of services that Liverpool already has setup:

* Sport and Recreation Services of Liverpool City Council provide a range of services at leisure centres across Liverpool. This includes Lifestyles, which provide discounted and free passes to encourage physical activity for all people.

* Exercise for Health and Fit for Life schemes provides doctors and nurses the ability to refer people to this programme of physical ability. This links the health authority and the City Council which together can provide tailored support for people who would benefit from increasing their level of physical activity.

* A volunteer based scheme called Walk For Life which is a walking programme in local communities

* For the older people Age Concern has provided a range of Active Ageing Programmes. They are provided at many leisure centres and the active Age Centre. As well as helping towards physical activity it has also been successful at reducing social isolation, increasing independence and reducing the risks of falling in the over 50’s.

* The SportsLinx schools programme which provides a range of activity and fitness programmes for children aged 9-10 years. Throughout the programme over 25,000 children have taken part in sports and physical activity through this programme.

* Annual large community events that thousands of people take part. These include the Liverpool Corporate fun run, the Liverpool to Chester cycle ride and the Liverpool women’s 10 Km run, Liverpool Community Games and Merseyside Youth Games.

The Liverpool: Active City 2005-2010 Aims

Their vision is to make more people, more active more often. They want to exceed National Targets in Liverpool. In the next 5 years they aim to:

* Increase by 1% per year the proportion of people who are moderately active for 30 minutes or more 3 times per week (to reach 5% by 2010)

* Increase by 1% per year the proportion of people who are moderately active for 30 minutes 5 times per week (to reach 5% by 2010)

* Increase by 1% per year the proportion of children who are moderately active for 60 minutes 5 times per week (to reach 5% by 2010)

* All children will have two hours physical activity per week in schools – to increase to 75% in 2006, 85% by 2008 and 100% by 2010.

They hope that this will produce a satisfying outcome that will mean in Liverpool,

* 4000 adults will become more active every year

* Over 30000 children will be more active at school by 2010

* By 2010 there will be 124000 adults participating in 30 minutes of moderate physical activity on at least 5 days a week.

How are they going to do it?

Increase the profile of active living in Liverpool

* Promote physical activity through media and marketing campaigns and also raise awareness of physical activity

* Be sure to include an element of physical activity where possible during all participation events in Liverpool

* Train NHS and council staff, community volunteers and voluntary organisations to provide physical activities, to pass on key messages and signpost people to appropriate services

Improve the coordination of existing services

* Ensure that active statutory and voluntary services work better together to achieve our physical activity targets

* Develop a local directory to let people know what is available and it is also an efficient way of sign posting people to appropriate services and opportunities for physical activities

Ensure that everybody has access to appropriate activity

* Make regular reviews of current services to make sure they reach the right people at the right time in the right place

* Support the national target of at least 2 hours a week physical activity for school children

* Ensure all vulnerable groups have access to appropriate physical activity services and programmes

* Listen to local communities and develop activity programmes that are based on the needs of the individual, families and communities

Ensure structural support for physical activity

* Make sure that active living is fully incorporated into urban planning, new capital developments as well as transport and housing policies

* Transport changes using green travel plans that partners will develop and implements to encourage walking. These plans will include school and work travel plans, walking schemes and cycle schemes.

* Encourage the use of local green spaces and waterways.

The Liverpool Physical Activity Strategy aims to make physical activity an easier choice for people by providing a variety of activity opportunities that individuals can choose to suit themselves and their daily lifestyles.

By doing this, it makes exercise flexible whenever and wherever people want to do it. Ultimately this helps towards making Liverpool a healthier city, providing opportunities to get fit and active.

Some partner organisations involved in the development of the Liverpool Physical Activity Strategy include:

� Age Concern

� Central Liverpool Primary Care Trust

� Eastern Link Sports Alliance and Sport co-ordinator

� Heart of Mersey Campaign

� Liverpool JMU

E – Evaluation

The main solution of the obesity policy is to stop the rise of it by 2010. The Government are currently facing a very steep up hill struggle to decrease the amount of obese children under 11. People’s awareness of healthy eating has increased but will this help towards making the UK a healthier country?

I will now list advantages and disadvantages of the current obesity policy.

Advantages

It is obvious what will happen if the Government finally take control of the obesity situation. People will live longer, the NHS will save huge amounts of money and in generally people will be healthier. But in the meanwhile there are a great amount of disadvantages while the Government plan what to do next.

Disadvantages

There are more people applying for weight loss surgery, therefore costing the NHS money that could be spent on things that are needed more in hospitals, there are without a doubt young girls starving themselves to look more like size 0 celebrities because the UK is so obsessed with weight issues, eating disorders are also on the rise. Many more people are developing heart disease and diabetes therefore cutting their life expectancy a great deal.

When I look at the current news topic from a national broadsheet I wonder will the Government ever finally get a grip of the situation and turn it around. When reading that the policy is confused and poorly co-ordinated, it makes me think whether the Government is needed to cut out unhealthy eating and lack of exercise in the UK. The Government is obviously trying to help, but with a majority people in Liverpool who are obese on the “bread-line” will obesity ever become a thing of the past? Poverty plays a huge part in people being obese and whether the Government works on that as well, I don’t think that they will ever be able to control the obesity issue.

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