Berni Lee, consultant in Public Health, Shropshire Council

Cathy Levy, Public Health Development Officer, Shropshire Council

The Board received the report of the Public Health Registrar, the Consultant in Public Health and the Public Health Development Officer – copy attached to the signed Minutes – which provided an overview of progress to date with development of the Healthier Weight Strategy for Shropshire.  The Public Health Registrar introduced and amplified the report.  She highlighted the main findings and gave a presentation (copy of slides attached to signed Minutes) which covered the following areas:

·         Why weight matters

·         What we know locally

·         Healthier Weight Strategy for Shropshire 2023/2028

·         Underpinning principles

·         Delivery themes

·         Recommendations

The Public Health Registrar explained that there was a rising tide of unhealthy weight and that two out of three adults were overweight in Shropshire, this was a growing problem and was only getting worse and that rates of childhood obesity were about 5 times higher now than they were in the 1990s.  Excess weight leads to a multitude of health problems, reduces life expectancy and also prolongs the amount of time that people were living in poor health all of which increased the cost to the NHS, to healthcare and to social care (social care costs were double for someone experiencing severe obesity).

She went on to say that our bodies were not designed for the environment in which we now lived and where what we eat is less and less recognisable as real food, about 50% of which is ultra-processed and were exposed to increasingly time poor, stressful and sedentary lifestyle.  Our body’s normal response to this environment is  fuelled by our biological and genetic disposition to hold on to weight and calories even when we try to lose it, so individual weight support may be useful for some but would be limited at population level given the significant changes to our environment.  The focus on individuals did derive stigma and discrimination for those who were experiencing unhealthy weight which was counterproductive to the problem and that preventing unhealthy weight in the first place whilst modifying our environment were key.  The most deprived groups had double the risk of obesity than the least deprived groups and that that gap was widening with age.

The Public Health Registrar informed the meeting that locally the rates of obesity in Shropshire were higher than the national average including those in early pregnancy, the highest rates being in the most deprived areas, in the context of living in a low-wage economy with rising levels of children in poverty and higher than average levels of food insecurity in the County and she drew attention to the many assets and opportunities available in Shropshire for improvement that could be utilised.  The Public Health Register went on to highlighted and explained the high-level strategic priorities, the underpinning principles and the three strategic delivery themes (set out in Appendix A to the report).

A brief discussion ensued around inequalities, food insecurity, the cost of living crisis, access to good quality food and tackling stigma.  In relation to psychological support for families around healthy weight, the Consultant in Public Health informed the Board that there was a deficit in the availability of psychological support generally but that the tier 3 service was very small and would not cover the need described.  A key part of this and something that was considered early in the strategy development was around looking from infancy at how not only feeding children/weaning babies on to healthy foods but also starting to create a good relationship with food rather than food being ‘good’ or ‘bad’ but being seen as fuel for our bodies and these things could be built into the mainstream services, so they were more psychologically informed.

The Head of Joint Partnerships felt the strategy needed to be more explicit in how it linked to the Joint Forward Plan and the work of partners.  In response to a query, it was explained that the emergent weight management drugs had not been considered so far in the Strategy due to timing but conversations were needed and thought given across the system and linking in with health partners to manage the messaging around this.

RESOLVED:

1)    to provide feedback and comments on the Draft Strategy

2)    to approve the draft Strategy for public and stakeholder consultation

3)    to contribute to the development of the action plan required to underpin delivery
       of the strategy

4)    to note that the final version of the Strategy will return to the HWBB for
       endorsement following the public and stakeholder consultation, prior to going to
       partner governing bodies and Council Cabinet for approval

Reports for approval of recommendations, with discussion by exception