Agenda item

Cllr Oconnor (Cabinet Member for Public Health and Inequalities), Derys Pragnell (Consultant in Public Health), and David Munday (Consultant in Public Health) have been invited to present a report on Oxfordshire Healthy Weight, with a focus on tackling Obesity with the County.

The Committee is invited to consider the report, raise any questions and AGREE any recommendations arising it may wish to make.

The following were invited to respond to the Committee’s questions in relation to the Oxfordshire Healthy Weight Report; David Munday (Consultant in Public Health), Dery’s Pragnell (Consultant in Public Health), and Cllr Michael OConnor (then Cabinet Member for Public Health and Inequalities).

The Committee stated that this item’s purpose was to examine the work undertaken to help promote Healthy Weight within the county, and that it would also be looking at the Whole Systems Approach to tackling excess weight. It was also emphasised that the timing of this item was crucial given that excess weight affected many residents and families, and that it was crucial for there to be plans in place to support residents well as their families in this regard.

The Committee noted how pregnant women faced an increased risk of excess weight, and enquired about the support that was available for women both during and after pregnancy (including with breastfeeding) to help avoid this. The point was also raised regarding whether there was sufficient awareness of, as well as support for women diagnosed with gestational diabetes to help them manage this condition, particularly through early diabetes testing. The Committee also emphasised and asked about the importance of guiding children on chewing their food adequately and on eating more healthily, as well as spacing out the intervals between food consumption into specific meal and snack periods.

It was responded to the Committee that a needs assessment was carried out that was published earlier this year, which also looked at everything that could be done in terms of best practice, what was currently happening, as well as the latest guidance around early years, pregnancy, breastfeeding, weaning, and fussy eating, and that these were focused areas of work that were currently being looked at; with considerations being made as to what actions were required in these areas so as to contribute to healthy weight overall. It was also stated that licences were put to support people working in early years settings. The Consultants in Public Health emphasised that if support for healthy eating started early, particularly in terms of promoting a healthy balanced diet, then individuals who received this support would be more likely to perpetuate these eating habits later on in their lives in the long run. There was also work being undertaken with early years settings, including a survey which was conducted to understand what might support people in early years settings; both to help with food in these settings as well as to help parents. It was also emphasised to the Committee that there was a Whole Systems Approach to promoting healthy weight, and that it was pivotal for healthy weight to be maintained during pregnancy, as this could also have a positive effect on the weight of the child in question later on. Therefore, the essence of the Whole Systems Approach was to cover the entire life course.

It was also highlighted to the Committee that unhealthy weight could often manifest within more disadvantaged communities, including some ethnic minority groups, within the County, and that the Whole Systems Approach aimed to address this proclivity also. The existing data on children and excess weight was stronger and more readily available as opposed to the data on adults, and through utilising this data one could observe that some areas manifest with more excess weight than others; with deprivation also being a key determinant of excess weight amongst Children. Nonetheless, it was also stressed that the wider environment was also a factor in eliciting unhealthy weight, as opposed to deprivation per se. For instance, there may be areas with a greater presence of fast-food outlets, which could create easily available unhealthy dietary options for families and children who resided in such areas.

The point was also made to the Committee that prevention was a crucial element of the Whole Systems Approach to healthy weight, and that particular services had been established for some ethnic groups as well as for men, whilst further considerations were being made for establishing more services for Women during pregnancy. It was highlighted to the Committee that it was the wider environmental factors that required further attention and work to help reduce unhealthy weight; and it was cited that many other areas beyond Oxfordshire had developed work on the wider environmental factors which had an impact on an individual’s weight.

The Committee was also informed about the role of advertising of unhealthy products, which remained prevalent within Oxfordshire and which other areas beyond the County had sought to tackle. Residents that reside in areas with higher levels of deprivation were more likely to face exposure to such forms of unhealthy advertising, which could again relate to the presence of particular food outlets within these areas.

The Committee then enquired about what specific measures would be adopted so as to tackle some of the wider environmental challenges highlighted above, particularly in relation to the presence of fast-food outlets, the licensing for these, and the prevalence of unhealthy food advertising. It was responded that this was not an easy task, and that planning and licensing were a significant factor in the aforementioned environmental proclivities, and that both of these factors predominantly laid in the District Council level. A meeting was convened which involved key representatives from the District Council level, where the evidence base beyond the Needs Assessment was examined. Areas where problems laid had been flagged up, and discussions had been held with relevant officers around potential changes to wordings in local plans and licensing; and further conversations were being held regarding advertising. Lessons were also being learned from how policies were being utilised elsewhere, whether such policies had proven effective, or whether they have had a detrimental impact on businesses.

The Committee reiterated the imperative of engaging with District Councils to further address the aforementioned challenges around fast-food outlets, advertising, and the planning and licensing policies and practices around these. The Committee was then reassured that the health improvement board (a sub-board of Oxfordshire’s Health and Wellbeing board) also worked on promoting healthy weight within the County, with the benefit being that representation of the District Councils also existed on this board.

The Committee proposed that they could also play a positive role in contributing toward addressing challenges around planning, licensing, and unhealthy weight. It was also cited that this was the only committee within the County Council that had District Council representation. The Public Health Consultants welcomed the Committee’s support on this.

The Committee then cited the promotion of walking and/or cycling, which were already being promoted by the Council for environmental factors; and queried the degree to which such initiatives also tied into the work around promoting healthy weight. The Public Health Consultants agreed with the Committee on this, and emphasised the significant health benefits of active forms of travel. The Committee was informed that work was already underway in this regard, particularly in the context of the Health Improvement Board also. It was also highlighted that the Health and Wellbeing Strategy was a context where this case could be made, and that plans were in place to further work on increasing active forms of travel given its proven benefits on weight and overall health and wellbeing.

The Committee then pertained to the cost-of-living crisis, and how this made it harder for residents on lower incomes to afford to purchase foods that may contribute to a healthy balanced diet. It was queried how this would be taken into account when tackling unhealthy weight, and about the support that residents could expect to receive to help achieve a healthy balanced diet in the context of a cost-of-living crisis. The importance of supporting food banks to distribute more healthy foods was also highlighted.

It was responded that there was often a misconception that heathier foods were more costly and less affordable when compared to unhealthier foods, which may not always be entirely true. The key issue related to accessibility to healthier foods, as some areas may not contain a plethora of shops which sell healthier food products. However, the Committee was also informed that piloting work was underway to attempt to make healthy foods within local community stores cheaper than unhealthier foods. In relation to support for foodbanks, there was a piece of work under a separate “Food Strategy”, and the Council was influencing what was being done to help ensure that healthier foods were provided through foodbanks. The Public Health Consultants appreciated the Committee’s concerns around the cost and accessibility of healthy foods, but highlighted the complexities behind the root causes of, as well as the solutions to these challenges.

The Executive Director of Healthwatch Oxfordshire reiterated the importance of access to healthier foods, as well as access to healthy food that was also culturally appropriate for certain communities, which was also an area that required more work on. It was also emphasised that there was always a danger of shifting the blame onto individuals, and that this needed to be avoided at all costs.

The Committee queried the extent to which the Covid-19 pandemic had been responsible for increased rates of excess weight within Oxfordshire, and if there was a trend of recovery from this? It was clarified that the Covid-19 Pandemic had resulted in an increase in excess weight throughout the Country, but that the data for the period of 2022/2023 had not yet been made available to help determine whether the trend for rising levels of excess weight had continued up until most recently, although the expectation was that Covid-19 related excess weight patterns should be levelling off.

The Committee also raised a point regarding the lack of information and emphasis in the report on men, and the significant focus on Women and Children relative to men. The Committee was reassured that the Whole Systems Approach aimed to promote healthy weight overall, and that there was no deliberate move to ignore the role or indeed the importance of men.

The Committee enquired how the work in the context of the Health and Wellbeing Strategy related to the Whole Systems Approach to healthy weight, and whether the Health and Wellbeing Strategy played any significant role as a wider system strategy, including whether there was any potential learning that could come out of this. The Committee also queried the extent to which language was central and crucial to the work on healthy weight, as well as how the newly developed language and principles around promoting healthy weight would be actualised and potentially even accepted by residents within the County. It was reiterated to the Committee that the needs assessment had highlighted the importance of the role of the wider environment, and that the health and wellbeing strategy did feed into the work on healthy weight. The feedback received from residents as part of the wider work on the Health and Wellbeing Strategy had indicated that residents would prefer for there to be an avoidance of negative stigmatisations/use of language around weight, and this had been taken on board in shaping the work on promoting healthy weight. It was also stated that the key to promoting healthy weight in the long-run within the County stemmed from pivotal principles including Prevention; promoting a healthy weight environment; having good system leadership, as well as providing adequate support to residents.

The Committee AGREED to make the following Recommendation:

1.    To orchestrate a meeting with HOSC, to include senior Planning/Licensing officers, Chairs of Planning Committees of the District Councils, the lead officer responsible for advertising/sponsorship policy, as well as the relevant Cabinet Membesrs, to discuss the planning and licensing around the presence of fast-food outlets in certain areas around the County and the advertising of HFSS products.