This year marks the fifth anniversary of the publication of the Scottish Government’s Diet and Healthy Weight Delivery Plan and associated ambition to halve childhood obesity by 2030.
Halving childhood obesity in Scotland by 2030 would mean achieving a child obesity prevalence of 7%, as measured through the Scottish Health Survey. However, the latest data presents a stark and worrying picture, and indicates we’re heading in completely the wrong direction. Data from the 2021 Scottish Health Survey, the latest available, reports that 18% of children are at risk of obesity, which is a 4-percentage point increase from the baseline of 14%, and moves us even further away from achieving the ambition.
There is also stark inequality in child weight outcomes. Children in the most deprived quintile are more than twice as likely to be at risk of overweight and obesity than their least deprived counterparts (44% compared to 20%).
The lack of progress on this issue is unsurprising. We have seen policy commitments that would improve the food environment for children, such as restrictions of unhealthy promotions, delayed, with the Covid-19 pandemic, cost of living crisis and impact on industry cited as justifications. But are these delays justified and can we continue to jeopardise the health of our children?
Why does it matter?
Childhood is a critical stage and has a significant impact on health outcomes in adulthood. Evidence shows children at risk of obesity are much more likely to have obesity as adults. Obesity in childhood also has a profound impact on children’s physical and mental health and wellbeing, including increased risk of high blood pressure and type 2 diabetes, as well as low self-esteem and impaired social, physical and emotional functioning. These all impact on the ability of a child to live a happy and healthy life.
Years of austerity-led policy, followed by a pandemic and cost of living crisis have created a perfect storm of rising food prices, worsening health outcomes and growing health inequalities. Food prices have risen sharply, well above the overall rate of inflation, and, although both inflation and food prices are now starting to fall, food prices remain stubbornly higher than they were 18 months ago. Not only that, within this overall context of rising food prices, it is the healthier and staple foods like eggs, some fruit and vegetables, and milk that have seen the biggest rise, with prices of unhealthy discretionary products rising much less sharply. This is having a profound impact on children’s diet now, as many families struggle to afford a healthy diet, and will of course have longer-term health impacts too. It has never been more pressing to address childhood obesity and the associated health problems it creates.
With the majority of promotions on unhealthy products high in fat, salt and sugar (HFSS), it is easy to see the negative health consequences these promotions are likely to have. Crucially, this doesn’t mean that all promotions should be banned. Rather, it’s about rebalancing the system, so that promotions are used on healthier products, making them cheaper and easier for families to access.
The time for action is now
There are a range of evidence-based policies that fall within the devolved competencies of the Scottish Government that will have a significant impact on preventing and reducing childhood obesity. These policies, aimed at addressing the availability, affordability and acceptability of unhealthy foods, include restricting promotions and advertising of HFSS products, and improving the out of home food environment. We now need urgent action from Scottish ministers to take these policies forward to full implementation.
These policies are needed and would make a difference. Evidence from a recently published modelling study commissioned by the Scottish Government on the potential impact of restricting unhealthy food promotions, found an average reduction of 442.6 calories per capita, per week across the categories of families with children.
Yet, despite the strong evidence, little to no policy action has been taken. Earlier this year, the Scottish Government changed plans to introduce a Public Health (Restriction of Promotions) Bill, committed to in last year’s Programme for Government and instead confirmed that restrictions on promotions will now be taken forward via secondary legislation in the form of regulations. We are awaiting a consultation on this – a consultation that will become the fourth since the publication of the Delivery Plan, and the second in 2 years. A commitment to regulations is welcome but it has taken more than 5 years and three consultations to get this stage. The timescale for and scope of the consultation and regulations remains unclear.
So, what can we do?
The evidence is clear. We know what works, and the Scottish Government and its partners have the powers and levers that can make a difference. We now need them to act on these powers by taking bold and urgent policy decisions. Recent polling evidence shows state intervention to improve the food system is overwhelmingly backed by UK public.
Failure to act will result in even more children growing up at risk of obesity and subsequently living with obesity as adults, with profound implications for the health and economic prosperity of the country.
Our campaign pledge
To reflect the need for action and put the spotlight back onto the health of children, we’ve launched our new campaign pledge ‘Child healthy weight matters to me’. We launched the campaign pledge at our exhibition stand in the Scottish Parliament in June and received cross-party support. We’re now rolling-out the campaign further to gain support from other third sector organisations which we hope will help to further raise awareness of childhood obesity and accelerate political action to address it.
For more information on the campaign, or to sign-up your organisation as a supporter, visit our exhibition stand at the conference, or contact us directly.
Blog written by Jennifer Forsyth, Policy and Evidence Manager, Obesity Action Scotland