Health And Nutrition Needs Assessment On Childhood Obesity In Surrey, UK

Health needs assessment

Describe about the Health and Nutrition Needs Assessment?

Health needs assessment (HNA) is a systematic approach that is taken up for reviewing the health issues that a particular population faces and this method leads to agreed priorities and resource allocation in order to improve health conditions of the population and reduce inequalities (Thompson 2014). HNA is a widely recommended public health tool for providing evidence about a population so that health services can be planned (Pennel et al. 2015). An opportunity is provided for engaging with particular population and enabling them to contribute to service planning and resource allocation (Barth 2015). Certain benefits can be gained from conducting a HNA. These include strengthened involvement of community in taking health related decisions, professional development of experience and skills, better use of resources and improved partnership working (Tomlinson et al. 2013).

The present report is a Health Needs Assessment on childhood obesity for 4-5 years old (reception) in Surrey (South East of England). A personal reflection is also presented on the usefulness of health needs assessment. It includes a reflective section on the advantages and the disadvantages of working in a group for carrying out the assessment.

The main aim of the health needs assessment is to give information to plan, negotiate and bring changes in health services for improving the health conditions of the population (Sheehy et al. 2015). The needs assessment has the focus on many services that have the impact on the health of the chosen population. This particular health assessment takes into account the following elements:

The chosen population for the assessment

The identified health priorities

Assessment of a health priority

Action planning and strategies to be taken up for health outcomes

Measuring the possible impact and choosing the next health priority

Surrey is located in Suth-East of England, United Kingdom and covers around 1500 square kilometres between Surrey hills to the south and London to the north. The population of Surrey is over a million. Around 85% of the population live in urban areas, covering 15% of the county (cfsurrey.org.uk 2016).

Consequently, the children of the county come from different and contrasting backgrounds, starting from very deprived to very well-off. The county can be considered as an affluent one, having a population with better employment, better education and better in terms of health. However, there are many people who have to struggle for maintaining a healthy life. Effectively meeting the needs that the children of the county have with specific vulnerabilities is a difficult job and  the authorities have set up strategies in order to take care of the hard situations (noo.org.uk 2016).

The target population for this health needs assessment is children having age between 4-5 years in Surrey county and the health complications of the children is focused onto (Healthysurrey.org.uk 2016). .

The following chart shows the number of children aged between 0-14 in Surrey:

Children in Surrey have good health conditions on an overall basis. But certain health priorities come up that draws the attention of health care services. The most significant health issue for children of Surrey is obesity.

Chosen population

Obesity is a common health complication found among the children below 18 years across the globe (Faintuch and Faintuch 2014). Obesity is the health condition where a person has an accumulated body fat more than what is desirable and having a negative impact on the health (Bray and Bouchard 2014). If the body weight of the person is 20% more than the desirable weight, it is considered to as obesity (Neff et al. 2015). Several health complications are associated with obesity, including increased risks of heart diseases, type 2 diabetes, cancer, osteoarthritis, obstructive sleep apnea (Kiess et al. 2015). 

Children in Surrey have better than average obesity levels. Around 6.7% of children aged between 4 and 5 years (reception)  are obese. The prevalence of obesity is found to be increasing with the rise with socioeconomic deprivation (Healthysurrey.org.uk 2016).

Figure 1: Children aged 4-5 years as obese or overweight, 2013/14 (percentage)

Source: (www.gov.uk, 2016)

Figures from the National Child Measurement Programme (NCMP) highlights that in Surrey, around 17.6% children aged between 4 and 5 years are overweight or obese. Although chdilhood obesity is common in all communities in Surrey, some sections of the population are at more risk for being obese and developing the psychological and health complications that have association with obesity. Data for childhood obesity, as gathered by NCMP, shows that prevalence of obesity rises with age and therefore the obesity rate for 4-5 year olds (reception) is lower than in 10-11 years old. Boys are vitally more likely to be obese than girls among the age group of 4-5 years. Among the 4-5 years old, obesity has seen reduction to 9.9% from 10.7% for boys. For girls, it has remained stable at 9.0% (mycouncil.surreycc.gov.uk 2016).

In Surrey, in 2011, the prevalcne for obesity for 4-5 years was almost twice less than 10-11 years. That is 6.8% in comparison to 14.4%. Among 4-5 years old, obesity has witnessed a slight fall to 6.8% in 2011 from 7.9% in 2007 (Surreyi.gov.uk 2016).

Figure 2: Trends and numbers of obese 4-5 year olds (reception) for 2007/2008, 2008/2009, 2009/2010, 2010/2011, 2011/2012 by gender and district

Source: NCMP 2007-2012

The NMCP has collected valuable data since the year 2006 and it has identified influences and trends on children obesity. The factors are gender, age, ethnicity and obesity. Analysis of data from the NCMP shows that there is a strong positive relationship between obesity prevalence and deprivation for children in reception year. The increased socio-economic deprivation is measured by the 2010 Index  of Multiple Deprivation (IMD). Obesity prevalence has a significant relation with free school meals. Children who live in areas with higher eligibility rate of free school meals have higher rate of obesity than those who live in areas having low eligibility rate (Surreyi.gov.uk 2016).

Figure 3: Percentage of obese 4-5 year olds (reception), 2009/2012 by IMD 2010

Source: NCMP 2009/2012

Childhood obesity also has relation to social class. Children from families with main income earners from professional occupation have low rates of obesity. NCMP also states that variation in childhood obesity prevalence between ethnic groups is also present. Among 4-5 year olds Black African, Black Bangladeshi and Black other boys and  Black African and Black Other ethnic girls have the highest prevalence of obesity (Surreyi.gov.uk 2016).

Identified health priorities

Figure 4: Prevalence of obesity among reception children by ethnic group and gender

Source: National Obesity Observatory (NOO) 2012

The key findings from Surrey are:

Eventhough the county has a lower prevalence of obese children than neighbouring local authorities, there are large numbers of obese children and overweight children due to the larger population

National trends are followed with those living in more deprivation having a higher incidence of obesity

Obesity of children aged between 4 and 5 years (reception) is twice less than those aged 10-11 years

Boys are at more risk of being obese than girls (www.gov.uk, 2016)

Obesity is an important public health concern in Surrey, especially with children. This reflects the escalating rates and serious financial and health consequences it brings with it. Of particular concern is the level of the rising trend in obesity in children aged 4-5 years (reception). The estimated annual costs to Surrey Primary Care Trust of diseases concerning overweigth and obesity were £251.3 million in 2007. Handling obesity is essential for meeting the PSA obesity target. Surrey has particular health problems and most of them are due to the size of the population and the huge number of partner organisations in health. The rising trend of obesity has led to mapping of current programs and interventions for preventing the prevalence of obesity among children. However, service planning is lacking an evidence-base for managing childhood obesity (getsurrey.co.uk 2011). Efforts have been made for involving the maximum number of organisations across the geographical location for the consultation process. But there lies some challenges and barriers that affect the current service provision put in place for obese and overweight children. Despite the programmes put forward in local levels for addressing obesity and those that are delivered nationally, there is an increasing prevalence of obesity among children aged 4-5 years (reception). The converted interventions are found to be not effective to the maximum level (Guildford.gov.uk 2016).

Prevention and interventions for families having more risk of obesity must be stared as soon as possible. This must include interventions at antenatal classes and must be encoursged throughout the schoollife. It is necessary to establish health eating patterns, active lifestyle and family based interventiosn and education. Parent education is important for assessing obesity in children (Swinburn et al. 2015). The following is a strategic action plan for improving the scenario in context to obesity as prevalent among 4-5 year old children in Surrey:

Needs identified in Surrey	Recommendations / Actions to be taken
The advantages of a healthy weight are promoted by implementation of a child health promotion program	Provide strong local public health surveillance data on child weight status Identify and put up training for meeting the needs arising from implementation of the program
Families need support for ensuring that good weaning practices are taken up	Ensure that advice and adequate support is available by promoting feeding guidelines
Carers and parents are not aware that the child is obese	Implement more surveillance to rasie issues with parents
Emotional wellbeign of children and their families are addressed for bringin changes in eating behaviour	Provide opportunity to have interaction with parents
Education must start early idealy in preschool	Children centers must develop role in obesity prevention by healthy lifestyle programs
Emphasis must be placed on all families for beign more active and taking up more indoor and outdoor activites	Encourage those in contact with children to provide opportunity for active play
All schools must provide a healthy environment by provision of health choices of food and the opportunity to be active physically.	Ensure that traingin is given to schools for providing resources to the students

In view of increasing number of children aged 4-5 years being obese, both population-based and individual services are to be taken up for tackling the issue. Interventions would produce effective changes in behaviour due to population based approach. All health organisations must monitor and evaluate the effectiveness of the interventions put in place. A list of community-based programmes and initiatives for addressing  childhood obesity needs to be evaluated on a regular basis, preferably, yearly. The key indicators for bringing positive changes in the health issue are as follows:

A deep understanding of the prevalence of childhood obesity and their behaviours

Clearly identified responsibility for considerable actions, with overall governance and leadership agreed by all health care partners

All children growing with a healthy weight and having active lifestyle

All schools are supported with education by children’s centres, local community and health services

Less consumption of unhealthy foods like those with high salt, sugar and fat (Etienne 2014)

Robust monitoring of performance would be established by evaluating programmes and having a clear knowledge of the evidence based data. The promotion of health benefits by health and non-health professionals would lead to positive changes in the issue of weight among children, especially 4-5 year olds (reception).

The opportunity of taking up the health needs assessment was highly beneficial, according to me and it gave a golden chance for understanding the health issues faced by the particular community. The reason for doing the healths needs assessment was to understand the present scenario of health issues regarding childhood obesity in Surrey. The cost of health care is increasingly changing in recent times. At the same time, there is limitation of resources for health care. It is therefore necessary to chalk out the health issues that the community faces and set up an action plan for bringing changes in a rapid pace. Health conditions can be improved if the needs for health care in that community as accurately assessed. Keeping this point in mind, the present health needs assessment was taken up. I learnt and gathered considerable knowledge from the needs assessment and the areas for improvement. It is needful to undertake certain actions in relation to the health needs assessment as a result of the rich experience I had. More planning of strategies that can be effective in this regard would be beneficial. Significant strategies, thereby established would pave the way for better health outcomes.

It was a fruitful experience of working in groups for carrying out the health needs assessment in a group. It gave a good chance to build up strong relations with the batchmates and bring coordination amongst each other. I would also like to bring into light the positive and negative sides in working in groups. I feel that the experience was a good one and there were certain advantages of conducting the assessment in a group. The assessment was more productive as the output was complete. The quality of work was not compromised on as every member of my group gave their best towards the completion of the assessment. More resources could be utilised as different members gathered information from different sources. On certain instance,  a group member was not well and could not contribute to the assessment. This issue was handled effectively as other members completed the work. Such coordination and substitution is only possible with group work. I learnt new things while working with my batchmates and there was a good amount of exchange of thoughts and ideas between the team members. This was highly welcomed. Exchange of information increased knowledge and easy flow of information was built on. However, there were some issues faced while working in groups. The main issue was unequal participation. There was also intrinsic conflict among the member in some instances. Decision making was difficult and in some cases I had felt that there could be more chances of my opinion being heard.

On the whole, the experience of doing the health needs assessment was a good one. Given an opportunity, I would conduct such an assessment in future again. It would enhance my knowledge and experience and I would have an opportunity to grow personally as well as professionally.

References    

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