The correlation between child and adolescent obesity and poverty widened in the twenty-first century, according to UCL research

Bann, David et al. | Socioeconomic inequalities in childhood and adolescent body-mass index, weight, and height from 1953 to 2015: an analysis of four longitudinal, observational, British birth cohort studies  | The Lancet Public Health | Vol. 0 |  0 | ePub | Doi: https://doi.org/10.1016/S2468-2667(18)30045-8

Researchers from University College London examined socioeconomic inequalities in childhood body- mass index (BMI).  Previous research findings revealed an association between rich countries and childhood-adolescent weight status, this study sought to address uncertainty surrounding how these markers (height, weight and BMI) have changed over time in Britain.

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The longitudinal study looked at data from four longitudinal, observational, British birth cohort studies from 1946, 1958, 1970 and 2001. They categorised those in the 1946, 1958 and 1970 studies as the earlier-born cohorts and those from the 2001 cohort study as the later- born cohort.  They found that although inequalities traditionally associated with  height and weight narrowed or reversed, whereas differences in BMI between the poorest and wealthiest children expanded.

While there was little inequality in childhood BMI in the earlier-born cohorts, inequalities were present in the 2001 cohort and widened from childhood to adolescence in the 1958–2001 cohort. Their research has identified an association between obesity and poverty. According to the researchers, “these substantial changes highlight the impact of societal changes on child and adolescent growth and the insufficiency of previous policies in preventing obesity and its socioeconomic inequality. As such, new and effective policies are required to reduce BMI inequalities in childhood and adolescence.”

The full article is available from The Lancet Public Health 

As The Lancet Public Health is an open access journal the full article can be downloaded here 

Related: The Lancet’s comment Trends in childhood height and weight, and socioeconomic inequalities can be read here 

In the media:

The Telegraph  Poor children in Britain now fatter than wealthy in dramatic reversal

Express  Child obesity: How children lost the war on weight

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Malnutrition in UK is under reported

British Specialist Nutrition Association| March 2018 |New Research for Nutrition and Hydration Week 2018 

Analysis of malnutrition data for 2015/16 by the British Specialist Nutrition Association (BSNA) shows that more than fifty per cent of hospital trusts in England are under-reporting malnutrition rates compared to accepted national estimates. In their report the BSNA highlight the extent of malnutrition: it estimates that 3 million people, (5 per cent of the UK population) are malnourished or at risk of malnutrition.  Deaths where malnutrition was named as a contributory factor are also increasing, having
risen by more than 30% from 2007 to 2016.

Malnutrition
Image source: bsna.co.uk

This new research, argues that the costs and implications of not addressing malnutrition are higher than associated treatment costs. For instance an average of £7,408 per year is spent on care for a malnourished patient, this is more than three times the £2,155 for a well-nourished patient.  The costs of treating malnutrition and its affects, are estimated at £19.6 billion in England, a figure which represents approximately 15% of overall health and social care expenditure.

The report provides a summary of its findings:

  • Malnutrition remains a significant, growing yet largely preventable problem.
  • The number of deaths involving malnutrition is rising as are the reported primary and secondary diagnoses of malnutrition.This is despite significant effort to improve clinical practice, most notably NICE CG32 on Nutrition Support for Adults.
  • The cost of doing nothing significantly outweighs the cost of early intervention, such as dietetic support and provision of oral nutrition supplements (ONS) if appropriate.
  • Regional disparities exist in progress made by Trusts in this area.
  • There are fundamental inconsistencies in the way that data on malnutrition are collected and reported by individual Trusts, meaning that the overall incidence of malnutrition is likely to be significantly under recorded.

The BSNA calls for:

  1. Guidelines to be implemented and followed in all healthcare settings
  2. New clinical pathway- the introduction of a new, comprehensive jointly
    developed and delivered  clinical care pathway for the frail elderly, across
    all systems.
  3. Additional incentives-  perhaps through the introduction of a new
    Quality and Outcomes Framework (QOF) or equivalent on malnutrition.
  4. Recognition of the integral role of oral nutritional supplements (ONS)
    ONS should be accessible to all patients who need them, alongside support from dietitians. Nutritional intervention should only be used when appropriate and be reviewed regularly.

The infographic can be downloaded from BSNA here 

The full report is available from BSNA

BSNA |  Forgotten not Fixed: A Blueprint to Tackle the Increasing Burden of Malnutrition in England |

The impact of poverty on health

UK Poverty 2017 is the latest report on the state of the nation from the Joseph Rowntree Foundation, an independent organisation working to inspire social change through research, policy and practice. The report found that 14 million people, 20% of the population are living in poverty- half of these people are living in a working household. This concerning rise in poverty is attributed by the Foundation to stagnating earnings, the increasing cost of housing  and a freeze on working age benefits.

joseph rowntree
Image Source: The Health Foundation health.org.uk

The Health Foundation uses this report as a starting point, stating that what is less well known is the damage this is doing to the health of the nation. People on the lowest incomes are twice as likely as those in the richest 40% to be experiencing anxiety and depression. Poor health and disabilities can present additional costs for families already struggling, including barriers to finding work. Currently nearly a third of disabled people are living in poverty.

They make three recommendations to improve progress

  • End the freeze on working age benefits- if the government was to end the freeze, it would provide immediate relief to low income families, who have incomes that are not keeping up with the prices and bills they need to pay.
  • Increase the supply of low-cost rented housing- successive governments have not delivered the number of homes needed to meet demand.This has forced more families to live in the private rented sector, where housing is often more expensive, of poorer quality, and there is less security of tenure.
  • Tackle in-work poverty – many people get trapped in low-paid work, one in eight workers in the economy is living in poverty, and our research has shown that three quarters of low paid workers are still in low pay a decade later.

Full details at The Health Foundation 
Robb, C. | 2018| For a healthier nation, we must solve UK poverty | The Health Foundation

The Impact Of Homelessness On Health

New report warns that that the rising number of older homeless will create significant extra pressures for councils | Local Government Association

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The Local Government Association (LGA) says that older homelessness is a growing hidden phenomenon that needs greater understanding.  Latest figures show that between April and June this year, councils accepted 620 people aged over 60 as homeless – at a rate of nearly 10 a day. This is up from the 270 accepted between October and December 2009, which was the lowest number since records began in 2005.

The LGA, which represents more than 370 councils in England and Wales, is warning that based on existing trends, this is set to double by 2025.

The LGA is calling for government to address the undersupply in specialist housing for older people, and an adaption to the implementation of welfare reforms to reduce the risk of homelessness. It says councils need to be able to borrow to invest in new council housing to increase supply, boost home ownership and reduce homelessness.

Full report: The Impact of Homelessness on Health: A guide for Local Authorities

 

Poverty and child health: Views from the frontline

Poverty is ‘making children sick’, say children’s doctors | 

A new report from the Royal College of Paediatrics and Child Health (RCPCH) and Child Poverty Action Group (CPAG) claims that poverty and low income is seriously affecting the health of UK children.

poverty
Image source: http://www.rcpch.ac.uk

This report is based on a survey of more than 250 paediatricians and provides an insight into the reality of life for UK children living in poverty. The report looks at a number of areas including food insecurity; poor housing; and worry, stress and stigma and their effect on the health of children.

It reveals that:

  • more than two-thirds of paediatricians surveyed said poverty and low income contribute ‘very much’ to the ill health of children they work with
  • housing problems or homelessness were a concern for two thirds of respondents.
  • more than 60% said food insecurity contributed to the ill health amongst children they treat 3
  • 40% had difficulty discharging a child in the last 6 months because of concerns about housing or food insecurity
  • more than 50% of respondents said that financial stress and worry contribute ‘very much’ to the ill health of children they work with

The full report can be downloaded here

Tackling poverty through housing and planning policy in city regions

The Joseph Rowntree Foundation has published ‘Tackling poverty through housing and planning policy in city regions’.

Tackling poverty through housing
Image source: https://www.jrf.org.uk/

This research draws on stakeholders in city regions to identify good practice and what more could be done through housing and planning policy to reduce or mitigate poverty. It finds that:

  • Combined authorities are well placed to lead on poverty reduction, given their central role in the devolution process, growing focus on poverty and inequality, constituent authorities’ housing and planning expertise, and the ability to co-ordinate across multiple policy areas.
  • Further action could be taken in two key areas: linking housing development to poverty reduction, and improving conditions in the private rented sector.

Read the report here