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The Role of Interprofessional Working in Public Health
Introduction
Obesity is widely recognised as one of the greatest public health challenges of the twenty-first century. It not only contributes to physical health problems such as type 2 diabetes, heart disease, and stroke, but also affects mental wellbeing, social inclusion, and quality of life. Public Health England’s report From Evidence into Action (2014) identified obesity as one of seven national priorities for action, stressing that prevention and management are crucial if future health inequalities are to be reduced. London, like the rest of the country, faces rising obesity levels, but certain boroughs experience the problem more acutely than others. Tower Hamlets, one of the most deprived boroughs in England, records some of the highest rates of childhood and adult obesity, making it an urgent local health priority.
This essay examines obesity in Tower Hamlets with a focus on interprofessional working. It explores the social and health issues that drive obesity in the borough, analyses the frameworks of collaborative practice, and evaluates the role of different professionals and agencies in addressing the issue. By applying theories of interprofessional practice and examples from local initiatives, the discussion highlights the importance of integrated, patient-centred approaches in tackling such a complex and multifaceted health challenge.
Background: Obesity as a Public Health Priority
Obesity has steadily risen across the United Kingdom over the past four decades. According to the NHS Digital Health Survey (2023), more than one in four adults in England are obese, with an even greater proportion classified as overweight. Childhood obesity rates are particularly concerning, as they have significant long-term consequences for health, educational achievement, and economic productivity.
The Public Health England (2014) strategy emphasised that obesity prevention requires system-wide approaches, tackling not only individual lifestyle choices but also the broader social, economic, and environmental determinants of health. These include poverty, housing, education, urban design, and food availability. Obesity is not evenly distributed across the country: it disproportionately affects deprived communities and minority ethnic groups.
Tower Hamlets exemplifies this trend. Data from the National Child Measurement Programme (NCMP, 2022) shows that almost 28% of Year 6 pupils in Tower Hamlets are obese, compared to a national average of 23%. Among adults, nearly 60% are either overweight or obese. The borough also experiences high rates of diabetes, hypertension, and cardiovascular disease, all strongly linked to excess weight.
Social and Health Issues Linked to Obesity in Tower Hamlets
The high prevalence of obesity in Tower Hamlets cannot be explained by individual behaviour alone. Several interconnected social and health issues contribute to the problem.
First, deprivation plays a central role. Tower Hamlets is ranked among the most deprived local authorities in England, with high rates of child poverty, unemployment, and housing insecurity. Families living in poverty often struggle to afford healthy food options, relying instead on cheaper, calorie-dense processed products. Fast-food outlets are heavily concentrated in the borough, making unhealthy choices more accessible than fresh produce.
Second, cultural and ethnic factors are significant. Tower Hamlets has a large Bangladeshi population, and research indicates that people of South Asian heritage are more susceptible to obesity-related health problems such as type 2 diabetes at lower body mass index thresholds. Cultural dietary practices, combined with limited access to culturally appropriate health promotion, can exacerbate risks.
Third, environmental factors such as housing density, limited access to green spaces, and unsafe streets can discourage physical activity. Children may have fewer opportunities for safe outdoor play, while adults may find it difficult to incorporate exercise into their daily lives.
Finally, psychological and mental health issues contribute to obesity. Stress, depression, and social isolation can all lead to unhealthy eating patterns and reduced motivation for physical activity. The COVID-19 pandemic worsened these problems, with lockdowns contributing to weight gain across all age groups.
Together, these factors create a complex web of influences, meaning that obesity in Tower Hamlets cannot be addressed by individual education campaigns alone. Instead, it requires integrated solutions delivered through interprofessional and inter-agency collaboration.
