Practice-Based Public Health Profile and Strategy

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Practice-Based Public Health Profile and Strategy

Introduction

Childhood obesity has become one of the most serious public health challenges in the UK. In England, nearly one in four children are obese or overweight by the end of primary school (NHS Digital, 2023). Within this national context, the London Borough of Lewisham faces a particularly high prevalence, with obesity rates above both the London and national averages. This profile analyses the local determinants of obesity among 10–11-year-olds (Year 6 pupils) in Lewisham, explores its wider social and health implications, and develops a local strategy aimed at reducing obesity through targeted, evidence-based interventions.

Public Health Profile: Childhood Obesity in Lewisham

According to the National Child Measurement Programme (NCMP), in 2022–23, around 29% of Year 6 pupils in Lewisham were classified as overweight or obese, compared with 23% nationally (Public Health England, 2023). Obesity is unevenly distributed, with higher rates among children from deprived households and ethnic minority backgrounds. The borough has pockets of significant deprivation, ranking among the 20% most deprived areas in England (Lewisham Council, 2022).

Obesity in children aged 10–11 poses both immediate and long-term health risks, including type 2 diabetes, hypertension, asthma, and poor mental wellbeing (WHO, 2022). Beyond physical health, overweight children may experience low self-esteem, social stigma, and reduced academic performance. These consequences also translate into long-term health system costs and reduced quality of life.

Determinants of Childhood Obesity in Lewisham

Childhood obesity in Lewisham is influenced by a mix of social, environmental, behavioural, and economic factors.

Socioeconomic Inequality

Lewisham’s levels of income deprivation are directly linked to poorer diets and reduced access to safe play spaces (Marmot, 2020). Families in deprived wards often rely on low-cost, calorie-dense foods due to financial constraints. According to the Child Poverty Action Group (2023), nearly 35% of children in Lewisham live in poverty, which increases the risk of poor nutrition.

Food Environment

The borough’s food landscape contributes significantly to unhealthy eating habits. High densities of fast-food outlets are located near schools and residential areas. Research by the Greater London Authority (2022) found that Lewisham had one of the highest concentrations of takeaway outlets per square mile in South London, creating an obesogenic environment that encourages poor dietary choices.

Physical Activity Levels

Physical inactivity is another major determinant. While the borough has several parks, safety concerns, limited community sports programmes, and increased screen time reduce active play opportunities (Sport England, 2023). The 2022 Active Lives Survey showed that only 41% of Lewisham children achieved the recommended 60 minutes of daily physical activity.

Cultural and Family Influences

Family lifestyle and cultural norms play a vital role in shaping children’s diets. Some ethnic minority families associate higher body weight with health or prosperity, which can normalise obesity. Additionally, busy parents balancing multiple jobs may depend on ready-to-eat or processed foods for convenience.

Current Public Health Policies and Initiatives

Lewisham’s local public health strategy aligns with national frameworks such as Healthy Weight, Healthy Lives (Department of Health, 2008) and the Childhood Obesity Plan (HM Government, 2017). Locally, the borough has introduced several initiatives:

• The Lewisham Obesity Alliance, which brings together schools, healthcare providers, and community groups to coordinate action.

• The Daily Mile in primary schools, encouraging pupils to walk or run for 15 minutes daily.

• Healthy Start Vouchers supporting low-income families to access fresh fruit and vegetables.

• Restriction of Fast-Food Outlets near schools through local planning policies.

Despite these positive measures, the obesity rate remains stubbornly high, indicating that more targeted, multi-level strategies are needed.