Protecting Scotland’s Children: is tackling childhood obesity more vital than ever?

21 October 2020

So far, 2020 has been a year of unknowns. With the coronavirus pandemic hitting the world with force, children in Scotland have seen a massive upheaval to their everyday lives. Schools closed, school meals changed, activities stopped and non-essential health services put on hold. In 2019, we took a dive into the statistics for childhood obesity prevalence from the Scottish Health Survey to see how far we needed to go to reach the Scottish Government’s ambition to halve childhood obesity by 2030. In this blog we do the same, considering how the current context has altered these priorities.

Is tackling childhood obesity in Scotland more vital now than ever before?

How coronavirus has impacted Scotland’s children

In March, Scotland entered a state of national lockdown. By 20th March all schools in Scotland closed, with children only returning to full time face-to-face learning mid-August. During that time, children’s lives were impacted dramatically. Local authorities provided support for those eligible for free school meals in the form of supermarket vouchers, cash payments, meal deliveries or food packages. When schools returned in August, the in-school dining situation had to be adapted to fit the new situation, with almost half of all local authorities offering a cold menu or ‘grab-and-go’ alternative to normal school meals. As we near the end of October, this situation is beginning to revert back to the pre-COVID norm, with more local authorities making the move back to hot meals in normal dining hall surroundings.

Not only were schools impacted, but the coronavirus measures also impacted children’s physical activity, sports classes and other activities, with research from Public Health Scotland reporting that 5 in 10 children did less physical activity, and only 2 in 10 did more.

With obesity found to be a risk factor in the severity of COVID-19, and links identified between obesity and poorer outcomes in younger people, the need to improve the health of Scotland’s population has never been more urgent.

Current childhood obesity prevalence in Scotland

In September, the latest Scottish Health Survey report was published, detailing obesity prevalence across all age groups, prior to the COVID-19 pandemic. In 2019 in Scotland:

Calculated from the 2019 Scottish Health Survey report and mid-year 2019 population data for children aged 2-15. The number of children aged 2-15 in Scotland at risk of overweight or obesity is approximately 245,367. The number of children aged 2-15 in Scotland at risk of obesity is approximately 130,863.

As we reported last year, the childhood obesity prevalence data is disappointing, and we remain way off course from achieving a halving of childhood obesity. Scotland’s childhood obesity prevalence is relatively unchanged, having remained within a four percentage point window over the last 10 years.

All children (aged 2-15) at risk of obesity in Scotland. Scottish Health Survey, 2010-2019

When we wrote our blog last year, it was confirmed that the Scottish Government’s pledge to halve childhood obesity by 2030 was based on 2016's figures, meaning that the ambition is to reduce childhood obesity prevalence in Scotland to 7% by 2030. The percentage of children at risk of obesity in Scotland remains the same as last year (16%), so with mid-year population changes since the previous year, this equates to over 18,000 more children at risk of obesity in Scotland since 2016.1

This year, the percentage at risk of overweight or obesity has risen by one percentage point, equating to almost 10,000 more children at risk than last year. Importantly, we must keep in mind that as this data is for 2019, it won't capture the significant impact that COVID-19 has had - and will continue to have - on the physical and mental health and wellbeing of children in Scotland.

Widening inequalities: the gap continues to grow

Over recent years, Scotland has seen a widening gap in childhood obesity prevalence amongst those living in the least and most deprived areas of society. Sadly, the 2019 report data shows that this gap has continued to grow. In 2018, prevalence of overweight or obesity in children was 24% in the least deprived areas and 31% in the most deprived areas: a difference of 7%. In 2019, prevalence was 23% in the least deprived areas, compared to 35% in the most deprived areas: a difference of 12%. Unfortunately, this suggests that the inequalities gap in prevalence of overweight and obesity in Scotland’s children has continued to grow, widening by 5% between 2018 and 2019.

This is extremely worrying and, alongside the growing health inequalities and food insecurity highlighted and exacerbated by the coronavirus pandemic, is a major cause for concern.

While we must be careful not to label fluctuations as trends before seeing data for the years ahead, these findings indicate that the widening inequalities gap in risk of overweight and obesity observed between children living in the least and most deprived areas of Scotland was this year driven by a decrease in prevalence in the least deprived areas, alongside a more rapid increase in the most deprived areas.

All children (aged 2-15) at risk of overweight, including obesity, by SIMD quintile.

Scottish Health Survey 2014-2019

In the last 6 years (as shown on the graph above), the inequalities gap in overweight and obesity prevalence between children living in Scotland’s most and least deprived was at its narrowest in 2016: the year that the figure in the pledge to half childhood obesity was based on. This means that since the pledge was made, not only has progress on childhood obesity prevalence halted, but inequalities in this area have got progressively worse.

Where do we go from here?

Throughout the period of lockdown and the continuing and variable levels of restrictions in place due to the global coronavirus pandemic, the lives of children in Scotland have been impacted drastically. Not only have children experienced the direct effects of school closures and restrictions to their normal activities, but they may have also suffered indirect effects related to the loss of parental income as a result of furlough and job losses. Increasing levels of family food insecurity have been reported, with more families in Scotland having no choice but use the support of food banks in order to eat.

It is still possible to deliver healthy weight for children; however, it needs strong, urgent, and ambitious action.  We can still take steps to achieve improvement, as we adapt to our new way of living, by enabling and supporting healthful food and physical activity environments, services and activities.  Although the full impact of 2020 on the health of children in Scotland remains to be seen: what is certain is the absolute necessity of measures designed to prevent and reduce childhood overweight and obesity. What has been evident for many years is the urgent need to address poverty and inequalities in Scotland, highlighted once again by the coronavirus pandemic.

In order to build a population in Scotland that is resilient to any future outbreaks, we must include such measures in our coronavirus adaptation and recovery plans.

Children are an integral part of Scotland’s population and our future: we must support them to thrive.

 

1 In the Scottish Government’s 2018-19 Programme for Government it was noted that the commitment to halve childhood obesity by 2030 would mean that approximately 56,000 fewer children would be at risk of obesity. This indicated that the baseline for halving childhood obesity was the 2016 figure, as just over 112,000 children aged 2-15 in Scotland were at risk of obesity in 2016 (14%) and these were the most up to date statistics at the time of the announcement. Last year this was confirmed, meaning that the ambition is for us to achieve a rate of 7% of children being at risk of obesity by 2030. This year's Scottish Health Survey Report (which contains 2019's figures) found that 16% of children in Scotland are now at risk of obesity. Mid-year population estimates for children aged 2-15 in Scotland in 2019 puts this at 130,863 children currently at risk. This is a rise of over 18,000 children since the year the pledge was based on. (Exact figures. 2016: 112,534, 2019: 130,863).