Deprivation, Childhood Obesity and Walking to School

(Originally posted to petergates3.com on 22nd January 2020)

Crisis? Just what Crisis is it?

It is no doubt still a shocking feature of our society that childhood obesity is one of the biggest health problems we face. “Nearly a quarter of children in England are obese or overweight by the time they start primary school aged five, and this rises to one third by the time they leave aged 11” (NHS Digital). “Our childhood obesity rates mean that the UK is now ranked among the worst in Western Europe” (OECD 2017). Indeed “childhood overweight/obesity rates have increased 10-fold in the past 40 years” (NCD-Ris).

The actual figures for obesity are reported by Rob Noonan (2020a, p. 3) as “32.4% among the most deprived neighbourhoods compared to 20.9% in the least deprived“. So even among the most well off, there is a significant level of childhood obesity. Surely we need to ask, what’s their excuse?

One might think that such a potential crisis would engender a non-partisan response from even a Conservative government widely recognised as one of the most right-wing for a generation. Of course, though, that is not to be. The Government’s response in their “Childhood Obesity Plan for Action, gives us four areas where they will focus their resources:

  • Sugar Reduction
  • Calorie Reduction
  • Advertising and Promotions
  • Schools

In particular:

We intend to ban price promotions, such as buy one get one free and multi-buy offers or unlimited refills of unhealthy foods and drinks in the retail and out of home sector through legislation, consulting before the end of 2018.

We intend to ban the promotion of unhealthy food and drink by location (at checkouts, the end of aisles and store entrances) in the retail and out of home sector through legislation, consulting before the end of 2018.

DHSC, p. 10

It is very easy, and effective to demonise the poor; it is a common and constant feature of our media. The narrative is the parents are to blame for feeding their children with sweet, fatty unhealthy foods. They either do not care what they feed their children in order to keep them quiet, or simply are ignorant and do not know about healthy food.

This is the standard ideological tactic of differentiation, and expurgation to create social fragmentation (Thompson, 1991, p. 60-67), and once you recognise this, you start to see it all over. The resulting policy and political response is to tell the poor how to live (..like the middle classes). They need to buy different food. They need to exercise more. They need to be better parents. They need to stop driving their children to school and make them walk. But hang on a minute. Aren’t these the undeserving poor, most of whom do not even have a car, (though they could have if they stopped spending on fags and booze).

But surely, it costs nothing to go outside, get exercise, go to the park. Well even that isn’t that easy when you live in a neighbourhood that is one of

the least supportive social and built environments for physical activity. For example, research shows that the most deprived neighbourhoods are perceived by parents as unsafe and have the least access to parks, playgrounds and recreational facilities for physical activity (Noonan et al., 2016).

Noonan, 2020, p. 2

What this narrative refuses to recognise is, that the poor have very little influence or control over their income and those living in the most deprived neighbourhoods are not likely to have the financial resources to support a balanced healthy diet (Jones, Tong, & Monsivais, 2017). Furthermore they are unlikely to have the resources (time, transport etc), or even the social and cultural to participate in healthy physical activities (Hardy et al., 2010). The real culprits here are the employers paying low poverty wages meaning their employees cannot even afford to feed their children in a way even the Government agree is necessary. The supermarket chain Morrisons is well aware of the effect on the retail sector:

Today, research reveals that the UK’s lowest income homes are being forced to spend a disproportionate amount of their weekly expenditure on food shopping. The average household in the UK spends 11 per cent of its weekly expenditure on food. However, 20 percent of households (those on lower incomes) are actually forced to spend proportionately at least 30 per cent more of their current weekly food spend than the national average.

(Morrisons, 2012)

Oxfam, in collaboration with the Child Poverty Action Group, put it this way:

Whilst the level of food poverty is worrying enough, what is of greater concern is the exponential growth in the numbers of people across the UK who are experiencing real hunger and hardship. Perhaps the most extreme manifestation of food poverty is the rising number of people who depend on emergency food aid.

Cooper & Dumpleton, 2013

But of course, if your entire upbringing has been one of privilege, it is very easy to not have a clue what it is like living in poverty. You might never have met or interacted with really poor people, (and probably don’t want to, other than to knock on their door and ask for their vote every few years). You might even go to the ludicrous extent of suggesting obese working class and poor children should walk to school in order to get fit. You are unlikely to even know, that most already do.

Children living in the most deprived neighbourhoods in England were most likely to commute to and from school actively but were at greatest risk of overweight/obesity and all unhealthy behaviour indicators. Active school commuting alone is unlikely to be enough to prevent and reduce inequalities and prevalence of childhood overweight/obesity in deprived neighbourhoods.

Noonan, Rob, 2020a, p. 5

So the demonisation of the lazy, work-shy proletariat, needs resisting. Children are becoming obese because they are abused by a political and economic system because we have moved into a scenario where the poor are working but being paid low wages on insecure hours.

The number of people trapped in poverty in working families has risen by over one million in the three years to 2016/17. This means almost three million children are now locked in poverty despite living in a working family. The situation is set to worsen further in future. This is simply not right

Joseph Rowntree, 2018

The rest of us bail out the employers by topping up low wages, and our children face unhealthy futures with restricted life expectancy, simply because … they really are expendable.

Indeed, it is not right.

References

Cooper, Niall and Dumpleton, Sarah (2013). Walking the breadline. The scandal of food poverty in 21st century britain. Oxfam/Child Poverty Action Group.

Department of Health and Social Care (DHSC) (2018) Childhood obesity: a plan for action, Chapter 2.

Hardy, Louise; Kelly, Bridget; Chapman, Karthy; King, Lesley and Farrell, Louise (2010) Parental perceptions of barriers to children’s participation in organised sport in Australia. Journal of Paediatrics and Child Health, 46, 197–203.

Jivraj, Stephren (2020) Are self-reported health inequalities widening by income? An analysis of British pseudo birth cohorts born, 1920–1970. Journal of Epidemiology and Community Health. doi:doi:10.1136/jech-2019-213186

Jones, Nicholas; Tong, Tammy and Monsivais, Pablo (2017). Meeting UK dietary
recommendations is associated with higher estimated consumer food costs: An
analysis using the National Diet and Nutrition Survey and consumer expenditure
data, 2008–2012
. Public Health Nutrition, 21, 948–956.

Morrisons (2012). Poorest budgets eaten up by food. Retrieved from https://www.morrisons-corporate.com/media-centre/corporate-news/poorest-budgets-eaten-up-by-food/.

NCD Risk Factor Collaboration (NCD-RisC). (2017) Worldwide trends in body-mass
index, underweight, overweight, and obesity from 1975 to 2016: A pooled analysis
of 2416 population-based measurement studies in 128⋅9 million children,
adolescents, and adults
. Lancet, 390, 2627–2642.

NHS Digital. (2017) National Child Measurement Programme 2016/17

Noonan, Rob; Boddy, Lynne; Knowles, Zoe and Fairclough, Stuart (2016). Cross-sectional associations between high-deprivation home and neighborhood environments, and health-related variables among Liverpool children. BMJ Open, 6, e008693.

Noonan, Rob (2018) Prevalence of childhood overweight and obesity in Liverpool
between 2006 and 2012: Evidence of widening socioeconomic inequalities
.
International Journal of Environmental Research and Public Health, 15, 2612.

Noonan, Rob (2020a) To what extent do unhealthy behaviour indicators explain the neighbourhood deprivation gradient in overweight among 11-year-old English children? Population Health, 10(100541).

Noonan, Rob (2020b) Walking to school is not enough to prevent obesity, The Conversation.

Noonan, Rob and Fairclough, S. (2018). Is there a deprivation and maternal education
gradient to child obesity and moderate-to-vigorous physical activity? Findings from
the Millennium cohort study
. Pediatric Obesity, 13, 458–464.

OECD (2017) Health at a glance 2017: OECD Indicators. Paris: OECD Publishing.

Joseph Rowntree (9018) Budget 2018: tackling the rising tide of in-work poverty.

Sullivan, Rory (2020) Poor Britons have worse health than generation born a century ago. The Independent, 22nd January 2020.

Thompson, John (1991) Ideology and Modern Culture. Critical Social Theory in the Era of Mass Communication. Stanford: Stamford University Press.

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