gia singapore - childhood obesity (mulgan)

CHILDHOOD OBESITY [innovation session]

Childhood obesity is one of the most serious

public health challenges of the 21st century.

Overweight and obese children are likely to stay

obese into adulthood and more likely to develop

noncommunicable diseases like diabetes and

cardiovascular diseases at a younger age.

Globally, in 2010, the

number of overweight

children under the age

of five is estimated to

be over 42 million.

Close to 35 million of

these are living in

developing countries.

THE PROBLEM

High Prevalence of Overweight and Obesity in Schoolchildren

THE PROBLEM

Increasing Number of Overweight Children Around the World

THE PROBLEM

Increase in Schoolchildren At Risk As Well

THE PROBLEM

Both Developed and Developing Countries Face the Challenge

THE PROBLEM

• Obesity prevalence varies between ethnic groups within countries.

• Gender differentials in obesity prevalence are also frequently observed and need to

be considered in programme planning.

• Evidence shows that television advertising influences children’s food preferences,

purchase requests and consumption patterns and that increasingly children are being

exposed to a wide range of other marketing techniques.

• Peers can serve as remarkably powerful role models for children and may share their

unhealthy eating or exercise habits with them.

• Obesity is linked to socioeconomic deprivation

• There is some evidence that parental and household behaviours shape the food

and exercise habits of the child

Factors that Influence Risk

THE PROBLEM

Economic Assessment of the Intervention at the Population Level

(Average Effect per Year)

THE CONTEXT

Cost per Life Year Gained in Good Health of Interventions to Tackle Obesity

THE CONTEXT

• Arkansas Act 1220 of 2003 requires that

all public school students have an annual

BMI screening

• Recent initiatives that limited access to

vending machines in schools, while at the

same time providing healthier alternatives

• Efforts to increase physical activity in

schools

Healthy Arkansas Initiative

THE OPPORTUNITY SPACE

• Compulsory membership of

Health Clubs for overweight

schoolchildren

• Monitor her height and weight

every month

• Teachers meet parents

regularly to recommend

healthier ways to prepare their

meals at home

Singapore “Fighting Obesity”

THE OPPORTUNITY SPACE

The big lesson on behaviour change is that environments and service design

matter more than individual treatments/intervention

THE OPPORTUNITY SPACE

How do we redesign our approach to tackling childhood obesity?

DRIVERS OF BEHAVIOUR

Habits

Beliefs

Translating Intention into Action

Automatic vs. Self-Reported Attitudes

Moral Climate

Habits are repeated behaviours, often fairly automatic and sometimes difficult to control, triggered by environmental cues. Habits can challenge motivations for behaviour change.

Beliefs about consequences, social norms and relative costs and benefits influence the behaviour changes that people are willing to make.

A perceived lack of time, reluctance toward short-term costs, distractions and stress can heighten a risk of failing to start or failing later on.

Automatic attitudes are those that people are unable or unwilling to retrieve from memory themselves. These often conflict with explicit or ‘self-reported’ attitudes (e.g. “I don’t like cake.”).

The effect that attitudes have on some behaviours is, in part, determined by moral norms.

Adapted from UK Government Office for Science, Tackling Obesities: Future Choices, 2nd ed.

POSSIBLE ROUTES TO ACTION

• Food regulation

• Fat taxes

• Public awareness

• TV

• Cycling lanes

• Walking buses for children

• Slow food

• Personal health technologies

Impact

Risk

POSSIBLE ROUTES TO ACTION