A health problem that just keeps getting bigger

 

SECOND OPINION:New Government needs to get serious about obesity, writes JACKY JONES

THIS YEAR’S larger-sized Holy Communion outfits highlight once again Ireland’s obesity problem in children. A growing number of eight year olds need teenage sizes as they are too fat for clothes in their own age group. It is estimated that the number of overweight children in Ireland has trebled in the last decade, with more than 300,000 children now overweight or obese. A recent study carried out in Co Mayo measured the prevalence of obesity in 3,482 children. Overall, 27 per cent were classified as overweight or obese, with more girls (31 per cent) than boys (23 per cent) affected.

One of the biggest problems for parents is recognising what a healthy weight is for their child. According to Prof Mary Rudolf, a paediatrician who advises the UK government on childhood obesity, the ribs of a 10 year old should be clearly visible or the child is overweight. Parents may find that hard to believe, but we have got so used to seeing fat children that we don’t know what is normal any more.

Only about 14 per cent of parents with an obese child recognise that their child actually has a weight problem. As Irish people get fatter, our idea of what is a normal weight changes and our eyes add several more kilos to what used to be the norm.

If we want to fix the problem of obesity, then what is required is the implementation of healthy public policies. We need transport policies and systems that prioritise walking, cycling and public transport. We don’t have this. A number of local authorities are making an effort such as “Smarter Travel” schemes, but the needs of car owners still prevail. We need whole-school programmes to make the healthy choice for students the easier choice. We don’t have this.

The Social, Personal and Health Education (SPHE) programme is still not mandatory at senior cycle and the Health Promoting School concept is very difficult to implement due to all other demands on the school system.

As the recession bites, schools are likely to do even less of what are often seen as optional activities. Many schools have vending machines containing nutrient-poor, high-calorie foods and there is no policy saying schools cannot sell these foods.

We need urban design regulations and infrastructures that provide fair and safe access for walking, cycling and physical activity generally.

Planning regulations should require mixed-use zoning that places shops, services and jobs near homes, and highly connected street networks that make it easy for people to walk and cycle to their destinations.

Fairness is particularly important and it is well known that the poorest people in Ireland have the worst infrastructure and the richest the best.

Walking the prom in Galway is one thing, walking through the poorest estates is a less pleasant experience. I know of several estates in the West connected only by roundabouts where a parent could not safely allow their child to walk or cycle to school. It is simply too dangerous. We need public education programmes which will encourage parents to advocate for healthy public policies. Instead, we get campaigns from the HSE such as “Little Steps”, which is patronising and middle class, and will only succeed in making parents feel childhood obesity is all their fault.

The National Obesity Taskforce Report (2005) was supposed to have sorted out Ireland’s obesity problem, but five years on very little has changed. Why is this? I was a member of this task force and, as I argued at the time to no avail, the sectors that could actually do something about preventing obesity were not invited to be members. The task force had no representatives from the education sector, local authorities, the transport sector or the media, all absolutely essential partners in bringing about the changes required. The argument was made that a committee can’t include everybody, but it had six doctors, two dietitians, and two from IBEC. Surely one from each of these groups would have been enough which would have made room for seven extra partners from other sectors?

The Government has actually known since the early 1980s that health problems, including obesity, will be solved only by the implementation of healthy public policies. Twenty five years ago the Health Education Bureau produced a document called Promoting Health through Public Policy, most of which was not implemented. However, the smoking ban in Ireland is an example of very successful public health policy.

If it can be done for tobacco it can be done for food, transport, schools, communities and all the rest. Let’s hope the new Government will take the action required to finally deal with obesity.

Dr Jacky Jones is a former regional manager of health promotion at the HSE