Childhood Obesity in Birmingham 2006 The School BMI Survey results
In 2003 the Birmingham City Council Scrutiny Committee Report Children’s Nutrition – Obesity found that there was no locally based data on childhood obesity. To address this gap in our knowledge the BMI schools survey, led by Mrs Deirdre Bryant, a senior teacher, was conducted in the academic year 2005-2006. We have measured over 3000 9-10 year old schoolchildren across 70 schools in Birmingham. Our results are worrying, with 37% of the children being overweight (including obese) and nearly one in four, 23%, being obese. How was the survey conducted? In the survey body mass index (BMI) data was collected by working in partnership with Primary schools to run a specially designed numeracy lesson. In this method, which was piloted successfully in North Birmingham PCT during 2004, children were encouraged to take measurements of body parts while a trained school Learning Support Assistant measured their height and weight. Anonymous data on gender, age, postcode, ethnicity, height and weight was sent back to the PCT for each child and analysed. Comparison with National Figures The most recent national figures, obtained from the 2003 Health Survey for England, show rates of overweight (including obesity) of 32% and obesity of 16.5% for 8-10 year old children.
Percentage
Prevalence of childhood overweight and obesity in Birmingham, 2006, and England, 2003 40 35 30 25 20 15 10 5 0 Birmingham 2006 (9-10yrs)
England 2003 (8-10yrs)
Overweight (including obese)
Obese
Our higher rates reflect either a higher rate than the national average of overweight and obesity in Birmingham, or an increased rate nationally over the last three years (or a mixture of both). From September 2006 all Primary Care Trusts have to submit data on levels of childhood obesity in both Reception (aged 4-5 yrs) children and those in Year 6 (aged 10-11yrs). When analysed this data will allow us to see whether Birmingham does indeed have a higher level of overweight and obesity than the country as a whole. We already know that the levels of obesity we have found in Birmingham this year are more than four times the UK national average in 1990. This is because we have used the 95th centile of the UK 1990 data as a cut off point for obesity (the 85th centile being the cut off for overweight). From our figures it seems that, in sixteen years, the numbers of children who are suffering from obesity has increased by more than 300%. Ethnic group differences Differences were found between the various ethnic groups in Birmingham. The highest level of overweight and obesity was found in the Black ethnic group at 42% (with 30% obese). This compares with a prevalence of 39% (with 25% obese) in Asians and 35% (with 22%) in Whites. (The ‘mixed’ and ‘other’ groups contain very small numbers of various ethnic mixes so are unlikely to give any useful information here).
Percentage
Prevalence of overweight and obesity in 9-10 year old children by ethnic group, 2006 45 40 35 30 25 20 15 10 5 0 Asian n=867 Black n=229 Mixed n=152 White n=1352 Other n=62 Overweight and obese
Obese
If we look more closely at the Black, Asian and White ethnic groups we find that there is a gender split in the Asian group that is not found in the Black and White groups. Asian boys have a significantly higher prevalence of obesity than Asian girls. Prevalence of obesity in 9-10 year old children by gender and ethnic group 35 Percentage
30 25 20 15 10 5 0 Asian
Black
White
Ethnic group Boys
Girls
Differences due to level of deprivation We have found that there are probably higher levels of obesity in those living in the more deprived areas. Studies in other parts of the country have found a similar link between obesity and deprivation. P revalen ce o f o verw eig h t an d o b esity b y d ep rivatio n q u in tile (IM D 2004)
Percentage
50 40 30 20 10 0 1 n=1558
2 n=516
3 n=305
4 n=112
D ep riv atio n q u in tile (1 is m o st d ep riv ed ) O verw eight (inc obese)
O bese
5 n=77
Summary of results
We have measured 3000 9-10 year old children in 70 Birmingham schools 37% of these children were found to be overweight (including obese) 23% were obese These levels compare with national figures from 2003 of 32% and 16.5% respectively (for 8-10 year olds). The highest prevalence of overweight and obesity was found in Black children. Asian children were the next most likely to be overweight. Asian boys had a significantly higher level of overweight and obesity than Asian girls. There was no such significant gender split in the Black or White ethnic groups. Children living in more deprived areas are probably more likely to be obese than those in less deprived areas
Conclusions If our figures are a true representation of all 9-10 year old children across Birmingham we have a worryingly high level of childhood overweight and obesity in the city. Our levels may be higher than the national average but we do not have up to date national figures with which to compare. It is likely that levels of overweight and obesity seen in this age group will be reflected in other age groups. Overweight and obesity tends to worsen as a child ages – so the levels in our teenagers may well be higher than this figure. Children who are obese have an increased risk of being obese adults and so we are storing up huge potential problems for our future adult population in terms of the complications of obesity such as coronary heart disease and diabetes. We know that Southeast Asians are at particular risk of coronary heart disease and diabetes and so we should be particularly worried that we have found such high levels of overweight and obesity among our young Asian population. And the fact that we have found a particularly high level of overweight and obesity among Asian boys adds further to the concerns that have already been identified in Birmingham about male life expectancy in this group. The results from this survey confirm that childhood obesity is a serious and important problem for the present and future health of the City of Birmingham.
Dr Kristina Routh Specialist Registrar in Public Health North Birmingham PCT Kingsnorth House 1 Blenheim Way Kingstanding Birmingham B44 8LS Tel: 0121 465 5154
Deirdre Bryant Birmingham Child Obesity Survey Coordinator South Birmingham PCT Public Health Directorate 6th Floor Triplex House Eckersall Road Kings Norton B38 8SS Tel 0121 465 8012