School aged children and young people

Healthy child programme

The healthy child programme [external link] is a national framework for improving the health and wellbeing of children and young people. It sets out the evidence-based approaches to prevention, early intervention and family support and should be used by the NHS and local authorities to inform the commissioning and delivery of services.

As Director of Public Health, I have responsibility for commissioning a public health nursing service. This includes the provision of health visitors and school nurses. This is the Growing Healthy service in Darlington, which is provided by Harrogate and District NHS Foundation Trust.

Darlington Growing Healthy Service

The service works with children, young people and families to empower and enable them to make informed decisions about health and support them in transitioning safely and happily into adult life. The Growing Healthy 5-19 Team works in the home, school and community settings to deliver universal and targeted interventions.

For school aged children and young people this offer includes:

named school nurses for each school
vision screening for reception children
height and weight checks for children in reception and year 6
emotional health and wellbeing support
advice and information on a range of health issues, including smoking, drug and alcohol use, relationships, sexual health and pregnancy and oral health
support with parenting and behavioural problems
lower level advice and support about enuresis (involuntary urination)
supporting children and families with additional health needs or disability
regular secondary school health drop ins
promotion of healthy lifestyles, in person, online and through the Children’s Health Service app

National Child Measurement Programme and Child Obesity

Performance in Darlington

26.9%

of children in reception are overweight (including obesity)

35.7%

of children in year 6 are overweight (including obesity)

32%

of primary school children and 30% of secondary school children eat a takeaway / fast food 1-2 times each week

Darlington has 145 fast food outlets per 100,000 population – the second highest in the north east

The National Child Measurement Programme (NCMP) is a mandated public health programme in England. Established in 2006, it is one of the public health responsibilities of local authorities. The height and weight of children in reception and year 6 are taken (with parental consent). This provides data which allows us to monitor patterns and trends and the prevalence of underweight, healthy weight, overweight and obesity in children. It also provides data on child height.

The World Health Organisation [external link] reports that childhood obesity increases the risk of developing a range of health conditions in childhood and later life. Living with obesity in childhood can also lead to low self-esteem, poor mental health, bullying and school absence.

Worryingly, we now have Darlington level data from Fingertips Public Health profiles [external link] that shows:

ward level data from the NCMP shows that areas which experience the greatest disadvantage typically have more overweight or very overweight children at reception and year 6
76.8% of children who were overweight (including obesity) in reception remained overweight in year 6 (the England average is 77.1%)
22% of children who were a healthy weight in reception were overweight (including obesity) in year 6 (the England average is 29.4%)

The 10 Year Health Plan for England [external link] has identified addressing obesity as a priority, with a commitment to restrict junk food advertising targeted at children and banning the sale of high-caffeine energy drinks to under 16 year olds. Whilst these are positive steps we need to be bolder in our actions.

The sugar tax (previously the soft drinks industry levy) will be extended to milk-based drinks from 2028:

it was first introduced in 2018 and already applies to most sugary and fizzy soft drinks
there is evidence that it has already had a positive impact in terms of leading to a 39.8% decline in the amount of sugar purchased from soft drinks [external link] and a reduction in hospital admissions for dental caries [external link] related to tooth extractions in children.

The environment in which we live, and work, impacts our health and wellbeing, both positively and negatively. The ease of availability of fast food makes unhealthy food choices easier, and we know that there are more fast food outlets in areas with greater levels of disadvantage. This is not right, and we should work together to ensure that the areas of Darlington which already experience higher levels of disadvantage and greater levels of child obesity are not further impacted by increasing numbers of fast food outlets. We should limit the advertising of foods which are high in fat, sugar and salt and which we know appeal to children.