Children's health and food

What will it take to close the gap?

20 September 2019
4 min read

Programme Director Sarah Hickey shares what our childhood obesity goals mean in practice and how we’re creating a roadmap for change.

Sarah Hickey
Sarah Hickey
Interim Executive Director

At the heart of our childhood obesity programme is the aim to make sure all children can grow up healthy, no matter where they live. We’re now two and a half years into our programme. With that in mind, how have we identified our goals, what do they mean in practice, and how do we track and measure our impact?


Defining our goal

When we started, our first question was ‘what are we talking about when we talk about childhood obesity? Secondly, what’s our role as an urban health foundation in supporting a place to tackle this issue?’

To answer this, we look at evidence from three important angles: data and academic literature; the experience of experts already working on the issue; and the perspective of children and families themselves.

First, data demonstrated that rates of childhood obesity tracked strongly with an area’s average income. This is an extreme example of our national picture. It shows that where you grow up strongly influences your chances of being overweight and obese. And this correlation has only got stronger over time.

Childhood obesity and income

This evidence has guided our programme from the outset. We believe that by designing interventions around families on the lowest incomes, they are likely to work for everyone.

This shaped our programme’s ten-year goal: to close the childhood obesity inequality gap. We do this by bringing the high rates of childhood obesity in neighbourhoods with the lowest incomes down to the level of the more affluent ones.

It means much of the activity that we support focuses on the areas with lower average incomes, where childhood obesity rates are highest.


Creating a roadmap for change

Spending time with local children and families helped us understand what was happening beneath this data. Families are up against a flood of unhealthy food options. Reduced financial resources limit healthy options even more.

Across the world, successful approaches have focused on re-designing the spaces where children and families spend their time, particularly in urban areas.

This shaped our programme approach: to make sure all children have healthy food options and places to run and play by redesigning the spaces where children and families spend their time. We weight more heavily towards food, as we think this has the largest impact.

Our programme’s projects and activities focus on three areas to make sure children and families can live healthy lives:

  • Homes – we aim to create healthy food environments at home and in early years settings for all children, regardless of where they live. 
  • Schools – we support healthy and nutritious food options and more time for children to play and move throughout the school day.
  • Streets – we look to re-design the places families spend time in outside of home and school. It ranges from food shops and takeaways to spaces for play and active travel.


Working in partnership

There is international consensus that tackling childhood obesity requires a whole-system approach.

What’s unique about our approach is our focus on a goal and a place. We work across the entire system to make change happen in Lambeth and Southwark. Everything that we do in our programme is in partnership with others. We see our role as bringing convening power and support to help tackle this issue through lots of different approaches, organisations and people.

We work at different scales to increase the flow of healthy options for children and families. Some levers for change exist locally and some involve national or international partnerships. Equally, some involve using detailed insights from our work to influence national policy and practice.


Measuring our impact

We developed an outcome framework to define specific goals, track progress and test assumptions from our theory of change. We believe that no single intervention can tackle childhood obesity alone. So, we use measurement and evaluation to track the cumulative impact of a portfolio of projects.

When it comes to most partners, we don’t actually ask them to measure their impact on childhood obesity. Rather, we ask that they rigorously assess their impact on a factor within their control. For example, a project that supports schools to change their food environment tracks what changes have occurred within the schools, and how many unhealthy food options have been removed.

Our core strategy remains the same as when we launched. Yet, we’ve made significant progress in strengthening what underpins our thinking. We need to reach as many children as possible and re-design our food system and local places to create neighbourhoods with healthy options and opportunities to run and play.

My colleagues at the Charity will be sharing more detail on what we’ve learned so far through our programme strands. And, growing our understanding of the types of projects we’re keen to partner with in future – so keep an eye out for more in the next few weeks.