Report of the Director of Public Health / Population Health Consultant in Public Health

This report provides an overview of the health data for Manchester children in relation to childhood obesity and infant mortality.  Information is provided on the causes and impact of obesity and the work taking place to develop a Manchester Healthy Weight Strategy 2020-2025, which will take a whole system, partnership approach to tackling obesity in the city. The report includes an update on new service models being commissioned to reduce obesity in children and their families.  It also summarises the progress that has been made in delivering the Manchester Reducing Infant Mortality Strategy following its publication in March 2019.

The Committee received a report of the Director of the Public Health/ Population Health Consultant in Public Health which provided an overview of the health data for Manchester children in relation to childhood obesity and infant mortality.  Information was provided on the causes and impact of obesity and the work taking place to develop a Manchester Healthy Weight Strategy 2020-2025, which would take a whole system, partnership approach to tackling obesity in the city. The report included an update on new service models being commissioned to reduce obesity in children and their families. It also summarised the progress that had been made in delivering the Manchester Reducing Infant Mortality Strategy following its publication in March 2019.

Officers referred to the main points and themes within the report which included:

·         Childhood obesity;

·         Measuring obesity in children;

·         Cause and impact of obesity;

·         Developing a new Healthy Weight Strategy to tackle obesity;

·         Commissioned Services - Healthy Weight;

·         Obesity and safeguarding;

·         Reducing infant mortality;

·         Patterns and trends in infant deaths;

·         Summary of Manchester Reducing Infant Mortality Strategy; and

·         Progress on delivering the Reducing Infant Mortality Strategy.

The Consultant in Public Health reported that there was an error in table 2 (Infant Mortality Data for 2018 - Manchester and England) under point 9.2 and clarified that the neonatal period was 0-28 days, not 7-28 days, as stated in the table.

Some of the key points and themes that arose from the Committee’s discussions were:

·         What could be done to address the increase in obesity between reception and Year 6, noting that this was above the national average;

·         The impact of poverty and deprivation;

·         Reasons behind the increase in infant mortality;

·         Drinking during pregnancy and whether the Committee could consider Foetal Alcohol Spectrum Disorder at a future meeting;

·         The impact of takeaways, particularly those close to schools, and whether there should be more regulation of this;

·         The impact of smoking on infant mortality; and

·         Why stillbirths were not included in the infant mortality figures.

The Consultant in Public Health advised the Committee that tackling child obesity required working not just in schools but also with families and in the community.  The Commissioning Manager (Starting Well) reported that the Population Health Team had reviewed their approach to tackling child obesity, advising that Public Health England had advocated a whole system approach.  The Consultant in Public Health explained that this involved a range of partners such as the Early Help Hubs, Manchester Local Care Organisation (MLCO) and Licensing working together to tackle obesity and advised that a workshop was being planned to bring different partners together to develop a shared approach.  The Manchester Healthy Weight Strategy Lead author informed Members that the Healthy Weight Strategy was due to be published in Spring 2020 and informed Members of the some of the other partners to be involved in this including businesses, transport and the Food Board.

The Commissioning Manager (Starting Well) reported that the Healthy Schools Team had a dedicated weight management project.  He advised that his service had recently commissioned this team to do some additional work focusing on reception age children and that work was also starting to take place with the 0 – 5 year age range.

The Consultant in Public Health noted the relationship between deprivation and both childhood obesity and infant mortality rates and advised that this could explain the increase in infant mortality in the city.  She highlighted that poverty was linked to poor housing conditions and other factors which impacted on infant mortality rates and informed Members that this was incorporated into the strategy.  The Executive Member for Children and Schools advised Members that poverty also led families towards poor food choices such as cheap takeaway meals.  He informed Members about the midwife-led smoking cessation programme at St Mary’s Hospital and suggested that the Committee might want to look at this in future.

In response to a Member’s question, the Consultant in Public Health reported that she would contact the Member outside of the meeting to provide him with more detail on the data and analysis behind the information in the report.  The Chair supported this and commented that, if there was any additional information for circulation to the wider Committee, to do this via the Scrutiny Support Officer.

The Programme Lead reported that the infant mortality rate was a national measure so officers could not change it to include stillbirths; however, she advised that the work being done in Manchester to reduce infant mortality, for example work to reduce smoking in pregnancy and to raise public awareness about changes in foetal movement, should also reduce stillbirths.  She advised Members that her team was monitoring stillbirth rates, despite this not being included in the infant mortality rate figure.

Decisions

1.            To support the proposed Manchester Healthy Weight Strategy to reduce obesity.

2.            To receive a report on Foetal Alcohol Spectrum Disorder at a future meeting.

[Councillor Alijah declared a personal interest as a member of the steering group of the charity Safety4Sisters.]