Phase 2 of whole-systems approach to obesity

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Background

Using the action mapping tool in phase 2 of the whole-systems approach to obesity, Dudley Metropolitan Borough Council found that there were many small-scale interventions addressing obesity locally. However, partnerships tended to involve solely public health or NHS colleagues and there was a lack of connection between the partnerships and the community.

Phase 2 of the 6-phase whole systems approach to obesity entails:

  • collating important information about obesity to build the local picture
  • starting to understand the local assets including community capacity and interest
  • establishing a comprehensive overview of current actions
  • identifying the departments, local organisations and individuals currently supporting work around obesity

What was involved

An action mapping tool, based on the Dahlgren and Whitehead wider determinants of health model, supports part of this phase. The council used it to create a borough-wide picture showing where obesity efforts were focussed. This was carried out with internal council departments and external partners over a 3-week period.

They mapped these actions against the determinants of health to create a visual representation of the results, which they then shared at action-planning workshops with partners, including:

  • internal council departments
  • NHS partners
  • voluntary sector partners

Working well

Mapping actions at a borough-wide level for the first time helped partners ‘see their place’ in the system and how they could contribute to reducing obesity levels. It also revealed how the borough’s efforts to combat obesity had focused mainly on lifestyle and environmental interventions, highlighting the imbalance between these and actions targeting more ‘upstream’ factors like social disadvantage and inequities.

Stakeholders reponded that there was not enough emphasis on community engagement or communities being part of the system. Off the back of this, the council decided to change direction and have the local community be the driving force whilst still taking a whole-systems approach.

To achieve this, they commissioned a provider to carry out a ‘deliberative’ enquiry, involving the local community in decision-making. This gave smaller groups of 15 to 20 local residents the opportunity to make recommendations and co-design actions.

The council also held a small preliminary workshop ahead of the initial formal one, which helped with gathering some preliminary information. This also allowed the director of public health to set the scene and tell partners that, despite all local efforts to combat obesity, data is showing year-on-year increases of obesity prevalence and interventions have not been effective on a population level.

This made it clear to partners that adopting a whole systems approach to obesity showed potential as a new and different perspective, and gave them the confidence to view it as a blank canvas to develop.

Next steps

The council will share their action map with partners and networks, including those outside of the whole-systems approach to obesity action plan process.

For further information, contact Balraj Johal, Public Health Manager (Healthy Places), Dudley Metropolitan Borough Council.

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