1. Improving the wider social determinants of health in Sunderland through the Lifestyle, Activity & Food programme Julie Gray, Head of Community Services, Sunderland City Council Victoria French, Wellness Manager, Sunderland City Council

2. Our Challenges

3. Sunderland's Challenges Average health is poorer than across England 11 of 25 wards ranked within the 10% most deprived nationally 16.6% aged under 65 suffer from a long term limiting illness or disability Only 20.03% of adults are meeting national guidelines of 3 x 30 min physical activity each week Lifestyle behaviours, smoking, diet & alcohol consumption are poorer than the average for England Many illnesses GP’s see every day are preventable

4. Where are we in Sunderland ? 68,300 children & young people between the ages of 0-19 Anticipated over 20% of children and young people in Sunderland will need some form of additional help to enable them to: –be healthy –stay safe –enjoy and achieve –make positive contribution –achieve economic well-being

5. The Childhood Obesity Challenge Gradually seen as a government priority National targets have been set - halt the year on year increase in obesity among children under 11 by 2020 2005 National Child Measurement Programme (NCMP) measuring children entering reception year (aged 5) measuring those in their final year (yr 6) of primary school (aged 10/11) Measurements included for both their height & weight, allowing calculation of the child’s BMI score

6. In Sunderland … NCMP 2006/07 indicated: – 12.4% of reception year children and – 21.4% of year 6 children –ARE OBESE AND OVERWEIGHT Worst case scenario….. but a possibility: –first generation coming through with lower life expectancy than their parents

9. Our Solutions

10. Raising to the challenge Strategic focus given to: –community cohesion –tackling health inequalities –improving public health Achievable through the delivery of services in communities with the most pressing challenges Tackling obesity is a priority indicator within LAA

11. Where were we … Organisations working separately to try to tackle health inequalities that exist Developmental, pilot based work, dependent on short term money Parallel to strategic work Where we moved to… A commissioning relationship between Sunderland City Council, STPCT and City Hospitals Recognition of the need to work together Shared agendas – reducing inequalities Agreed joint ways of working Joint delivery of services

12. Lifestyle Activity & Food Programme (LAF) Multi agency, multi component –City Hospitals Dietetic Department –Sunderland's Wellness Service –Sunderland's Food In School Team Families referred in by Consultants, GP’s & School Nurses 5-16 year olds and their families 8 week programme –(weekly 1hr physical activity, 1hr education) Delivered in non clinical environments –leisure centre's, community venues Delivered in a fun interactive manner

13. Aims and objectives of LAF Not a diet programme ! To support identified overweight and obese children and their families Increase child and family physical activity levels Decrease sedentary behaviour Improve understanding about healthy eating Improve understanding of weight maintenance

14. What about prevention ? LAF Programme - targeted intervention Food In Schools team –Provide nutritional training for school based staff –Provide training to lunchtimes supervisors to make the lunchtime experience more fun –Deliver family learning activities to increase skills on healthy cooking

16. Our Impact

17. Impact so far… 8 programmes Supported 91 young people & their families Data collected identifies an average weight loss between 1- 3kgs End of the programme 85% of young people and their families report an : –Increase in their physical activity levels –Increase in fruit and vegetable consumption –A reduction in sedentary behaviour

18. Programme Dates No. of recruits attended No. of recruits that completed Av. weight lost Av. waist circumference lostAv.BMI lost Oct - Jan 06116-2.32kg-4.0cm1.37 July – Aug 071412-1.5kg-9.16cm0.72 July – Aug 0817 -0.32kg-3.57cm0.96 Impact so far…

19. Robert – Before and after lost 19.05kg & 9cm from waist over a 10 month period “ I always eat breakfast now, lunch includes fruit & vegetables. I am a lot more confident I don’t feel as though people are looking at me all of the time.”

20. Louise – Before and after lost 6.0kg and 9cm from waist over a 3 month period “ I feel much better in myself and I’m not teased so much at school”

21. The wider impact “Since joining LAF Roberts confidence has shot through the roof he used to miss out on a lot of activities know he doesn’t miss a thing. As a whole family our diet has improved I have lost 12lbs myself, we also exercise regularly we couldn’t have done it without The LAF Programme.” Roberts parent

22. Conclusion Success only achieved through collective action LAF is an example of a shared vision working We believe Sunderland is an exceptionally innovative authority with a clear and mature vision for tackling health inequalities as part of our approach to improving the wider social determinants of health

23. Thank you victoria.french@sunderland.gov.uk Julie.d.gray@sunderland.gov.uk