Obesity

The most reliable source of data on child obesity is the National Child Measurement Programme (NCMP), participation in which is compulsory in state-maintained schools. The NCMP measures children at age 4-5 (Reception Year) and age 10-11 (Year 6).  For more detail, see Services and Support section.

Due to there being only one state-maintained primary school in the City of London, National Child Measurement Programme (NCMP) data for Hackney and the City of London have been combined to maintain school anonymity, while ensuring that all data are represented. These NCMP data are based on all children who attend state-maintained schools within Hackney and the City of London, regardless of the borough in which they reside.

In Reception Year (age 4-5), almost three quarters (73%) of pupils were a healthy weight in 2014/15, one quarter (26%) were overweight or obese and a tiny proportion (around 1%) were underweight (Figure 1). However, in Year 6 (age 10-11) only 57% of children were a healthy weight, while the proportion who were obese was more than double that in Reception Year pupils (26% and 12%, respectively).

Figure 1: NCMP weight categories in Hackney and the City (2014/15)
Figure 1: NCMP weight categories in Hackney and the City (2014/15)

Source: National Child Measurement Programme

There is a very high rate of participation in the NCMP among pupils of mandated schools in Hackney and the City (between 96% and 98% in the seven years over which data is available). However, Hackney and the City have a higher proportion of five and 10-year-old pupils being educated in independent schools (24.5%) than London (10.1%) or nationally (5.7%) and these schools are not required to participate in NCMP. [20] In particular, almost a quarter (22%) of local 5-19 year olds belong to the Stamford Hill Orthodox Jewish (‘Charedi’) community, the majority of whom are educated in independent Charedi schools. Therefore, despite high participation in mandated schools, local NCMP data represent a lower proportion of the children of Hackney and the City of London than in other boroughs.

In order to address this, a pilot Reception Year health check was performed in 22 of the 23 independent Charedi primary schools in Hackney between January and July 2015. This pilot scheme included height and weight measurement (as collected in the NCMP), hearing and vision checks and a dental assessment. Ninety-five per cent of the 723 children in these schools participated, a participation rate comparable with national participation in the NCMP. The vast majority (around 80%) of the participating children were Hackney residents.

The results of this pilot are presented in Figure 2 for different weight categories, with a higher proportion of children found to be a ‘healthy weight’ than in local state-maintained schools, and a smaller proportion were found to be overweight or obese. Combining these results with the NCMP data for 2014/15 reduces the overall obesity rate in Reception Year children slightly from 12% to 11%, and the proportion overweight from 14% to 13%.

Figure 2: Proportion of Reception Year children in each weight category, 2014/15
Figure 2: Proportion of Reception Year children in each weight category, 2014/15

Source: National Child Measurement Programme; locally sourced pilot data

Obesity treatment for children and young people covers those with a BMI greater than the 98th centile or those with problems engaging in group-based interventions (for more information, please see Services and Support section). Based on the 2013/14 NCMP data, 106 Reception Year children and 156 Year 6 children would be eligible for this service in Hackney and the City (i.e. they are above the 98th BMI centile). Over the 12 months to December 2014 the local service received 178 referrals, of which 127 clients attended one or more appointments. 11]. This suggests a potentially significant unmet need among children eligible for this support.

As discussed previously, the factors underlying child obesity are complex and causal effects can be difficult to prove. However, local data on levels of physical activity and dietary behaviour amongst children and young people provide some clues. For example, one source suggests that only 10% of 15 year olds in Hackney and the City are meeting the Chief Medical Officer’s recommendation to undertake one hour of physical activity every day, and 71% are sedentary for more than seven hours a day during the week. 12

Data on dietary behaviour is more ambiguous. As a proxy for a ‘healthy’ diet, one local survey found that just 15% of 11-19 year olds regularly ate the recommended five portions of fruit and vegetables a day. 13 Another survey, this time of 15 year olds, reported that this figure was much higher at 56%. 14

Oral health

Data from 2012/13 to 2014/15 identified that, on average, 42% of children and young people in Hackney (aged under 18) had visited their dentist over this period. In the City of London, the number of dental visits was greater than the number of resident children and young people. Ten per cent of all under-18s in Hackney, and 20% in the City of London, have had a fluoride varnish application. 15

Figure 3 shows the extent of tooth decay in Reception Year pupils in Hackney, comparing national dental survey data (which only cover state-maintained primary schools) and data from the 2015 pilot health check in Charedi schools described earlier in this section. Data are not available for the City of London as the numbers were deemed too small to produce robust results. Half of Hackney’s Charedi Reception age children had evidence of decayed teeth, in comparison to one third of children of the same age attending local state schools. The number of decayed/missing/filled teeth was also much higher in Charedi children than the wider Hackney pupil population (2.2 and 1.2 teeth per child, respectively).

Figure 3: Tooth decay in Reception age children, 2012 (Hackney) and 2015 (Charedi)
Figure 3: Tooth decay in Reception age children, 2012 (Hackney) and 2015 (Charedi)

Sources: National dental epidemiology programme. [24] Public Health England (PHE) Orthodox Jewish dental survey. [25]  Confidence intervals not available.

In a survey of Charedi parents undertaken by Public Health England (a sample of 67 people), over three quarters (51) stated that they took their child for ‘regular dental care’ (frequency was not defined), seven answered that they took their child to the dentist only if they were in pain, and nine parents revealed that they had never taken their child to a dentist. 16

Substance misuse

Smoking

Recent surveys of young people in Hackney and the City suggest that around three quarters have never smoked. [22] [23] For example, Figure 4 shows that 76% of 15 year olds report never having smoked, 6% are current smokers, 4% are ex-smokers and 14% say they have tried smoking at some point.

According to the same source, one quarter (24%) of 15 year olds in Hackney and the City report having tried tobacco other than in cigarettes. This is likely to predominantly relate to shisha tobacco, as the question asked in the survey gave the following examples to help participants answer the question: ’shisha pipe, hookah, hubble-bubble and water pipe’ (all being words to describe the instrument through which shisha tobacco is smoked).

Figure 4: Self-reported smoking prevalence in 15 year olds in Hackney and the City, 2015
Figure 4: Self-reported smoking prevalence in 15 year olds in Hackney and the City, 2015

Source: What About YOUth? (WAY) survey, Health and Social Care Information Centre (HSCIC), 2015 17

Alcohol

Almost one in three 15 year olds (29%) in Hackney and the City report being current alcohol drinkers, with 6% saying they drink at least every fortnight (‘frequent drinking’), and 24% reporting that they drink less frequently than this.D18

In Hackney and the City in 2010/11 and 2012/13 combined, the rate of alcohol-related hospital admissions in people aged under 18 was 22 per 100,000 population per year. [18]

Other substances

In Hackney and the City, 14% of 15 year olds say they have ever tried cannabis and 3% have tried other drugs. Just over half (52%) of those 15 year olds who report having ever tried cannabis say they have used it within the last month. 19 In 2011/12 and 2012/13, the rate of substance misuse-related hospital admissions in people aged 15-24 in City and Hackney was 54.7 per 100,000 population.

The three most common substances reported by young people receiving specialist drug and/or alcohol treatment in Hackney are cannabis, alcohol and nicotine. Almost all (96%) of these service users report using cannabis (Table 2). None of Hackney’s service users report injecting substances.

Table 2: Substances reported by young people in Hackney receiving specialist drug and/or alcohol treatment (only those above 5% shown) (2014/15)

Substance Proportion of young people reporting use of substance
Cannabis 96%
Alcohol 38%
Nicotine 17%
Ecstasy 6%

Source: National Drug Treatment Monitoring System

Note: For these and subsequent data on substance misuse service use, any national figures quoted relate to the final quarter of 2014/15, whereas Hackney figures relate to the whole year (2014/15) so numbers are not so low as to be identifiable.

Reproductive health

The two most commonly prescribed types of contraception in sexual and reproductive health (SRH) services in under-25s in Hackney are oral contraception (2,490 prescriptions in 2014) and male condoms (1,695 distributed) – see Figure 5. E The most common form of long-acting reversible contraception (LARC) prescribed was the implant, making up almost three-quarters (72%) of all LARC prescriptions.

Figure 5: Contraception prescriptions at SRH services in those aged 24 and under in Hackney (2014)
Figure 5: Contraception prescriptions at SRH services in those aged 24 and under in Hackney (2014)

Source: NHS Digital, Sexual and Reproductive Health Activity Data Set (SRHAD)

Note: The contraceptive injection and the contraceptive patch are considered ‘intermediate’ contraception methods – they are not user-dependent on a daily or exposure basis (such as the contraceptive pill or barrier methods) nor are they long-acting (lasting 8-13 weeks and one week, respectively).

LARC is also available through GP practices as well as SRH services. LARC was prescribed through GPs at a rate of 19.8 per 1,000 women aged 15-44 in 2014 (data are not available for younger women separately). This constitutes 8% of all GP contraception prescriptions, compared with 26% of prescriptions in SRH services for women aged 15-44.

SRH services in Hackney and the City of London distributed emergency contraception to 15 per 1,000 women aged 13-54 in 2014/5. F In total, a similar number of emergency contraception prescriptions are provided through GPs (1,035) as through SRH services (1,570).

In 2013, there were 97 teenage conceptions in Hackney and the City of London, equating to a rate of 24 conceptions per 1,000 females aged 15-17 years old and 4.1 conceptions per 1,000 females aged 13-15 years old. 20

The rate of abortions in women aged 15-17 in Hackney in 2014 was 15.3 per 1,000. There were no abortions in women aged 15-17 in the City of London in 2014. Over one third of abortions in women aged under 25 in Hackney and in the City of London were repeat abortions.

In 2013 the rate of births in women aged 15-17 years in City and Hackney was 5.7 per 1,000 population. The absolute number of births at Homerton University Hospital NHS Foundation Trust (HUHFT) for women aged 15-17 was 26 in 2013/14 and 19 in 2014/15.

 

Notes

  1. Figures do not sum to total due to rounding.
  2. There were five fewer male condoms (1,695) distributed than the barrier methods (1,700) as barrier methods also include the diaphragm and cap.
  3. Emergency contraception includes prescribed oral and intrauterine device (IUD) methods but does not include over the counter purchases.
  4. Figures do not sum to total due to rounding.
  5. There were five fewer male condoms (1,695) distributed than the barrier methods (1,700) as barrier methods also include the diaphragm and cap.
  6. Emergency contraception includes prescribed oral and intrauterine device (IUD) methods but does not include over the counter purchases.

References

  1. “Departmental communication,” Homerton University Hospital NHS Foundation Trust, 2015.
  2. “What About YOUth? survey,” Health and Social Care Information Centre, 2015.
  3. “Healthy living in Hackney: Young people’s health behaviours and attitudes,” rockpool research associates, 2012.
  4. “What About YOUth? survey,” Health and Social Care Information Centre, 2015.
  5. “NHS Dental Statistics for England,” Health and Social Care Information Centre, 2014/15.
  6. Public Health England, “Dental health and oral health behaviours of five-year-old children in the Orthodox Jewish (OJ) community in North London,” 2015.
  7. “What About YOUth? survey,” Health and Social Care Information Centre, 2015.
  8. “What About YOUth? survey,” Health and Social Care Information Centre, 2015.
  9. “What About YOUth? survey,” Health and Social Care Information Centre, 2015.
  10. “Public Health Profiles (‘Fingertips’),” Public Health England, 2015.
  11. “Departmental communication,” Homerton University Hospital NHS Foundation Trust, 2015.
  12. “What About YOUth? survey,” Health and Social Care Information Centre, 2015.
  13. “Healthy living in Hackney: Young people’s health behaviours and attitudes,” rockpool research associates, 2012.
  14. “What About YOUth? survey,” Health and Social Care Information Centre, 2015.
  15. “NHS Dental Statistics for England,” Health and Social Care Information Centre, 2014/15.
  16. Public Health England, “Dental health and oral health behaviours of five-year-old children in the Orthodox Jewish (OJ) community in North London,” 2015.
  17. “What About YOUth? survey,” Health and Social Care Information Centre, 2015.
  18. “What About YOUth? survey,” Health and Social Care Information Centre, 2015.
  19. “What About YOUth? survey,” Health and Social Care Information Centre, 2015.
  20. “Public Health Profiles (‘Fingertips’),” Public Health England, 2015.