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Health inequalities and obesity

Professor Rachel Batterham, RCP special adviser on obesity, explores the link between health inequalities and obesity.

Obesity is a complex and often progressive chronic disease, characterised by excess body fat (adiposity) that impairs health. Obesity increases the chances of a person developing several life-limiting diseases including heart disease, type 2 diabetes and several types of cancer, that can lead to reduced quality of life and ultimately to premature death. Scientific advances have shown that the drivers of weight gain are complicated and vary from person to person but include genetic make-up, biological and social factors, the latter being markedly influenced by health inequalities.

A myriad of socio-economic factors – including income, housing, education, access to space, exposure to advertising and sale of unhealthy foods – impact upon whether we can be active or eat healthily and thus ultimately our risk of developing obesity. The predominant driver of all of these factors is what we eat, which in turn is shaped by our food environment, and we need to understand how this plays a key role in driving health inequalities between people living in advantaged and disadvantaged circumstances. For example, for one in five people in England, who are living in poverty, eating healthy food is secondary to eating at all.

Access to healthy food should be a right and not a privilege.

The impact of deprivation on obesity rates is deeply concerning, with adults in the most deprived regions having almost double the prevalence of obesity compared with the least deprived (36% compared with 20%). The effect of deprivation upon childhood obesity is even more alarming. In 2018/19, the prevalence of obesity in children aged 10–11 was 27% in the most deprived areas and 13% in the least deprived areas. The gap in obesity prevalence between children from the most deprived and least deprived areas is stark and growing, with an increase from 8.5% in 2006/7 to 13.9% in 2018/19.

It is clear that socio-economic factors such as under-employment or poverty play a key role in driving obesity and poor health, and that a whole-government approach is critical in order to reduce health inequalities and obesity rates.

This is one of a series of blogs to mark the launch of the Inequalities in Health Alliance, a coalition of organisations who have come together to campaign for a cross-government strategy to reduce health inequalities.