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Report: Impact of Cuts to Spending on Children’s Centres on Childhood Obesity
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Authors: Kate Mason, Alexandros Alexiou,Davara Lee Bennett, Carolyn Summerbell, Ben Barr, David Taylor-Robinson
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Published by: Journal of Epidemiology and Community Health, June 2021
SUMMARY
Evaluation of the early phase of Sure Start found children at age five living in neighbourhoods with access to a Sure Start centre were less likely to be overweight than those in comparable areas without a centre.
Austerity measures, including cuts to local government funding, adopted by the UK government from 2010 resulted in the closure of many children’s centres. Researchers from the University of Liverpool set out to assess whether changes in spending after 2010 are associated with changes in the prevalence of obesity at school reception – age four to five years – particularly in areas of deprivation.
The researchers analysed sources including the National Child Measurement Programme and expenditure data for children’s services. The analysis found that between 2010/11 and 2016/17, average local authority spending per child – between birth and four years old – on Sure Start and early years services decreased by 53 per cent. Spending in the most deprived local authorities decreased by £422 per child compared with £133 per child in the least deprived. Annual real-term cuts to spending averaged 8.3 per cent per year, varying from six per cent in the least deprived to 11 per cent in the most deprived areas.
On average, obesity increased more in areas with larger cuts to Sure Start spending. The researchers estimated each 10 per cent spending cut in a financial year was associated with a 0.34 per cent increase in obesity prevalence the following academic year. Over the study period as a whole, the research model suggests an additional 4,575 children became obese compared with the expected number had funding not reduced. This represents an additional 108 per 100,000 children per year with obesity.
The average annual change in obesity prevalence for the period 2007/08 to 2010/11 ranged from a 2.2 percentage point decrease to a 0.9 point increase. The association between spending and obesity within local authorities after 2010/11 was stronger in areas where obesity had been falling up to that point.
The report authors suggest the scaling back of Sure Start, alongside cuts to public health budgets, has constrained the provision of specific child obesity prevention programmes, such as the Henry approach, that were delivered through some centres. It has also diminished wider services that can indirectly support healthy weight in childhood such as breastfeeding support groups.
IMPLICATIONS FOR PRACTICE
The researchers say government plans to tackle obesity by restricting price promotions and advertising of unhealthy foods to children are important, overdue steps in the right direction. However, they also highlight the need to address root causes of obesity such poverty and deprivation. Reversing cuts to Sure Start, which disproportionately affected deprived areas, could be effective as part of a wider, multi-faceted approach to reducing childhood obesity and narrowing the deprivation gap.
Looking ahead to what is likely to be a period of increased financial pressure on local government due to the pandemic, the researchers warn obesity rates in young children may increase and inequalities widen. Across England, a return to 2010 levels of spending would involve re-investing around £900m per year above current levels. The report suggests alternative models for funding and service delivery – involving the voluntary, business or charity sectors – may be able to achieve the same or better outcomes.
FURTHER READING
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Area-Level and Family-Level Socioeconomic Position and Body Composition Trajectories: Longitudinal Analysis of the UK Millennium Cohort Study, Charis Bridger Staatz and others, The Lancet Public Health, August 2021
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The Biological and Social Determinants of Childhood Obesity: Comparison of Two Cohorts 50 Years Apart, Natassia Robinson and others, The Journal of Pediatrics, January 2021
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Socioeconomic Inequalities in Childhood and Adolescent Body-Mass Index, Weight and Height from 1953 To 2015: An Analysis of Four Longitudinal, Observational, British Birth Cohort Studies, David Bann and others, The Lancet Public Health, March 2018
