Health Needs Assessment Report - Childhood Obesity in the London Borough of Barking and Dagenham (Other (Not Listed) Sample)

HEALTH NEEDS ASSESSMENT REPORT “CHILDHOOD OBESITY IN THE LONDON BOROUGH OF BARKING AND DAGENHAM “
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Introduction
According to WHO, health is not just about the absence of diseases but a state where a person experiences complete physical, mental, and social well-being (Bickenbach, 2015). Childhood obesity is growing concern to public health globally, and its prevalence is increasing at an alarming rate. According to the WHO report, obesity affects mostly the urban population (World Health Organization, 2016). In 2016, it was estimated that 41 million children under five were overweight, risking to suffer from obesity (World Health Organization, 2016). According to Trust for London (2020), the prevalence of childhood obesity is high in London. It is estimated that 23% of children aged six years were obese in London while 20% were obese in England (Trust for London, 2020). Barking and Dagenham leads with the childhood obesity rate standing at 29.6% in 2018/2019. The target population at Barking and Dagenham was critical because most people are younger than 32.1 years. The people in the area also comprise diverse groups, including Black British and Asians, who are less privileged than the majority white British. The British government has made some efforts to improve this population's health, including enacting the Health and Social Care Act, which requires the Clinical Commissioning Group to provide appropriate and equally accessible care. The current approach to tackle obesity is the whole system approach (Public Health England, 2019). Despite the government's efforts, high inequality in access to healthcare and other factors such as economic status is still a challenge in dealing with childhood obesity in borough.
By looking at the above statistics, it is evident that there is an urgent need to assess the current healthcare provisions in Barking and Dagenham so that appropriate strategies to improve the problem can be implemented. Better intervention can be achieved better by developing a Health Needs Assessment (HNA). The health needs assessment is crucial because it provides information on what improvements are needed and future interventions to address the current health needs (Vuik et al., 2016). This health needs assessment report hopes to provide an overview of the populations discussed and further analyse the current provisions and implementation challenges present and provide recommendations based on findings.
Part 1: Health Characteristics of the London Borough of Barking and Dagenham
Demographic Profile of Barking and Dagenham 
The local target area has a population of 187,000, according to the latest census of 2011 (Census 2011, 2013). 51% of this population were females, while 49% were males (Census 2011, 2013). The dominant group in the target are the whites comprising 58% of the community (Census 2011, 2013). The second-largest ethnic groups are Blacks or Black British comprising 20% of the population followed by the Asians or Asian British comprising about 16% of the population while other races, including Arabs and other minority groups taking the remaining percentage (Office of National Statistics, 2016). In 2018, it was estimated that 27% of the total population was persons aged between 0 and 15 in Barking and Dagenham (Barking & Dagenham, 2018). It was also determined that 63% of persons aged between 16 and 64, while 9% were persons aged 65 and above (Barking & Dagenham, 2018). 
In this place, life expectancy is 77.7 years for males and 81.9 years for females who are lowest compared to other sites such as London. There are high healthcare inequalities in the target area and ranked as one of London's most deprived areas. Multiple health risk factors and poor health are also contributed by childhood experiences and domestic violence (Joint Strategic Needs Assessment, 2018). According to the 2018 social progress index, nutrition and primary medical care were the dominant human basic needs followed by water and sanitation, shelter, and personal safety, respectively (Barking & Dagenham, 2018). 
Unique features within local borough
The local borough has various unique features than make it crucial for this assessment. One feature of this area is the high population of young people. The average age in the local borough is 33 years, while the median is lower at 32 (Census 2011, 2013). The target area also has the highest number of pre-school children in London. Additionally, it is a local authority with the highest number of people aged 5-19 years old than any UK (NHS, 2016). The high population of young people is increasing at a higher rate among the minority groups than most whites, as seen in the table below. Since the people of the most disadvantaged groups are rising more than the majority white British, their children are more likely to suffer from obesity. 
Figure SEQ Figure \* ARABIC 1: Population change among ethnic groups in Barking and Dagenham
Source: UK Census, 2011
The high population of young people may have contributed to a high childhood obesity level. Children from Black, Asian, or minority ethnic groups are more likely to suffer from obesity due to social marginalisation, difficulty accessing quality services, and economic constraints of their families to afford better diets (Karlsen et al., 2014). Health inequalities also exist between socioeconomic groups, and despite government efforts to promote access to healthcare, healthcare inequality still exist. According to Karlsen et al. (2014), minority groups are likely to suffer from obesity due to health inequality in England. Since the population of the most disadvantaged groups are the one increasing, they are likely to suffer from childhood obesity; hence, contributing to many obesity cases among the target population.
Another unique feature that could have contributed to the high obesity rate is the high level of poverty. The study area has a deprivation rate is 33.9%, higher than the average of 20.6% in England (Barking & Dagenham, 2018). Income deprivation in these areas is low compared with London. According to Trust for London (2020), the poverty level at Barking and Dagenham is 1.9 times higher than in other regions in the city. This characteristic can explain why this area has a high rate of childhood obesity. According to Noonan (2018), deprived communities can encourage the consumption of unhealthy foods as they struggle to afford a balanced diet. However, in another cohort study conducted by Goisis, Sacker, and Kelly, (2016), it was found that the reviews on the relationship between socioeconomic statuses about obesity among children are minimal. Such contradictions make it hard to conclude that deprivation is why there is a high obesity rate in the study area.