Every child a healthy weight — how do you set ten ambitions for London

Paul Lindley, September 5 2019

Eighteen months ago, I submitted my first job application in over 20 years. It was a long shot, but one that I was surprised and humbled to secure — Chair of the brand-new London’s Child Obesity Taskforce, convened by the Mayor of London, Sadiq Khan. His challenge, in a city where nearly 40% of its children are not a healthy weight, was to identify what actions would fundamentally change this. A complex, some say intractable, but vitally important issue — the sort of challenge I relish.

Within a few months we had brought together a diverse, professional and passionate taskforce determined to meet the Mayor’s challenge. At our first meeting we promised to be brave and innovative, thoughtful and impactful. We were determined to offer new thinking to an old problem, but how would we even start?

We started with a simple but audacious aim: to unleash a transformation in London so that every child has every chance to grow up eating healthily, drinking plenty of water and being physically active. We then built our ambitions around three core truths that we saw as key to step-changing important work already going on in the city, being:

• To place children at the centre of everything we would consider. We knew that actions, however well meaning, would work only if they were based on an understanding of the realities of the lives of London’s children and their families. To fix the system, we’d have to know how children experienced it from the inside. So, we developed profiles of London’s children and will continue to engage children, especially those living in poverty, in co-designing solutions. Our Vice Chair, Professor Corinna Hawkes has written this excellent blog on our child centred approach.
• To take a whole-systems approach to the challenge. We knew that multiple actions would be needed, re-enforcing each other to reshape what children eat and drink and how they move. Such an approach also means dispersing leadership across our communities and sectors, so that everyone feels responsible for some action towards achieving shared ambitions. It was fortuitous that this approach worked perfectly for a taskforce with no statutory power, little budget and limited resources, but with a strong voice and listening ears.
• To be bigger and bolder in amplifying many of the positive initiatives already happening, albeit currently often at small scale, short term and patchy. We knew we could link some, scale some and recommend minimum standards for others to build capacity across the city and be brave enough to trial and implement new actions — that might need to create their own evidence to measure impact and effectiveness. I find this entrepreneurial approach of learning by doing, adapting and iterating, partnering and collaborating to be liberating. We will take mis-steps, but that’s part of learning our way to the future.

The result has been an call to action in which we have set out ten ambitions to transform ten aspects of the daily lives of children and their parents in our stunning city. Each ambition includes two targeted calls to action, all are interconnected and only collectively can transform the city so that all its children can grow up eating healthier, drinking more water and taking more physical activity.

The interconnectedness of our calls to action is vital for success. It is absolutely no good picking one or two and believing the job will be done. Every action we propose has a knock-on effect to every other action.

If we simplify our calls to action to their core impact, they split into three distinct areas, being

• providing skills and financial resources to families to give them the capacity to live better lives;
• changing the environment in which children live their daily lives so they can eat healthily, drink more water and take plenty of physical exercise; and
• offering care and emotional support for children and their families so when they are struggling, they can easily find help that fits into their lives.

We published ‘Every Child a Healthy Weight. Ten Ambitions for London’ on 4th September and as we approach the first anniversary of the taskforce forming, I reflect on two huge personal learnings.

The first is that unhealthy weight and obesity in childhood are not the fundamental problems. They are symptoms of an underlying cause. The real problem is poverty. It’s poverty that forces parents to work multiple jobs which undermines family-time, to live in cramped, poor quality homes, often with unstable tenancies, in locations where air quality is poor, streets are not safe, schools are under resourced, health care support is patchy and takeaways are cheaper, easier and closer to home than shops or supermarkets. The cognitive attention of ANY family in such circumstances would be focused on the grind of survival. The evidence shows this is true, the statistics prove it and common sense confirms it. It is no co-incidence that our first, and critical, ambition is to end child poverty in London — with two specific calls to action to deliver this.

My second learning is realising the huge power of a lived experience for understanding where solutions may lie. As in other aspects to life, the best solutions are always found by those closest to the problem. I have learned that the true experts are not really the policy makers, politicians, NHS, Public Health England staff, academics or food experts. For they each must learn from those living within an obesogenic environment day in, day out — the children and families of the communities living in poverty in our city. Those communities know what needs to change. And it is they to whom we have tuned our ear most acutely.

Sadiq Khan was brave to deliver his health inequalities strategy and to give our independent taskforce a clean sheet to identify what actions are needed for this key aspect. We hope we have also been brave in building ambitions that start from a fresh perspective. We now need every Londoner to be brave and accept the challenge and responsibility to unleash a transformation in the city so that our children’s children can grow up healthily in the same, but a very different, place.

These are our ten ambitions, articulated — as you’d now expect — by London’s children.

Here is our full call to action: Every Child a healthy Weight. Ten Ambitions for London