Despite numerous initiatives, there have been no improvements in the levels of childhood excess weight and obesity in England over recent years.

Much of the research used to inform policy on childhood obesity has been based on ways of changing the behaviour of individuals rather than influences outside their control, like the characteristics of a local area. Understanding these external factors is particularly important for children, who cannot choose the environment they grow up in.

This research looks at childhood excess weight and obesity rates in Reception-age and Year 6 age groups. It finds associations with a set of local area characteristics in England by combining and analysing publicly available data in a novel way.

Key findings

Overweight and obesity levels among children at the upper-tier local authority level in England are likely to be higher in areas where:

There is more childhood poverty

• Local authorities with the highest percentage of children living in low income families had, on average, 6.9% more overweight or obese Year 6 children than those with the lowest percentage.
• Local authorities with the highest percentage of under-fives living in households in receipt of out-of-work benefits had, on average, 3.5% more overweight or obese Reception children than those with the lowest percentage.

There is poorer access to places for children to engage in physical activities and where fewer adults undertake physical exercise

• Local authorities with the lowest percentage of adults who are active had, on average, 2.9% more overweight or obese Year 6 children than those with the highest percentage.
• Local authorities with the highest percentage of under-fives living in areas with poor access to passive green space had, on average, 1.8% more overweight or obese Reception children than those with the lowest percentage.
• Local authorities with the lowest percentage of adults walking for leisure had, on average, 1.6% more Reception children and 1.8% more Year 6 children who were overweight or obese than those with the highest percentage.

There are lower breastfeeding rates

• Local authorities with the lowest breastfeeding rates had, on average, 1.9% more overweight or obese Reception children than those with the highest rates.

For Year 6 children, overweight and obesity levels were more likely to be higher in areas where there was a greater percentage of the population who were from a minority ethnic background.

Our research highlights the complexity of the routes that lead to overweight and obesity in childhood and the importance of external societal and environmental factors, which lie outside of an individual’s control, for weight outcomes.

The results also suggest that certain populations based on their socioeconomic and demographic status are more at risk of being overweight and obese, which is compounded by the challenges they face in accessing weight management services.

Targeted, culturally appropriate, responses are required to support these high-risk populations and individuals.

The results also highlight the importance of some current and proposed policies in tackling childhood excess weight and obesity – such as food promotion strategies, the use of health impact assessments in local planning and breastfeeding promotion, that should be continued, evaluated and strengthened based on the evidence.