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Local systems thinking: Making obesity everyone’s business

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In late 2015 I wrote about a new programme that aims to explore local systems and design new approaches to prevent and tackle obesity.

As we move into the project’s second year, now is a great time to share its progress with you.

My original blog discussed the need for systems thinking around obesity, reflecting the fact that we’re dealing with one of the most complex health challenges of our time.

And I highlighted that because we have a broad consensus that obesity is the result of many factors, activities and determinants, we must support new ways of making the issue everyone’s business at local level.

This complements projects at national level such as our work with industry to make food healthier or campaigns like Change4Life and One You that talk to individuals and families directly.

Working in partnership – the discovery phase

We’re lucky to have great buy-in for this project, partnering right from the start with the LGA, ADPH and the programme team at Leeds Beckett University.

To take it forward at local level we are working collaboratively in four pilot areas with very different populations, structures and geographies; County Durham, Lewisham, Gloucestershire and North Kesteven.

Our discovery phase examined what was already in place and what is working well in these areas, as well as the council’s priorities and current local partnerships.

And we were clear from the start that we needed to look realistically at what is being done in each area but also capitalise on their ambition to do more systems thinking, viewing obesity as much more than just a “public health” problem.

Of course, it goes without saying that we all want to take a systems approach but it’s easier said than done.

There might be an academic basis to work from but what does “whole systems thinking” mean when we get to the office on a Monday?

What can each of us do, taking into account our day-to-day resource or capacity challenges?

We’re acutely aware of the real enthusiasm to find approaches that can make a difference, and the key point to make is that we have to look at strategic, long term “approaches” not a single one-off solution.

Looking at levers

Calling the programme a ‘journey’ sounds like a cliché, but tackling obesity is a journey.

The next phase of the project sees us working with each pilot area and the wider community of learning to look at the causes and consequences of obesity in each area, and following this, the levers they have at their disposal.

For instance, we might expect to see some good examples of systems thinking linking health and planning professionals, but it’s how we truly make tackling obesity everyone’s business that's the bigger challenge.

Everyone involved is interested in return of investment of course, and we’re exploring how to make the case for a systems approach and importantly providing the tools to do it.

This phase is also where local communities are involved to provide a reality check.

As professionals we may have ideas for action that each local system should take but if we don’t take note and embed it in our communities, making the most of our assets, then our actions may ultimately fail.

Action plan

The third phase of the project will be creating action plans for each pilot area, bringing together everything we’ve discovered about the levers at their disposal and the systems that could be brought into play.

Because a true whole systems approach goes far beyond promoting healthy eating or exercise; it’s about addressing social and cultural norms and changing our obesogenic environment, never forgetting the connection between obesity and inequality.

A key objective of the programme is that there will be a set of tools, tried and tested at a local level, to support all local authorities in implementing whole systems approaches.

Will you get involved?

We are very aware that ‘whole systems thinking’ is not limited to this project and that other local authorities are having these conversations.

Last October, Leeds Becket University held a national conference attended by nearly 300 people to mark the end of the first year of the programme, and this provided a useful opportunity to update each other, but we’d like to hear more from any local authority engaged in this type of work.

The programme’s website has been set up as an ongoing community of learning because we know we will never necessarily reach a moment where we say; “project over, the obesity problem is solved”.

Obesity truly is a responsibility for all of us and it’s only by operating at every level that we can address the damaging human and financial cost to our society.

If you’d like to hear more about whole systems approaches to tackle obesity, as well as this programme and its progress, please subscribe to this blog and keep an eye on our Twitter feed.

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