Lothians obesity: Record high but most in denial

LEVELS of obesity in Lothian have hit record numbers, despite the vast majority of individuals believing they are fit and healthy.

One of the most comprehensive studies into the health of the region ever carried out also painted a stark picture of inequality, with a huge physical and mental health gap between those living in the richest and the poorest areas.

Experts said that the study had shown that people were looking at their own health through “rose-tinted glasses” and that it had proven that while high-profile education campaigns may have got health messages across to the general public, they had often failed to change behaviour in a meaningful way.

The Lothian Health and Lifestyle Survey, which saw almost 15,000 questionnaires returned from a representative sample of the population, revealed that more than 85 per cent of people think their general health is excellent, very good or good, with roughly the same proportion rating their fitness level as reasonable or better.

But in reality, almost six out of ten adults are now overweight or obese, a rise of more than 13 per cent in just eight years.

It also emerged that those living in the poorest areas were almost four times more likely to attempt suicide, twice as likely to use A&E and up to four times more likely to smoke, compared with those in the most affluent.

The report found “concerning” differences in deprivation levels across Lothian and that the data revealed several examples of inequalities caused by poverty.

The South Edinburgh area, including Morningside, Marchmont and the Grange, was found to have the highest levels of wellbeing, while West Lothian, including Bathgate and Whitburn, has the worst.

Professor Alison McCallum, NHS Lothain’s director of public health and health policy, said that the results would be used to decide where resources are targeted for years to come.

“This is an extremely important piece of research which has been designed to tell us more about the health of people in Lothian,” she said.

“The findings show that while the majority of people believe they are in good health, we are seeing an increase in the number of people who are overweight or obese and continue to see high levels of alcohol 
consumption.

“Since the last survey in 2002 we have seen improvements in a number of areas, including a reduction in smokers and an improvement in dental health which demonstrates that our evidence-based interventions in these areas are working.

“However, the report does highlight the continuing inequalities in physical and mental health, quality of life and social support. The findings on income, education and where people live, support our efforts to address the underlying causes of health inequalities as well as improving 
access to services.”

The Scottish Government has said that tackling inequality represents the biggest challenge for the NHS.

A series of initiatives have been introduced in Lothian in recent years intended to educate the public about the health implications of alcohol, smoking and diet while support has been offered to families. Positive results have been seen in some areas, including a reduction in smoking levels and obesity among five-year-olds.

But Christopher Mantle, food and health development worker with Edinburgh Community Food, said that many of the campaigns were failing to change lifestyles.

The report said that despite the recommendation to eat five portions of fruit and vegetables a day, just one in five men and less than a quarter of women do so nationwide.

It is predicted that by 2030, four in ten people in Scotland will be obese. The shock figure is likely to be 
mirrored in Edinburgh and the Lothians.

“The national diet survey shows that there has been no improvement in the last ten to 15 years,” Mr Mantle said. “The messages are just not getting through and behaviour is not changing. We are looking at an obesity epidemic.

“People tend to have rose-tinted glasses with regards to their own health. Most people know the messages but don’t follow them – it’s the ‘not going to happen to me’ type of attitude. Being overweight has been normalised – people don’t think they have an issue when everyone else is the same.

“What comes across in this report is that when it comes to the relationship between what you put into your body and how you feel, the understanding is much better in the richer areas. When we go to Wester Hailes or Craigmillar, people are quite surprised when we tell them that drinking four cans of an energy drink might be why they feel bad.”

Mr Mantle said that cookery courses, aimed at improving confidence in the kitchen, could hold the key to tackling the issue of poor diet. He also called on supermarket chains to do more to make fruit and vegetables more attractive.

“It is possible to eat healthily on a budget – lentil soup and stovies are very cheap to do – but price is an issue,” he added. “You can go to Asda and buy a packet of custard creams for 30p and have 2000 calories.

“There’s only choice on the surface. You go into a shop and there’s 50 different ways for you to get sugar, with just one rack of fairly brown apples and bananas that are not terribly tempting. The bigger chains in particular have the money and power to lead on it. They need to make fruit and vegetables more affordable and use offers for them in the same way that they do for soft drinks.

“We’re saving up all of the cost for the future. People can function fairly well until they’re 60 or 70, then the medical cost will snowball. If we do not tackle this now – and as it stands we are not tackling it – things are going to be really bad in 15, 20 and 30 years’ time.”

Cammy Day, the city’s deputy health leader, said that while some positive trends had been identified in the study, it had highlighted others that “must be addressed”.

He added: “The issue of health inequality is one that we take very seriously and we have targeted funding of £3 million in place to help tackle this. It is vital that people in less affluent areas of the city are not at a disadvantage and are able to enjoy the same levels of health and 
wellbeing.

“We have been focusing on local action to encourage healthy, active lifestyles and provide advice and support to help people to achieve this.”

How the Lothians measure up

• Seven per cent of West Lothian residents have no teeth, compared with 2.9 per cent in Edinburgh South.

• People in North Edinburgh are the most regular drinkers. More than 34 per cent drink alcohol at weekends and during the week, compared with less than a quarter in West Lothian.

• Overall, more than 90 per cent of people in each area agreed with the statement: “This is an area I enjoy living in.” However, those in deprived areas were less positive than those in the richest.

• Of women, 7.4 per cent, and 4.6 per cent of men said they had made an attempt to take their own life.

• Just 74.3 per cent of people from Midlothian have 20 or more teeth. The figure is 85.9 per cent in South Edinburgh and 84.8 per cent in North Edinburgh.

• 26.5 per cent in West Lothian, 25.6 per cent in Midlothian and 24.8 per cent in East Lothian are obese. The rate falls to less than 20 per cent in North and South Edinburgh.

• The survey said the highest proportion of smokers are in Midlothian, where 21.2 per cent currently smoke.

• In the richest parts of South Edinburgh, 56.8 per cent of people are degree educated. In the poorest parts of Midlothian, it is eight per cent.

• 17.4 per cent of people in West Lothian said they were carers, compared with 13.3 per cent in South Edinburgh.

• 17.5 per cent of people in the poorest areas of Lothian had been admitted to hospital in the previous 12 months, compared with 9.8 per cent in the richest.

Key issue ahead of independence vote

THE issue of inequality leading to disproportionately poor health among the poorest is likely to become a key issue ahead of next year’s independence referendum.

The Scottish Government has said that if it is given full control of the welfare state, which would include power to set benefit levels and taxation, it would be able to tackle poverty.

Others have said that the government is not doing enough with the powers it already has.

Currently, there is a ten-year gap in life expectancy between people living in the most and least deprived areas of Scotland.

Health Secretary Alex Neil said: “For far too long, successive Westminster governments have singularly failed to tackle the health inequalities that blight Scottish society. It is simply not good enough that someone’s life expectancy should depend on whether they live in Edinburgh or West Lothian, or the income of their parents.

“Where [we] can act, we have. We’ve banned smoking in public places. We are tackling excessive drinking and will introduce a minimum price for alcohol. But the main levers to tackle the kind of poverty that is a driver of health inequality remain in the hands of London governments seemingly either unable or unwilling to act.”

But Labour Lothians MSP and shadow health secretary Neil Findlay said it was “callous and cynical” to make health inequality a constitutional issue.

He said: “Health inequality is Scotland’s biggest health issue. We need concerted action across government now, to begin addressing these deep-seated problems.

“The SNP government could and should act now using the powers and budget they have but choose not to. They are shamefully letting down some of our most needy communities.”