Archive for February, 2015

I am a child. During the next 15 years I am likely to: Question my body image. Make my first independent decision about my diet and exercise. Witness or experience bullying. Have my first sexual experience. Be offered a cigarette. Be offered my first taste of alcohol. Make my first decision about drug use. So, asks the PSHE Association, ‘Who is going to teach the knowledge and skills I will need to manage these ‘first moments’ and stay healthy and safe? (1)

  • By Marie Findlay, Policy Team, Royal Society for Public Health

Around 9% of teenagers in England are regular smokers by the age of 15 (2) and in the last month in the UK, more than half of 15-16 year-olds consumed five alcoholic drinks (3).  Teenage pregnancy rates are among the highest in Europe (4) while 31% of young men and 37% of young women aged 11-18 are overweight or obese  and only a minority do the recommended amount of physical activity (6).

Over half of mental health problems develop in teenage years (7). The significance of adolescence in forming behaviours that impact on health over a lifetime can hardly be overstated, and yet the health outcomes of young people in some of our communities are among the worst in the developed world (8).

Eight Young Health Champions recieve an award from Duncan Selbie

RSPH Chief Executive Shirley Cramer, CBE, (left) joins children from Manningtree High School. They were the first graduates to be awarded the RSPH Level 2 Certificate for Youth Health Champions (YHC) by Duncan Selbie (centre), at a ceremony attended by Jane Davis (right of Ducan Selbie), YHC Coordinator at Manningtree High School. 

Schools are unique, being one of the only agencies that have regular contact with almost all children and young people during these formative years. It is therefore essential we utilise this opportunity to properly integrate health education in order to equip everyone with the knowledge, understanding and skills to navigate a complex world of choices and lead healthy, fulfilling lives.

Personal, Social, Health and Economic education (PSHE), highlighted by the Chief Medical Officer as a ‘bridge’ between education and public health (9), not only provides this opportunity but can also drive improvements in a range of Public Health Framework Outcome indicators (10).  Young people themselves are hungry to learn, with 86% of pupils feeling they need to be taught about PSHE topics in school.  Why, then, does PSHE remain a non-statutory part of our children’s education?

Perhaps the issue is masked by the fact that most schools deliver elements of PSHE in some form. But while curriculum requirements entail coverage of some components, quality of provision is hugely variable (12) and the 2012 Ofsted Report concluded that it was not yet good enough in a sizeable proportion of schools (13). This leaves many children and young people vulnerable with gaps in knowledge and skills spanning relationships, mental health and alcohol misuse (14).

Following the latest review, Elizabeth Truss, then Parliamentary Under Secretary of State for Education and Childcare, deemed a change of status unnecessary as ‘Teachers are best placed to understand the needs of their pupils and do not need additional central prescription’ (15). But teachers suffer from the lack of emphasis placed on a non-statutory PSHE. Many simply don’t want to teach it (16) and this is unsurprising when support from schools is variable.

Research has found that only 28% of secondary school teachers find it easy to be released for PSHE CPD training and only 21% find it is easy to get funding (17).  Teachers may also feel uncomfortable talking about sensitive and controversial issues without adequate training (18) resulting in topics such as sexuality, mental health and domestic violence being dropped.

Practical, innovative input from schools is vital to improving PSHE provision and evidence points towards an integrated approach (20).  In 2012, the Royal Society for Public Health (RSPH) hosted a workshop with stakeholders across health and education who stressed the need to move away from responding to deficits by combating bullying or teaching sex education and healthy eating as isolated issues. Good practice was seen not just as providing information to pupils but building confidence and resilience, including the ability to take measured risk and make active decisions, both of which are believed to be key determinants of individual health action (21). Schools that perform well put health and development at the heart of their curriculum and ethos (22).

One way to nurture these skills is through a peer-led approach. The Youth Health Champions initiative, piloted by North East Essex Primary Care Trust, trained students as facilitators of health education and to act as signposts for their peers. This has been developed by RSPH into a movement to engage young people in their own health journeys. In schools, Youth Health Champions consult with teachers on content and work with small groups during PSHE sessions with feedback indicating messages are ‘far more relevant and easy to understand when delivered by… their contemporaries’ (23).

Crucially, delivery can be approached by schools in partnership with public health authorities to target specific public health interventions in addition to meeting learning goals. The PSHE Association has, for example, supported Portsmouth City Council’s Health Improvement team to assess local public health priorities and adapt a programme of study to suit their needs – truly using the subject as a bridge between education and public health.

It is now time to strengthen this bridge with statutory underpinning. Caroline Lucas, whose bill to introduce statutory PSHE will be read in parliament for the second time in late February, has said: ‘as long as PSHE remains a non-statutory…subject…there will be virtually no coverage…in teacher training. In school, PSHE teachers are not given the curriculum time or training that they need – statutory status is key.’

We must get serious about empowering children and young people to manage their own health if we are to see changes in worrying health indicators. If we don’t do this in schools, where will we do it?

1) PSHE Association
2)  Cancer Research UK
3) RCN
4) FPH manifesto, ‘Start Well, Live Better’,
5) ‘Key Data on Adolescence for 2013’ published by the Association for Young People with the support of Public Health England
6) Chief Medical Officer’s Report, 2012
7)  RCN
8) RCN
9) Chief Medical Officer’s Report, 2012
10)  PSHE Association
11) Ofsted report on personal, social, health and economic education in English schools in 2012
12) Independent Review of the proposal to make Personal, Social, Health and Economic Education statutory, 2009
13) Ofsted 2012 report
14) Ofsted 2012 report
15) Draft Written Statement: links to a pdf
16) Kath Sanderson, ‘Health education in schools: strengths and weaknesses in relation to long-term behaviour development’, Perspectives in Public Health, DOI: 10.1177/1757913911430915
17) Formby et al, ‘ Personal, Social, Health and Economic (PSHE) Education: A mapping study of the prevalent models of delivery and their effectiveness’, January 2011
18) Ofsted report, 2012
19) Ofsted report, 2012
20) Formby et al, ‘ Personal, Social, Health and Economic (PSHE) Education: A mapping study of the prevalent models of delivery and their effectiveness’, January 2011
21) Kath Sanderson, ‘Health education in schools: strengths and weaknesses in relation to long-term behaviour development’, Perspectives in Public Health, DOI: 10.1177/1757913911430915
22) Lolc Menzies, ‘Charting a Health Literacy Journey – overview and outcomes from a Stakeholder Workshop’, Perspectives in Public Health, DOI: 10.1177/1757913911431041
23) Martin Page, ‘How to avoid ‘dad dancing’: a peer-led approach to the delivery of health education in secondary schools’, Perspectives in Public Health, DOI: 10.1177/1757913911430913

Read Full Post »

  • Amy Smullen
  • Policy Officer
  • British Heart Foundation

The nation’s oversized waistline is putting our hearts under increasing strain.

We know that obesity puts people at a greater risk of coronary heart disease and having their lives shortened by a heart attack or stroke. But this isn’t just a problem of the here and now. It’s one that’s already waiting in the wings to devastate future generations as well.


Watershed? why we need to ban some food adverts before 9pm

Around 30% of children in the UK are now classed as either overweight or obese. (1) Dietary surveys show that children are also eating too much saturated fat, salt and sugar. (2) Together, these factors put too many children at risk of carrying their excess weight and poor eating habits into adulthood, putting their hearts at risk.

That is why the British Heart Foundation (BHF), alongside many other organisations, such as the Faculty of Public Health want to see advertisements for food and drink that is high in saturated fat, salt and sugar (HFSS) banned before the 9pm watershed.

The BHF are acutely aware that obesity is a complex problem that requires action on lots of fronts. We don’t pretend banning junk food adverts is a magic bullet. But the sad reality is that our children are being bombarded with clever marketing encouraging them to eat products that have little nutritional value whether it’s walking to school, surfing the internet or watching TV at home. Banning these adverts before 9pm and tightening online regulation has to be part of the solution.

So why have we focused in on junk food adverts?

Firstly; because children aren’t like us adults. They cannot distinguish between what is harmless entertainment and what is persuasive advertising (3) and are they are therefore classed as a vulnerable group when it comes to advertising. Industry regulator Ofcom (4) states that ‘media literacy develops with age and … it isn’t until after 11 or 12 years of age that children can articulate a critical understanding of advertising.’

Second, research shows that food promotion, such as TV ads, can influence children’s food preferences and consumption. (5) Adverts also encourage general consumption, meaning that an advert for a specific chocolate bar won’t make you more likely to buy just that specific brand but any chocolate bar in general. (6)

And thirdly, on average our children are spending 27 hours either online or watching TV every week. That averages out at just under 4 hours per day. And it’s not just a few children skewing the average. Over 80% of children aged 5-15 watch the TV almost every day (7).

In 2007, the Government acknowledged that HFSS advertising was a problem, and banned any HFSS adverts during children’s programming. (8) But, while reducing the number they saw, this hasn’t stopped children seeing them.

That’s because adverts which are banned during children’s shows can be shown during family programming. Shows such as The Simpsons, X-Factor, and Britain’s Got Talent are technically classed as ‘family programmes’ despite high child audience levels. (The last two programmes made it into the top 20 programmes most watched by children in 2013.) (9) As such, marketeers are allowed to advertise any product they want. An audit by the University of Liverpool in 2013 showed that  almost one in four TV adverts shown between 8-9pm, when children’s viewing peaks, were for food products. (10)

Online, it’s even worse. It’s no secret that our children are online more than ever. Worryingly many of the techniques used to promote food and drinks online blur the lines between persuasion and entertainment, making it difficult for children to identify online marketing. (11)

Take, for example, advergames. These are online games that have a brand or marketing message integrated into them. Where a TV advert may only last for 30 seconds, research has shown that children spend longer engaging with the product message and engage with the brand at a deeper subconscious level. (12)

Adding to this the Committee of Advertising Practice Code, which governs marketing on advertisers own websites and their social media channels, doesn’t distinguish between healthy and unhealthy food.

The code states that “marketing communications should not condone or encourage poor nutritional habits or an unhealthy lifestyle in children’ – but what constitutes ‘condoning and encouraging’ or ‘poor habits’ is not defined.

But isn’t it all down to the parents? Shouldn’t they be policing their children more?

While we agree that parents are responsible for helping children eat a healthy balanced diet, these adverts undermine their efforts to do that. When we asked parents for their views, 70% of them told us that they had been pestered to buy HFSS products that their children had seen advertised on TV and 39% of parents said that these adverts were making it difficult for them to help their children eat a healthy diet. (13)

Over 30,000 people have already signed our petition, which calls on the Government to ban HFSS adverts before the 9pm watershed. Alongside the BHF and Faculty of Public Health the Academy of Medical Royal Colleges, the Royal College of Paediatrics and Child Health, Children’s Food Campaign, UK Health Forum, The Heart of Mersey, the British Dental Association, Family and Childcare Trust, the Association for the study of Obesity and the University of Liverpool also call for a 9pm watershed ban.

The demand for action is getting stronger and louder.

Help us stop these adverts by signing our petition to send a clear message to the Government that they must stop our children from being bombarded with HFSS adverts to protect their health.

1) British Heart Foundation (2013) ‘Children and Young People Statistics’ http://www.bhf.org.uk/publications/view-publication.aspx?ps=1002326
2) Department of Health (2014) ‘National Diet and Nutrition Survey: Headline Results from Years 1, 2 and 3 (combined) of the Rolling Programme 2008/09 – 2011/12.
3)  E.g. Young B (2003) ‘Does food advertising influence children’s food choices?’ International journal of Advertising 22: 441-459. Hastings et al (2003) ‘Review of the research on the effects of food promotion to children.’ Food Standards Agency
4)  Livingstone S (2004) Childhood Obesity – Food Advertising in Context.
5)  Ofcom (March 2006) ‘Television Advertising of Food and Drink products to Children: Options for new restrictions: A consultation’ (para 1.8).
6) Hastings et al (2003) ‘Review of the research on the effects of food promotion to children.’ Food Standards Agency.
7)  Ofcom (2014)
8) Ofcom (2007) ‘Television advertising of food and drink products to children – final statement.’
9) Ofcom (2014)
10) Boyland, E and Whalen E (2014) ‘Analysis of food adverts shown during a sample of primetime television.’
11)  A.Nairn (2009) ‘Changing the rules of the game: implicit persuasion and interactive children’s marketing.’ Berkley Media Studies Group
12) Nairn, A. (2012) ‘Advergames: It’s not child’s play.
13)  British Heart Foundation (2015) survey.

Read Full Post »