1. National Child Measurement Programme 2006/07 school year Headline Results Compiled by Sally Cornfield on behalf of PAN-WM

2. Introduction The National Child Measurement Programme provides the first reliable, local-level assessment of childhood obesity in England. In total 876,416 valid measurements were received – approximately 80% of those eligible i. 435,927 children were measured in Reception. 440,489 children in Year 6 were measured i. (Table 1 details the breakdown for gender, year group & BMI classification) The 80% coverage represents an increased participation rate of 32%. Only 48% of eligible children were measured in 2005/06 i. A breakdown of West Midlands prevalence and coverage by PCT can be seen in Table 2 i. When interpreting the results it is important to consider the possible effects of participation rate on prevalence rates. Year 6 estimates may be underestimated!

3. Year 6 Reception Table 1 Overweight but not Obese ObeseOverweight & Obese combined Number measured Boys13.6%10.7%24.3%223,361 Girls12.4%9.0%21.5%212,566 Both13.0%9.9%22.9%435,927 Boys14.2%19.0%33.2%227,984 Girls14.1%15.8%30.0%212,505 Both14.2%17.5%31.6%440,489

4. Table 2 Overweight (Prevalence)Obese (Prevalence)Participation rate % PCTReceptionYear 6ReceptionYear 6ReceptionYear 6Total BEN12.1%13.6%10.3%20.3%88%87% Coventry14.6%13.7%11.3%19.4%83%89%86% Dudley13.9%15.1%11.4%23.4%97%89%92% HOB10.7%13.9%12.7%23.8%86%88%87% Herefordshire12.4%13.9%8.9%16.7%83%77%80% North Staffs15.3%15.1%12.4%18.8%83%86%85% Sandwell11.3%13.5%10.6%20.2%68%72%70% Shropshire14.8%13.4%10.1%16.8%86%80%83% Solihull12.1%13.9%8.9%14.5%79%71%74% South B’ham13.3%14.4%10.5%19.5%93%58%74% South Staffs12.1%14.1%8.4%16.8%61%80%71% Stoke On Trent14.6%14.1%10.9%20.4%74%73% Telford & Wrekin17.0%16.0%12.5%19.0%85%84%85% Walsall12.3%14.7%10.3%19.4%92%87%89% Warwickshire13.6%13.9%8.2%15.6%87%79%83% Wolverhampton12.6%14.7%10.8%25.4%79%91%85% Worcestershire15.7%15.1%9.8%15.2%82%76%79%

5. Key Findings In Reception almost 1 in 4 of children measured were either overweight or obese i. (Table 1) In Year 6 nearly 1 in 3 children measured were either overweight or obese i. (Table 1) The prevalence was significantly higher in boys than in girls in both age groups i. (Figure 1) The prevalence of obesity is significantly higher in Year 6 than in Reception i. (Figure 1) Obesity prevalence is significantly higher than the national average in the North East, West Midlands & London SHAs for both school years i. (Figures 2 & 3) Participation rates suggest that there might be higher levels of opting out among children with higher BMIs i.

6. Figure 1 Boys Overweight Boys Obese Boys Combined Girls Overweight Girls Obese Girls Combined

7. Figure 2 Prevalence of obese & overweight children in Reception by SHA, 2006/07

8. Figure 3 Prevalence of obese & overweight children in Year 6 by SHA, 2006/07

9. Key Findings The mean weight for children in Reception is 19.8kg i. (Figure 4) The mean weight for children in Year 6 is 40.9kg, more than twice that for Reception i. (Figure 5) Weight is more varied in Year 6 than in Reception i. (Figures 4 & 5) Using Figures 4 & 5 it is clear that the distributions are not symmetrical. Both distributions are positively skewed (the right tail is longer than the left). This is due to a greater proportion of children at the higher end of the weight scale i. The skew is more pronounced for Year 6 i. (Figure 5)

10. Figures 4 & 5 Weight distributions of children in Reception & Year 6, 2006/07

11. Key Findings The mean height for children in Reception is 110.4cm i. (Figure 6) The mean height for children in Year 6 is 146.3cm i. (Figure 7) Both distributions are symmetrical, without the skews that are evident for weight i. The mean BMI for children in Reception is 16.2kg/m 2. (Figure 8) i The mean BMI for children in Year 6 is 18.9kg/m 2. (Figure 9) i Using Figures 8 & 9 it is clear that the distributions are not symmetrical. Both distributions are positively skewed (the right tail is longer than the left). This is due to a greater number of children at the higher end of the BMI scale i. The skew is more pronounced in Year 6 i.

12. Figures 6 & 7 Height distributions of children in Reception & Year 6, 2006/07

13. Figures 8 & 9 BMI distributions of children in Reception & Year 6, 2006/07

14. Key Findings The prevalence of obese & overweight children by year group and sex are shown in Figures 10 & 11 i. The percentage of children who are overweight is only slightly higher in Year 6 than in Reception, however the prevalence of obesity is significantly higher i. In Reception the prevalence of overweight children is greater than the prevalence of obese. In Year 6 the opposite is true i. Figure 12 compares the prevalence of overweight & obese combined children in Year 6, by SHA. (The bars are ranked by prevalence in Year 6) i. Areas with high obesity prevalence in one year group tend to also have high obesity prevalence in the other year group i. (Figure 12 & Figure 2 & 3)

15. Figure 10 Prevalence of obese & overweight children in Reception, by sex 2006/07

16. Figure 11 Prevalence of obese & overweight children in Year 6, by sex 2006/07

17. Figure 12 Prevalence of “obese & overweight combined" children by Year & SHA 2006/07

18. Key Findings The top four SHAs (of which the West Midlands is one) occupy the same rank order for children in both years i. (Figures 2, 3 & 12). There is a significant positive relationship between deprivation (measured by IMD score) & obesity prevalence in children i. (Figure 13) The gradient is steeper in Year 6 i. (Figure 13) Using the percentage of children eligible for free school meals (FSM) as an indicator of deprivation also shows a significant positive relationship between obesity prevalence and deprivation i. (Figure 14) Using the line of best fir (r 2 ) FSM data provides a better predictor of obesity prevalence in Year 6 than IMD score i. (Figure 14

19. Figure 13 Prevalence of obese children against 2007 IMD score by LA, 2006/07

20. Figure 14 Prevalence of obese children against percentage of children eligible for FSM by LA, 2006/07

21. Key Findings Since a fairly low percentage (32%, n.279,699)of records were returned with ethnicity information, the following statements should be treated with caution i. Figures 15 &16 show the prevalence of obese & overweight children by ethnic category i. In Reception obesity prevalence in the following ethnic groups is higher than the national average: Black African, Any Other Black Background, Black Caribbean, White & Black Caribbean, Any Other Ethnic Group, Bangladeshi, Pakistani & Any Other White Background. Prevalence is lower than the national average for: Chinese, White & Asian and Indian & White British. For many of these groups, the difference is small in percentage terms but statistically significant i. (Figure 15) In Year 6 obesity prevalence is significantly higher than the national average for all children in all ethnic groups except Chinese, White & Asian and Indian & White British i. (Figure 16)

22. Figure 15 Prevalence of obese & overweight children in Reception by ethnic category, 2006/07

23. Figure 16 Prevalence of obese & overweight children in Year 6 by ethnic category, 2006/07

24. Key Findings Collection of home postcode was optional. 58% (n.505,583) records included home postcodes. Each record was assigned a rural/urban classification from the lower super output area that the postcode was aggregated to. Obesity prevalence is significantly higher in urban areas than in non-urban areas for both years i. (Figures 17 & 18) Overweight prevalence is similar between areas in both years i. Obesity prevalence is significantly higher in Year 6 than in Reception in all areas i. The prevalence of overweight children from urban areas is significantly lower in Reception than in Year 6 i. (Figure 18)

25. Figure 17 Prevalence of obese & overweight children in Reception by rural/urban classification, 2006/07

26. Figure 18 Prevalence of obese & overweight children in Year 6 by rural/urban classification, 2006/07

27. Considerations Measurements could be taken at any time during the 2006/07 academic year. Consequently some children were almost two years older than others in the same school year at the point of measurement i. Comparisons between the 2005/06 & 2006/07 results have not been made because the increase in participation rates from 48% to 80% may skew comparisons i. Prevalence rates were calculated by deriving every child’s SMI & referencing the age and sex-specific UK National BMI percentiles to count the number of children defined as overweight or obese i. Geographical analyses are base on the child’s school rather than home address i. NHS Public Observatories are expected to produce more detailed analysis in due course i.

28. Reference i National Child Measurement Programme: 2006/07 school year, headline results. (2008) The Information Centre. Available at: http://www.ic.nhs.uk/webfiles/publications/ncmp/ncmp0607/NCM P%202006%2007.%20Bulletin%20Final.pdf