From lifestyles to societal determinants
Recently, many voices in your community have been calling for 'something to be done' about the increasing proportion of children and teenagers who are overweight and obese. Teachers, parents, doctors—and children too—all have something to say about the scale and causes of the problem, how it affects young people (as well as the broader community) and its long-term impacts.
You are a staff member of a rural primary health care service that is also a partner in a local network of health care services. As you, and some of your colleagues, think that the data about weight trends are too ominous to ignore, there is agreement that a local strategy needs to be devised to bring down the rate of increase of obesity in young people.
Focus groups have explored the perceptions of different groups of people living in the town and surrounding areas. They show a general belief that the problem has many dimensions—poorly maintained sports facilities which are uninviting as venues for sports activities; parents who work at times when young people want to have adventures in parks and natural settings but are encouraged to 'stay safe' inside playing computer-based games; vending machines in workplaces and schools which supply cheap, carbonated drinks to children and workers; the preference of children for takeaway foods as the snack of choice.
While some community members appreciate the interest expressed by health