Healthy Weight Strategy - Queensland Health
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Healthy Weight Strategy 2017 to 2020 Maintaining a healthy weight is good for the health of individuals, families, communities, the health system and our economy. Encouragingly, in recent years there has been gradual societal change. This includes a greater awareness of the benefits of not carrying excess weight than a decade ago.1 After decades of increases, obesity rates for Queensland children and adults are beginning to slow.1 This is progress; however, obesity remains a major health and societal issue. The challenge of reducing overweight and obesity is a global problem. Energy imbalance has resulted from changes in food type, availability, affordability and marketing to increase intake of high-energy foods, as well as a decline in physical activity partly due to increased screen time and sedentary behaviour. 2 Burden of an unhealthy weight Being an unhealthy weight can impair a person’s wellbeing, quality of life, ability to earn, and life satisfaction.3 Poor diet, physical inactivity and obesity all significantly contribute to poor health, chronic diseases and reduced life expectancy in Queenslanders. Carrying excess weight places individuals at higher risk of cardiovascular disease, type 2 diabetes, high blood pressure, musculoskeletal conditions and some cancers. Children who are overweight or obese have higher rates of asthma, bone and joint complaints, sleep disturbances and early onset of diabetes. The financial cost of obesity is high and was estimated in 2015 at $8.6 billion nationally (about $1.72 billion in Queensland).1 Of this, 44% was due to health system costs, 40% to tax foregone, 12% to productivity losses including absenteeism, and 4% to government subsidies. The impact of loss of wellbeing and premature death was assessed at $47.4 billion nationally ($9.5 billion in Queensland) taking the total cost of obesity in Queensland in 2015 to $11.2 billion. Opportunity Even a small degree of weight loss can bring health and societal benefits. Multiplied across the Queensland population, these small benefits can have a large impact on the community through reducing the overall cost of healthcare and lost productivity due to illness, disability and premature death. An international study estimated that 1 in 6 premature deaths in Australia could be avoided if all those who were currently overweight or obese were within the healthy weight range.4
The Healthy Weight Strategy is part of the Health and Wellbeing Strategic Framework 2017 to
2026 which sets a prevention-focused pathway for:
• creating healthier places where people live, work, learn and play
• empowering people with the knowledge, positive attitudes, motivation and skills to live
healthy lives.
Overweight and obesity is not the same for everyone1
• Adult obesity rates are 76% higher in socioeconomically disadvantaged areas of
Queensland compared to advantaged areas.
• Compared to major cities, adult obesity rates are 22% higher in outer regional and 36%
higher in remote and very remote areas. While disparities are not as evident among
children, it is likely that family lifestyle choices over the longer term will put children at
risk of weight gain.
• Young adults (18–24 years) gain weight very rapidly as they transition through their
twenties—on average about 1kg a year.
• Adult obesity rates were 39% higher among Indigenous Queenslanders than non-
Indigenous.
• Of women that gave birth in Queensland in 2014, nearly half were overweight or obese.
Trend data
Current trend data (pages 3 and 4) show that in Queensland the rate of childhood obesity has
not changed since 2007–08 and adult obesity since 2011.2 Of concern, however, is that 26% of
children and 64% of adults are overweight or obese in Queensland.
The vast majority (96%) of children do not eat enough vegetables, and 41% eat unhealthy food
every day. More than half of children are not meeting the recommended one hour of daily
physical activity.
These unhealthy trends—not enough vegetables, too much junk food and not enough physical
activity—are similar for adults.
Healthy Weight Strategy 2017 to 2020 -2-Childhood overweight and obesity
of children were
59,000 obese in 2016
26% measured
overweight or obese
in 2014–15 158,000 overweight in 2016 =
sex age region socioeconomic status
measured 2014–15 proxy report 2016 proxy report 2016 proxy report 2016
overweight/obese overweight/obese
5–7
prevalence
19% + 7% = 27%*
8–11 No difference between No difference between
major cities and other advantaged and
12–15 areas, and between HHSs disadvantaged areas
18% + 7% = 27%*
16–17
*may not sum due to rounding
10-year trend
No change in childhood overweight and obesity (measured) between
2007–08 and 2014–15
Indigenous Queenslanders high birthweight
prevalence
13% of Indigenous Queenslander children (5–17 years) were 1.7% of infants born in Queensland in 2014
obese by measurement in 2012–13 weighed 4500 grams or more
Queensland overweight and obesity rates (measured) did not differ from national rates in 2014–15
national
Queensland was ranked 5th highest of jurisdictions
Related risk factors
30% 96% 41% 55% 38%
DID NOT DID NOT of ENERGY INTAKE was DID NOT EXCEEDED
prevalence 2016
meet recommendations meet recommendations sourced from meet recommended maximum
for fruit consumption for vegetable discretionary foods daily activity levels recommended screen
consumption (2011–12) time
Boys more likely to
NOT meet More boys than girls,
recommendations than Younger children more and more older
girls Peak consumption was likely to be active children than younger
in teenagers every day than older children exceeded the
Older children more
likely to NOT meet children maximum screen time
recommendations than recommendations
younger
Healthy Weight Strategy 2017 to 2020 -3-Adult overweight and obesity
of adults were
1.1 million obese in 2016
64% measured
overweight or obese
in 2014–15 1.2 million overweight in 2016 =
sex age region socioeconomic status
measured 2014–15 self report 2016 self report 2016 self report 2016
overweight/obese overweight/obese Compared to major cities,
18–24 obesity prevalence was 22% ↑
prevalence
29% + 28% = 57%* 25–34 in outer regional and 36% Obesity was 76% ↑ in
35–44 ↑ in remote and very
remote areas disadvantaged areas
45–54
55–64 compared to advantaged
5 HHSs had ↑ prevalence of
38% + 32% = 71%* 65–74 overweight and obesity areas.
75+ than Queensland - on average
*may not sum due to rounding 14% higher
10-year trend
No change in self reported adult overweight and obesity since 2011
From 2004–2011, self reported obesity ↑ by 3.1% p.a.
Indigenous Queenslanders pregnant mothers
40% of Indigenous Queenslander adults were obese by Of women that gave birth in Queensland in 2014:
prevalence
measurement in 2012–13 49% were overweight or obese
39% more likely to be obese (measured) than non- 27% were overweight
Indigenous Queenslander adults in 2012–13 22% were obese
Queensland overweight and obesity rates (measured) did not differ from national rates in 2014–15
national
Queensland was ranked 5th highest of jurisdictions
Related risk factors
prevalence 2016
43% 93% 36% 39%
DID NOT DID NOT of ENERGY INTAKE was DID NOT
meet recommendations for meet recommendations for from discretionary foods meet recommendations for
fruit consumption vegetable consumption (2011–12) physical activity
Males ↑ than females Males ↑ than females Females ↑ than males
Disadvantaged ↑ than advantaged Disadvantaged ↑ than advantaged Disadvantaged ↑ than advantaged
Prevalence of sufficient physical activity is
10-year trend
Proportion meeting Proportion meeting recommended daily plateauing:
recommended daily fruit vegetable serves: ↑ by 6.2% p.a. 2004–2009, slowing to ↑1.9%
serves ↑ for 18-44 year olds ↓ for 45+ year olds by 2.8% p.a. p.a. 2010–2016
by 2.1% p.a. ↓ for disadvantaged by 3.1% p.a. SES gap narrowing for males: advantaged ↑
1.3% p.a., disadvantaged ↑ 4.5% p.a.
Healthy Weight Strategy 2017 to 2020 -4-Our approach
A multi-strategy approach can significantly contribute to the achievement of healthy weight
objectives and targets. The six integrated strategies below are informed by evidence-based
recommendations for influencing broad and sustainable health improvements.
Public policy and Sector development Social marketing
legislation
supporting health and raising awareness,
non-health sectors to motivating and
creating environments integrate prevention into influencing healthy
that make it easier to their core business and behaviours
lead healthy lives initiatives
Personal skills Risk assessment, early Health surveillance
development intervention and research
and counselling
empowering people with providing timely and
the knowledge and skills identifying and helping robust information to
to make healthy choices people at greater risk to inform policy and
take early action to practice
improve their health
Shared commitment and partnerships
Actions to be implemented by Preventive Health Branch, Prevention Division, under this
Strategy are part of a growing movement led by the health sector and increasing in the non-
health sector to improve health and wellbeing. Examples of other agencies and sectors involved
in promoting healthy weight include:
• Public health commission – once established under Queensland legislation, this
independent statutory body will bring new insights and innovative ways of working to
tackle Queensland’s high obesity and chronic disease rates by supporting children,
young people and families to adopt a healthy lifestyle
• Queensland Government departments and agencies, particularly Department of Housing
and Public Works; Department of Transport and Main Roads; Department of Education;
Workplace Health and Safety Queensland; Department of State Development,
Manufacturing, Infrastructure and Planning; Department of Local Government, Racing
and Multicultural Affairs; Department of Agriculture and Fisheries; Department of
Aboriginal and Torres Strait Islander Partnerships; and Public Service Commission
• Australian Government departments and agencies, particularly Department of Health;
Department of Human Services; Department of Infrastructure and Regional
Development; Department of Industry, Innovation and Science; Australian Sports
Commission; and Australian Bureau of Statistics
• Local Government and the Local Government Association of Queensland
• Hospital and Health Services (HHSs)
• Aboriginal community-controlled health services
• Primary Health Networks
• health research networks
• non-government organisations
• academia, education and training sectors
• industry and businesses.
Healthy Weight Strategy 2017 to 2020 -5-Monitoring performance
A Performance Monitoring Strategy has also been developed to monitor and report on the
outputs, impacts and outcomes of the Health and Wellbeing Strategic Framework 2017 to 2026
and the Healthy Weight Strategy.
Specific childhood and adult targets to be achieved by 2020 have been set for healthy weight
prevalence as well as key behavioural improvements. These targets are ambitious but essential
for achieving improved health and wellbeing in Queensland.
The Performance Report for 2016-17 assessed progress to date towards the 2020 targets
showing mixed results for both children and adults. The report however demonstrated
strengthened support for healthy eating and drinking in fast food chains, Queensland hospitals
and facilities, sporting clubs and state school tuckshops; improved planning guidelines and
walking infrastructure to support physical activity; and improvement in knowledge, attitude and
skills of individuals to adopt and maintain healthy behaviours.
2020 Targets Numbers needed to reach 2020
Targets*
Increased healthy weight 69% healthy weight 29,000 more healthy weight children
(2014–15: 66%)
Reduced overweight and 23% overweight or obese 11,000 fewer overweight or obese
obesity (2014: 24%) children
Improved physical activity 43% children active every day 34,000 more children active every day
(2014: 39%)
Children
Increased fruit 74% eating recommended fruit 59,000 more children eating
consumption serves daily recommended fruit serves daily
(2014: 67%)
Increased vegetable 7% eating recommended vegetable 5,000 more children eating
consumption serves daily recommended vegetable serves daily
(2014: 6%)
Increased healthy weight 37% healthy weight 69,000 more healthy weight adults
(2014–15: 35%)
Reduced overweight and 55% overweight or obese 114,000 fewer overweight or obese
obesity (2014: 58%) adults
Improved physical activity 65% physically active 217,000 more adults becoming active
(2014: 60%)
Adults
Increased fruit 64% eating recommended fruit 231,000 more adults eating
consumption serves daily recommended fruit serves daily
(2014: 58%)
Increased vegetable 11% eating recommended 41,000 more adults eating
consumption vegetable serves daily recommended vegetable serves daily
(2014: 10%)
* Than there would have been if no behaviour change had occurred since 2014 baseline.
Action Plan
Healthy Weight Strategy 2017 to 2020 -6-Our actions are influenced by current evidence, best-practice, innovation and engagement and
are guided by the strategic priorities of Our Future State: Advancing Queensland’s Priorities.
A plan outlining universal and targeted actions for healthy eating and physical activity to be
delivered under the multi-strategy approach has been developed for the two-year period from 1
July 2018 to 30 June 2020 (see over).
Preventive Health Branch, Prevention Division, is accountable for implementing the actions in
this plan. This may be undertaken directly by the Branch, in partnership with others, or procured
from non-government organisations. The action plan will be updated every two years.
Strategic Communications Branch, Corporate Services Division, is accountable for developing
and delivering social marketing activities which contribute to the multi-strategy approach and
achievement of healthy weight targets.
Continued effective delivery of initiatives, combined with ongoing investment and effort to create
healthier environments and systems responsive to prevention will contribute to empowering
Queenslanders to live healthier lives through improved lifestyles.
Sources:
1. Queensland Health. The health of Queenslanders 2016: report of the Chief Health Officer Queensland.
Queensland Government: Brisbane; 2016.
2. World Health Organisation. Report of the commission on ending childhood obesity. WHO Document Production
Services: Geneva, 2016.
3. Butland B, Jebb S, Kopelman P, McPherson K, Thomas S, Mardell J, et al. Foresight. tackling obesities: future
choices - project report. Second edition. UK: Government Office for Science; 2007 Available from:
http://www.bis.gov.uk/assets/foresight/docs/obesity/17.pdf.
4. The Global BMI Mortality Collaboration, Di Angelantonio E, et al. Body-mass index and all cause mortality:
individual-participant-data-meta-analysis of 239 prospective studies in four continents. The Lancet: published
online 13 July 2016.
Healthy Weight Strategy 2017 to 2020 -7-HEALTHY WEIGHT Action Plan 2018-19 and 2019-20
Public policy and legislation Sector development Social marketing Personal skills development Risk assessment, early intervention and Health surveillance and research
counselling
Universal 1. Influence the development and 6. Collaborate with the health sector to 15. Collaborate with Strategic 18. Increase food literacy knowledge 21. Increase access to a statewide 24. Monitor prevalence, trends and
actions that delivery of whole-of-government embed healthy weight policies and Communications Branch to and skills, and build capacity in healthy lifestyle modification impacts of eating habits, physical
can reach efforts for a healthy and programs into health systems and support the development and communities to sustain healthy service for Queenslanders aged 16 activity, overweight and obesity
prosperous Queensland, e.g. Our create healthier environments for delivery of marketing activities eating messages and activities. years plus who are at risk of using:
people
Future State roadmaps, public health service clients, staff and that provide clear and consistent developing a chronic disease. - Queensland preventive health
living in 19. Increase daily physical activity,
health commission, Sport and communities. messaging to promote physical survey
cities, and with a focus on walking for
Active Recreation Strategy, activity and healthy food and - National measurement surveys
7. Partner with the workplace health and individuals and communities.
regional Walking Strategy, and State drinks choices at home and - hospitalisations
safety sector to embed health and
and remote Infrastructure Plan. eating out. - deaths
wellbeing culture and programs into
areas 2. Develop options for strengthening core business, with a focus on 16. Provide expert nutrition and - burden of disease.
menu labelling legislation to industries and occupational groups at physical activity advice to 25. Assess changes in prevalence of
encourage businesses selling fast high risk of chronic disease. Strategic Communications overweight and obesity, physical
food to increase the availability of Branch to expand the impact of activity, healthy and unhealthy food
8. Strengthen partnerships with the sport media and communication consumption by sociodemographic
healthier menu choices.
and recreation sector to increase activities. groups (sex, age, socioeconomic
3. Influence the food regulation regular participation in sports and status, remoteness, and HHS) for
system to deliver and evaluate active recreation across the life span, adults and children.
existing policies and activities, and and improve the supply and promotion
establish new initiatives, for of healthy food and drinks at sporting 26. Identify and apply system insights
healthier eating. clubs. through monitoring and sharing
updates on public health
4. Finalise the development of 9. Work with the education sector to approaches, research and media
national reforms to limit the strengthen efforts and encourage related to healthy weight.
impact of unhealthy food and healthy eating at state and non-state
drinks on children in key settings schools using a whole school approach. 27. Explore and assess options for
through the COAG Health Council. strengthening policies and systems
10. Collaborate with the early childhood to support:
5. Work with Queensland food sector to explore opportunities to
- healthy food advertising on
service sector to encourage promote healthy growth and
government owned spaces
voluntary adoption of the national development.
- food pricing and availability.
healthy food pledge scheme.
Targeted 11. Collaborate with the health sector on 17. Collaborate with Strategic 20. Build the knowledge and skills of 22. Increase access to a statewide 28. Scope and develop a process for
actions for new initiatives for: Communications Branch to school students to make healthier healthy lifestyle modification assessing past Preventive Health
groups at - breastfeeding support the integration of lifestyle choices through service with tailored programs for: Branch investments (with an initial
- healthy gestational weight gain marketing and communication supporting teaching and learning. - women planning a pregnancy or focus on food environments in early
higher risk
- children 0-5 years and families activities for: pregnant childhood education and care), and
of or with use findings to inform future
- Aboriginal and Torres Strait - families (including pre- - Aboriginal and Torres Strait
higher activity.
Islander peoples. conception) Islander peoples
overweight - pregnant women and - preventing diabetes type 2.
12. Incentivise HHSs to use clinical 29. Explore options for engaging with
and obesity partners
pathways to support modifiable lifestyle 23. Increase access to a statewide adults of child bearing age to
rates - parents and carers of support healthy weight and
risk factor behavior change in adults, health risk assessment and lifestyle
commencing with patients booked for children (0-18 years) modification program for adoption of healthy lifestyle
elective surgery. - Aboriginal and Torres Strait Queensland adults at highest risk of behaviours for pre-conception and
Islander families. developing a chronic disease, beyond.
13. Build the capacity of local governments
including tailored programs for: 30. Investigate opportunities to deliver
to create healthier food and physical
activity environments, with a focus on - Aboriginal and Torres Strait statewide, family-focused early
Aboriginal and Torres Strait Islander Islander peoples intervention support for healthier
communities and local governments - people from Culturally and eating and increased physical
ready to act. Linguistically Diverse activity.
backgrounds.
14. Partner with Department of Housing
and Public Works to create healthier
environments and increase access to
healthy lifestyle interventions for public
housing tenants.
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