Analysis Of Obesity in Thurrock, Essex 1

ANALYSIS OF OBESITY IN THURROCK, ESSEX

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 Analysis Of Obesity in Thurrock, Essex 2

Introduction

Health needs assessment is a critical approach that helps in providing intelligence and

making rational decisions when it comes to planning and deployment of the resources needed to

address the health priorities of the local populace. In the contemporary healthcare practice,

assessment of the health needs of the local population encompasses considering not just the

mental and physical well-being of the local population, but also the wider determinants of social

factors like education, housing, and employment that influence their health. One of the areas of

interest for Thurrock region in Sussex is the rampant cases of obesity making it an important

exploration topic for this discourse. An array of data sources such as the World Health

Organization and NHS England among others will be used to explain the impact of the

healthcare needs of the inhabitants of Thurrock in Sussex and propose appropriate

recommendations to improve the situation. The various barriers such as laxity by healthcare

professionals will be discussed. Moreover, the role of nurses in health promotion will be

presented guided by the healthy promotion theory. The rationale of this discourse, therefore, is to

provide insight into the analysis of obesity in Thurrock, Essex

Locality

The locality selected for this discourse is Thurrock which is located on the northern part

of the River Thames immediately to the East of London, Sussex County. Thurrock has a

population of about 176, 000 individuals according to the Census Report of 2021. The population

of females is 51 per cent while that of males is 49 per cent (Thurrock.gov., 2023, n.p.). 14 per

cent of the populace is above 65 years, 24 per cent is between 45 and 64 years, 30 per cent is

between 25 and 44 years, 11 per cent are between 15 and 24 years, and the remaining 21 per cent

are below 14 years of age. Thurrock has registered a significant increase in population by 11.6
 Analysis Of Obesity in Thurrock, Essex 3

per cent from 2011 (Thurrock.gov., 2023, n.p.). The White population is 76.8 per cent, black

people constitute 11.9 per cent, and Asians comprise 6.99 per cent. Multiple ethnic groups are 3

per cent of Thurrock’s population while the other ethnic groups are 1.5 per cent.

Figure 1 shows the location and place of Thurrock. Location and place | Thurrock facts

and statistics | Thurrock Council

Figure 2 shows the ethnicity of Thurrock, Sussex as compared to the East region and England.

Obtained from Population | Thurrock Facts and Statistics | Thurrock Council

Health and Social Care Data

 Analysis Of Obesity in Thurrock, Essex 4

The need to tackle obesity is based on the fact that obesity correlates to unquestionable

proof that it is a major risk factor for an array of health problems. For instance, it is widely

known as the major contributing factor for osteoarthritis, diabetes Type 2, hypertension, and

heart disease (Thurrock.gov., 2023, n.p.). It is worth noting that the incidence of these conditions

tends to aggravate with the increase in body weight. Being obese has adverse implications for

sleep apnoea, mental health, as well as respiratory problems. Additionally, there is a serious

impact of obesity when it comes to mental and physical health and wider social and economic

costs (Thurrock.gov., 2023, n.p.). The prevalence of obesity has dramatically increased in the last

2 decades in Sussex County more so in the Thurrock region and it is now estimated to cost more

to the economy of the County as compared to smoking. If a person is obese, the condition can be

identified by calculating the body mass index (BMI). A BMI of more than 25 is categorized as

overweight and if it is 30 and above, then such a person is considered to be obese

(Thurrock.gov., 2023, n.p.). It is also worth noting that a BMI of more than 25 indicates that the

health of the person is at risk.

Lifestyle choices such as smoking, eating habits, alcohol intake, and physical activity can

be the primary contributing factors to the health and well-being of the people in Thurrock. Its

populace indicates many poor impacts of lifestyles choice as compared to the entire of England

(Thurrock.gov., 2023, n.p.). Between 2016 and 2017, 69.4 per cent of the people in the region

were classified as obese or overweight - this was much worse than the number of people in

England who were obese. Many children in Thurrock are more obese than those in England. For

instance, 23 per cent of the children in Year 6 were obese in Thurrock as compared to 20 per cent

in England overall in 2016/2017 (Thurrock.gov., 2023, n.p.). Additionally, within this time, it

was found out that 51.3 per cent of the populace was taking the recommended 5-a-day portion of
 Analysis Of Obesity in Thurrock, Essex 5

fruits and vegetables on the usual days which was quite low as compared to the 57.4 per cent in

England.

The table below indicates the appraised prevalence of obesity for adults that are more

than 15 years of age by the local authority areas as compared to the geographical neighbours east

of England and England (Thurrock.gov., 2023, n.p.). It is apparent from the graph that Thurrock

has a higher proportion of adults that have been diagnosed with obesity as compared to the

neighbouring regions of Brentwood, Havering, and Basildon and is substantially worse for the

percentage of obese adults than the national average of 24.1 per cent as well as the east of

England which was 23.58 per cent (Thurrock.gov., 2023, n.p.). Nationally, the number of people

being diagnosed with obesity has been on the rise being 23 per cent in 2008 and 25 per cent in

2016. This clearly shows how high the cases in Thurrock are as compared to the national

statistics and this means there is a great urgency for this trend to be curtailed

Figure 3 shows an estimated percentage of people that were obese between 2006 and

2008
 Analysis Of Obesity in Thurrock, Essex 6

It is worth noting that the Public Health Outcomes Framework has an indicator that

measures the incidence of excess weight – obesity or overweight – derived from the Active

People Survey, which is a self-reported measure. The Public Health of England usually

standardizes these outcomes since it is documented that most people do not report their precise

weight (Thurrock.gov., 2023, n.p.). The data for 2013 to 2015 indicated that in Thurrock, 70.3

per cent of adults who were above 16 years had been diagnosed with obesity which was a higher

value as compared to the national average at the time which was 64.8 per cent. Persons of colour

more so blacks and Asians constitute the highest number of individuals that are obese in

Thurrock and Sussex County (Thurrock.gov., 2023, n.p.). Another thing is that people from low-

socioeconomic status are major victims of the condition.

Figure 4 shows the prevalence of people that are overweight and obese between 2013 and

2015
 Analysis Of Obesity in Thurrock, Essex 7

According to the World Health Organization (WHO), more than 1.9 billion adults were

overweight by the year 2016 and 650 million individuals were obese. The mortality rate

worldwide is at least 2.8 million people per year. According to NHS England (2023, n.p.),

obesity was reported to have tripled between 1975 and 2016 and is prevalent in high-income

nations. There is a need to worry about the obesity trends in Thurrock after a close check of

national and international data which means that appropriate measures must be implemented to

avert the issue in the future. The United Kingdom is leading in the cases of Obesity in Europe

with England having two-thirds of the population being obese. The locality obesity rates are

almost the same as the national data but quite less than the international data.

Determinants, Inequalities, and Barriers to Health

The World Health Organisation (2023) defines social determinants of health as the non-

medical factors that impact health outcomes. They can be described as the conditions in which

people are born and grow, live, work, and age, as well as the wider systems and forces that shape

the conditions in their daily lives. They include education, income status, social protection,

poverty, social inclusion and discrimination, and access to affordable healthcare services among

others (WHO, 2023, n.p.).

Being obese can result in a vicious cycle whereby the person cannot find or keep his job

or is even not able to afford healthy and nutritious food. A combination of unemployment and

obesity is ascribed to the exacerbated risk of illness, low self-confidence, early death, lower

quality of life, and poor health (Campbell et al., 2021, Pg. 8). The emergence of COVID-19

worsened the situation and Thurrock and many people became obese as a result of being

unemployed. Obese people have a higher risk of hospitalization and mortality since they become

food insecure because of losing their jobs. They cannot afford to buy a balanced diet and most of
 Analysis Of Obesity in Thurrock, Essex 8

the time they consume unhealthy foods. For instance, families on a low income cannot afford

adequate fresh foods such as vegetables and fruits, which are a key part of a healthy diet

(Campbell et al., 2021). Such a family is just concerned with hunger and there chooses any food

that can fill their bellies without considering its nutritional status.

Findings from historical studies of the purchasing patterns of food by various households

suggest parents that who have a restricted budget usually prefer food that has a higher satiety

value like a packet of biscuits over a bag of apples as a snack for their children (Campbell et al.,

2021, Pg. 3). This type of decision in the long term contributes to a higher level of malnutrition

and obesity in this socially deprived household. Interestingly, this reality applies with equal force

in the case of Thurrock Sussex as evidenced by the statistics below. 85.3 per cent of the

individuals in Thurrock are economically active which is quite higher than that of Great Britain

which is 78.5 per cent. The remaining 14.7 per cent are unemployed and therefore struggle to

make ends meet (Campbell et al., 2021, Pg. 5). Approximately 17.7 per cent of the children in

Thurrock stem from low-income families meaning that even though some of these people are

employed, the amount of money they get on a weekly or monthly basis is not sufficient for all

their basic needs and therefore are forced to compromise their health at the expense of other

priorities such as rent and school fees. The rate of homeless is quite low, at 0.86 per cent which

means that the government is trying to ensure that fewer people are without basic commodities

such as homes (Campbell et al., 2021, Pg. 8).

 Analysis Of Obesity in Thurrock, Essex 9

Figure 5 indicates the rate of employment and unemployment between January and December

2022

https://fingertips.phe.org.uk/static-reports/health-profiles/2019/e06000034.html?area-

name=thurrock

Another determinant of health is the level of education. Research has proven that there is

a significant correlation between the level of nutritional knowledge and eating habits with cases

of obesity. Children and adults that have less healthy eating habits and limited knowledge of
 Analysis Of Obesity in Thurrock, Essex 10

obesity were more than 5 times more likely to be associated with fewer cases of obesity.

Education has been thriving in Thurrock since many schools have been established. This means

that this factor has less impact on why people are obese in Thurrock but is very relevant in public

education for the people in the region to adopt a healthy lifestyle and improve the cases of

obesity.

Healthcare inequalities in the dispensation of care in Thurrock region have remained a

concern and there is every need to address this concern as it has frustrated efforts of managing

and preventing healthcare conditions such as obesity and other illnesses (Morries & Scobie,

2020, Pg. 1). It has been proven that most Black and Asian people in Sussex County, United

Kingdom including Thurrock region are obese. Even though the NHS argue that addressing

healthcare inequalities in the quality of care provided is in its policy agenda, it is important to

hasten everything for the sake of the affected persons. The ‘Long Term Plan’ maintains that

though the NHS has a limited role when it comes to shaping the wider health determinants, it has

to contribute to curtailing inequalities in healthcare and unwarranted variation (Morries &

Scobie, 2020, Pg. 6). Healthcare inequalities mainly affect low-income status people most of

whom are the non-Whites more so the Black demographics.

When it comes to the patient, the cost of the private sector services, stigma, and previous

experiences of attempting to lose weight are some of the barriers between medical practitioners

and patients. The stigma of being obese is an important barrier that hinders the willingness of the

patient to raise the issue of weight to the healthcare professional (Morries & Scobie, 2020, Pg.

11). Most patients would prefer to go to private hospitals but at the same time, when they are

recommended to use a healthcare service for which they will have to pay some amount of

money, then they complain they cannot afford it and saw little value over the same. Medical
 Analysis Of Obesity in Thurrock, Essex 11

practitioners are of the opinion that the local commissioning services place limitations that are

unnecessary when it comes to the development of obesity services in the healthcare practice

(Morries & Scobie, 2020, Pg. 14). For instance, performance measures such as the quality as

well as outcome framework act as a barrier for some of the respondents while at the same time

allowing others.

A Review of the Current Service Provision

Thurrock’s obesity strategy has played a major role in implementing measures to reduce

cases of obesity. The strategy concentrates on the wider determinants of health as well as the

implications that the multiple sectors are having on the lifestyle and health related to obesity via

a whole systems approach (Gov.UK, 2023, n.p.). The establishment of a “Health and Wellbeing

Strategy” has also set priorities in Thurrock to reduce the existing inequalities in health and

enhance the well-being of the people there. Previous studies have found that another barrier is

that some of the healthcare professionals viewed the NICE guidelines as not for them to

implement but perceive that is the work of the local commissioners

The NHS launched a Weight Loss Plan app that helps adults to adopt healthier eating

habits, start losing weight, and be more active. Additionally, the NHS.UK. is the largest health

information service that was created to give advice, tools, and tips that can help individuals

residing in England make judicious choices about their well-being and health (Gov.UK, 2023,

n.p.). The government also 2021 established the ‘All Our Health’ program that encourages

healthcare professionals to help people live healthy lifestyles, reduce healthcare inequalities, and

make healthy choices to help manage adult obesity in the country (Gov.UK, 2023, n.p.).

NICE has also developed various obesity pathways. For instance, obesity prevention

(CG43) is the first national guidance that focuses on helping to be that are obese and overweight,
 Analysis Of Obesity in Thurrock, Essex 12

both children and adults in Wales and England. Another one is known as Weight management

before, during, and after pregnancy which has six commendations based on the approaches that

have been substantiated for the whole populace (NICE, 2023, n.p.). NICE recommends that

healthcare professionals adopt pharmacological interventions for the adults after their dietary

interventions, behavioural approaches, and exercises have been commenced and assessed.

Pharmacological intervention is not recommended for children younger than 12 years (NICE,

2023, n.p.). NICE also provides other provisions to address obesity such as Bariatric surgery and

follow-up care among others. There are various private and charitable organizations that help in

obesity education and management. These include the Sussex County Health Coalition, Sussex

County Association of Realtors, and Hands of Hope among others. These organizations also seek

sponsorship to help the children and adults diagnosed with diabetes and also help other members

of the community with ways of preventing the condition.

Role of the Nurse in Health Promotion and Screening

The health promotion theory argues that each individual has special features and

experiences that influence subsequent actions. The set of variables for behavioural-specific

knowledge and impact has incredible motivational implications. These variables are usually

modified via nursing interventions (Gonzalo, 2023, n.p.). Health-promoting behaviour is defined

as the required behavioural outcome and is also the endpoint when it comes to the health

promotion model. Such behaviours result from a better quality of life in all the stages of

development, an enhanced functional ability, and improved health. The final behavioural demand

is usually influenced by the immediate competing preferences and demands, that tend to derail

the intended actions meant for health promotion (Gonzalo, 2023, n.p.). It is worth noting that the

health promotion model was intended to be a complementary counterpart to health protection

 Analysis Of Obesity in Thurrock, Essex 13

models as it integrates health improvement behaviours and applies across the lifespan. The

rationale is to help frontline healthcare providers know and comprehend the primary

determinants of health behaviours as key benchmarks in counselling and the promotion of

healthy lifestyles and well-being of people (Gonzalo, 2023, n.p.).

The health promotion model is an effective theory for developing a health promotion plan

for managing or preventing obesity. Obesity has a few non-modifiable risk factors along with

many several modifiable ones. The models first look at the personal features and experiences of

the patient (Gonzalo, 2023, n.p.). The proposition that prior behaviour as well as features

influence affects, beliefs, as well as health promotion behaviours, was one of the major

assertions that Pender noted in her theory. Since the theory argues that looking into past

behaviour is a good metric that the behaviour will continue unless it is altered (Gonzalo, 2023,

n.p.). Through the examination of the outcomes of the initial screening as well as holding the

participants to be accountable for their own actions and suggesting the ways in which they can

change their behaviour. When the patient manages to keep an account of the concerns and

feelings accurately in a journal including the physical exercises and food logs, then he or she can

be held to a higher level and can control his or her health (Gonzalo, 2023, n.p.).

Nurse practitioners and Nurses have a critical opportunity to bring an impact on the issue

of obesity in Thurrock. Nurses usually act as role models whereby they educate the patients

together with their families on nutritional issues, obesity-related illnesses, and healthcare systems

(Khodaveisi, et al., 2017, Pg. 4). Nurse practitioners can act as personalized counsellors and can

therefore help the patients in Thurrock region, Sussex identify their health goals and even help

them come up with ways of achieving them. There is no doubt that a healthy diet is a key

benchmark in curtailing weight and promoting the overall health of people in Thurrock. The
 Analysis Of Obesity in Thurrock, Essex 14

nurse can work together with the community members to establish the healthcare challenges they

are facing (Khodaveisi, et al., 2017, Pg. 7). The nurses must also act as policymakers and compel

the government to support obesity-related initiatives and also address the issue of healthcare

inequalities.

Conclusion

To sum it up, it is apparent from the health needs assessment of Thurrock, Sussex that

obesity is a major health issue affecting the populations there. Thurrock is a part of Sussex

County in the Northern part of the River Thames with a population of 176, 000 individuals. The

largest proportion of Thurrock’s population is young and therefore addressing the issue of

obesity in terms of prevention and management could be the key to reducing the cases of obesity

in the future. Obesity is associated with serious comorbidities such as Type 2 Diabetes and

hypertension among other illnesses. It is mainly brought about by a bad lifestyle and poor

healthy eating habits. The region has quite a number of people that are not employed and most of

them come from low-income status backgrounds.

It is therefore a challenge for these people to get a nutritional diet due to the priorities in

their life and therefore eat what can fill their bellies without caring about its implications on their

health. This is one of the major reasons for the increase in obesity cases in the region. Healthcare

professionals have been waiting on the local commissioners to implement the NICE guidelines

even though they are the ones mandated to do and this has become a major barrier to averting the

issue. Additionally, stigma has made many obese individuals not seek help hindering their

breakthrough in overcoming the condition. However, the government together with various

Charity services has improved their effort to overcome this problem. The nurses have a major

role in this and help in educating the patients and other members of the community to help them
 Analysis Of Obesity in Thurrock, Essex 15

manage the disease. Prevention has also been a major part of the health promotion campaign.

These efforts are supported by the health promotion model focus on behavioural change. Nothing

is impossible when the mind and hearts are put towards it, the problem will be averted in

Thurrock.

Recommendations for Practice

The healthcare providers in Thurrock must recognise obesity as a chronic illness and ask

for permission from the patient to offer to advise and dispense care in an unbiased way. They

should also assess the person struggling with obesity using proper measurements and pinpoint

the root causes, existing complications, as well as barriers to treatment (Wharton et al., 2020, Pg.

9). They have also to discuss the core therapy options – physical activity and medical nutrition

therapy – as well as adjunctive treatments that might be needed including pharmacologic,

psychological, and surgical interventions. Healthcare professionals need also to have an

agreement with the patient concerning the therapy goal and specifically focus on the value that

the person will derive from health-based approaches (Wharton et al., 2020, Pg. 12). Engagements

of the patient with the healthcare profession has to continue after treatment and reassessment and

encouragement of advocacy provided to enhance care for this chronic illness

 Analysis Of Obesity in Thurrock, Essex 16

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