This report presents information on obesity, physical activity and diet drawn together from a variety of sources for England. More information can be found in the source publications which contain a wider range of data and analysis. Each section provides an overview of key findings, as well as providing links to relevant documents and sources. Some of the data have been published previously by NHS Digital. A data visualisation tool (link provided within the key facts) allows users to select obesity related hospital admissions data for any Local Authority (as contained in the data tables), along with time series data from 2013/14. Regional and national comparisons are also provided. The report includes information on: Obesity related hospital admissions, including obesity related bariatric surgery. Obesity prevalence. Physical activity levels. Walking and cycling rates. Prescriptions items for the treatment of obesity. Perception of weight and weight management. Food and drink purchases and expenditure. Fruit and vegetable consumption. Key facts cover the latest year of data available: Hospital admissions: 2018/19 Adult obesity: 2018 Childhood obesity: 2018/19 Adult physical activity: 12 months to November 2019 Children and young people's physical activity: 2018/19 academic year

This statistical report presents information on obesity, physical activity and diet, drawn together from a variety of sources. The topics covered include: Obesity related hospital admissions. Prescription items for the treatment of obesity. Adult obesity prevalence. Childhood obesity prevalence. Physical activity levels among adults and children. Diet among adults and children, including trends in purchases, and consumption of food and drink and energy intake. Each section provides an overview of the key findings from these sources, as well as providing sources of further information and links to relevant documents and sources. Some of the data have been published previously by NHS Digital. A data visualisation tool at the link below allows users to select obesity related hospital admissions data for any Local Authority (as contained in Excel tables 3, 7 and 11 of this publication), along with time series data from 2013/14. Regional and national comparisons are also provided.

SUMMARYThis analysis, designed and executed by Ribble Rivers Trust, identifies areas across England with the greatest levels of obesity in adults (aged 18+). Please read the below information to gain a full understanding of what the data shows and how it should be interpreted.ANALYSIS METHODOLOGYThe analysis was carried out using Quality and Outcomes Framework (QOF) data, derived from NHS Digital, relating to obesity in adults (aged 18+).This information was recorded at the GP practice level. However, GP catchment areas are not mutually exclusive: they overlap, with some areas covered by 30+ GP practices. Therefore, to increase the clarity and usability of the data, the GP-level statistics were converted into statistics based on Middle Layer Super Output Area (MSOA) census boundaries.The percentage of each MSOA’s adult population (aged 18+) that are obese was estimated. This was achieved by calculating a weighted average based on:The percentage of the MSOA area that was covered by each GP practice’s catchment areaOf the GPs that covered part of that MSOA: the percentage of registered patients that have that illness The estimated percentage of each MSOA’s adult population that are obese was then combined with Office for National Statistics Mid-Year Population Estimates (2019) data for MSOAs, to estimate the number of people in each MSOA that are obese, within the relevant age range.Each MSOA was assigned a relative score between 1 and 0 (1 = worst, 0 = best) based on:A) the PERCENTAGE of the adult population within that MSOA who are estimated to be obeseB) the NUMBER of adults within that MSOA who are estimated to be obeseAn average of scores A & B was taken, and converted to a relative score between 1 and 0 (1= worst, 0 = best). The closer to 1 the score, the greater both the number and percentage of the population in the MSOA that are estimated to be obese compared to other MSOAs. In other words, those are areas where it’s estimated a large number of people are obese, and where those people make up a large percentage of the population, indicating there is a real issue with obesity within the adult population and the investment of resources to address that issue could have the greatest benefits.LIMITATIONS1. GP data for the financial year 1st April 2018 – 31st March 2019 was used in preference to data for the financial year 1st April 2019 – 31st March 2020, as the onset of the COVID19 pandemic during the latter year could have affected the reporting of medical statistics by GPs. However, for 53 GPs (out of 7670) that did not submit data in 2018/19, data from 2019/20 was used instead. Note also that some GPs (997 out of 7670) did not submit data in either year. This dataset should be viewed in conjunction with the ‘Health and wellbeing statistics (GP-level, England): Missing data and potential outliers’ dataset, to determine areas where data from 2019/20 was used, where one or more GPs did not submit data in either year, or where there were large discrepancies between the 2018/19 and 2019/20 data (differences in statistics that were > mean +/- 1 St.Dev.), which suggests erroneous data in one of those years (it was not feasible for this study to investigate this further), and thus where data should be interpreted with caution. This dataset also shows rural areas (with little or no population) that do not officially fall into any GP catchment area and for which there were no statistics regarding adult obesity (although this will not affect the results of this analysis if there are no people living in those areas).2. It was not feasible to incorporate ultra-fine-scale geographic distribution of populations that are registered with each GP practice or who live within each MSOA. Populations might be concentrated in certain areas of a GP practice’s catchment area or MSOA and relatively sparse in other areas. Therefore, the dataset should be used to identify general areas where there are high levels of adult obesity, rather than interpreting the boundaries between areas as ‘hard’ boundaries that mark definite divisions between areas with differing levels of adult obesity.TO BE VIEWED IN COMBINATION WITH:This dataset should be viewed alongside the following datasets, which highlight areas of missing data and potential outliers in the data:Health and wellbeing statistics (GP-level, England): Missing data and potential outliersLevels of obesity, inactivity and associated illnesses (England): Missing dataDOWNLOADING THIS DATATo access this data on your desktop GIS, download the ‘Levels of obesity, inactivity and associated illnesses: Summary (England)’ dataset.DATA SOURCESThis dataset was produced using:Quality and Outcomes Framework data: Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital.GP Catchment Outlines. Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital. Data was cleaned by Ribble Rivers Trust before use.COPYRIGHT NOTICEThe reproduction of this data must be accompanied by the following statement:© Ribble Rivers Trust 2021. Analysis carried out using data that is: Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital.CaBA HEALTH & WELLBEING EVIDENCE BASEThis dataset forms part of the wider CaBA Health and Wellbeing Evidence Base.

Note 09/05/2013 A presentation error has been identified in the data in tables 7.1 and 7.2 originally included in this publication. The tables have been republished with corrected figures. The accompanying errata note provides more detail. The Health and Social Care Information Centre apologise for any inconvenience this may have caused. Summary: This statistical report presents a range of information on obesity, physical activity and diet, drawn together from a variety of sources. The topics covered include: Overweight and obesity prevalence among adults and children Physical activity levels among adults and children Trends in purchases and consumption of food and drink and energy intake Health outcomes of being overweight or obese. This report contains seven chapters which consist of the following: Chapter 1: Introduction; this summarises government policies, targets and outcome indicators in this area, as well as providing sources of further information and links to relevant documents. Chapters 2 to 6 cover obesity, physical activity and diet and provides an overview of the key findings from these sources, whilst maintaining useful links to each section of these reports. Chapter 7: Health Outcomes; presents a range of information about the health outcomes of being obese or overweight which includes information on health risks, hospital admissions and prescription drugs used for treatment of obesity. Figures presented in Chapter 7 have been obtained from a number of sources and presented in a user-friendly format. Some of the data contained in the chapter have been published previously by the Health and Social Care Information Centre (HSCIC) or the National Audit Office. Previously unpublished figures on obesity-related Finished Hospital Episodes and Finished Consultant Episodes for 2011/12 are presented using data from the HSCIC's Hospital Episode Statistics as well as data from the Prescribing Unit at the HSCIC on prescription items dispensed for treatment of obesity.

This statistical report presents a range of information on obesity, physical activity and diet, drawn together from a variety of sources. The topics covered include: Overweight and obesity prevalence among adults and children Physical activity levels among adults and children Trends in purchases and consumption of food and drink and energy intake Health outcomes of being overweight or obese. This report contains seven chapters which consist of the following: Chapter 1: Introduction; this summarises government policies, targets and outcome indicators in this area, as well as providing sources of further information and links to relevant documents. Chapters 2 to 6 cover obesity, physical activity and diet and provides an overview of the key findings from these sources, whilst maintaining useful links to each section of these reports. Chapter 7: Health Outcomes; presents a range of information about the health outcomes of being obese or overweight which includes information on health risks, hospital admissions and prescription drugs used for treatment of obesity. Figures presented in Chapter 7 have been obtained from a number of sources and presented in a user-friendly format. Some of the data contained in the chapter have been published previously by the NHS Information Centre (NHS IC) or the National Audit Office. Previously unpublished figures on obesity-related Finished Hospital Episodes and Finished Consultant Episodes for 2010/11 are presented using data from the NHS IC's Hospital Episode Statistics as well as data from the Prescribing Unit at the NHS IC on prescription items dispensed for treatment of obesity.

Note, August 2011: A number of errors have been identified in Table 7.5 - GHQ 12 score by body mass index (BMI) and gender, 2008 on page 62 of the Statistics on Obesity, Physical Activity and Diet: England, 2011 report. The errors also affect the corresponding table in the accompanying Excel workbook. The commentary in the pdf report is unaffected. Please see the errata note for further information and corrected figures. The NHS IC apologises for any inconvenience this may have caused. Summary: This statistical report presents a range of information on obesity, physical activity and diet, drawn together from a variety of sources. The topics covered include: overweight and obesity prevalence among adults and children physical activity levels among adults and children trends in purchases and consumption of food and drink and energy intake health outcomes of being overweight or obese This report contains seven chapters: Chapter 1: Introduction; this summarises Government plans and targets in this area, as well as providing sources of further information and links to relevant documents. Note, many of these were introduced by the previous government but were relevant at the time the data were collected. Chapters 2 to 6 cover obesity, physical activity and diet providing an overview of the key findings from a number of sources of previously published information, whilst maintaining useful links to each section of the reports. Additional analysis has been undertaken of the Health Survey for England (HSE) to provide more detailed information previously unpublished. Chapter 7: Health Outcomes; presents a range of information about the health outcomes of being obese or overweight which includes information on health risks, hospital admissions and prescription drugs used for treatment of obesity. Figures presented in Chapter 7 have been obtained from a number of sources and presented in a user-friendly format. Most of the data contained in the chapter have been published previously by the NHS Information Centre or the National Audit Office. Previously unpublished figures on obesity-related Finished Hospital Episodes and Finished Consultant Episodes for 2009/10 are presented using data from the NHS Information Centre's Hospital Episode Statistics as well as data from the Prescribing Unit at the NHS Information Centre on prescription items dispensed for treatment of obesity.

SUMMARYThis analysis, designed and executed by Ribble Rivers Trust, identifies areas across England with the greatest levels of obesity, inactivity and inactivity/obesity-related illnesses. Please read the below information to gain a full understanding of what the data shows and how it should be interpreted.The analysis incorporates data relating to the following:Obesity/inactivity-related illnesses (asthma, cancer, chronic kidney disease, coronary heart disease, depression, diabetes mellitus, hypertension, stroke and transient ischaemic attack)Excess weight in children and obesity in adults (combined)Inactivity in children and adults (combined)The analysis was designed with the intention that this dataset could be used to identify locations where investment could encourage greater levels of activity. In particular, it is hoped the dataset will be used to identify locations where the creation or improvement of accessible green/blue spaces and public engagement programmes could encourage greater levels of outdoor activity within the target population, and reduce the health issues associated with obesity and inactivity.ANALYSIS METHODOLOGY1. Obesity/inactivity-related illnessesThe analysis was carried out using Quality and Outcomes Framework (QOF) data, derived from NHS Digital, relating to:- Asthma (in persons of all ages)- Cancer (in persons of all ages)- Chronic kidney disease (in adults aged 18+)- Coronary heart disease (in persons of all ages)- Depression (in adults aged 18+)- Diabetes mellitus (in persons aged 17+)- Hypertension (in persons of all ages)- Stroke and transient ischaemic attack (in persons of all ages)This information was recorded at the GP practice level. However, GP catchment areas are not mutually exclusive: they overlap, with some areas covered by 30+ GP practices. Therefore, to increase the clarity and usability of the data, the GP-level statistics were converted into statistics based on Middle Layer Super Output Area (MSOA) census boundaries.For each of the above illnesses, the percentage of each MSOA’s population with that illness was estimated. This was achieved by calculating a weighted average based on:The percentage of the MSOA area that was covered by each GP practice’s catchment areaOf the GPs that covered part of that MSOA: the percentage of patients registered with each GP that have that illness The estimated percentage of each MSOA’s population with each illness was then combined with Office for National Statistics Mid-Year Population Estimates (2019) data for MSOAs, to estimate the number of people in each MSOA with each illness, within the relevant age range.For each illness, each MSOA was assigned a relative score between 1 and 0 (1 = worst, 0 = best) based on:A) the PERCENTAGE of the population within that MSOA who are estimated to have that illnessB) the NUMBER of people within that MSOA who are estimated to have that illnessAn average of scores A & B was taken, and converted to a relative score between 1 and 0 (1= worst, 0 = best). The closer to 1 the score, the greater both the number and percentage of the population in the MSOA predicted to have that illness, compared to other MSOAs. In other words, those are areas where a large number of people are predicted to suffer from an illness, and where those people make up a large percentage of the population, indicating there is a real issue with that illness within the population and the investment of resources to address that issue could have the greatest benefits.The scores for each of the 8 illnesses were added together then converted to a relative score between 1 – 0 (1 = worst, 0 = best), to give an overall score for each MSOA: a score close to 1 would indicate that an area has high predicted levels of all obesity/inactivity-related illnesses, and these are areas where the local population could benefit the most from interventions to address those illnesses. A score close to 0 would indicate very low predicted levels of obesity/inactivity-related illnesses and therefore interventions might not be required.2. Excess weight in children and obesity in adults (combined)For each MSOA, the number and percentage of children in Reception and Year 6 with excess weight was combined with population data (up to age 17) to estimate the total number of children with excess weight.The first part of the analysis detailed in section 1 was used to estimate the number of adults with obesity in each MSOA, based on GP-level statistics.The percentage of each MSOA’s adult population (aged 18+) with obesity was estimated, using GP-level data (see section 1 above). This was achieved by calculating a weighted average based on:The percentage of the MSOA area that was covered by each GP practice’s catchment areaOf the GPs that covered part of that MSOA: the percentage of adult patients registered with each GP that are obeseThe estimated percentage of each MSOA’s adult population with obesity was then combined with Office for National Statistics Mid-Year Population Estimates (2019) data for MSOAs, to estimate the number of adults in each MSOA with obesity.The estimated number of children with excess weight and adults with obesity were combined with population data, to give the total number and percentage of the population with excess weight.Each MSOA was assigned a relative score between 1 and 0 (1 = worst, 0 = best) based on:A) the PERCENTAGE of the population within that MSOA who are estimated to have excess weight/obesityB) the NUMBER of people within that MSOA who are estimated to have excess weight/obesityAn average of scores A & B was taken, and converted to a relative score between 1 and 0 (1= worst, 0 = best). The closer to 1 the score, the greater both the number and percentage of the population in the MSOA predicted to have excess weight/obesity, compared to other MSOAs. In other words, those are areas where a large number of people are predicted to suffer from excess weight/obesity, and where those people make up a large percentage of the population, indicating there is a real issue with that excess weight/obesity within the population and the investment of resources to address that issue could have the greatest benefits.3. Inactivity in children and adultsFor each administrative district, the number of children and adults who are inactive was combined with population data to estimate the total number and percentage of the population that are inactive.Each district was assigned a relative score between 1 and 0 (1 = worst, 0 = best) based on:A) the PERCENTAGE of the population within that district who are estimated to be inactiveB) the NUMBER of people within that district who are estimated to be inactiveAn average of scores A & B was taken, and converted to a relative score between 1 and 0 (1= worst, 0 = best). The closer to 1 the score, the greater both the number and percentage of the population in the district predicted to be inactive, compared to other districts. In other words, those are areas where a large number of people are predicted to be inactive, and where those people make up a large percentage of the population, indicating there is a real issue with that inactivity within the population and the investment of resources to address that issue could have the greatest benefits.Summary datasetAn average of the scores calculated in sections 1-3 was taken, and converted to a relative score between 1 and 0 (1= worst, 0 = best). The closer the score to 1, the greater the number and percentage of people suffering from obesity, inactivity and associated illnesses. I.e. these are areas where there are a large number of people (both children and adults) who are obese, inactive and suffer from obesity/inactivity-related illnesses, and where those people make up a large percentage of the local population. These are the locations where interventions could have the greatest health and wellbeing benefits for the local population.LIMITATIONS1. For data recorded at the GP practice level, data for the financial year 1st April 2018 – 31st March 2019 was used in preference to data for the financial year 1st April 2019 – 31st March 2020, as the onset of the COVID19 pandemic during the latter year could have affected the reporting of medical statistics by GPs. However, for 53 GPs (out of 7670) that did not submit data in 2018/19, data from 2019/20 was used instead. Note also that some GPs (997 out of 7670) did not submit data in either year. This dataset should be viewed in conjunction with the ‘Levels of obesity, inactivity and associated illnesses: Summary (England). Areas with data missing’ dataset, to determine areas where data from 2019/20 was used, where one or more GPs did not submit data in either year, or where there were large discrepancies between the 2018/19 and 2019/20 data (differences in statistics that were > mean +/- 1 St.Dev.), which suggests erroneous data in one of those years (it was not feasible for this study to investigate this further), and thus where data should be interpreted with caution. Note also that there are some rural areas (with little or no population) that do not officially fall into any GP catchment area (although this will not affect the results of this analysis if there are no people living in those areas).2. Although all of the obesity/inactivity-related illnesses listed can be caused or exacerbated by inactivity and obesity, it was not possible to distinguish from the data the cause of the illnesses in patients: obesity and inactivity are highly unlikely to be the cause of all cases of each illness. By combining the data with data relating to levels of obesity and inactivity in adults and children, we can identify where obesity/inactivity could be a contributing factor, and where interventions to reduce obesity and increase activity could be most beneficial for the health of the local population.3. It was not feasible to incorporate ultra-fine-scale geographic distribution of

SUMMARYTo be viewed in combination with the ‘Levels of obesity, inactivity and associated illnesses: Summary (England)’ dataset.This dataset shows where there was no data* relating to one of more of the following factors:Obesity/inactivity-related illnesses (recorded at the GP practice catchment area level*)Adult obesity (recorded at the GP practice catchment area level*)Inactivity in children (recorded at the district level)Excess weight in children (recorded at the Middle Layer Super Output Area level)* GPs do not have catchments that are mutually exclusive from each other: they overlap, with some geographic areas being covered by 30+ practices.GP data for the financial year 1st April 2018 – 31st March 2019 was used in preference to data for the financial year 1st April 2019 – 31st March 2020, as the onset of the COVID19 pandemic during the latter year could have affected the reporting of medical statistics by GPs. However, for 53 GPs (out of 7670) that did not submit data in 2018/19, data from 2019/20 was used instead. This dataset identifies areas where data from 2019/20 was used, where one or more GPs did not submit data in either year (this could be because there are rural areas that aren’t officially covered by any GP practices), or where there were large discrepancies between the 2018/19 and 2019/20 data (differences in statistics that were > mean +/- 1 St.Dev.), which suggests erroneous data in one of those years (it was not feasible for this study to investigate this further), and thus where data should be interpreted with caution.Results of the ‘Levels of obesity, inactivity and associated illnesses: Summary (England)’ analysis in these areas should be interpreted with caution, particularly if the levels of obesity, inactivity and associated illnesses appear to be significantly lower than in their immediate surrounding areas.Really small areas with ‘missing’ data were deleted, where it was deemed that missing data will not have impacted the overall analysis (i.e. where GP data was missing from really small countryside areas where no people live).See also Health and wellbeing statistics (GP-level, England): Missing data and potential outliers dataDATA SOURCESThis dataset was produced using:- Quality and Outcomes Framework data: Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital.- National Child Measurement Programme: Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital. - Active Lives Survey 2019: Sport and Physical Activity Levels amongst children and young people in school years 1-11 (aged 5-16). © Sport England 2020.- Active Lives Survey 2019: Sport and Physical Activity Levels amongst adults aged 16+. © Sport England 2020.- GP Catchment Outlines. Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital. Data was cleaned by Ribble Rivers Trust before use.- Administrative boundaries: Boundary-LineTM: Contains Ordnance Survey data © Crown copyright and database right 2021. Contains public sector information licensed under the Open Government Licence v3.0.- MSOA boundaries: © Office for National Statistics licensed under the Open Government Licence v3.0. Contains OS data © Crown copyright and database right 2021.COPYRIGHT NOTICEThe reproduction of this data must be accompanied by the following statement:© Ribble Rivers Trust 2021. Analysis carried out using data that is: Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital; © Sport England 2020; © Office for National Statistics licensed under the Open Government Licence v3.0. Contains Ordnance Survey data © Crown copyright and database right 2021. Contains public sector information licensed under the Open Government Licence v3.0.CaBA HEALTH & WELLBEING EVIDENCE BASEThis dataset forms part of the wider CaBA Health and Wellbeing Evidence Base.

SUMMARYThis analysis, designed and executed by Ribble Rivers Trust, identifies areas across England with the greatest levels of cancer (in persons of all ages). Please read the below information to gain a full understanding of what the data shows and how it should be interpreted.ANALYSIS METHODOLOGYThe analysis was carried out using Quality and Outcomes Framework (QOF) data, derived from NHS Digital, relating to cancer (in persons of all ages).This information was recorded at the GP practice level. However, GP catchment areas are not mutually exclusive: they overlap, with some areas covered by 30+ GP practices. Therefore, to increase the clarity and usability of the data, the GP-level statistics were converted into statistics based on Middle Layer Super Output Area (MSOA) census boundaries.The percentage of each MSOA’s population (all ages) with cancer was estimated. This was achieved by calculating a weighted average based on:The percentage of the MSOA area that was covered by each GP practice’s catchment areaOf the GPs that covered part of that MSOA: the percentage of registered patients that have that illness The estimated percentage of each MSOA’s population with cancer was then combined with Office for National Statistics Mid-Year Population Estimates (2019) data for MSOAs, to estimate the number of people in each MSOA with cancer, within the relevant age range.Each MSOA was assigned a relative score between 1 and 0 (1 = worst, 0 = best) based on:A) the PERCENTAGE of the population within that MSOA who are estimated to have cancerB) the NUMBER of people within that MSOA who are estimated to have cancerAn average of scores A & B was taken, and converted to a relative score between 1 and 0 (1= worst, 0 = best). The closer to 1 the score, the greater both the number and percentage of the population in the MSOA that are estimated to have cancer, compared to other MSOAs. In other words, those are areas where it’s estimated a large number of people suffer from cancer, and where those people make up a large percentage of the population, indicating there is a real issue with cancer within the population and the investment of resources to address that issue could have the greatest benefits.LIMITATIONS1. GP data for the financial year 1st April 2018 – 31st March 2019 was used in preference to data for the financial year 1st April 2019 – 31st March 2020, as the onset of the COVID19 pandemic during the latter year could have affected the reporting of medical statistics by GPs. However, for 53 GPs (out of 7670) that did not submit data in 2018/19, data from 2019/20 was used instead. Note also that some GPs (997 out of 7670) did not submit data in either year. This dataset should be viewed in conjunction with the ‘Health and wellbeing statistics (GP-level, England): Missing data and potential outliers’ dataset, to determine areas where data from 2019/20 was used, where one or more GPs did not submit data in either year, or where there were large discrepancies between the 2018/19 and 2019/20 data (differences in statistics that were > mean +/- 1 St.Dev.), which suggests erroneous data in one of those years (it was not feasible for this study to investigate this further), and thus where data should be interpreted with caution. Note also that there are some rural areas (with little or no population) that do not officially fall into any GP catchment area (although this will not affect the results of this analysis if there are no people living in those areas).2. Although all of the obesity/inactivity-related illnesses listed can be caused or exacerbated by inactivity and obesity, it was not possible to distinguish from the data the cause of the illnesses in patients: obesity and inactivity are highly unlikely to be the cause of all cases of each illness. By combining the data with data relating to levels of obesity and inactivity in adults and children (see the ‘Levels of obesity, inactivity and associated illnesses: Summary (England)’ dataset), we can identify where obesity/inactivity could be a contributing factor, and where interventions to reduce obesity and increase activity could be most beneficial for the health of the local population.3. It was not feasible to incorporate ultra-fine-scale geographic distribution of populations that are registered with each GP practice or who live within each MSOA. Populations might be concentrated in certain areas of a GP practice’s catchment area or MSOA and relatively sparse in other areas. Therefore, the dataset should be used to identify general areas where there are high levels of cancer, rather than interpreting the boundaries between areas as ‘hard’ boundaries that mark definite divisions between areas with differing levels of cancer.TO BE VIEWED IN COMBINATION WITH:This dataset should be viewed alongside the following datasets, which highlight areas of missing data and potential outliers in the data:Health and wellbeing statistics (GP-level, England): Missing data and potential outliersLevels of obesity, inactivity and associated illnesses (England): Missing dataDOWNLOADING THIS DATATo access this data on your desktop GIS, download the ‘Levels of obesity, inactivity and associated illnesses: Summary (England)’ dataset.DATA SOURCESThis dataset was produced using:Quality and Outcomes Framework data: Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital.GP Catchment Outlines. Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital. Data was cleaned by Ribble Rivers Trust before use.MSOA boundaries: © Office for National Statistics licensed under the Open Government Licence v3.0. Contains OS data © Crown copyright and database right 2021.Population data: Mid-2019 (June 30) Population Estimates for Middle Layer Super Output Areas in England and Wales. © Office for National Statistics licensed under the Open Government Licence v3.0. © Crown Copyright 2020.COPYRIGHT NOTICEThe reproduction of this data must be accompanied by the following statement:© Ribble Rivers Trust 2021. Analysis carried out using data that is: Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital; © Office for National Statistics licensed under the Open Government Licence v3.0. Contains OS data © Crown copyright and database right 2021. © Crown Copyright 2020.CaBA HEALTH & WELLBEING EVIDENCE BASEThis dataset forms part of the wider CaBA Health and Wellbeing Evidence Base.

SUMMARYIdentifies Middle Layer Super Output Areas (MSOAs) with the greatest levels of excess weight in children (as measured in children in Reception and Year 6 respectively: three year average between academic years 2016/17, 2017/18, 2018/19).Although this layer is symbolised based on an overall score for excess weight, the underlying data, including the raw data for Reception and Year 6 children respectively, is included in the dataset.ANALYSIS METHODOLOGYThe following analysis was carried out using data for Reception and Year 6 children independently:Each MSOA was given a relative score between 1 and 0 (1 = worst, 0 = best) based on:A) the NUMBER of children in that year group with excess weight and;B) the PERCENTAGE of children in that year group with excess weight.An average of scores A & B was taken, and converted to a relative score between 1 and 0 (1= worst, 0 = best). The closer to 1 the score, the greater both the number and percentage of children with excess weight, compared to other MSOAs, within that year group. In other words, those are areas where a large number of children have excess weight, and where those children make up a large percentage of the population of that age group, suggesting there is a real issue with childhood obesity in that area that needs addressing.The scores for the Reception and Year 6 analyses were added together then converted to relative scores between 1- 0 (1 = high levels of excess weight in children in both Reception and Year 6, 0 = very low levels of excess weight in either school year). The greater the total score, the greater the levels of excess weight in children within the local population, and the greater the benefits that could be achieved by investing in measures to reduce this issue in those areas.The data overall scores for Reception and Year 6 children, respectively, can be viewed via the following datasets:Excess weight in Reception children, England (three year average: academic years 2016-19)Excess weight in Year 6 children, England (three year average: academic years 2016-19)DATA SOURCESNational Child Measurement Programme: Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital. MSOA boundaries: © Office for National Statistics licensed under the Open Government Licence v3.0. Contains OS data © Crown copyright and database right 2021.COPYRIGHT NOTICEBased on data: Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital.; © Office for National Statistics licensed under the Open Government Licence v3.0. Contains OS data © Crown copyright and database right 2021. Data analysed and published by Ribble Rivers Trust © 2021.CaBA HEALTH & WELLBEING EVIDENCE BASEThis dataset forms part of the wider CaBA Health and Wellbeing Evidence Base.

All data relating to Obesity and mortality during the coronavirus (COVID-19) pandemic, England: 24 January 2020 to 30 August 2022

SUMMARYThis analysis, designed and executed by Ribble Rivers Trust, identifies areas across England with the greatest levels of hypertension (in persons of all ages). Please read the below information to gain a full understanding of what the data shows and how it should be interpreted.ANALYSIS METHODOLOGYThe analysis was carried out using Quality and Outcomes Framework (QOF) data, derived from NHS Digital, relating to hypertension (in persons of all ages).This information was recorded at the GP practice level. However, GP catchment areas are not mutually exclusive: they overlap, with some areas covered by 30+ GP practices. Therefore, to increase the clarity and usability of the data, the GP-level statistics were converted into statistics based on Middle Layer Super Output Area (MSOA) census boundaries.The percentage of each MSOA’s population (all ages) with hypertension was estimated. This was achieved by calculating a weighted average based on:The percentage of the MSOA area that was covered by each GP practice’s catchment areaOf the GPs that covered part of that MSOA: the percentage of registered patients that have that illness The estimated percentage of each MSOA’s population with hypertension was then combined with Office for National Statistics Mid-Year Population Estimates (2019) data for MSOAs, to estimate the number of people in each MSOA with hypertension , within the relevant age range.Each MSOA was assigned a relative score between 1 and 0 (1 = worst, 0 = best) based on:A) the PERCENTAGE of the population within that MSOA who are estimated to have hypertension B) the NUMBER of people within that MSOA who are estimated to have hypertension An average of scores A & B was taken, and converted to a relative score between 1 and 0 (1= worst, 0 = best). The closer to 1 the score, the greater both the number and percentage of the population in the MSOA that are estimated to have hypertension , compared to other MSOAs. In other words, those are areas where it’s estimated a large number of people suffer from hypertension, and where those people make up a large percentage of the population, indicating there is a real issue with hypertension within the population and the investment of resources to address that issue could have the greatest benefits.LIMITATIONS1. GP data for the financial year 1st April 2018 – 31st March 2019 was used in preference to data for the financial year 1st April 2019 – 31st March 2020, as the onset of the COVID19 pandemic during the latter year could have affected the reporting of medical statistics by GPs. However, for 53 GPs (out of 7670) that did not submit data in 2018/19, data from 2019/20 was used instead. Note also that some GPs (997 out of 7670) did not submit data in either year. This dataset should be viewed in conjunction with the ‘Health and wellbeing statistics (GP-level, England): Missing data and potential outliers’ dataset, to determine areas where data from 2019/20 was used, where one or more GPs did not submit data in either year, or where there were large discrepancies between the 2018/19 and 2019/20 data (differences in statistics that were > mean +/- 1 St.Dev.), which suggests erroneous data in one of those years (it was not feasible for this study to investigate this further), and thus where data should be interpreted with caution. Note also that there are some rural areas (with little or no population) that do not officially fall into any GP catchment area (although this will not affect the results of this analysis if there are no people living in those areas).2. Although all of the obesity/inactivity-related illnesses listed can be caused or exacerbated by inactivity and obesity, it was not possible to distinguish from the data the cause of the illnesses in patients: obesity and inactivity are highly unlikely to be the cause of all cases of each illness. By combining the data with data relating to levels of obesity and inactivity in adults and children (see the ‘Levels of obesity, inactivity and associated illnesses: Summary (England)’ dataset), we can identify where obesity/inactivity could be a contributing factor, and where interventions to reduce obesity and increase activity could be most beneficial for the health of the local population.3. It was not feasible to incorporate ultra-fine-scale geographic distribution of populations that are registered with each GP practice or who live within each MSOA. Populations might be concentrated in certain areas of a GP practice’s catchment area or MSOA and relatively sparse in other areas. Therefore, the dataset should be used to identify general areas where there are high levels of hypertension, rather than interpreting the boundaries between areas as ‘hard’ boundaries that mark definite divisions between areas with differing levels of hypertension .TO BE VIEWED IN COMBINATION WITH:This dataset should be viewed alongside the following datasets, which highlight areas of missing data and potential outliers in the data:Health and wellbeing statistics (GP-level, England): Missing data and potential outliersLevels of obesity, inactivity and associated illnesses (England): Missing dataDOWNLOADING THIS DATATo access this data on your desktop GIS, download the ‘Levels of obesity, inactivity and associated illnesses: Summary (England)’ dataset.DATA SOURCESThis dataset was produced using:Quality and Outcomes Framework data: Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital.GP Catchment Outlines. Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital. Data was cleaned by Ribble Rivers Trust before use.COPYRIGHT NOTICEThe reproduction of this data must be accompanied by the following statement:© Ribble Rivers Trust 2021. Analysis carried out using data that is: Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital.CaBA HEALTH & WELLBEING EVIDENCE BASEThis dataset forms part of the wider CaBA Health and Wellbeing Evidence Base.

This statistical report presents a range of information on obesity, physical activity and diet, drawn together from a variety of sources. This publication also summarises government plans and targets in this area, as well as providing sources of further information and links to relevant documents and key sources. There are several notable additions to this, The Information Centre's second report on obesity, physical activity and diet. Waist circumference analysis has been included where possible to reflect the importance of using this measurement in conjunction with Body Mass Index (BMI) in order to identify those at increased risk of health problems associated with obesity. More regional data is presented with a greater number of tables providing government office region and Strategic Health Authority breakdowns. Where possible information at a more local level has been reported on.

SUMMARYThis analysis, designed and executed by Ribble Rivers Trust, identifies areas across England with the greatest levels of depression in adults (aged 18+). Please read the below information to gain a full understanding of what the data shows and how it should be interpreted.ANALYSIS METHODOLOGYThe analysis was carried out using Quality and Outcomes Framework (QOF) data, derived from NHS Digital, relating to depression in adults (aged 18+).This information was recorded at the GP practice level. However, GP catchment areas are not mutually exclusive: they overlap, with some areas covered by 30+ GP practices. Therefore, to increase the clarity and usability of the data, the GP-level statistics were converted into statistics based on Middle Layer Super Output Area (MSOA) census boundaries.The percentage of each MSOA’s population (aged 18+) with depression was estimated. This was achieved by calculating a weighted average based on:The percentage of the MSOA area that was covered by each GP practice’s catchment areaOf the GPs that covered part of that MSOA: the percentage of registered patients that have that illness The estimated percentage of each MSOA’s population with depression was then combined with Office for National Statistics Mid-Year Population Estimates (2019) data for MSOAs, to estimate the number of people in each MSOA with depression, within the relevant age range.Each MSOA was assigned a relative score between 1 and 0 (1 = worst, 0 = best) based on:A) the PERCENTAGE of the population within that MSOA who are estimated to have depressionB) the NUMBER of people within that MSOA who are estimated to have depressionAn average of scores A & B was taken, and converted to a relative score between 1 and 0 (1= worst, 0 = best). The closer to 1 the score, the greater both the number and percentage of the population in the MSOA that are estimated to have depression, compared to other MSOAs. In other words, those are areas where it’s estimated a large number of people suffer from depression, and where those people make up a large percentage of the population, indicating there is a real issue with depression within the population and the investment of resources to address that issue could have the greatest benefits.LIMITATIONS1. GP data for the financial year 1st April 2018 – 31st March 2019 was used in preference to data for the financial year 1st April 2019 – 31st March 2020, as the onset of the COVID19 pandemic during the latter year could have affected the reporting of medical statistics by GPs. However, for 53 GPs (out of 7670) that did not submit data in 2018/19, data from 2019/20 was used instead. Note also that some GPs (997 out of 7670) did not submit data in either year. This dataset should be viewed in conjunction with the ‘Health and wellbeing statistics (GP-level, England): Missing data and potential outliers’ dataset, to determine areas where data from 2019/20 was used, where one or more GPs did not submit data in either year, or where there were large discrepancies between the 2018/19 and 2019/20 data (differences in statistics that were > mean +/- 1 St.Dev.), which suggests erroneous data in one of those years (it was not feasible for this study to investigate this further), and thus where data should be interpreted with caution. Note also that there are some rural areas (with little or no population) that do not officially fall into any GP catchment area (although this will not affect the results of this analysis if there are no people living in those areas).2. Although all of the obesity/inactivity-related illnesses listed can be caused or exacerbated by inactivity and obesity, it was not possible to distinguish from the data the cause of the illnesses in patients: obesity and inactivity are highly unlikely to be the cause of all cases of each illness. By combining the data with data relating to levels of obesity and inactivity in adults and children (see the ‘Levels of obesity, inactivity and associated illnesses: Summary (England)’ dataset), we can identify where obesity/inactivity could be a contributing factor, and where interventions to reduce obesity and increase activity could be most beneficial for the health of the local population.3. It was not feasible to incorporate ultra-fine-scale geographic distribution of populations that are registered with each GP practice or who live within each MSOA. Populations might be concentrated in certain areas of a GP practice’s catchment area or MSOA and relatively sparse in other areas. Therefore, the dataset should be used to identify general areas where there are high levels of depression, rather than interpreting the boundaries between areas as ‘hard’ boundaries that mark definite divisions between areas with differing levels of depression.TO BE VIEWED IN COMBINATION WITH:This dataset should be viewed alongside the following datasets, which highlight areas of missing data and potential outliers in the data:Health and wellbeing statistics (GP-level, England): Missing data and potential outliersLevels of obesity, inactivity and associated illnesses (England): Missing dataDOWNLOADING THIS DATATo access this data on your desktop GIS, download the ‘Levels of obesity, inactivity and associated illnesses: Summary (England)’ dataset.DATA SOURCESThis dataset was produced using:Quality and Outcomes Framework data: Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital.GP Catchment Outlines. Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital. Data was cleaned by Ribble Rivers Trust before use.COPYRIGHT NOTICEThe reproduction of this data must be accompanied by the following statement:© Ribble Rivers Trust 2021. Analysis carried out using data that is: Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital.CaBA HEALTH & WELLBEING EVIDENCE BASEThis dataset forms part of the wider CaBA Health and Wellbeing Evidence Base.

• to provide annual data about the nation’s health;
• to estimate the proportion of people in England with specified health conditions;
• to estimate the prevalence of certain risk factors associated with these conditions;
• to examine differences between population subgroups in their likelihood of having specific conditions or risk factors;
• to assess the frequency with which particular combinations of risk factors are found, and which groups these combinations most commonly occur;
• to monitor progress towards selected health targets
• since 1995, to measure the height of children at different ages, replacing the National Study of Health and Growth;
• since 1995, monitor the prevalence of overweight and obesity in children.

The survey includes a number of core questions every year but also focuses on different health issues at each wave. Topics are revisited at appropriate intervals in order to monitor change.

Further information about the series may be found on the NHS Digital Health Survey for England; health, social care and lifestyles webpage, the NatCen Social Research NatCen Health Survey for England webpage and the University College London Health and Social Surveys Research Group UCL Health Survey for England webpage.

Changes to the HSE from 2015:
Users should note that from 2015 survey onwards, only the individual data file is available. The household data file is no longer released for analysis. In addition, users may see other changes; for example only grouped age is now available instead of single year of age. NHS Digital have issued the following statement on changes to the HSE from 2015:

"NHS Digital has recently reviewed how we manage access to survey datasets. In doing this we have sought to strike a balance between protecting the privacy of individuals and enabling maximum use of these valuable, publicly funded data collections. We have thoroughly reviewed our disclosure control measures, including taking advice from experts at the Office of National Statistics. The result is that additional disclosure control measures have been applied to the 2015 survey [onwards] to enable a suitable dataset to be made available through the UK Data Service via end user licence. This involved providing less detail on some aspects, such as geographical classifications, ethnicity and household relationships. To provide greater protection of the answers of children and adults within households it is not possible to identify people within the same household on this dataset, however parent/guardian derived variables appended to their children (if they have any) have been added to enable some intra‐household analysis.”

It is hoped that a second dataset with more detail including family and household relationships will be made available via Special Licence. In the meantime, researchers who want to do analysis of health and behaviours within families or households, and the derived intra-household variables do not meet your needs, are advised to register their interest for a more detailed dataset with NatCen Social Research and provide information about their proposed research and which data they want.

For the third edition (December 2019), corrections have been made for two equivalised income derived variables (Eqv3 and Eqv5); in the previous editions the number of cases coded to -1 was incorrectly higher than normal, and some cases have been coded with the wrong score.