The rhetoric of play as an instrumental tool is everywhere (within the limited incidence of its national discussion). It seems that politicians (if they even engage with the idea of ‘play’ at all), journalists, the majority of those who work with children in any capacity, et al, seem to be predominately fixated on outcomes, desirable goals, end product, future-fixing. Play, in this construct, is a means to an end. Play, in this formation, is an adult-manipulation. What children see is different, and it is what children see and how and why they engage in their play that should be the most important consideration when play is the subject of contemplation.
For a long while I’ve been banging this particular drum, but recently and specifically I’ve been somewhat grated by the whole affair that is the instrumental use of play in order to help ‘solve’ the ‘national obesity crisis’. The cynic in me suspects (though can’t yet substantiate) that there is no great and overwhelming desire for the health and well-being of people in the eyes of the government and other powers that be: it’s more to do with counting the beans and keeping the costs to the NHS down. I do wonder about the numbers. That is, I’m dubious about how much of a crisis this ‘crisis’ really is. I’m particularly dubious with regards to the contention that there’s a huge obesity crisis in school children.
Now, before I go further, some balancing out: yes, I have witnessed some examples of particularly overweight children in my day-to-days in various locations, and it’s fair to say that this highlights that those children exist, of course, beyond the dry spreadsheet data. I’m also aware that some areas of the country, or of particular towns, cities or rural areas, might be more prone to a greater occurrence of higher body mass index (BMI) in children (by way of all manner of complex socio-economic factors). However, having worked in some areas of recognised socio-economic ‘deprivation’, I just don’t see what the statistics are saying. (I don’t claim extensive observational evidence, of course: who could? I accept that this is a snapshot).
Could it be that, simplistically, all the obese children are indoors on their Xboxes and Playstations and not out and about playing? Well, the instrumental argument follows a simple cause and effect of ‘run around, get fit’, after all. That said, why aren’t all the underweight and, for want of an appropriate word, ‘normal’ (whatever that is) weighted children (within the acceptable BMI percentile) who play in such ways considered in that equation? i.e. not seen out and about, so must be lazy, on their way to obesity, need to be ‘fixed’. The discussion is wider than the one that often goes along the lines of: if we use play to make children fit, then there will be less obesity and people will be better for it. ‘If we use play’ is a red flag to this particular playworker.
So, this post is an entire exercise in ‘back of an envelope’ calculations and notes. (Fair warning: there will be some rough workings and plenty of scribbling of numbers). How many obese children are there actually? We get fed the message of a ‘crisis’ or an ‘obesity epidemic’ but we don’t always get the numbers to back it up. Then, when we receive some data, we get this in handy sound-bites too, without really knowing how that relates to the whole. This line of thinking struck me on reading a recent article in The Guardian entitled Obesity putting strain on NHS as weight-related admissions rise (Boseley, 2018). Apart from the article’s title feeding my cynicism re: the economic impact on the NHS, the main point of interest was the following:
Childhood obesity has not shifted very much since the school measurement programme was introduced in 2006-7. Last year  10% of children starting school in the reception year were classed as obese, a slight decrease over time.
It was number crunching time! For the purposes of balance here, Boseley does go on to add that ‘the proportion for those leaving in Year 6 for secondary school was 20%, which is a small increase.’ It’s beyond the scope of this particular post to speculate on the causes of the apparent 10-20% increase between school years R-6 (age 4 to 11 in the UK) because I’m interested in comparing observational (and albeit piecemeal) data with the statistics of younger children deemed to be obese.
Are there really such huge numbers of obese four year olds in the UK? Ten per cent screams out like a crisis. However, what are we really looking at here? Before we go any further, a quick overview of body mass index (BMI) and ‘obesity’. According to information given by diabetes.co.uk, if your BMI (measured by dividing your weight in kg by your height in metres squared) is 30 or above then you’re classed as obese. If there’s an obesity crisis in children (in this study, four year olds in Reception class), another question is how much might all these children weigh to be classed as obese?
So, to the number crunching. The Department for Education (DfE) (2017) provides figures for England on school attendees (so, the start of back of an envelope workings-out if extrapolation needs doing for the UK as a whole). It states that there are, as of January 2017, some 4,689,660 children at state funded primary schools in England and that there are 16,786 state funded primary schools in this country. This gives an average of 279 children per primary school. According to the Office for National Statistics (2015), 2011 being the most up to date census, in which admittedly, all the following are closer to secondary school age now than Reception age, there were at that date some 763,851 four year olds in the UK. It doesn’t give the figures for England alone so some creative extrapolation needs to be done: ukpopulation.org suggests that, as of 2017, there were around 54.99 million people in England. Calculating, from the 2011 census, that the percentage of four year olds to the UK total population was around 1.21% (763,851 out of 63,379,787), this gives a current working figure of around 662,738 four year olds in England (yes, I’m aware that I’m working on 2011 and 2017 data sets, but it’s back of the envelope stuff, this). That is, 1.21% of 54.99 million total population of England, rather than the UK. If we divide this 662,738 by the DfE statistic of 4,689,660 children at state funded primary schools in England in 2017, we reach the figure of some 14% of primary school children being 4 year olds, i.e. Reception age. (Checking my maths is fine, and please let me know if you see an error in the calculations).
If there are 279 children per primary school on average, then 14% of this figure gives us an estimate of 39 four year olds per primary school. Citing the Organisation for Economic Co-Operation and Development (OECD) (2017), Boseley (2018) reckons on 10% of four year olds being obese. That, according to my number crunching, equates to four Reception class four year olds per primary school in England (i.e. 10% of 39 children per school). Four.
Now, as the quote goes, there are lies, damn lies and statistics, but four isn’t a crisis, is it? There are those who will, no doubt, shout out that even one is too many. Yes, if we’re talking about genuine health grounds for concern, then maybe. We should look at what BMI calculations for four year olds mean in numbers. If the average four year old is, taking into account variations for gender, around 1.05m tall (or, 3 feet 5 inches in ‘old money’) then their weight would need to be in the region of 33kg (or, around 5 stone 3lbs, because, frankly, you might as well ask me to weigh someone out in buckets of sand for all I know about how much 33kg is!) for their BMI to hit the obese classification of 30. Here’s the point: 33kg, or a little over 5 stone, is a lot for a four year old to weigh. How many of those do you actually see?
I’m still dubious after all my number crunching. There’s an extra layer of cynicism here as well though: this may well come back to bite me in some way but if playworkers jump on the ‘obesity agenda’ bandwagon to get their work funded, for example, then aren’t they falling into the trap that supports the notion that play has to be ‘for’ something, future-fixing? We know what play’s about, playworkers. We really do. If the future fixers over-ride the idea of play for play’s sake, as children know it to be, then play gets fully subsumed as a subset of sport, citizenship, social engineering and so on. Play should not be taken over by the soft- or hard-line control agenda. The agenda goes something like this: play in ‘xyz’ way because sport/fitness, or any other health agenda, will help you be healthy model citizens, you’ll be ‘responsible’ (i.e. thinking in the same way as the rest of the masses), and you won’t cost the country as much, economically or otherwise.
Play is better than this, more magical than this, more ineffable. On the rare occasion that it does manage to be uttered from the mouth of a politician, it often comes out distorted. I recently sat through forty minutes of a recorded online ministerial debate, poorly attended as it was, though at least play was nominally the subject (my apologies for not yet being able to transfer the link). It was brought up for discussion by Chris Leslie MP (Labour) and though he did bring the subject of funding for playgrounds up (so, all good there), he did bang the ‘play and obesity’ drum a little too much. I sighed, again. Still, the other fella (Conservative MP, Rishi Sunak) was playing on his phone somewhat and not giving the impression he was paying attention and thus, I suspect was the case, when his turn came he rattled off his pre-prepared speech, slipping in an attempted one-up to the Rt Hon other fella by claiming one more offspring, and then going on ad nauseum about the instrumental nature of all things play without ever mentioning play, in essence, at all (sport, fitness, yes, as I remember it, even mental health, and social cohesion, but not play).
Thus ends today’s sermon of number crunching and disconsolation at the instrumental perception of play, to the accompaniment of the banging of drums and the shrill peeping of pipes, which — being maybe in so high a pitch that very few can actually hear — keep on saying, over and over: play for play’s sake, play for play’s sake.
Or, to shift the inflection with the flick of a comma: play, for play’s sake.
Thank you to Jim Ley (see comments below) for the feedback on the difference between BMI calculations for adults and children. In the spirit of how this blog has always been written, these posts are all works in progress (playworkings in themselves) and so an addendum is required to the above writing. As Jim points out, a BMI of 30 for children would be extremely high and different figures are considered for those of a younger age. Whilst I was aware of the percentile aspect of the BMI calculations, this didn’t get relayed in my writing. So, although some of the calculations above are going to change, the argument still stands that the obese child is not, as observed, as prevalent as we’re led to believe.
Jim suggests a more ‘mid-healthy’ BMI for a child to be 15 rather than 23 for an adult and, whilst knowing where the line is crossed for obesity in an adult is said to occur (stated as 30), the calculation isn’t so clear for a child.
The Centers for Disease Control and Prevention website states that: ‘Obesity is defined as a BMI at or above the 95th percentile for children and teens of the same age and sex’, meaning that ‘the child’s BMI is greater than the BMI of 95% of [children] in the reference population.’
So, to return to my calculation of a 3 feet 5 inch (1.05m) tall four year old and using a back of the envelope BMI of 23 (assuming this to fall above the 95th percentile for this age) then that child would still need to weigh a little over 25kg (4 stone) to be classed as obese. The argument still stands.
Thank you again, Jim, for your corrections. This blog and its posts are an ongoing conversation, so I leave the original in its place with this addendum (in the spirit of showing all my workings!)
Boseley, S. (2018), Obesity putting strain on NHS as weight-related admissions rise [online]. Available from: https://www.theguardian.com/society/2018/apr/04/obesity-putting-strain-on-nhs-as-weight-related-admissions-rise (Accessed April 17, 2018)
Department for Education (2017), Schools, pupils and their characteristics [online]. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/650547/SFR28_2017_Main_Text.pdf (Accessed April 17, 2018)
Office for National Statistics (2015), 2011 census: population estimates for the UK [online]. Available from: https://www.ons.gov.uk/file?uri=/peoplepopulationandcommunity/populationandmigration/populationestimates/datasets/2011censusunitedkingdomsubmissionforunitednationsquestionnaireonpopulationandhousingcensuses/part2/rfttable1_tcm77-392509.xls (Accessed April 17, 2018)
Organisation for Economic Co-Operation and Development (OECD) (2017), Obesity update 2017 [online]. Available from: https://www.oecd.org/health/obesity-update.htm (Accessed April 17, 2018)