Taking a whole system approach to healthy weight in Cardiff and the Vale of Glamorgan

Rebecca Stewart, Principal Public Health Practitioner

As the number of people living with overweight and obesity has risen in recent years, and in recognition of the complexity of the issue, the need to look beyond individual solutions to collaboratively addressing systemic issues and drivers through a whole system approach has never been more critical.

What surrounds us shapes us; the opportunities and options that enable accessible and affordable food and active lives for all are shaped by the environment in which we live, and the settings in which we work and play.  To create the right conditions for change everyone has a part to play.

Through a whole system approach a wide range of perspectives are brought together, building collective understanding of the reality of the challenge, how the system is working and where there are opportunities for change.  The approach is ongoing, dynamic and flexible and there are parallels with placemaking as a way of working.

Move More, Eat Well Plan

Launched in 2020, and aligned to the strategic priorities of Cardiff Public Service Board (PSB), Vale of Glamorgan Public Service Board (PSB)  and the Regional Partnership Board, the Move More, Eat Well plan (2020-2023) set out our shared priorities for improving healthy weight. Our collaborative approach has enabled alignment across the system, through plans and programmes of work such as: PSB Wellbeing Plans, Food Vale, Food Cardiff, Cardiff Move More Physical Activity and Sport Strategy, and the Healthy Travel Charter helping to drive change and increase reach.

During January to March of 2024, and building on our progress and learning to date, a series of in person and online workshops were held to collectively shape our revised local Framework for Move More, Eat Well (2024-2030). A wide range of ideas, perspectives and voices were brought together from across the system, sharing:

  • Aspirations for what moving and eating well should mean for our communities and look like in our environment.
  • The variables that can, and do impact on being active and eating well.
  • Aspirations for our ways of working.
  • The enablers and challenges to progress change.

As part of the workshops, building a series of system maps helped us to collectively develop our understanding of the reality of the challenge.  To do this we:

Defined the variables

Identifying factors that affect how active we are and the food that we eat.

Created the connections

Considering how the factors are connected and where change in one may impact another.

Integrated the connection circles

Collating all the connections to understand the areas of the system where we need to shift change.

Created our system maps

Refining and sense checking connections between areas of the system, creating a causal loop diagram that helps us to understand the story behind the system and where opportunities to intervene and shift change may occur.

Our revised framework, reflecting the themes of Welsh Government’s national strategy, Healthy Weight: Healthy Wales, will provide strategic direction until 2030.  It will outline how, in continuing to take a regional approach, we will work collaboratively to create change across the areas of the system that have emerged as priorities.  Our work in Cardiff and the Vale of Glamorgan is contributing to the national approach, and building shared learning with other regions across Wales.