Health and social care, Housing and planning

Calling time on takeaways?

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Doner kebab slowly roasted on a vertical rotating spit

Introduction

In recent years, as childhood obesity rates have climbed, the debate surrounding the prevalence of fast-food outlets near schools has gained more traction. More and more local governments are implementing planning guidance to restrict the number of fast-food outlets in their council area. This approach aims to curb the opportunities young people can have with accessing fast food, and in turn help tackle childhood obesity.

The debate on restricting fast food outlets near schools encapsulates a complex interplay of health, economic, and planning considerations. Health advocates argue that the right planning interventions can help combat the rising childhood obesity epidemic. On the other hand, opponents raise concerns about the potential impact on local businesses. Some studies argue that closer proximity to fast food restaurants is connected to increased Body Mass Index for nearby schoolchildren. While the potential health benefits of such restrictions seem evident, other studies are less convinced of their impact on our health environments.

Since 2021, some 50% of local authorities in England and Wales use planning guidance to restrict fast food outlets. This is by no means a recent policy approach: Waltham Forest Borough Council introduced restrictions on new fast-food outlets as early as 2009 and hasn’t approved a planning application for a takeaway since. Meanwhile, in Scotland, certain restrictions have been in place since 2001. So why are these schemes needed?

Health and the food environment

The UK is in the midst of a quiet childhood obesity crisis, with close to a quarter of children in England either overweight or obese by the time they start primary school, rising to more than one-third when they reach the age of 11. Obese children face not only an increased risk of developing serious illnesses, such as type 2 diabetes, coronary artery disease and even cancer in adulthood, but social and psychological challenges. Obesity-related conditions are creating a staggering financial burden – an estimated £19 billion annual cost per year for the NHS and a total annual estimated cost of at least £98 billion.

But what’s driving this crisis? One answer may lie in our food environment – the surroundings in which we purchase, interact with, and consume food. It encompasses our schools, workplaces, residential areas, shops and transport routes. Within these food environments, food quality, affordability, availability and appeal significantly impact our dietary habits, in particular among young people and children. Food environments with an abundance of readily available, calorie-dense options and poor access to fresh, healthy food are referred to as ‘food deserts’ or ‘obesogenic environments’. These environments are more common in deprived areas and have been linked to a heightened risk of weight gain for people in them. One sign of a poor food environment is a high prevalence of fast-food outlets.

When tackling childhood obesity, a major food environment to consider are schools and their surrounding area. Schools play a pivotal role in shaping the dietary habits of young people. Research from the US emphasises the influence of the food environment surrounding schools, in particular the quality of available food, on their food choices. Food shops surrounding secondary schools are popular with students, but serve food with generally poor nutritional content and a significant proportion of a young person’s salt, fat and sugar intake. Unsurprisingly, some studies indicate a correlation between proximity to takeaways and student obesity. Because of this, the distribution and density of fast-food outlets is increasingly a focal point of local health interventions.

Takeaway exclusion zones

In England, takeaway outlets have their own use-class category within the planning system. The council grants or refuses planning permission for new takeaway premises or to change an existing premises into a fast-food outlet. However, they are unable to remove planning permission from existing takeaways.

As mentioned earlier, the use of planning policy to create healthier food environments is increasingly popular for UK councils. This usually takes the form of councils using three types of planning guidance to limit the number of fast-food outlets in the council area. They are: School exclusion zones, designed to restrict the granting of planning permission for new fast-food outlets within a certain radius of secondary schools or other places frequented by children; Restrictions on new fast-food outlets if a certain threshold of outlets in the local retail space is met; and restrictions on new outlets if a percentage of the local population being classified as overweight or obese is met, such as a percentage of children starting secondary school.

The first, the school-based takeaway management zone, is the most common of the three planning approaches in England. Each approach can vary depending on the local authority, differing in size, shape, or focus, surrounding either primary schools, secondary schools, or both.

But are they successful?

It should be stated that the causes of obesity can’t solely be addressed through planning interventions, and the fact that these policies have been debated, trialled and/or implemented for more than 20 years reinforces the difficulty of getting child obesity policy right. However, studies on the success of takeaway exclusion zones are few and generally inconclusive. Generally, young people at school are less likely to choose to eat from fast food outlets if there’s a reasonable walk involved, but at the same time, the impact of takeaway exclusion zones on creating healthier food environments remains inconclusive. While some argue for the extension of exclusion zone schemes across the UK, others are more uncertain about their current success. Most argue that councils should pursue complementary strategies to help create healthy food environments. These range from encouraging hot food outlets to offer healthier options or reformulate their menus to lower their calories, to councils approving healthier, more affordable food outlets. While greater access to unhealthy food outlets has been linked to higher odds of being overweight or obese, conversely higher numbers of healthy food outlets have been linked to the opposite, and outlets selling healthy food in areas with a high density of fast-food outlets can actually mitigate the adverse effects of exposure to unhealthy food, suggesting limitations on fast food outlets are not the only approach.

However, as more and more councils and researchers are undertaking planning interventions to limit access to fast food, more evidence will likely emerge on their efficacy and the relationship between fast food access and childhood obesity in general.

Read more: 
Tackling childhood obesity through planning – lessons from South Tyneside Council
An obesogenic environment? Childhood obesity and urban planning



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