Document Type : Original Article
Authors
1
MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
2
Department of Marketing, Faculty of Business and Economics, University of Antwerp, Antwerp, Belgium
3
Office for Health Improvement and Disparities, Department of Health and Social Care, London, UK
4
Department of Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
5
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
6
Population Health Innovation Lab, Department of Public Health, Environments & Society, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, UK
7
Department of Urban Planning, College of Architecture and Urban Planning, Tongji University, Shanghai, China
8
Great Ormond Street Institute of Child Health, University College London, London, UK
9
Global Food System and Policy Research, School of Global Health, Faculty of Health, York University, Toronto, ON, Canada
10
School of Health and Social Work, University of Hertfordshire, Hatfield, UK
Abstract
Background
Takeaway food is often high in calories and served in portion sizes that exceed public health recommendations for fat, salt and sugar. This food is widely accessible in the neighbourhood food environment. As of 2019, of all local authorities in England (n = 325), 41 had adopted urban planning interventions that can allow them to manage the opening of new takeaway outlets in “takeaway management zones around schools” (known elsewhere as “exclusion zones”). Before adoption, local authorities undertake mandatory public consultation where responses objecting to proposals can be submitted. Evidence on common objections could be insightful for practitioners and policy-makers considering this intervention.
Methods
We included 41 local authorities that adopted a takeaway management zone around schools between 2009 and 2019. We identified and analysed objections to proposals submitted by or on behalf of food retailers and local authority responses to these. We used reflexive thematic analysis with a commercial determinants of health lens to generate themes, and investigated if and how objections and responses changed over time.
Results
We generated four themes: The role of takeaways in obesity, Takeaway management zone adoption, Use and interpretation of evidence, and managing external opinions. Despite not being implicated by the adoption of takeaway management zones around schools, planning consultants objected to proposals on behalf of transnational food retailers, however, independent takeaways did not respond. Objections attempted to determine the causes of poor diet and obesity, suggest alternative interventions to address them, undermine evidence justifying proposals, and influence perspectives about local authorities and their intervention. Objections consistently raised the same arguments, but over time became less explicit and expressed a willingness to partner with local authorities to develop alternative solutions.
Conclusion
Objections to local authority proposals to adopt an urban planning intervention that can stop new takeaways opening near schools featured strategies used by other industries to delay or prevent population health intervention adoption. Practitioners and policy-makers can use our findings when developing proposals for new takeaway management zones around schools. By using knowledge about their local context and addressing arguments against specific aspects of the intervention, they can pre-empt common objections.
Keywords
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