Correlates of English local government use of the planning system to regulate hot food takeaway outlets: a cross-sectional analysis.
The international journal of behavioral nutrition and physical activity
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Keeble, M., Adams, J., White, M., Summerbell, C., Cummins, S., & Burgoine, T. (2019). Correlates of English local government use of the planning system to regulate hot food takeaway outlets: a cross-sectional analysis.. The international journal of behavioral nutrition and physical activity, 16 (1), 127. https://doi.org/10.1186/s12966-019-0884-4
Background: Greater neighbourhood takeaway food outlet access has been associated with increased takeaway food consumption, and higher body weight. National planning guidelines in England suggest that urban planning could promote healthier food environments through takeaway food outlet regulation, for example by restricting the proliferation of outlets near schools. It is unknown how geographically widespread this approach is, or local characteristics associated with its use. We aimed to address these knowledge gaps. Methods: We used data from a complete review of planning policy documents adopted by local government areas in England (n=325) containing policies for the purpose of takeaway food outlet regulation. This review classified local government area planning policies as having a health (diet or obesity) or non-health focus. We explored geographical clustering of similar planning policies using spatial statistics. We used logistic regression models to investigate whether the odds of planning policy adoption varied according to local characteristics, for example the proportion of children with excess weight or the current number of takeaway food outlets. Results: We observed clusters of local government areas with similar adopted planning policies in the North East, North West, and Greater London regions of England. In unadjusted logistic regression models, compared to local government areas with the lowest, those with highest proportion of 10-11 year olds with excess weight (OR: 25.31; 95% CI: 6.74, 94.96), and takeaway food outlet number (OR: 54.00; 95% CI: 6.17, 472.41), were more likely to have a health-focused planning policy, than none. In models adjusted for deprivation, relationships for excess weight metrics were attenuated. Compared to local government areas with the lowest, those with the highest takeaway food outlet number remained more likely to have a health-focused planning policy, than none (OR: 16.98; 95% CI: 1.44, 199.04). When local government areas were under Labour political control, predominantly urban, and when they had more geographically proximal and statistically similar areas in the same planning policy status category, they were also more likely to have health-focused planning policies. Conclusions: Planning policies for the purpose of takeaway food outlet regulation with a health focus were more likely in areas with greater numbers of takeaway food outlets and higher proportions of children with excess weight. Other characteristics including Labour political control, greater deprivation and urbanisation, were associated with planning policy adoption, as were the actions of similar and nearby local government areas. Further research should engage with local policymakers to explore the drivers underpinning use of this approach.
Humans, Models, Statistical, Cross-Sectional Studies, Local Government, Health Policy, Restaurants, Child, Health Promotion, England, Overweight, Fast Foods
The NIHR School for Public Health Research is a partnership between the Universities of Sheffield; Bristol; Cambridge; Imperial College London; University College London; The London School for Hygiene and Tropical Medicine (LSHTM); LiLaC – a collaboration between the Universities of Liverpool and Lancaster; and Fuse - The Centre for Translational Research in Public Health, a collaboration between Newcastle, Durham, Northumbria, Sunderland and Teesside Universities. This study is funded by the National Institute for Health Research (NIHR) School for Public Health Research (Grant Reference Number PD-SPH-2015-10025). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. JA, MW and TB are funded by the Centre for Diet and Activity Research (CEDAR), a UK Clinical Research Collaboration (UKCRC) Public Health Research Centre of Excellence. Funding from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research, and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged.
Department of Health (via National Institute for Health Research (NIHR)) (PD-SPH-2015-10029 BH154142)
Wellcome Trust (087636/Z/08/Z)
Department of Health (via National Institute for Health Research (NIHR)) (unknown)
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External DOI: https://doi.org/10.1186/s12966-019-0884-4
This record's URL: https://www.repository.cam.ac.uk/handle/1810/299152
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