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Rahilly J, Amies-Cull B, Chang M, Cummins S, Derbyshire D, Hassan S, Huang Y, Keeble M, Liu B, Medina-Lara A, Mytton O, Rogers N, Savory B, Schiff A, Sharp SJ, Smith R, Thompson C, White M, Adams J, Burgoine T. Changes in the number of new takeaway food outlets associated with adoption of management zones around schools: A natural experimental evaluation in England. SSM Popul Health 2024; 26:101646. [PMID: 38650739 PMCID: PMC11033196 DOI: 10.1016/j.ssmph.2024.101646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/19/2024] [Accepted: 02/27/2024] [Indexed: 04/25/2024] Open
Abstract
By the end of 2017, 35 local authorities (LAs) across England had adopted takeaway management zones (or "exclusion zones") around schools as a means to curb proliferation of new takeaways. In this nationwide, natural experimental study, we evaluated the impact of management zones on takeaway retail, including unintended displacement of takeaways to areas immediately beyond management zones, and impacts on chain fast-food outlets. We used uncontrolled interrupted time series analyses to estimate changes from up to six years pre- and post-adoption of takeaway management zones around schools. We evaluated three outcomes: mean number of new takeaways within management zones (and by three identified sub-types: full management, town centre exempt and time management zones); mean number on the periphery of management zones (i.e. within an additional 100 m of the edge of zones); and presence of new chain fast-food outlets within management zones. For 26 LAs, we observed an overall decrease in the number of new takeaways opening within management zones. Six years post-intervention, we observed 0.83 (95% CI -0.30, -1.03) fewer new outlets opening per LA than would have been expected in absence of the intervention, equivalent to an 81.0% (95% CI -29.1, -100) reduction in the number of new outlets. Cumulatively, 12 (54%) fewer new takeaways opened than would have been expected over the six-year post-intervention period. When stratified by policy type, effects were most prominent for full management zones and town centre exempt zones. Estimates of intervention effects on numbers of new takeaways on the periphery of management zones, and on the presence of new chain fast-food outlets within management zones, did not meet statistical significance. Our findings suggest that management zone policies were able to demonstrably curb the proliferation of new takeaways. Modelling studies are required to measure the possible population health impacts associated with this change.
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Affiliation(s)
- John Rahilly
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
- Great Ormond Street Institute of Child Health, University College London, UK
| | - Ben Amies-Cull
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Michael Chang
- Office for Health Improvement and Disparities, Department of Health and Social Care, UK
| | - Steven Cummins
- Department of Public Health, Environments & Society, Faculty of Public Health & Policy, London School of Tropical Hygiene and Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Daniel Derbyshire
- Department of Public Health and Sport Sciences, Faculty of Health and Life Sciences, University of Exeter, UK
| | - Suzan Hassan
- Department of Public Health, Environments & Society, Faculty of Public Health & Policy, London School of Tropical Hygiene and Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Yuru Huang
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Matthew Keeble
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Bochu Liu
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
- Department of Urban Planning, College of Architecture and Urban Planning, Tongji University, Shanghai, China
| | - Antonieta Medina-Lara
- Department of Public Health and Sport Sciences, Faculty of Health and Life Sciences, University of Exeter, UK
| | - Oliver Mytton
- Great Ormond Street Institute of Child Health, University College London, UK
| | - Nina Rogers
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Bea Savory
- Department of Public Health, Environments & Society, Faculty of Public Health & Policy, London School of Tropical Hygiene and Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Annie Schiff
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Stephen J. Sharp
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Richard Smith
- Department of Public Health and Sport Sciences, Faculty of Health and Life Sciences, University of Exeter, UK
| | - Claire Thompson
- School of Health and Social Work, University of Hertfordshire, UK
| | - Martin White
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Jean Adams
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Thomas Burgoine
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
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Rahilly J, Williams A, Chang M, Cummins S, Derbyshire D, Hassan S, Huang Y, Keeble M, Liu B, Medina-Lara A, Mytton O, Savory B, Schiff A, Sharp SJ, Smith R, Thompson C, White M, Adams J, Burgoine T. Changes in the number and outcome of takeaway food outlet planning applications in response to adoption of management zones around schools in England: A time series analysis. Health Place 2024; 87:103237. [PMID: 38564989 DOI: 10.1016/j.healthplace.2024.103237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 03/11/2024] [Accepted: 03/21/2024] [Indexed: 04/04/2024]
Abstract
Physical exposure to takeaway food outlets ("takeaways") is associated with poor diet and excess weight, which are leading causes of excess morbidity and mortality. At the end of 2017, 35 local authorities (LAs) in England had adopted takeaway management zones (or "exclusion zones"), which is an urban planning intervention designed to reduce physical exposure to takeaways around schools. In this nationwide, natural experimental study, we used interrupted time series analyses to estimate the impact of this intervention on changes in the total number of takeaway planning applications received by LAs and the percentage rejected, at both first decision and after any appeal, within management zones, per quarter of calendar year. Changes in these proximal process measures would precede downstream retail and health impacts. We observed an overall decrease in the number of applications received by intervention LAs at 12 months post-intervention (6.3 fewer, 95% CI -0.1, -12.5), and an increase in the percentage of applications that were rejected at first (additional 18.8%, 95% CI 3.7, 33.9) and final (additional 19.6%, 95% CI 4.7, 34.6) decision, the latter taking into account any appeal outcomes. This effect size for the number of planning applications was maintained at 24 months, although it was not statistically significant. We also identified three distinct sub-types of management zone regulations (full, town centre exempt, and time management zones). The changes observed in rejections were most prominent for full management zones (where the regulations are applied irrespective of overlap with town centres), where the percentage of applications rejected was increased by an additional 46.1% at 24 months. Our findings suggest that takeaway management zone policies may have the potential to curb the proliferation of new takeaways near schools and subsequently impact on population health.
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Affiliation(s)
- John Rahilly
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Alexandra Williams
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Michael Chang
- Office for Health Improvement and Disparities, Department of Health and Social Care, UK
| | - Steven Cummins
- Department of Public Health, Environments & Society, Faculty of Public Health & Policy, London School of Tropical Hygiene and Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Daniel Derbyshire
- Department of Public Health and Sport Sciences, Faculty of Health and Life Sciences, University of Exeter, UK
| | - Suzan Hassan
- Department of Public Health, Environments & Society, Faculty of Public Health & Policy, London School of Tropical Hygiene and Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Yuru Huang
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Matthew Keeble
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Bochu Liu
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Antonieta Medina-Lara
- Department of Public Health and Sport Sciences, Faculty of Health and Life Sciences, University of Exeter, UK
| | - Oliver Mytton
- Great Ormond Street Institute of Child Health, University College London, UK
| | - Bea Savory
- Department of Public Health, Environments & Society, Faculty of Public Health & Policy, London School of Tropical Hygiene and Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Annie Schiff
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Stephen J Sharp
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Richard Smith
- Department of Public Health and Sport Sciences, Faculty of Health and Life Sciences, University of Exeter, UK
| | - Claire Thompson
- School of Health and Social Work, University of Hertfordshire, UK
| | - Martin White
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Jean Adams
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Thomas Burgoine
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.
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O'Malley CL, Lake AA, Moore HJ, Gray N, Bradford C, Petrokofsky C, Papadaki A, Spence S, Lloyd S, Chang M, Townshend TG. Regulatory mechanisms to create healthier environments: planning appeals and hot food takeaways in England. Perspect Public Health 2023; 143:313-323. [PMID: 37572038 PMCID: PMC10683341 DOI: 10.1177/17579139231187492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/14/2023]
Abstract
AIMS To explore existing regulatory mechanisms to restrict hot food takeaway (HFT) outlets through further understanding processes at local and national levels. METHODS The Planning Appeals Portal was utilised to identify recent HFT appeal cases across England between December 2016 and March 2020. Eight case study sites were identified using a purposive sampling technique and interviews carried out with 12 professionals involved in planning and health to explore perceptions of and including factors that may impact on the HFT appeal process. Additionally, documents applicable to each case were analysed and a survey completed by seven Local Authority (LA) health professionals. To confirm findings, interpretation meetings were conducted with participants and a wider group of planning and public health professionals, including a representative from the Planning Inspectorate. RESULTS Eight case study sites were identified, and 12 interviews conducted. Participants perceived that LAs would be better able to work on HFT appeal cases if professionals had a good understanding of the planning process/the application of local planning policy and supplementary planning documents; adequate time and capacity to deal with appeals cases; access to accurate, robust, and up to date information; support and commitment from elected members and senior management; good lines of communication with local groups/communities interested in the appeal; information and resources that are accessible and easy to interpret across professional groups. CONCLUSIONS Communication across professional groups appeared to be a key factor in successfully defending decisions. Understanding the impact of takeaway outlets on health and communities in the long term was also important. To create a more robust appeals case and facilitate responsiveness, professionals involved in an appeal should know where to locate current records and statistical data. The enthusiasm of staff and support from senior management/elected officials will play a significant role in driving these agendas forward.
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Affiliation(s)
- C L O'Malley
- Centre for Public Health Research, School of Health & Life Sciences, Teesside University, Middlesbrough TS1 3BA, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK c.o'
| | - A A Lake
- Centre for Public Health Research, School of Health & Life Sciences, Teesside University, Middlesbrough, UK
- Fuse, the Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - H J Moore
- Fuse, the Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
- School of Social Sciences, Humanities & Law, Teesside University, Middlesbrough, UK
| | - N Gray
- School of Social Sciences, Humanities & Law, Teesside University, Middlesbrough, UK
| | - C Bradford
- Centre for Public Health Research, School of Health & Life Sciences, Teesside University, Middlesbrough, UK
- Fuse, the Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | | | - A Papadaki
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - S Spence
- Fuse, the Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
- Human Nutrition Research Centre, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - S Lloyd
- Fuse, the Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
- Public Health South Tees, Middlesbrough, UK
| | - M Chang
- Department of Health and Social Care, Office for Health Improvement and Disparities, London, UK
| | - T G Townshend
- Fuse, the Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
- School of Architecture, Planning & Landscape, Newcastle University, Newcastle upon Tyne, UK
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Lake AA, O'Malley C, Moore HJ. Environmental drivers of obesity: Individual willpower versus societal responsibility. NUTR BULL 2022; 47:277-281. [PMID: 36045107 DOI: 10.1111/nbu.12574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 07/06/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Amelia A Lake
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - Claire O'Malley
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - Helen J Moore
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
- School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, UK
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Zhang Y, Wen Z. Mapping the environmental impacts and policy effectiveness of takeaway food industry in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 808:152023. [PMID: 34861304 DOI: 10.1016/j.scitotenv.2021.152023] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 11/15/2021] [Accepted: 11/23/2021] [Indexed: 06/13/2023]
Abstract
The takeaway food industry, involving more than 0.4 billion consumers in China, has brought mass of packaging waste and salient environmental burden. Here we mapped the distribution of takeaway food industry across China including the industry scale, diet structure and order time based on the analysis of more than 35 million takeaway food orders. The real use situation of various packaging materials in the takeaway food industry market has been clarified. The life cycle assessment of "a piece of takeaway food delivery order" has been carried out in different regions. Results show that in addition to plastic waste generation, takeaway food industry causes more types of environmental impacts. In terms of the national resource consumption, greenhouse gases emission, water pollution and health damage risk, the top 5 ranked provinces in each accounted for 44%, 48%, 43% and 49%, respectively. Under the latest Chinese plastic pollution control policy, the industry needs to reduce 1.12 million tons of non-degradable plastic packaging by the end of 2025, and 65% of the pressure is clustered in the metropolis and provincial capitals. However, without targeted and regionally differentiated plastic pollution control policies, the environmental impact control of takeaway food industry is still ineffective. It is urgent to explore the control measures applicable to different regions. Overall, packaging reduction is more effective than material substitution.
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Affiliation(s)
- Yuting Zhang
- State Key Joint Laboratory of Environment Simulation and Pollution Control (SKLESPC), School of Environment, Tsinghua University, Beijing 100084, China; Industrial Energy Saving and Green Development Assessment Center, Tsinghua University, Beijing 100084, China
| | - Zongguo Wen
- State Key Joint Laboratory of Environment Simulation and Pollution Control (SKLESPC), School of Environment, Tsinghua University, Beijing 100084, China; Industrial Energy Saving and Green Development Assessment Center, Tsinghua University, Beijing 100084, China.
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