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Why the planning system and planners are critical to stop an increasingly obese nation during post-Covid-19 recovery

Takeaways / iStock-1232401725

Planning for a healthier food environment is a win-win for everyone, argues Dr Alison Tedstone

The obesity crisis continues to pose national and local challenges - we all need to act now. The impact of obesity is felt by individuals, their families, the health system, local authorities and wider society. All professions including planners, transport planners and environmental health officers need to recognise that tackling obesity is everybody’s business.

At its simplest level obesity is caused by consistently consuming more calories than we need. However, the drivers of this are complex and include environmental, behavioural, biological and societal factors. Although obesity is common in all groups of the population, prevalence is particularly high for lower socioeconomic groups and some ethnic minorities.

Although there are many causes of excess calorie consumption, addressing the impact of the food retail environment has received less policy attention and action than other measures. But some of the other land use actions needed to address causes of obesity are also within the remit of the planning system, including improving opportunities in active travel and green space access.

Takeaway foods tend to contain higher levels of overall fat, saturated fats, sugar and salt, and have bigger portion sizes, but can represent an appealing low-cost option to the consumer. Evidence shows 20-25 per cent of an adult’s calorie intake now comes from out of home food businesses including deliveries and takeaways. Research shows people who live or work near a greater number of takeaways are more likely to eat more takeaway food and to be overweight. It also shows that takeaway premises are more prevalent in more deprived local authorities than less deprived. Taking action to prevent neighbourhoods from becoming unsustainably saturated with less healthy food premises will help decrease obesity prevalence and ultimately obesity-related ill health.

How land use planning affects people’s dietary options

Just as the focus of the planning system is not to approve housing of poor quality, it should also not allow a proliferation of new less healthy food premises, particularly where they are likely to impact on people with poorer health outcomes. Decisions made by planners and businesses influence the degree to which location and density of premises can affect how people make choices around food and nutrition.

The principle of using planning to tackle the environmental determinants of obesity is established in the National Planning Policy Framework and the Planning Practice Guidance since 2017. Planning can play a role where it is demonstrated by the local evidence from public health teams, usually from the statutory Joint Strategic Needs Assessment and as part of wider local authority actions from the Joint Health and Wellbeing Strategy.

There are examples where actions are being taken across all tiers of the planning system from spatial development strategies (SDS) to neighbourhood plans when properly supported by the wealth of evidence. For example, the Liverpool City Region Combined Authority’s SDS is proposing a policy approach to restrict new hot food takeaways in locations where obesity levels are high or near where children and young people congregate, such as schools, community centres and playgrounds.

Planners are working with the local authority directors of public health and their public health teams as exemplified through the Childhood Obesity Trailblazer programmes. For example, planners in Blackburn with Darwen Council are testing the use of existing planning powers such as granting personal permissions for individual businesses.

How planners can support national and local efforts

I believe having a pragmatic and evidence-based approach to planning for a healthier food environment is a win-win for everyone. The following key messages for planners are based on PHE guidance:

  • Policy planners can work with public health professionals to create proportional and locally specific policies on access to healthier food and retail offer when drawing on the local evidence base.
  • Development management planners can make positive planning decisions to help people make healthier choices.
  • Planning inspectors can recognise the significant preparatory work of local authorities to be consistent in their approaches to Examinations and appeals.
  • Planning consultants can advise their clients of the importance and financial benefits of investing in a healthier and more diverse retail offer.

Dr Alison Tedstone is chief nutritionist in the diet, obesity & physical activity division of Public Health England.

Image credit | Dr Alison Tedstone, iStock (top)


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