How are planning approaches used to promote a healthier food environment?

Exclusion zones can be used to limit the proliferation of less healthy establishments, such as hot food takeaways, within specified areas such as within proximity to schools (1), (2). In 2009, the London Borough of Waltham Forest introduced a supplementary planning document specifically to tackle the health impacts of hot food takeaways, by restricting their development in the proximity around schools (3). Other councils such as Gateshead Council have also adopted similar policies with positive impact on reducing hot food takeaway applications submitted to the council without negative effect on businesses.

Research has shown that the introduction of exclusion zones to address the proliferation of hot food takeaway establishments was the single most adopted planning policy approach to promote health in England between 2017 and 2018 (4).

Research has demonstrated the introduction of these zones can lead to reductions in number of establishments, contributing positively to reductions in outlet exposure, obesity prevalence, and incidence of diseases, and savings in healthcare costs (5). Zones can also be associated with benefit to local economies.

Takeaway management zones focus on locations often frequented by children and families. They are often located around schools, but also include parks and leisure centres (6). The coverage of the zones is usually 400 metres from a premise, which is widely accepted as a reasonable walking distance of 5 minutes (7). However, research suggests that children may travel much further than 400 metres to access hot food takeaways, leading to the suggestion that an 800-metre zone, or a 10-minute walk, may be more realistic (8), (9). This may be challenging for local planning authorities to introduce because the 400-metre zone distance is so widely adopted in practice.

The reasonable distance principle is also applicable to primary schools, even though it is acknowledged that primary school children are often not permitted out of the school grounds during the school day, and children of this age are likely to be accompanied by a supervising parent, guardian or adult during their journey to and from school. However, some primary school children, such as those in year 6 (age 10 to 11), walk to and from school on their own in preparation for the transfer to secondary school. In addition, the presence of an adult does not necessarily mean that takeaway food will not be purchased and subsequently consumed by children.

There have been examples where planning permission applications for hot food takeaways have been submitted just outside of the 400-metre zone, resulting in difficulty for local planning authorities to apply the exclusion policy despite public health concerns. Therefore, it may be appropriate to restrict hot food takeaway just beyond the 400-metre zone, subject to local circumstances, including:

• Prevalence of childhood obesity (and trends)
• Mapping of the main school routes used by the majority of children in the area
• Density of the existing food retail uses in the area

It is important to appreciate that planning measures to promote a healthier food environment should be considered as part of a long-term, whole systems approach to bring about long-term health outcomes in improving the health of adults and children (5).