MRC Epidemiology UnitRetail impacts
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
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We used interrupted time series analyses to estimate the impact of takeaway management zones on changes in the number of takeaway planning applications received by LAs and the percentage they rejected. We observed an overall decrease in the number of applications received by intervention LAs at 12 months post-intervention, and an increase in the percentage of applications that were rejected at first and final decision, the latter taking into account any appeal outcomes. These proximal, process measures of effectiveness will necessarily precede any downstream retail and health impacts. Our findings suggest that management zone policies may have the potential to curb the proliferation of new takeaways near schools and subsequently impact on population health.
Changes in the number of new takeaway food outlets associated with adoption of management zones around schools: a natural experimental evaluation in England
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By the end of 2017, 35 local authorities in England had adopted takeaway management zones around schools, designed to reduce the number of new takeaways. These are sometimes referred to as takeaway “exclusion zones”. In this study, we assessed the impact of these zones on takeaways and chain fast-food outlets. Using data from up to six years before and after adoption, we found that there was a decrease in the number of new takeaways opening within management zones. Six years after the intervention, there was an 81% reduction in new takeaway openings per local authority, compared to what would have been otherwise expected. Overall, 54% fewer new takeaways opened than expected over these six years. There was no change in the number of new takeaways on the outskirts of zones, or in the presence of new chain fast-food outlets within zones. These results suggest that takeaway management zones effectively limited the growth.
Health impacts
Health impacts of takeaway management zones around schools in six different local authorities across
England: a public health modelling study using PRIMEtime
This article has been accepted for publication in BMC Medicine
In England, the number of takeaway food outlets has been growing for over two decades. Takeaway management zones around schools are an effective way to restrict new takeaway growth but their impacts on health are unknown. Here we model the impact of takeaway management zones on health outcomes, by 2040, in the adult population who were aged 25-64 years in 2018. Six local authorities (LAs) representing the urban-rural spectrum were included: Wandsworth, Manchester, Blackburn with Darwen, Sheffield, North Somerset, and Fenland. We estimated changes in exposure to takeaways (across home, work, and commuting zones) based on the assumption that 50% of new outlets were prevented from opening because of management zones and we estimated how this would translate into changes in BMI at the population level. Finally, we modelled the impact of changes in BMI, on a range of dietrelated diseases. We estimate takeaway management zones would reduce prevalence of obesity by 1.5 to 2.3 percentage points by 2040 in all LAs and lead to reductions in incidence of BMI-related diseases, the largest being in type 2 diabetes (e.g. 964 fewer cases /100,000 population for males in Manchester from 2018 to 2040). Reductions in incidence were also observed for cardiovascular diseases, certain cancers, musculoskeletal conditions and asthma. Gains in quality-adjusted life years and healthcare savings were also estimated. These results suggest that takeaway management zones around schools may be an effective population-level intervention to improve diet-related health in adults in the UK.
Economic impacts
The Economic Impacts of Local Authority Takeaway Management Zones around Schools
Hot food takeaways around schools can increase the desire and consumption of food that is typically high in fat and salt and low in nutrients. To prevent adolescents consuming this type of food, local authorities have established takeaway management zones around schools across England to limit the number of new hot food takeaways that can open. However, the economic impact of takeaway management zones on local economies are currently unknown and this intervention has been criticised by commercial and other actors for the associated potential loss of economic benefit to the local community. We estimated the future economic impacts of takeaway management zones in three local authorities (Manchester, Sheffield and Wandsworth) using financial data provided by businesses and collected in the national Annual Business Survey. With these data, we estimated the financial cost when planning permission for a new hot takeaway is refused, leading to a vacant high street premises for up to 3, 6 and 12 months before uptake of an alternative use (retail, hair and beauty and restaurants and cafes). We also accounted for healthcare savings predicted to be associated with this intervention. Our results suggest that takeaway management zones are associated with economic benefits, despite the concerns of policymakers and objections from industry regarding potential economic losses. These results are mainly explained by the relatively low economic contribution of takeaways on the high street and the relatively high economic contribution of potential alternative usages.
Planning guidance to limit hot food takeaways: understanding the possible economic impacts
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When local authorities attempt to introduce takeaway management zones, they can face objections from representatives of the takeaway industry about the potential for negative economic impacts. However, the economic impacts have not previously been studied. We developed a flowchart to provide an overview of the potential economic impacts of takeaway management zones in terms of the local business community, the local authority, the national government and the National Health Service. These potential economic impacts include changes in the local labour market in terms of the number and type of jobs available, which in turn has impacts on the government tax receipts and benefit expenditure. Other potential economic impacts include reductions in healthcare spending and reductions in sickness absence from work. Overall, this research highlights the complex nature of the potential economic impacts due to takeaway management zones.
Experiences of adoption and implementation
The adoption and implementation of local government planning regulations to manage hot food takeaways near schools in England: A qualitative process evaluation
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We spoke with public health and planning officers working within local authorities across England about their experiences adopting and implementing takeaway management zones. We were interested in finding out what problems they encountered, how they overcame these and what they thought about the effectiveness of the policy. They explained that it was important that decision-makers like councillors, planning and public health leaders were on board with the policy to help push it forward. They also reported that planning and public health teams should work collaboratively to ensure that the policy is successfully adopted and implemented. They explained that they had complementary skills and knowledge (i.e. an understanding of public health evidence, the examination and appeals process) which were important when the policy was challenged by external parties like the planning inspectorate or prospective takeaway businesses. However, this relationship was sometimes strained by the different priorities that public health and planning officers were required to meet. Sometimes, planning officers were concerned that the policy could have a negative impact on local economics, whilst public health officers were interested in the potential health benefits. To help bridge the gap between planners and public health officers, policy champions and people in specialist posts (i.e. trained in both planning and public health) were employed. We also found that local authorities did not all report adopting full management zones (i.e. where takeaways were completely denied if falling within a specific distance from a school). Some felt that they could not justify this based on the evidence they had available, whilst others were concerned about the potential that the takeaway management zone policy may negatively impact local economies. Therefore, some only included restrictions on opening times (i.e. not permitted to operate between 3-3.30pm as children travel home between these hours) or where town centres would not be subject to the policy. Having a process in place for implementing the policy and clarity in the wording and specifications of the policy helped ensure effective implementation. Whilst it was believed that the takeaway management zone policy helped refuse planning permission for takeaways, it was also explained that prospective businesses may have found other ways to operate. This included operating as restaurants or cafes with a secondary takeaway function, not subject to the policy. They also thought that the policy did not tackle the broader food environment more generally like sweet shops and bakeries which also sell unhealthy foods. Overall, our findings show that takeaway management zones can be adopted and implemented by local authorities across England. Although challenging, public health and planning officers found ways to overcome difficulties and work together. The lessons learnt in this study form the basis of our toolkit guide and can be taken forward by other local authorities who wish to adopt and implement takeaway management zones.
Business reactions
Retailer responses to the proposals for takeaway exclusion zones around schools: a longitudinal qualitative analysis of public consultations from 2009-2019
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Local authorities in England can adopt takeaway management zones near schools (referred to elsewhere as ‘exclusion zones’) to decide if, when, and where new takeaway food outlets can open. The primary aim of these zones is to improve population health, especially among young people. Between 2009 and 2019, internationally established fast-food retailers consistently objected to the adoption of takeaway management zones near schools. Fast-food retailers claimed that there was little evidence to support takeaway management zone adoption. They also made poor diet and health out to be the result of a single cause that was unrelated to the food they sold. Doing so meant that they could propose alternative interventions that would not stop them from opening new outlets in the future. The findings from our research have highlighted the ways that internationally established fast-food retailers prioritise their future development and profits over population health, especially of the next generation.
Public acceptability
Public acceptability of proposals to manage new takeaway food outlets near schools: cross-sectional analysis of the 2021 International Food Policy Study
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Imagine you were asked for your opinion about proposals from your local council to adopt takeaway management zones. Would you offer your support? Do you think they would be effective in helping people to eat better? How do you think that the zones would work? We asked these types of questions during an online survey in 2021. Here’s how over 3300 adults living across England, Scotland and Wales answered:
- More than half said they would support proposals from their local council to adopt takeaway management zones around schools.
- Less than one in ten said they would be against proposals, and about a third said that they had a neutral perspective.
- Most reported that takeaway management zones around schools would be effective in helping people to eat better.
- They typically agreed that if there were fewer takeaways near schools then other types of food outlets could open, schools would find it easier to promote healthy food and young people would eat takeaway food less often.
We’re encouraged by our findings because they suggest that adults living in Great Britain already support takeaway management zones. This could be important from a political perspective because it might mean that there will be little direct opposition from members of the public if they propose to adopt a measure that can manage if, how and when takeaways are allowed to open. In turn, this might increase local council backing for such measures. Improving the diet and health of young people is one rationale for adopting takeaway management zones near schools. Because of this, we also asked 16 and 17 year olds what they thought having fewer takeaways near schools might achieve. We used information from over 350 responses to try and better understand their perspectives. Generally speaking, the young people who answered our questions believed that if there were fewer takeaways near schools then other young people would not:
- travel to takeaways further away from school to buy the food they wanted;
- have food delivered to schools or buy unhealthy food from other places;
- necessarily eat takeaway food less often.
We’re optimistic about our findings because it might be that adopting takeaway management zones around schools would not accidentally encourage young people to seek out takeaway food from places that could have only opened further away. However, our findings indicate that young people buy takeaway food outside of school times or from places that are not near their school, meaning that we need to think about other types of food and other types of shops. We also need to think about the other ways that takeaway food can be purchased like through online food delivery service platforms. The findings from our recently published research suggest that takeaway management zones near schools would be supported by adults. However, it might be that further measures that consider the other places where we purchase food are needed.
“It does help but there’s a limit…”: Young people’s perspectives on policies that restrict hot food takeaways opening near schools
Young people are an important target population of takeaway management zone policies, yet their perspectives remain largely unexplored. In this study, we investigated young people’s (aged 11-18) views of takeaway management zones through walking interviews around the food environment near their schools. By following routes chosen by participants, starting at the school and typically leading to the nearest high street, we gained insights into their everyday food purchasing and consumption habits both within and outside the school environment. Most participants found management zones acceptable since these policies only restrict new takeaways, leaving the existing food landscape and its benefits unchanged. However, participants also believed that the impact of management zones is limited because they only focus on takeaways and do not address other food outlets, like convenience stores, which are frequently used by young people. Participants felt that simply reducing the number of new takeaways is not enough to reduce exposure to unhealthy foods. They also highlighted that inadequacies in school food and the school dining environment drive young people towards eating unhealthy foods and spending time in takeaways. Consequently, they advocated for similar governmental or Local Authority interventions within schools, as well as in the external food environment. Our findings suggest that while takeaway management zones around schools may help curb the growth of new takeaways, future policies should consider the broad range of factors influencing young people’s relationship with food to increase impact.