Keeble Matthew, Chang Michael, Derbyshire Daniel, White Martin, Adams Jean, Amies-Cull Ben, Cummins Steven, Hassan Suzan, Liu Bochu, Medina-Lara Antonieta, Mytton Oliver, Penney Tarra L, Rahilly John, Rogers Nina, Savory Bea, Schiff Annie, Smith Richard, Thompson Claire, Burgoine Thomas
MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.
Department of Marketing, Faculty of Business and Economics, University of Antwerp, Antwerp, Belgium.
Int J Health Policy Manag. 2024;13:8294. doi: 10.34172/ijhpm.8294. Epub 2024 Aug 27.
Takeaway food is often high in calories and served in portion sizes that exceed public health recommendations for fat, salt and sugar. This food is widely accessible in the neighbourhood food environment. As of 2019, of all local authorities in England (n=325), 41 had adopted urban planning interventions that can allow them to manage the opening of new takeaway outlets in "takeaway management zones around schools" (known elsewhere as "exclusion zones"). Before adoption, local authorities undertake mandatory public consultation where responses objecting to proposals can be submitted. Evidence on common objections could be insightful for practitioners and policy-makers considering this intervention.
We included 41 local authorities that adopted a takeaway management zone around schools between 2009 and 2019. We identified and analysed objections to proposals submitted by or on behalf of food retailers and local authority responses to these. We used reflexive thematic analysis with a commercial determinants of health lens to generate themes, and investigated if and how objections and responses changed over time.
We generated four themes: The role of takeaways in obesity, Takeaway management zone adoption, Use and interpretation of evidence, and managing external opinions. Despite not being implicated by the adoption of takeaway management zones around schools, planning consultants objected to proposals on behalf of transnational food retailers, however, independent takeaways did not respond. Objections attempted to determine the causes of poor diet and obesity, suggest alternative interventions to address them, undermine evidence justifying proposals, and influence perspectives about local authorities and their intervention. Objections consistently raised the same arguments, but over time became less explicit and expressed a willingness to partner with local authorities to develop alternative solutions.
Objections to local authority proposals to adopt an urban planning intervention that can stop new takeaways opening near schools featured strategies used by other industries to delay or prevent population health intervention adoption. Practitioners and policy-makers can use our findings when developing proposals for new takeaway management zones around schools. By using knowledge about their local context and addressing arguments against specific aspects of the intervention, they can pre-empt common objections.
外卖食品通常热量很高,其提供的分量超出了公共卫生对脂肪、盐和糖的建议摄入量。这类食品在社区食品环境中随处可得。截至2019年,在英格兰所有地方当局(共325个)中,有41个采用了城市规划干预措施,使其能够在“学校周边外卖管理区”(在其他地方称为“禁区”)管理新外卖店的开业。在采用该措施之前,地方当局会进行强制性公众咨询,在此期间可以提交反对提案的意见。关于常见反对意见的证据可能会对考虑实施这一干预措施的从业者和政策制定者具有启发性。
我们纳入了2009年至2019年间在学校周边采用外卖管理区的41个地方当局。我们识别并分析了食品零售商或代表食品零售商提交的对提案的反对意见以及地方当局对这些意见的回应。我们运用基于健康商业决定因素视角的反思性主题分析来生成主题,并调查反对意见和回应是否以及如何随时间变化。
我们生成了四个主题:外卖在肥胖中的作用、外卖管理区的采用、证据的使用和解读以及管理外部意见。尽管学校周边外卖管理区的采用并未涉及规划顾问,但他们代表跨国食品零售商反对提案,然而,独立外卖店并未做出回应。反对意见试图确定不良饮食和肥胖的原因,提出解决这些问题的替代干预措施,削弱支持提案的证据,并影响对地方当局及其干预措施的看法。反对意见一直提出相同的论点,但随着时间的推移变得不那么明确,并表达了与地方当局合作制定替代解决方案的意愿。
对地方当局关于采用城市规划干预措施以阻止新外卖店在学校附近开业的提案的反对意见,体现了其他行业用于延迟或阻止采用人口健康干预措施的策略。从业者和政策制定者在制定学校周边新外卖管理区的提案时可以利用我们的研究结果。通过运用关于当地情况的知识并回应针对干预措施具体方面的论点,他们可以预先排除常见的反对意见。