Friday, 27 July 2018

Do councils have what they need to help tackle obesity?

Guest post by Michael Chang, Project and Policy Manager, Town & Country Planning Association

The new revised National Planning Policy Framework (NPPF) is published by the Ministry for Housing, Communities and Local Government this week (24 July). It now provides the policy basis for planning healthy communities (Section 8 Paragraphs 91 and 92). In this context, here I want to explore whether there are enough planning powers to successfully tackle fast food outlets. At a Fuse event earlier this year on ‘Planning for Healthier diets: restricting hot food takeaway proliferation’, I also highlighted interesting results of recent planning policy developments and planning appeal decisions.

Back to the future… again?

Firstly it should be stated that concerns about the physical built environment and food environment in relation to people’s health and wellbeing are not a new trend. There has long been an understanding (with increasing supporting academic evidence) of the negative implications of food deserts and extant planning policies to tackle the negative environmental impacts from food outlets such as smells, noise, opening hours, litter and traffic generation.

The Foresight Tackling Obesities report was published in 2007 which, in the context of addressing the issue through a whole system approach, suggested two actions in which urban planners can effect change in the living environment, one of which refers to food and drink access and availability[1]. But a year earlier, the Royal Commission on Environmental Pollution, an independent standing body established in 1970 to advise the Queen, the Government, Parliament and the public on environmental issues, had already highlighted availability and cost of healthy food as an environmental determinant to cardiovascular risk in its seminal 26th report on The Urban Environment[2].

Is there an enabling policy environment to tackle obesity?

Given the weight of evidence, research and high-level recommendations in the last decade, in 2018, do planning practitioners working in local authorities have the right policy tools to do something about it? The main indicator is whether local plans, which each local authority across England have created, have the right policies? Local plans are powerful because in addition to setting out the council’s long-term vision and pathway for creating sustainable local communities, they are the basis with which decisions on planning applications are made from extensions to your house, to opening new shops on the high street to the creation of a complete new neighbourhood.

CEDAR (Centre for Diet and Activity Research) will publish more extensive results on local plans and fast food outlet policies so I will focus on the wider issue of tackling obesity. As part of the Planning Healthy Weight Environment work in 2014[3], the Town & Country Planning Association (TCPA) undertook an extensive policy review of local plans in England. Forty-one percent (41%) did reference obesity but generally only in the introductory paragraphs where they identified that obesity was a problem in the area. Only 17% followed through to the policy sections, but always in the supporting text rather than in the policy text. In statutory Joint Health and Wellbeing Strategies, only 31% make specific links to the built environment as one of the wider determinants of obesity. 

There is no reason, if supported by evidence and needs assessment, for councils not to have relevant policies such as on active travel, open space and food environment with a specific objective to help reduce local obesity rates. Recent planning inspector reports on draft local plans, before they are approved by councils, indicate a growing positive picture of a more welcoming stance on restricting fast food outlet policies including greater acceptance of the exclusion zone approach.

Have planning appeal decisions been favourable?

How are councils actually faring when they apply these policies in defending their decisions to refuse planning permission for new fast food outlets? The picture is more mixed with some councils successfully defending their decisions while many others have their decisions overturned by planning inspectors. The justifications by planning inspectors are not as you might expect.

"...this is politics, it's not medicine..." - 24 TV series
To illustrate the way planning appeals have been decided for and against planning applications for new fast food takeaways, take for example a scene from the hit American drama ‘24’. President Palmer’s advisor Wayne Palmer said to the President’s doctor Anne Packard: “It’s he said, she said, you see this is politics, it’s not medicine, so do me a favour and stay out of it”. 

Most, if not all the recent judgements I have seen (but there would need to be a more systematic review), do reference national guidance and support the obesity crisis as a valid planning reason. The health and medical arguments appear to have been won, but other wider considerations including local ‘political’ issues come into play and only evidence presented on the day are valid. This scene underlies the tension in planning decisions, which is why in its three reports into the government’s Childhood Obesity Plan in the last three years, the Health and Social Care Select Committee[4] has consistently called for health to be a material planning consideration in an arena of competing considerations from economic to employment.

What does this all means?

There needs to be more research done in the area to better understand the implications of proliferation of fast food outlets on population health from the health inequalities lens. There also needs to be more applied research to understand why practitioners could not effectively implement policies and what the real barriers are. Evidence and aspiration can only go so far. It is time we all take a breather from pursuing perfect evidence to properly supporting practitioners at the coal-face.

Michael Chang is a Chartered Town Planner at the Town and Country Planning Association (TCPA), leads on TCPA’s Reuniting Health with Planning Initiative and currently undertaking a part time Master by Research at Leeds Beckett University on using planning powers to promote healthy weight environments.

  1. Foresight, 2007, Tackling Obesities: Future Choices:  
  2. Royal Commission on Environmental Pollution (RCEP), 2006, The Urban Environment:
  3. Town & Country Planning Association (TCPA), 2014, Planning Healthy-weight environments:
  4. Health and Social Care Select Committee, Childhood obesity inquiries reports 2015, 2017 and 2018: 

  1. "318-365 Year3 On Our Way Home" by John Garghan via, copyright © 2011:
  2. By The original uploader was Tuxo at German Wikipedia. [Public domain], via Wikimedia Commons:

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