Public Health Res (Southampt). 2026 Jul;14(19):1-36. doi: 10.3310/GJTB1721.
ABSTRACT
BACKGROUND: Takeaway food outlets (‘takeaways’) sell hot food for consumption off the premises. Takeaway management zones are areas around schools where new takeaways are not allowed to open. They are the most common planning intervention targeting takeaways across local authorities in England to date. We conducted an evaluation of these zones to: model their impact on adult health model their associated economic costs and benefits explore their acceptability and perceived effectiveness among young people investigate support and perceived effectiveness among adults explore barriers to and facilitators of their adoption and implementation among local authority staff.
DATA AND METHODS: We used a forecast of takeaway growth and a statistical model to estimate the impact of zones on diet-related health outcomes, quality-adjusted life-years and healthcare costs to 2040. We did this for adults aged 25-64 years in six different local authorities. We conducted a linked economic analysis to understand the future costs and benefits of zones to local authorities, the National Health Service and national government. We estimated costs when denial of planning permission results in a 3-, 6- or 12-month vacancy before alternative retail uptake. We asked 46 young people about how acceptable they thought the policy was. By conducting ‘go along’ interviews, we gained insights into their everyday food habits within and outside the school gates. We used survey data to understand public acceptability and perceived effectiveness of zones. We also asked whether having fewer takeaways near schools could reduce how often young people consume takeaway food. To evaluate adoption and implementation, we interviewed 29 local authority public health and planning officers about what lessons they had learned.
RESULTS: Compared to no intervention, future reductions in takeaway exposure ranged from 3 outlets/person in Fenland to 28 outlets/person in Manchester. Obesity prevalence was reduced in both sexes in all local authorities, for example, in Manchester, by 2.3 percentage points for males. We observed reductions in disease incidence, for example, in Manchester, by 964 type II diabetes cases/100,000 males. Zones produced a positive net economic impact of, for example, £8.49-12.78M in Manchester. Despite objections on economic grounds, zones are associated with economic benefits for local authorities, the National Health Service and national government. Young people found zones to be acceptable and perceived them to have some positive impacts. But, a wider policy, including other types of outlets selling convenience food, may better limit dietary risk. Out of 3323 adults, 51% supported zone adoption. Almost three-quarters believed that zones would help young people to eat better. Among those aged 16-17 years, 33% agreed that young people would consume takeaway food less often if there were fewer takeaways near schools. Effective working relationships between local authority colleagues were important for adoption and implementation. Some local authorities ensured this by developing cross-departmental roles and policy ‘champions’. A formal implementation process ensured confidence and consistency in implementation.
CONCLUSIONS: Takeaway management zones around schools were forecast to reduce obesity prevalence and disease incidence by 2040, with no net economic costs. The public see zones as acceptable and potentially effective. However, the reality of adopting and implementing zones is challenging, while other aspects of food retail also influence the behaviours of young people.
FUNDING: This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR130597.
PMID:42518263 | DOI:10.3310/GJTB1721
