Changes in the number of new takeaway food outlets associated with adoption of management zones around schools: A natural experimental evaluation in England

IF 3.1 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Ssm-Population Health Pub Date : 2024-03-19 DOI:10.1016/j.ssmph.2024.101646

John Rahilly , Ben Amies-Cull , Michael Chang , Steven Cummins , Daniel Derbyshire , Suzan Hassan , Yuru Huang , Matthew Keeble , Bochu Liu , Antonieta Medina-Lara , Oliver Mytton , Nina Rogers , Bea Savory , Annie Schiff , Stephen J. Sharp , Richard Smith , Claire Thompson , Martin White , Jean Adams , Thomas Burgoine

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Abstract

By the end of 2017, 35 local authorities (LAs) across England had adopted takeaway management zones (or “exclusion zones”) around schools as a means to curb proliferation of new takeaways. In this nationwide, natural experimental study, we evaluated the impact of management zones on takeaway retail, including unintended displacement of takeaways to areas immediately beyond management zones, and impacts on chain fast-food outlets. We used uncontrolled interrupted time series analyses to estimate changes from up to six years pre- and post-adoption of takeaway management zones around schools. We evaluated three outcomes: mean number of new takeaways within management zones (and by three identified sub-types: full management, town centre exempt and time management zones); mean number on the periphery of management zones (i.e. within an additional 100 m of the edge of zones); and presence of new chain fast-food outlets within management zones. For 26 LAs, we observed an overall decrease in the number of new takeaways opening within management zones. Six years post-intervention, we observed 0.83 (95% CI -0.30, −1.03) fewer new outlets opening per LA than would have been expected in absence of the intervention, equivalent to an 81.0% (95% CI -29.1, −100) reduction in the number of new outlets. Cumulatively, 12 (54%) fewer new takeaways opened than would have been expected over the six-year post-intervention period. When stratified by policy type, effects were most prominent for full management zones and town centre exempt zones. Estimates of intervention effects on numbers of new takeaways on the periphery of management zones, and on the presence of new chain fast-food outlets within management zones, did not meet statistical significance. Our findings suggest that management zone policies were able to demonstrably curb the proliferation of new takeaways. Modelling studies are required to measure the possible population health impacts associated with this change.

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与学校周边管理区的采用有关的新外卖食品店数量变化：英格兰自然实验评估

截至 2017 年底，英格兰已有 35 个地方政府（LA）在学校周围设立了外卖管理区（或称 "禁区"），以此来遏制新外卖的扩散。在这项全国范围的自然实验研究中，我们评估了管理区对外卖零售业的影响，包括外卖店意外迁移到管理区以外的地区，以及对连锁快餐店的影响。我们采用不受控制的间断时间序列分析方法，估算了学校周边外卖管理区采用前后长达六年的变化情况。我们评估了三项结果：管理区内新增外卖店的平均数量（以及三个已确定的子类型：全面管理区、镇中心豁免管理区和时间管理区）；管理区外围（即管理区边缘额外 100 米范围内）的平均数量；以及管理区内新增连锁快餐店的数量。在 26 个洛杉矶地区，我们发现在管理区内新开设的外卖店数量总体上有所减少。在干预措施实施六年后，我们观察到每个洛杉矶市新开设的外卖店数量比没有干预措施时少了 0.83 家（95% CI -0.30，-1.03），相当于新开设外卖店数量减少了 81.0%（95% CI -29.1，-100）。在干预后的六年时间里，新开外卖店的数量比预期减少了 12 家（54%）。如果按政策类型进行分层，全面管理区和城镇中心豁免区的效果最为显著。对管理区外围新开外卖店数量以及管理区内新开连锁快餐店数量的干预效果估计没有达到统计学意义。我们的研究结果表明，管理区政策能够明显抑制新外卖店的激增。需要进行模型研究，以衡量这一变化可能对人口健康产生的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ssm-Population Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

6.50

自引率

2.10%

发文量

298

审稿时长

101 days

期刊介绍： SSM - Population Health. The new online only, open access, peer reviewed journal in all areas relating Social Science research to population health. SSM - Population Health shares the same Editors-in Chief and general approach to manuscripts as its sister journal, Social Science & Medicine. The journal takes a broad approach to the field especially welcoming interdisciplinary papers from across the Social Sciences and allied areas. SSM - Population Health offers an alternative outlet for work which might not be considered, or is classed as ''out of scope'' elsewhere, and prioritizes fast peer review and publication to the benefit of authors and readers. The journal welcomes all types of paper from traditional primary research articles, replication studies, short communications, methodological studies, instrument validation, opinion pieces, literature reviews, etc. SSM - Population Health also offers the opportunity to publish special issues or sections to reflect current interest and research in topical or developing areas. The journal fully supports authors wanting to present their research in an innovative fashion though the use of multimedia formats.