Healthy “food deserts” in cities combined with junk food advertising is setting children up to live “shorter and unhealthier” lives, Professor Sir Chris Whitty has said in his annual report.
The study from England’s chief medical officer urges the Government and local policymakers to tackle the root causes of unhealthy eating in England’s cities, including the high availability of foods rich in fat, sugar and salt and the fact that, per calorie, healthy food “is almost twice as expensive as unhealthy food”, affecting poorer families the most.
The report said children and families in inner-city areas are less likely to have access to healthy, affordable food options in local shops, restaurants and takeaways and are “disproportionately exposed to unhealthy food advertising”.
Four out of five outdoor billboards in England and Wales are in poorer areas and “many of these are advertising junk food”, while poorer regions are often “saturated with fast-food outlets physically and online”, the study found.
Sir Chris said “meaningful change to food environments is possible”, with solutions including healthy food sales targets for businesses, specific taxes on unhealthy foods, and making it mandatory rather than voluntary for firms to report on what types and volumes of food they sell.
“Such measures could level the playing field for large industry actors, pave the way for progressive business and improve accountability for those who hold huge influence over children’s health,” the report said.
Research highlighted in the study shows that, for seven of the 10 biggest global food and drink businesses operating in the UK, more than two-thirds of their packaged food and drink sales came from products that are classed as high in fat, sugar or salt.
While “past and present governments have recognised the importance of reformulating the recipes of food and drink options to reduce the amount of fat, salt and sugar in products”, the “failure to mandate this approach” and instead leave it up to industry has led to a lack of meaningful progress.
Expert groups are quoted in the report, with solutions including an “excess profits” tax on retailers or producers of products with high sugar and salt content.
The report said the places people shop, especially families on lower incomes, are often “saturated” with unhealthy food choices.
“This means that food-related ill health is not experienced equally by children, families and communities across the country, with children and families living in more deprived areas more acutely affected by a food system where the unhealthy options are often the most available.”
The report added that the most deprived fifth of the population would need to spend 50% of their disposable income on food to meet the cost of the Government-recommended healthy diet, compared with 11% for the least deprived fifth.
It said: “The food environment in parts of cities entrenches inequalities in health and promotes obesity.
“Healthy food deserts combine with junk food advertising to set children and adults up to live a shorter and unhealthier life through obesity and the diseases it causes, particularly in the more deprived areas of our cities.”
Sir Chris said “calorie-dense, processed food… makes up the majority of our modern diets”, adding: “In fact, we dedicate almost as much land to growing sugar (110,000 hectares) as we do to growing all of the rest of the UK’s vegetables (116,000 hectares).”
Humans are “genetically wired to crave calorie-rich food” so it is “unwise to think we can rely on education and willpower alone to curb our appetites and to prevent the many diet-related diseases that constitute some of the biggest threats to public health”.
Other topics in the report included promoting “active travel” in cities so people can rely less on cars, tackling air pollution and how health services need to be adaptable to better serve residents.
Sir Chris said: “Cities provide great opportunities for a healthier life but many, especially in areas of deprivation, have poor access to healthy food choices, exercise and are exposed to air pollution. These are soluble problems.”
Anna Garrod, director of policy at Impact on Urban Health, which is part of the Guy’s & St Thomas’ Foundation, said: “Access to healthy, affordable food shouldn’t depend on your postcode, yet many children and families living in cities face significant barriers to accessing nutritious food, worsened by factors such as poverty and structural racism.
“The CMO’s (chief medical officer’s) report highlights clear pathways for policymakers, the food industry, and communities to come together, to reshape urban food environments so that nutritious options flow into every neighbourhood.”
