Planning joins the obesity fightback

Planning, 25 July 2008

The part that planners can play in promoting healthy lifestyles and tackling obesity has become a prominent issue. The National Institute for Health and Clinical Excellence (NICE) and the Department of Health (DoH) have both released documents linking the physical environment with the health agenda.

The NICE guidelines are directed at all professionals whose remit includes the built or natural environment. The institute describes its publication as the first national, evidence-based recommendations on how to improve the physical environment to encourage physical activity to improve health.

The DoH's Healthy Weight, Healthy Lives - A Cross-Government Strategy for England covers issues surrounding food labelling, vouchers and weight loss incentives. But the document goes further in seeing the obesity trend being tackled through a broader range of strategies such as town planning.

The environmental influences on obesity have been on the research agenda for some time. In 2002, Swinburn and Egger defined the obesogenic environment as "the sum of influences that the surroundings, opportunities or conditions of life have on promoting obesity in individuals or populations". This has obvious implications for planners.

Obesogenic environments are considered to be one of the driving forces behind today's escalating obesity epidemic. The analysis grid for environments linked to obesity, defined by Swinburn and colleagues, describes four categories. These are physical, political, socio-cultural - covering attitudes and beliefs - and economic. Building on this work, research at Newcastle University suggests that it may be useful to think of these environments operating at different scales.

These can be broken down into three categories, it suggests. Micro-environments include schools, workplaces and the home environment. Meso-environments cover the neighbourhoods around homes and workplaces such as shopping areas, while the macro-environment includes policy, the media, education and transportation and health systems.

The two documents could be described as tackling obesity at the micro, meso and macro-environmental levels. The DoH strategy includes a map of the major sectors that have a role to play - from individuals and families through to the food industry, public transport, planning and town planners.

The obesity problem is complex and the solutions need to be multidisciplinary. It requires professionals to cross traditional boundaries and develop partnerships.

- Amelia Lake is a NICE post-doctoral fellow at Newcastle University's human nutrition research centre. Tim Townshend is a senior lecturer at the university's global urban research unit. Their paper "Obesogenic Environments - Exploring the Built and Food Environments" appeared in the Journal of the Royal Society for the Promotion of Health 2006, 126:262-267.