Deprivation and obesity: the influence of fast-food outlet density Presenter: Rhys Gibbon, Public Health Wales Noddir gan Sponsored by

Fast-food and takeaway outlets investigation Aim To investigate, in Wales, the association between takeaway outlets, deprivation and obesity previously observed in England (Tedstone 2016). Obesity and overweight are major public health issues and exhibit a clear association with deprivation According to the WG: 65% in the most deprived areas, 53% in the least deprived areas are overweight or obese An excess of takeaways in more deprived areas may have important implications for obesity prevention efforts and local authority planning. The food environment, including Fast Food Take away Outlets may contribute to this An excess of takeaways in more deprived areas may have important implications for obesity prevention efforts and local authority planning The issue of takeaways, deprivation and obesity has been raised in the Senedd High on the political and Health agenda- linking to two principles of prudent healthcare: the (potential) co-production of solutions and the provision of care for those with the greatest health need (Bevan Commission 2015). Healthy weight in adults is part of a Well-being of Future Generations Act indicator (Welsh Government 2016). Rhys Gibbon Advanced Public Health Intelligence Analyst

Method Counts of takeaways for Lower Super Output Areas in Wales were obtained from the Points of Interest dataset, produced by OS- it holds a record of each commercial property in the country, categorising them appropriately Using a GIS, we were able to map these properties to an LSOA and assign a deprivation score using the 2015 WIMD We were also further able to assign a population estimate using the ONS SAPE and estimate BMI using the WHS (2013-2015) for national fifths of deprivation From these we were able to count takeaways by LSOA and count them by deprivation fifth and BMI

Weight by deprivation (%) Obesity followed a steep gradient from the least to the most deprived. There was less variation in overweight but it was most common in the less deprived fifths.  

Number of takeaways per 100,000 population All forms of takeaways were more common in the two most deprived fifths and were three to four times higher than in the least deprived fifth.   There were no takeaways in 75% of the least deprived LSOAs compared to 45% of most deprived fifth LSOAs. One in twenty LSOAs in the most deprived fifth had 10+ takeaways compared to one in four hundred LSOAs in the least deprived fifth.

% obese by number of takeaways, most deprived fifth only However, the proportion of the population of the most deprived fifth who were overweight did not vary much by density of FFTO -but varied considerably for obesity with areas with no takeaways having much higher levels of obesity than areas with 6+ FFTO Conclusion: Whilst it appears true that takeaways and obesity are most common in deprived areas, the inverse association between takeaways density and obesity within the most deprived fifth indicates a more complicated picture. Deprived areas may be more likely to include commercially attractive characteristics, such as busy thoroughfares, or rather that housing in areas with such characteristics are more affordable and hence attract a different demographic. This research indicates greater insight into this issue is required as it is inconclusive whether proximity to takeaways is the cause of higher levels of obesity.