Lack of available healthy food in cities combined with junk food advertising is setting children up to live “shorter and unhealthier” lives, England’s Chief Medical Officer Professor Sir Chris Whitty has said in his annual report, which suggests a tax on junk food to improve the health of the urban poor.
The wide-ranging report into the urban landscape and public health, released on Thursday, urges the government to do more to tackle what Whitty terms “healthy food deserts” in cities, which the report finds is a major cause of unhealthy eating.
Whitty, who became a well-known and controversial figure during the COVID-19 lockdown era, also points to the cost of food as a key factor impacting poorer people the most, finding that per calorie, healthy food “is almost twice as expensive as unhealthy food.”
Children and families in inner city areas are less likely to have access to healthy, affordable food choices in local shops, restaurants, and takeaways, and are “disproportionately exposed to unhealthy food advertising,” the 430-page report finds.
Four out of five outdoor billboards in England and Wales are in poorer areas, with many advertising junk food, while poorer regions are often “saturated with fast-food outlets,” both physically and online, the study found.
Targeted Food Taxes
Whitty said that businesses must be made to play a part in encouraging healthier eating habits, with proposed solutions including healthy food sales targets, 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, finding that “meaningful change to food environments is possible.”
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 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, Whitty said.
A number of different 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.
Supermarkets and shops, especially those where families on lower incomes shop, are often “saturated” with unhealthy food choices, which the report found was exacerbating health inequalities.
Health Inequalities
“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,” it said.
The report added that the most deprived fifth of the population would need to spend half of their disposable income on food to meet the cost of the government-recommended healthy diet, compared with just 11 percent for the wealthiest 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.”
Chief Medical Officer Sir Chris Whitty photographed giving a media briefing during the COVID-19 lockdown era. Jack Hill/The Times/PA
The report also looks at how food is produced in the UK, finding that almost as much land is dedicated to growing sugar (110,000 hectares) as to growing all of the nation’s vegetables combined (116,000 hectares).
Humans are “genetically wired to crave calorie-rich food,“ Whitty said, 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.”
Advertising Ban
Other measures suggested to improve the nation’s health include promoting “active travel” in cities so people use cars less, as well as tackling air pollution and reforming local health services to better serve communities.
Whitty 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.”
The government announced a pre-watershed ban on TV advertising of junk food earlier this month, with restrictions due to come into effect in October 2025.
The legislation will also impose a 24-hour restriction on paid-for online advertising for the same products, with the aim of removing 7.2 billion calories annually from children’s diets.
The latest survey by the NHS found that around one in eight children aged 2 to 10 in England are obese.
As well as looking at diet and obesity levels, Whitty’s report looks at other public health issues, such as problems with housing, disease, the threat of epidemics, and declining vaccination rates in cities.
The annual report is designed to give recommendations to the government, and although it is not binding it has led to policies such as the sugar tax on soft drinks in 2018, brought in by the Conservatives with the support of Labour.
Critics argue that that such taxes disproportionately impact the poor, because the higher price of healthier food and other factors mean poorer people are likely to consume more junk food.
In a recent article, published in PLOS Medicine, two academics argued that less affluent people could be negatively impacted by blanket health warnings about so-called “ultra-processed foods” without more scientific evidence.
Professor Eric Robinson of the University of Liverpool, one of the authors, said: “Foods classed as ultra-processed which are high in fat, salt and/or sugar should be avoided, but a number of ultra-processed foods are not.
“We should be thinking very carefully about what advice is being given to the public, as opposed to providing simplified and potentially misleading messages that grab headlines.”
