Evaluating HFSS ad restrictions: health, economic, and inequality impacts in Newcastle

Abstract

Restricting advertising of foods high in saturated fat, sugars, and salt (HFSS) is a promising strategy to reduce exposure to unhealthy food marketing, lower energy intake, and prevent obesity and related non-communicable diseases. However, evidence on the effectiveness of local government–led advertising policies remains limited, particularly in translating assumed reductions in calorie consumption into downstream health and economic outcomes. This study examines current HFSS advertising exposure within Newcastle and models the impact of two policy options: banning HFSS adverts within 500m of schools and banning HFSS adverts across all local authority-owned spaces. Externally derived estimates of calorie intake reduction are applied to explore variation in health, economic, and equity impacts. We adapted an established microsimulation model (HEALTHEI) to estimate the health, and equity impacts of local HFSS advertising restrictions. The model simulates the life course of individuals aged ≥5 years, projecting obesity-related outcomes including type 2 diabetes, cardiovascular disease, and mortality based on BMI-driven metabolic risk trajectories. Policy effects are incorporated as reductions in energy intake, scaled according to local advertising density and translated into changes in body weight. BMI is assumed to gradually return to baseline over four years. Outputs include changes in BMI, quality- adjusted life years (QALYs), NHS costs, and their distribution across socioeconomic groups. Preliminary findings suggest that a local authority–wide advertising ban produces greater benefits than a 500m school-based restriction. Areas with higher advert density, predominantly more deprived neighbourhoods, experience larger health gains, indicating potential to reduce health inequalities. These findings provide locally relevant evidence to inform equitable public health policy.