The built environment and child obesity: A review of Australian policies

Anna Henry; Leanne Fried; Andrea Nathan; Gursimran Dhamrait; Bryan Boruff; Jasper Schipperijn; Donna Cross; Ben Beck; Gina Trapp; Hayley Christian

doi:10.1111/obr.13650

. 2023 Oct 7;25(1):e13650. doi: 10.1111/obr.13650

The built environment and child obesity: A review of Australian policies

Anna Henry ¹, Leanne Fried ¹, Andrea Nathan ¹, Gursimran Dhamrait ^1,², Bryan Boruff ³, Jasper Schipperijn ⁴, Donna Cross ^1,², Ben Beck ⁵, Gina Trapp ^1,², Hayley Christian ^1,^2,^✉

PMCID: PMC10909561 PMID: 37804083

Summary

Child obesity is a serious public health challenge affected by both individual choice and societal and environmental factors. The main modifiable risk factors for child obesity are unhealthy eating and low levels of physical activity, both influenced by aspects of the built environment. Coordinated government policy across jurisdictions, developed using strong research evidence, can enable built environments that better support healthy lifestyles. This study reviewed current Australian and Western Australian government policies to understand if and how they address the impact of the built environment on child obesity, physical activity, sedentary behavior, and diet. Current government policy documents related to the built environment and child health were analyzed using the Comprehensive Analysis of Policy on Physical Activity framework. Ten Australian and 31 Western Australian government policy documents were identified. Most referred to the role of the built environment in supporting physical activity. Very few policies mentioned the built environment's role in reducing sedentary behaviors, supporting healthy eating, and addressing obesity. Few recognized the needs of children, and none mentioned children in policy development. Future government policy development should include the voices of children and child‐specific built environment features. Inter‐organizational policies with transparent implementation and evaluation plans are recommended.

Keywords: built environment, child, healthy eating, obesity, physical activity, policy, sedentary behavior

1. INTRODUCTION

Child obesity is one of the most serious public health challenges of the 21st century. ¹ It affects many countries, particularly in urban settings, and the prevalence has increased at an alarming rate. ² Globally, the number of overweight children under the age of five is estimated to be 39 million ³ with 340 million children aged 5–19 years identified as overweight. ⁴ Overweight children are more likely to experience obesity as adults, experience psychological comorbidities and various emotional and behavioral disorders, ⁵ and have an increased incidence of diabetes, coronary heart disease, and some cancers in adulthood. ⁶

The social‐ecological framework ⁷ highlights that a supportive neighborhood built environment is important for providing children with cues, opportunities, and infrastructure for encouraging physical activity and healthy eating that are key modifiable risk factors for preventing child obesity. Government policies associated with agricultural production, transport, urban planning, the environment, food processing, distribution and marketing, and education direct pathways through which the built environment can influence the modifiable risk factors for child obesity. ⁸

From a public health perspective, a key population‐wide opportunity for children's physical activity is active school transport. Yet, in many countries, rates of active school transport are low. ⁹ For example, fewer Australian children currently walk and cycle to school than ever before, with rates declining from 75% to 25% over the past 40 years. ¹⁰ Living close to school, mixed‐use neighborhoods (e.g., co‐location of houses, shops, and schools) ¹¹ , ¹² , ¹³ , ¹⁴ and street connectivity (with traffic calming measures) ⁸ , ¹⁵ , ¹⁶ , ¹⁷ , ¹⁸ , ¹⁹ , ²⁰ are positively associated with children's active school transport and physical activity. Other built environment features associated with increased physical activity in children include neighborhood esthetics (e.g., presence of trees, interesting features to look at, and appealing parks ²¹ , ²² ) and attributes of the home yard (e.g., yard size and play equipment). ²³ While there is evidence of the built environment features associated with children's physical activity, ⁸ , ¹¹ , ¹² , ¹³ , ¹⁴ , ¹⁵ , ¹⁶ , ¹⁷ , ¹⁸ , ¹⁹ , ²⁰ , ²¹ , ²² , ²³ , ²⁴ little is known about the role of government policy environment in influencing characteristics of the built environment that can impact on children's physical activity. Furthermore, some relationships between the built environment and physical activity are different for children compared with adults. ²⁵ For example, higher street connectivity and density support more active transport in adults ²⁶ ; however, these neighborhoods often have higher levels of traffic and can lead to safety issues that can reduce children's active transport, ¹⁶ , ²⁷ independent mobility, ²⁸ and unstructured play. ²⁹ Built environment‐related government policies need to consider the different impact the built environment can have on children, compared with adults.

Children's dietary behaviors are also shaped by the food environment ³⁰ , ³¹ and the policies that influence it. Convenience store access is associated with children's unhealthy dietary behaviors. ³² The availability of fast‐food outlets near secondary schools has also been shown to be significantly associated with increased frequency of unhealthy food and beverage purchasing by Australian children. ³³ , ³⁴ , ³⁵ Additionally, children's exposure to unhealthy food and beverage advertising influences food preferences and food purchases, contributing to poor dietary intake. ³⁶

Given the multiple ways through which government policy can influence the built environment, it is important we understand the context, content, and pathways through which built environment‐related policy can impact child obesity. Such information could guide the development of new or review of existing built environment‐related policies to better support children's physical activity and healthy eating. For example, policies that prevent the location of fast‐food outlets near schools have potential to be key policy strategies for preventing child obesity. ³⁷ , ³⁸ , ³⁹ , ⁴⁰

Little research has explored if and how built environment‐related government policies target obesity prevention in children. In particular, it is unclear in the Australian setting, to what extent features of the built environment known to influence child obesity are considered in government policies. This research investigated how Australian and Western Australian government policies related to the built environment addressed the health of children (0–17 years) through the built environment's influence on obesity and modifiable risk factors for obesity, physical activity, sedentary behavior, and diet. The aims of this review were to understand (i) the extent to which children are included in Australian and Western Australian government policies related to the built environment; (ii) the extent to which the built environment is specifically targeted in these policies; (iii) if and to what extent these policies are based on empirical evidence of the influence of the built environment on child obesity; and (iv) how these policies address the impact of the built environment on child obesity.

2. METHODS

2.1. The BEACHES project

The Built Environments And Child Health in WalEs and AuStralia (BEACHES) study aims to identify and understand how complex and interacting factors in the built environment influence modifiable risk factors (body mass index, physical activity, sedentary behavior, and diet) for non‐communicable disease across childhood. ⁴¹ It is an observational study using data from five established cohorts from Wales and Australia. The first phase of the BEACHES project involves engaging with stakeholders to undertake a policy landscape review to examine key built environment and child health‐related policies at national and local levels at each study site. Given the existing Australian cohort data have primarily been collected from Western Australia, the current sub‐study focuses on Australian and Western Australian government policy documents. Full details of the BEACHES study protocol have been previously published. ⁴¹

2.2. Overview of Australian government jurisdictions

In Australia, three levels of government provide services and create laws and policies, with shared responsibility for the built environment and public health policies. The Australian government is responsible for the conduct of national affairs and creates laws for the whole of Australia. State (including the Western Australian) and territory governments create laws for their own state, provide the regulatory framework, and approve local planning schemes. Local governments create laws for their region and are responsible for urban design frameworks, building regulations and development, local roads and footpaths, and parks and playing fields. The focus of this policy review was on relevant Australian and Western Australian government policy documents relevant to Western Australia, in line with the larger BEACHES study.

2.3. Search strategy

The primary search (completed by the second author) involved searching official Australian and Western Australian government department and agency websites for current policy documents related to the built environment using the terms “obesity” or “health” or “physical activity” and “policy” or “framework” or “plan” and “built environment” or “transport” or “planning.” The Comprehensive Analysis of Policy on Physical Activity (CAPPA) framework was used to guide the policy review and analysis. The CAPPA framework defines policies as written or unwritten formal statements, written standards and guidelines, formal procedures, or informal policies. ⁴² In this review government policies, Acts, strategy papers, frameworks, strategic plans, standards, procedures, reports, and guidelines were included.

A secondary search was performed through a Google Scholar search using the terms “obesity” or “health” or “physical activity” and “policy” and “built environment” and “Australia” and “review.” The first 10 pages of the search were examined to identify peer‐reviewed journal articles related to the built environment and child health. This ensured as many relevant articles as possible were captured within a feasible screening time while acknowledging the diminishing marginal returns by searching beyond 10 pages. These articles were then searched for reference to Australian or Western Australian government policies. The policies identified in the articles were scanned in accordance with the study inclusion criteria. Each policy included was then checked for references to other relevant policies and included if they met the inclusion criteria.

2.4. Inclusion/exclusion criteria

Policies developed by local government jurisdictions were excluded as were discussion papers. Policy documents were included if current (available at the time of the search [February 2021] and not classified as superseded or archived) and explicitly aimed to impact health through the built environment or were directed at built environment factors shown to influence child obesity as identified by the research evidence. These included parks and recreation facilities, esthetics, street connectivity, mixed land use, safety, food outlets, outdoor advertising, and social connection. ¹⁹ , ²⁴ , ³⁰ , ³² , ⁴³ , ⁴⁴ The search was confined to policies published from 2005 to 2021.

2.5. Analysis framework

The CAPPA defines elements of a comprehensive analysis of physical activity and sedentary behavior policies across six categories: purpose of analysis, policy level, policy sector, type of policy, stage of the policy cycle, and scope of analysis. ⁴² Elements of the six categories framework (e.g., policy sector: health, transport, planning, etc.) have been described in detail elsewhere. ⁴² The stage of policy cycle was not considered in this review as all policy documents were in the implementation stage. Given the CAPPA's relevance and broad application, it was also used to analyze dietary behaviors and obesity in relevant policies. To achieve the study aims, the scope of analysis category was expanded for greater specificity to include health and built environment‐related objectives and targets, if children were mentioned, presence and level of implementation and evaluation, and what built environment factors were included.

A content analysis approach was used to identify the specific information required for each CAPPA category. This top‐down qualitative approach to data analysis involved applying pre‐determined codes (in this case the CAPPA categories) to the data. For some CAPPA categories, a presence/absence was recorded (e.g., mention of children in policy document), whereas for others, specific details were extracted from the policy document and recorded.

2.6. Advisory group involvement

An advisory group comprising policy makers and practitioners from various state government departments (health; sport and recreation; transport) and not‐for‐profit (Cancer Council; Heart Foundation; Nature Play WA) and profit (architects; early learning sector) organizations within Western Australia was formed. This group provided input into the methods through regular stakeholder meetings to ensure all relevant policies were captured and that the process of analysis was relevant to policymaking and practice.

3. RESULTS

A total of 10 Australian and 31 Western Australian government policy documents met the inclusion criteria and were reviewed using the CAPPA criteria outlined in the methods section (see Table S1 for detailed results). Of the documents identified, eight were specific policies, one was an Act, and 32 were either strategic plans, frameworks, programs, guidelines, or a report. The policy documents were developed by various state and Australian government departments including those responsible for planning, health, transport, sport and recreation, local government, crime prevention, and parks and wildlife. Most policy documents were produced by a single government department or agency although there were exceptions. ¹¹ , ⁴⁵ , ⁴⁶ , ⁴⁷ , ⁴⁸ Some provided evidence of extensive consultation in the process of policy document development with input from those who received health services, carers, clinicians and staff in the Western Australian health system, health service providers, non‐government organizations, industry, and the wider community. ⁴⁹ , ⁵⁰

3.1. Focus on children in policies

None of the policies reviewed focused on children specifically. Only five Western Australian ⁴⁵ , ⁴⁶ , ⁴⁹ , ⁵¹ , ⁵² and no national policy documents recognized the specific needs of children in terms of the built environment. Children were mentioned in relation to children's crossings ⁴⁶ and children's road safety. ⁵² One policy document provided prompting questions to guide local government in planning the built environment for young children and outlined strategies for different age groups of children, recognizing that the needs of 0‐ to 6‐year‐old children are different to 7‐ to 12‐year‐old and 13‐ to 16‐year‐old age groups. ⁵¹ Another recognized that children have different needs compared with adults; children were identified as a specific group who had unique pedestrian requirements around schools. ⁴⁶ A further policy document recognized children as an important population sub‐group along with others: “design multi‐purpose public open spaces that are functional and accessible and cater for the needs of children, adolescents, adults, and seniors of all abilities.” ⁴⁵ Some policy documents mentioned the need for consideration of people across the life course without directly mentioning children. ⁵³ , ⁵⁴ , ⁵⁵

3.2. Child‐relevant built environment features included in policies

In relation to the child‐relevant built environment features outlined in the literature, 23 of the policy documents mentioned street connectivity; 22 mentioned safety, which included traffic safety and crime; and 21 addressed the need for high quality parks and recreation facilities (Table 1). Six policy documents addressed several child‐relevant built environment factors in the single policy document. ¹¹ , ⁵⁶ , ⁵⁷ , ⁵⁸ , ⁵⁹ , ⁶⁰ The most comprehensive documents, where over half of the child‐relevant built environment factors were addressed, are presented in Table 2 and indicate the features relevant for preventing child obesity.

TABLE 1.

Number of policies addressing child‐relevant built environment features (n = 41).

Built environment features	Number of policy documents n (%)
Street connectivity	23 (56.1)
Safety	22 (53.7)
Parks and recreation facilities	21 (51.2)
Esthetics	12 (29.3)
Social connection	9 (22.0)
Mixed land use	8 (19.5)
Food outlets and convenience stores	5 (12.2)
Outdoor advertising	1 (2.4)

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TABLE 2.

Policies mentioning the most child‐relevant built environment features.

Policy	Liveable neighborhoods ⁵⁶	State public health plan for W.A. ⁵⁷	Our cities our future ⁵⁸	Healthy spaces & places ¹¹	State planning policy 4.2 ⁶⁰	State planning strategy 2050 ⁶¹
Street connectivity	✓	✓	✓	✓	✓	✓
Safety	✓	✓	✓	✗	✓	✓
Parks and recreation facilities	✓	✓	✓	✓	✓	✓
Esthetics	✓	✓	✓	✓	✓	✓
Social connection	✓	✗	✗	✓	✗	✗
Mixed land use	✓	✗	✓	✓	✓	✓
Food outlets and convenience stores	✗	✓	✗	✗	✗	✓
Outdoor advertising	✗	✗	✗	✗	✗	✗

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3.3. Policies with child‐relevant built environment features and modifiable risk factors for obesity

Twenty‐six of the 41 policy documents mentioned the role of the built environment in improving and/or contributing to the health of the community. All but one of these 26 policy documents referred to the role of the built environment in supporting physical activity. ¹¹ , ⁴⁵ , ⁴⁶ , ⁴⁷ , ⁴⁸ , ⁵² , ⁵³ , ⁵⁴ , ⁵⁵ , ⁵⁷ , ⁵⁸ , ⁶⁰ , ⁶¹ , ⁶² , ⁶³ , ⁶⁴ , ⁶⁵ , ⁶⁶ , ⁶⁷ , ⁶⁸ , ⁶⁹ , ⁷⁰ , ⁷¹ , ⁷² , ⁷³ The role of the built environment in discouraging sedentary behavior was mentioned in three policy documents. ¹¹ , ⁴⁵ , ⁵⁴ The role of the built environment in supporting healthy eating and preventing obesity was mentioned in three ⁴⁹ , ⁵⁴ , ⁵⁷ and two ¹¹ , ⁵⁴ policy documents, respectively.

3.4. Policies with built environment targets

Seven policy documents included specific targets related to the built environment and physical activity. Most of the targets were related to active transport; however, it was not specified whether these targets were relevant for children's active school transport. Examples included as follows: public transport is available within about 10‐ to 15‐min walking time, or an 800‐m distance, for rail stations; about 5‐ to 7‐min walking time, or 400 m, for bus stops located on bus routes ⁶¹ ; pedestrian networks need to provide access from residential properties to mixed‐use centers and bus routes within a 400‐m walk and access to train stations within 800 m of strategic and secondary activity centers ⁴⁶ ; public transport, walking, and cycling will account for an increased modal share in our major cities and 30% of all passenger trips in our capital cities ⁶⁴ ; increase the number of walking trips per adult per week by 10 percentage points ⁶³ ; and public open space to be provided within 300 m (of safe walking distance) for all. ⁵⁶

3.5. Policy implementation and evaluation

Implementation and evaluation were mentioned in all policy documents, but only five included an implementation or evaluation plan. ⁴⁹ , ⁵¹ , ⁶³ , ⁶⁸ , ⁷⁴ Where an implementation or evaluation plan was mentioned but not included in the policy document, the corresponding plan was not found in a search of the department website. Common features of implementation and evaluation plans include a dedicated implementation working group, implementation and evaluation checklists, and evaluation frameworks.

4. DISCUSSION

This review investigated how Australian and Western Australian government policies address the health of children through the built environment's influence on the modifiable risk factors for obesity, physical activity, sedentary behavior, and diet. The health and wellbeing of the community was a stated objective of nearly two‐thirds of policy documents, most of which referred to the role of the built environment in supporting physical activity. The community was mostly considered as a single entity with the assumption all sub‐populations would be equally impacted by built environment‐related policy measures. More specifically, there was a lack of focus on children in policy documents, a group more differentially influenced by the impact of the built environment on health‐related behaviors. ²⁵ This lack of focus on children in built environment policy development, implementation, and evaluation could potentially lead to negative unintended consequences for children and families. For example, how do policy makers, city planners, and urban designers balance the need for highly integrated and connected streets while minimizing traffic volume?

The lack of focus and inclusion of children in built environment policy documents is not limited to Australia, with other high‐ and low‐middle income countries reporting similar findings. A recent review in Ghana highlights the lack of public policies on children's outdoor play, emphasizing a need for policies to consider children's play when designing urban built environments. ⁷⁵ Similarly, a review of Irish local government policies found few policies supported the planning and improvement of the built environment for children with children's interests not adequately considered in policy and decision making. ⁷⁶ It was recommended more should be done to increase the visibility of children when planning policy. ⁷⁶

A focus on children in built environment and health‐related policy could be achieved through their active involvement in policy development and review. Encouraging and enabling children's ongoing and systematic participation in urban planning could empower a new generation of youth to engage with planning. ⁷⁷ In this process, children can provide insight into what features of the built environment encourage and enable them to live active and healthy lives, preventing the design of environments that only cater to adults, ignoring the needs of children. Designing neighborhoods for, and with, children is becoming increasingly important worldwide and is exemplified by the Australian and global movements towards creating “child‐friendly cities.” ⁷⁸ One initiative that is gaining momentum is “child impact assessments” of all built environment‐related policies and large, as well as small, scale changes to the built environment. This involves assessing a policy with “the best interests of the child” at the center of the assessment. ⁷⁹ This process should be undertaken prior to the policy being adopted in addition to during and after implementation, considering the impact on children and adjusting the policy as required. ⁷⁹

Many countries are demonstrating their commitment to implementing the child‐friendly cities' initiative policy frameworks by utilizing a child impact assessment when developing policies, including those related to the built environment. ⁸⁰ , ⁸¹ The UK's National Children's Bureau has created the All Party Parliamentary Group for Children to bring the voices of children and young people to government and influence the development of policy that impacts children. ⁸² Moreover, Public Health Wales has created a three‐part resource that includes a planning policy template for policy makers to assist in the creation of healthy environments to prevent child obesity. ⁸³ New Zealand, Belgium, Finland, Italy, Sweden, and Austria are among other countries that prioritize children in policy development. The current policy review has identified that the Australian and Western Australian Government should consider implementing similar child impact assessment tools and resources. The Western Australian Commissioner for Children and Young People has recognized the same important need, encouraging all agencies whose work affects children to use their child impact assessment template and guidelines. ⁸⁴

While a half of the policy documents reviewed addressed parks, open spaces, and recreation facilities shown to influence children's structured and unstructured outdoor physical activity, the home yard was not considered. In young children, the home yard is an important behavior setting for supporting young children's active play and unstructured physical activity. ²³ Yet in many urban cities, the increase in housing density and larger houses built on smaller blocks results in reduced private space for children to be active outdoors at home. ⁸⁵ , ⁸⁶ This highlights the need to consider the impact of maximizing site coverage for residential dwellings on child health and development as well as the importance of having high quality public open spaces with child‐friendly features, close to home. Providing amenities such as neighborhood vegetation, numerous proximate and safe play spaces, and low‐traffic zones are important tools for policy makers and planners to support young and school‐aged children's outdoor physical activity.

Providing proximate and safe play spaces and routes to school can support school‐aged children to develop independent mobility, facilitating increased physical activity and active transport. ⁸⁷ While 22 of the policy documents mentioned safety, it was unclear if these referred to parent and or child perceived safety or objective measures of crime or traffic safety. This is important because low levels of parent perceived safety, regardless of actual levels, can negatively impact children's independent mobility and physical activity levels. ⁸⁸ Future research and built environment‐related policies should consider how best to address parent perceptions of safety (and actual safety) through built environment design to provide increased physical activity opportunities for children.

While some policy documents appeared to be jointly developed across different government and agency sectors with evidence of input from various stakeholders, these processes were not universal. Collaboration in policy development is vital given the many ways the built environment can impact the wellbeing of children across childhood. Traditionally, policy making has occurred in distinct administrative silos even though most policy interventions are implemented at different levels of government and thus have wide reach and implications. Although there is growing interest in improving inter‐organizational partnering, this has been limited to date. ⁸⁹

It was difficult to determine the extent to which policy documents had been implemented or evaluated as government websites did not consistently provide documentation of evaluations or reviews. It is essential that policies relevant to planning healthy communities have strong implementation plans, with designated funding, clear targets, and a commitment to evaluation. ⁹⁰ It is also important for policy design and implementation to become an integrated process rather than conducted in discrete stages. ⁹¹ Ongoing evaluation of policies is required, and the findings need to be readily accessible to the public. As there is no single policy that can solely help prevent or reverse the prevalence of child obesity, there is a need to adopt inter‐organizational and integrated obesity prevention policies and implementation plans involving multiple sectors to address child obesity.

Greater use of policy implementation‐based targets, goals, and indicators is also needed. ⁹² , ⁹³ Short‐, medium‐, and long‐term policy targets may support implementation of more ambitious, evidence‐informed policy. ⁹² Commitment to using built environment indicators (e.g., National Liveability Indicators ⁹⁴ ) tailored to children and families to measure the impact and outcomes of policies and monitor progress towards reform may assist policy makers to achieve policy goals that create healthy, liveable, and sustainable cities for children and future generations. ⁹⁵ Child‐friendly built environment indicators could be used by children, families, the community, and stakeholders to advocate and mobilize policy action for healthier built environments for children. Indicators can be well used in built environment and health policy contexts if made accessible and are directly linked to the needs of end users, policy makers, and practitioners. ⁹⁶

4.1. Future research

Most of the policies reviewed addressed the impact of the built environment on children's physical activity; however, few policies considered the built environment's impact on children's sedentary behavior. Children's sedentary behavior and built environment research needs further advancement to inform the development of health promoting policies for children. Similarly, the food environment received little attention in the policies reviewed despite there being significant research on the impact of the built environment on dietary behaviors. In Australia, the Food Policy Index ⁹⁷ has assessed the extent to which each state and territory implements policies related to food environments. In Western Australia, policies relating to food promotion (restrict promotion of unhealthy foods in child settings) and food retail (planning and zoning laws related to healthy and unhealthy foods) were limited and received “very little, if any” and “low” scores for policy implementation. ⁹⁷ , ⁹⁸ Improved policy implementation and evaluation with greater attention to the food environment in Australian policies is needed for improvement in children's healthy eating. Natural experiments of the impact of changes to the built environment and health‐related policy will provide stronger evidence for developing, implementing, and evaluating healthy built environment policy that supports children to establish healthy behaviors and prevent the rise in obesity. Finally, the approach used in the current study could be used in other countries to understand the policy landscape and identify if and how government policies address the impact of the built environment on child obesity, physical activity, sedentary behavior, and diet.

4.2. Study limitations

Limitations of this research include the exclusion of policies from other Australian states and territories (excluding Western Australia) and international policy documents. The exclusion of local government policy documents further limited the scope of relevant policies included. It is possible that local government policy documents may be more likely to target child‐specific built environment features and include children in their development. Additionally, the search was limited by pre‐determined search terms and website search processes. The lack of policies related to sedentary behavior, dietary behaviors, and obesity may have been influenced by the search terms. The analysis did not specifically focus on whether children were included in the policy development process. However, this may have been difficult to ascertain given the lack of information available on the policy documents development and the consultation process involved. Finally, the CAPPA framework was not designed specifically to assess policies relating to dietary behaviors or obesity and hence was modified to suit the policy review.

5. CONCLUSIONS

Whereas most policy documents addressed how the built environment can support physical activity and enhance community health, very few policies included how the built environment could reduce sedentary behaviors, support healthy eating, and reduce obesity levels overall. In addition, child input into policy development and the use of child‐specific built environment research to inform policy development were generally not evident. A stronger focus on children in policies will enable the design of built environments that will help to reduce obesity and facilitate healthy communities into the future. Policies that collaboratively engage end users in their development, particularly those that capture the voices of children, and are underpinned by research with clear implementation and evaluation plans are likely to be more effective in helping to reduce child obesity.

AUTHOR CONTRIBUTIONS

HC conceived and designed the study. AH and LF extracted and reviewed policy documents. AH, LF, and HC drafted the article. All authors interpreted the data and provided feedback on drafts of the paper, approved the submitted version, and have agreed both to be personally accountable for their own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature.

CONFLICT OF INTEREST STATEMENT

The authors declare that they have no conflicts of interest.

PREPRINT

This research was accepted as a preprint with the Life Course Centre Working Paper Series. https://doi.org/10.2139/ssrn.3956957

Supporting information

Table S1: Detailed Results Table.

OBR-25-e13650-s001.pdf^{(260.4KB, pdf)}

ACKNOWLEDGMENTS

We would like to thank our collaborators from Curtin University, Monash University, Queensland University of Technology, University of Southern Denmark, WA Department of Local Government, Sport and Cultural Industries, WA Department of Health, WA Department of Transport, WA Local Government Association, Australian Childcare Alliance, Nature Play Australia, Heart Foundation, The PLAY Spaces and Environments for Children's Physical Activity (PLAYCE) partners, Cancer Council WA, Goodstart Early Learning, and Hames Sharley. We would also like to thank Meredith Blake from The University of Western Australia for her advice and expertise. Open access publishing facilitated by The University of Western Australia, as part of the Wiley ‐ The University of Western Australia agreement via the Council of Australian University Librarians.

Henry A, Fried L, Nathan A, et al. The built environment and child obesity: A review of Australian policies. Obesity Reviews. 2024;25(1):e13650. doi: 10.1111/obr.13650

Funding information This work is part of the BEACHES project that is a joint initiative between Telethon Kids Institute, University of Western Australia and Swansea University. This work was supported the Australian National Health and Medical Research Council–UKRI‐NHMRC Built Environment Prevention Research Scheme (GNT1192764). This research was supported (partially) by the Australian Government through the Australian Research Council's Centre of Excellence for Children and Families over the Life Course (Project ID: CE200100025). HC is supported by an Australian National Heart Foundation Future Leader Fellowship (102549). BBe is supported by an Australian Research Council Future Fellowship (FT210100183). GT is supported by an Australian Research Council DECRA Fellowship (DE210101791). DC is supported by NHMRC Research Fellowship (GNT1119339). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

Table S1: Detailed Results Table.

OBR-25-e13650-s001.pdf^{(260.4KB, pdf)}

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PERMALINK

The built environment and child obesity: A review of Australian policies

Anna Henry

Leanne Fried

Andrea Nathan

Gursimran Dhamrait

Bryan Boruff

Jasper Schipperijn

Donna Cross

Ben Beck

Gina Trapp

Hayley Christian

Summary

1. INTRODUCTION

2. METHODS

2.1. The BEACHES project

2.2. Overview of Australian government jurisdictions

2.3. Search strategy

2.4. Inclusion/exclusion criteria

2.5. Analysis framework

2.6. Advisory group involvement

3. RESULTS

3.1. Focus on children in policies

3.2. Child‐relevant built environment features included in policies

TABLE 1.

TABLE 2.

3.3. Policies with child‐relevant built environment features and modifiable risk factors for obesity

3.4. Policies with built environment targets

3.5. Policy implementation and evaluation

4. DISCUSSION

4.1. Future research

4.2. Study limitations

5. CONCLUSIONS

AUTHOR CONTRIBUTIONS

CONFLICT OF INTEREST STATEMENT

PREPRINT

Supporting information

ACKNOWLEDGMENTS

REFERENCES

Associated Data

Supplementary Materials

ACTIONS

PERMALINK

RESOURCES

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