MAAP – Mapping Advertising Assets Project: A cross-sectional analysis of food-related outdoor advertising and the relationship with deprivation in Leeds, UK

Objective: Food environments can influence dietary behaviours. Promotion of foods high in fats, salt and sugars (HFSS) is a barrier to healthy eating. We explore advertising by deprivation in an English city. Design: Using a cross-sectional design, we describe the prevalence of outdoor advertising, the types of products advertised and the UK Nutrient Profile Modelling (NPM) scores for advertised foods and non-alcoholic beverages. Differences in outdoor advertising prevalence by area deprivation was assessed using Chi–squared tests. Setting: Six areas in each of 5 deprivation strata were randomly selected from all 482 Leeds neighbourhoods (England) (n = 30 neighbourhoods). Participants: Eligible outdoor advertisement assets (intentionally placed permanent/semi-permanent advertisements visible from the street) were photographed in May-June 2023. Results: A total of 295 outdoor advertising assets were recorded. The most deprived quintile had the highest number of advertising assets (n = 74). Bus shelters were the most prevalent asset (n = 68). The number of food adverts differed significantly by deprivation level. The 2 most deprived areas had higher than expected exposure while the 2 least deprived areas had lower than expected exposure (p<0.01). Data were insufficient to compare compliance against a hypothetical Healthier Food Advertising Policy (HFAP), however bus shelters were most likely to display HFSS food adverts. Conclusions: Food advertising in Leeds is unequally distributed with more food adverts in more deprived areas. Similar inequalities may exist in other cities, but data are scarce. Unhealthy adverts are most prevalent on bus shelters, highlighting an important asset for policy focus.