Food (Promotion and Placement) (Scotland) Regulations 2025: equality impact assessment

Key Findings

This section is a summary of existing evidence on expected impacts on population groups in Scotland through the lens of the protected characteristics in the Equality Act 2010.

A policy to restrict the location and price promotion of targeted HFSS food and non-alcoholic drinks is expected to have a positive impact on health outcomes across all population groups. A differential impact may occur across different population groups, primarily due to differences in consumption patterns of HFSS foods, shopping behaviours (thus exposure to promotions) and responsiveness to promotions. The prevalence of both price and placement promotions in store and online is such that that all consumers, regardless of characteristics, are exposed on a regular basis, and thus likely to be impacted to some extent.

Although the analysis focuses on one protected characteristic at a time, it is important to note that as a population-wide intervention, different protected characteristics inevitably intersect.

A recent evaluation of locations restrictions in England found that the policy did reduce sales of HFSS products and witnessed a ‘step change’ in data after implementation, suggesting this was not related to inflation or cost of living changing purchasing behaviours. The evaluation also concluded the restrictions were ‘equitable’ having assessed purchasing changes across a range of settings.

Age

Public health impact

Evidence suggests that children consume more HFSS foods than adults^[1]. Promotions can encourage bulk purchasing and increased consumption, which may disproportionately affect children’s dietary intake. By limiting such promotions, the policy could reduce exposure and consumption particularly among children, potentially contributing to healthier eating habits during formative years. However, while children consume more HFSS foods, a greater proportion of adults are overweight or obese, indicating that the policy could also have meaningful health implications for older populations.

Shopping behaviours could mediate the policy’s impact by age. There is limited evidence on where different segments of society shop. Available evidence, however, indicates that younger people are more likely to shop at discounters, such as Lidl (less reliant on volume promotions) and local/ convenience stores. In a 2023 survey, overall, 60% of groceries were reported to be purchased from supermarkets, 28% from discounters, 10% from convenience stores and 2% from other sources. Older people (55+) reported getting more of their grocery shopping at supermarkets (65%) than younger people (58% for 35-54yrs and 55% for 18-34yrs). Younger age groups reported a greater proportion of their shopping from discounters than older groups (31% for 18-34yrs vs 25% for 55+yrs).

All groups only obtain a relatively small percentage of their shopping from local/ convenience stores. The younger age group obtained a little more (12%) than the older group (9-10%). This could have some limited effect on the policy’s reach among younger adults, who may be less impacted by the regulations as they continue to be exposed to price and/ or location promotions of HFSS products through stores which are exempt from restrictions on the basis of business and/ or store size. This is mitigated by the inclusion of small businesses that have entered into a franchise or franchise like agreement (where the total number of employees of the franchisor and the businesses operating under the franchise agreement is 50 or more) within scope of regulations.

There is the potential for differential impacts of the restrictions given the potential for different responses to promotions by age. Again, the evidence is very limited, however, there are multiple studies that suggest that children have susceptible “unconscious short cuts” which predisposes them to more impulsive purchasing than adults. This is particularly the case for location promotions and the restrictions on these could be expected to have a greater impact for children or families with children^[2] which would see a differential positive effect on this cohort given the higher consumption of HFSS by children and families with children.

Dietary requirements

It has been suggested in consultation responses and by participants at the Health Inequalities Scoping Workshop that older adults may be more likely to rely on processed ready meals and could be negatively impacted if ready meals were in scope of the policy.

The policy will not restrict availability of ready meals or promotions of non-HFSS ready meals. It is a possibility that HFSS ready meals will increase in price however this will depend on retailer behaviour and whether the introduction of ‘everyday low pricing’ in place of price promotions is introduced. However, promotions do not always offer best value and can lead to consumers overlooking cheaper alternatives for instance own brand products, or purchasing more than they need to get the discount e.g. in the case of bulk buy/x for £y type offers. Restricting promotions of HFSS ready meals may shift purchasing behaviour toward healthier options and have a positive public health impact on this group.

It has been suggested that the inclusion of fortified cereals in restrictions may increase the risk of vitamin D deficiency in at risk groups, including older adults. The policy will not restrict availability of fortified cereals, which will still be available to purchase. The regulations will only restrict the promotion of products which are HFSS. This could lead to a shift in purchase towards healthier breakfast cereals, many of which may be fortified too. In addition, since it is difficult to get adequate vitamin D from dietary sources alone, population groups at higher risk of vitamin D deficiency are advised to take a daily vitamin D supplement all year round.

Disability

Public health impacts

In 2024, 39% of the adult population in Scotland reported living with a long-term limiting health condition, with women (42%) more likely than men (35%) to report having such a condition. There is limited evidence about intake of HFSS foods in this population group. Using fruit and vegetable consumption and average energy density as proxy indicators of how healthy in general the diet is, there was no difference between those with and without disabilities in 2021. It is acknowledged that there may be specific groups that have lower quality diets than non-disabled counterparts, and where that is the case, the policy will have a beneficial impact. In addition, the evidence is consistent that those with disabilities are more likely to live with overweight and obesity and hence the policy has further potential to have greater beneficial impact for this group.

In engagement with public health groups, it has been suggested that disabled individuals may be more likely to rely on processed ready meals. This policy will not restrict promotions of non-HFSS ready meals and ready meals that are in scope of restrictions will still be available to purchase, just not on promotion. As set out, promotions do not always offer best value and can lead to consumers overlooking cheaper alternatives or purchasing more than they need to get a discount. Therefore, restricting promotions on HFSS ready meals may encourage purchases of healthier options and have positive public health outcomes for those who frequently purchase them.

Disabled people are at greater risk of being overweight than those without a disability. Thus, anything that has the potential to influence intake of high calorie foods may benefit disabled people to a greater extent than those without a disability. There is limited evidence on where different segments of society shop. In a 2023 Scottish Government commissioned survey, no difference was observed in where people shopped depending on whether or not they had a disability. The survey found that the majority of people with or without disabilities buy their shopping from supermarkets or discount stores, and will therefore have similar exposure to promotions.

No evidence was identified of differential impacts – positive or negative – on specific subgroups of disabled people.

A limitation of disability evidence is that it rarely differentiates between types of disability or takes account of proportionately higher levels of long-term limiting illness in those on lower incomes or from more deprived areas or as people get older. Some considerations around disability may be similar to those captured under the earlier sub-section on age, given the link between age and potential onset of long term conditions.

Dietary requirements

Engagement for the EQIA suggested that consideration should be given to individuals with certain medical conditions who may require a specific diet. For example, those who require a high calorie diet, neurodivergent people who may be very particular about what they eat, or diabetics who may rely on sugary drinks to increase their blood sugar where required.

Following the policy’s implementation, those who rely on a particular product or specific brand of product may no longer be able to buy that product on certain types of promotion, which may lead to increased costs for those individuals. It is important to note that the policy does not restrict the sale of any product, and there are often cheaper and/or healthier alternatives available to those that are on promotion.

Sex

Public health impacts

The results of the 2024 Scottish Health Survey reported 69% of men and 63% of women having a BMI of 25 or more (defined as living with overweight, including obesity). Within that, 27% of men and 35% of women were reported to have a BMI of 30 or more (defined as living with obesity). Thus, anything that has the potential to influence intake of high calorie foods may benefit men more than women in general, but also those women living with the highest levels of obesity.

There has been no clear difference reported in overall diet quality between men and women. There was also no difference by sex reported as to where people grocery shop, with around two thirds of both men and women doing most of their shopping at supermarkets. It is, therefore, expected that there will be minimal difference in the policy’s impact based on consumption behaviours and exposure to promotions by sex.

No evidence was encountered regarding any differential response by sex to location or volume-based promotions.

A key consideration is the policy’s impact on low-income households. The lowest income households tend to be lone parent households. The large majority of lone parents are women and these households tend to experience the highest levels of food insecurity rates. Furthermore, women tend to be the main carers of children. These aspects and impacts on low-income households have been assessed further in an accompanying Fairer Scotland Duty Assessment.

Pregnancy and maternity

In 2022/23, obesity was recorded in 27.9% of maternities with a known BMI and this percentage is increasing more steeply over time. In an additional 28.6% of maternities, the individual was overweight totalling 56.5% living with overweight (including obesity). There has been a steady increase in maternal obesity, with a corresponding increase in gestational diabetes. Over a quarter and nearly a tenth of maternities were affected by obesity and diabetes respectively in 2023/24. Restriction of HFSS promotions is likely to have a positive impact given its expected positive impact on population level obesity and weight.

No evidence was encountered that investigated any differential consumption or shopping behaviours compared to the general population or responsiveness to promotions. Advice from NHS Scotland on eating well in pregnancy, is to limit intake of high fat and high sugar foods and follow a healthy diet as per the general population. Restricting promotions on HFSS foods could encourage and make it easier for those who are pregnant to make healthier choices.

Concern was also raised by a respondent to the 2022 consultation that the health of pregnant women and young children would be impacted by restricting promotions of dairy products. However, only promotions of those dairy products classed as HFSS would be restricted, while healthier products could still be promoted. The policy will not prevent consumers from purchasing any products but is intended to support people to make healthier choices.

It has been suggested that the inclusion of fortified cereals within scope of restrictions may negatively impact pregnant women, as cereals can be fortified with folic acid which is required for foetal development. Only cereals classed as HFSS would be subject to restrictions, and healthier fortified cereals could still be promoted. Further, it is recommended that women take a folic acid supplement prior to conception and for the first 12 weeks of pregnancy. Since 2017, all pregnant women in Scotland have been provided with free Healthy Start vitamins, which contain folic acid, throughout their pregnancy. From December 2026, non-wholemeal wheat flour will be fortified with folic acid, to help increase folate levels in women and is in addition to current supplementation advice. It is therefore expected that promotions restrictions would not have a differential impact on this cohort.

Pregnant women are more likely to live in the most deprived areas than the general population. Potential impacts of promotions restrictions by deprivation are considered further in the Fairer Scotland Duty Impact Assessment.

Gender reassignment

No evidence was encountered that investigated any differential consumption or shopping behaviours compared to the general population, or responsiveness to promotions. There has been no suggestion made that the policy will have a significantly different impact based on whether an individual is proposing to go, are undergoing or have undergone (part of) a process of gender reassignment.

Sexual orientation

No evidence was encountered that investigated any differential consumption or shopping behaviours compared to the general population, or responsiveness to promotions. There has been no suggestion made that the policy will have a significantly different impact based on an individual’s sexual orientation.

Race

In both adults and children, Black African or Caribbean groups are most at risk of obesity and Chinese or other Asian groups at lowest risk. However, the national weight surveillance methods do not take into account that Asian and Black groups are at higher risk of obesity at lower BMIs. Any measure that has the potential to influence intake of high calorie foods may benefit those at greatest risk of obesity.

Research indicates that diets of people from ethnic minority (EM) communities are complex and vary widely with significant heterogeneity such that no definitive differential impact from the restrictions can be predicted for ethnic minority groups as a whole.

There is limited evidence on where different segments of society shop. A Scottish Government commissioned consumer survey in 2023 found that White groups are more likely to do grocery shopping at supermarkets (61%) than EM groups (48%). All groups only obtain a relatively small percentage of their shopping from local/ convenience stores. There is a tendency for EM groups to obtain more than white groups (14% vs 10%), although this difference is not significant. This could limit the policy’s reach among ethnic minority adults, who may be less impacted by the regulations as they continue to be exposed to price and/ or location promotions of HFSS products through stores which are exempt from restrictions on the basis of business and/ or store size. This is mitigated by the inclusion of small businesses that have entered into a franchise or franchise like agreement, (where the total number of employees of the franchisor and of the businesses operating under those agreements is 50 or more) within scope of regulations.

Insufficient evidence was encountered to be able to comment on whether ethnic minorities may respond differentially to price or location promotions. Assuming equal impact of HFSS food promotion restrictions, those with the highest intakes of HFSS may benefit to a greater extent than those without.

Through engagement with the Health Inequalities Scoping Workshop, it was suggested that the inclusion of fortified cereals in restrictions may increase the risk of vitamin D deficiency in at risk groups, including individuals with darker skin tones and those who cover their skin for religious reasons. Following implementation of this policy, fortified cereals would still be available to purchase, and promotions would only be restricted on products deemed to be HFSS. This could lead to a shift towards the purchase of healthier breakfast cereals. In addition, since it is difficult to get adequate vitamin D from dietary sources alone, population groups at higher risk of vitamin D deficiency are advised to take a daily vitamin D supplement all year round.

Religion

There is limited evidence on whether promotion restrictions are likely to have a differential impact on people belonging to specific religious groups. In analysis from 2008-2011 the level of obesity amongst people who were Buddhist or Hindu was 15%, lower than the then national average of 27%. Amongst people who stated their religion as Roman Catholic, other Christian or Muslim the levels of obesity were approximately in line with the then national average. Levels of obesity amongst people who stated that they were Church of Scotland members were higher than the then national average at 30%. Any measure that has the potential to influence intake of high calorie foods may benefit those at greatest risk of obesity.