Putting health first: Liverpool City Region takes action on the commercial drivers of inequality

Health Equalities Group welcomes the Liverpool City Region Combined Authority’s decision to introduce new restrictions on unhealthy advertising across its portfolio of publicly owned and managed assets. This marks an important milestone in the region’s ambition to create healthier, fairer environments for its 1.6 million residents and reflects a growing recognition that the commercial determinants of health – particularly the influence of unhealthy commodity industries – play a powerful role in shaping patterns of preventable disease and inequality.

The new policy restricts advertising of foods and non-alcoholic drinks high in fat, salt and sugar (HFSS), alongside continued exclusions for tobacco and the extension of bans to include vaping products. This approach builds on sustained public health leadership across Cheshire and Merseyside, where Healthy Advertising Policies – pioneered first in Knowsley and subsequently developed in Halton, Liverpool, Sefton, St Helens and Wirral – have already been implemented across council-owned sites, supported by coordinated action from the All Together Fairer Programme’s network of Leads.

Evidence demonstrates that communities facing the greatest disadvantage are disproportionately exposed to marketing for unhealthy commodities, including junk food, ultra-processed products, alcohol, and gambling. A substantial body of research illustrates that the strategies used by major commercial actors – from aggressive marketing and strategic product placement to pricing tactics and political engagement – strongly influence consumption patterns and contribute to the growing burden of non-communicable diseases. By reducing exposure to harmful marketing in spaces people rely on every day, such as bus shelters, train stations and tunnels, the Combined Authority is helping to reset that imbalance.

Mayor Steve Rotheram emphasised that public assets should “work in the public interest,” noting that children in some communities “are growing up surrounded by adverts for products that damage their health.” The policy signals a commitment to put “people before profit” and to act decisively on avoidable health inequalities.

Crucially, the policy acknowledges the complexity of the advertising landscape. It introduces pragmatic mechanisms to ensure workable implementation — including proportionate adjustments to the Nutrient Profiling Model for incidental imagery or brand-only advertising — while maintaining a clear focus on harm reduction. It also commits to further review of alcohol and gambling advertising, which remain significant contributors to ill health and social harm across the region.

Matthew Philpott, Executive Director of Health Equalities Group, said:

“The Combined Authority’s decision to implement this initial policy and consider widening the scope of this work in due course is a powerful example of what local and regional leadership can achieve when it takes the commercial determinants of health seriously. By reshaping the environments that influence people’s everyday choices, this policy helps protect those communities who are most exposed to harmful marketing and most affected by preventable ill health.

“It is a clear, practical step towards creating fairer conditions for everyone across Liverpool’s city region – and a strong demonstration that coordinated, evidence-led action can begin to reduce the inequalities that hold so many people back.”