20-Minute Neighbourhoods, Criticisms, Conspiracy Theories, and Health: A Critical Discourse Analysis

Background 20-minute neighbourhoods (20MNs) and other proximity-based urban planning models are argued to improve communities, enhance population health, and reduce inequities. However, these links remain unevidenced. Conversely, there are science-driven criticisms that 20MNs could exacerbate health/social inequities requiring evaluation. These models have also resulted in conspiracy theories, believed to be linked to COVID-19 public health measures, which may hinder the implementation and evaluation of 20MNs and any expected health/inequity gains. Aim The aim of this research is to better understand how public and media perceptions, criticisms, and conspiracy theories about 20MNs have evolved since the pandemic, how these link to health/social inequities, and how these connect to misinformation and disinformation of public health interest. Methods A qualitative study design using thematic and critical discourse analysis (CDA). We systematically searched a selection of UK/US online newspapers from across the political spectrum for analysis. The timeframes of interest are the two 4-year periods before and after the pandemic was declared on March 11, 2020, to compare differences in discourse that may have resulted from the pandemic and its response. Results Coverage of 20MNs increased significantly in the post-pandemic period. Several themes emerged through the analysis, including restriction of movement/loss of privacy, social engineering, political affiliation, COVID-19 as an accelerator, worsening health/social inequities, classism, and liveability/resiliency. Conclusions There is a significant political divide in 20MN discourse. 20MNs were linked to other conspiracy theories such as anti-vaccine beliefs and climate change denial. Framing of these interventions may be a contributing factor.