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McDonald’s Restaurants and Neighborhood Deprivation in Scotland and England

https://doi.org/10.1016/j.amepre.2005.06.011Get rights and content

Background

Features of the local fast food environment have been hypothesized to contribute to the greater prevalence of obesity in deprived neighborhoods. However, few studies have investigated whether fast food outlets are more likely to be found in poorer areas, and those that have are local case studies. In this paper, using national-level data, we examine the association between neighborhood deprivation and the density of McDonald’s restaurants in small census areas (neighborhoods) in Scotland and England.

Methods

Data on population, deprivation, and the location of McDonald’s Restaurants were obtained for 38,987 small areas in Scotland and England (6505 “data zones” in Scotland, and 32,482 “super output areas” in England) in January 2005. Measures of McDonald’s restaurants per 1000 people for each area were calculated, and areas were divided into quintiles of deprivation. Associations between neighborhood deprivation and outlet density were examined during February 2005, using one-way analysis of variance in Scotland, England, and both countries combined.

Results

Statistically significant positive associations were found between neighborhood deprivation and the mean number of McDonald’s outlets per 1000 people for Scotland (p<0.001), England (p<0.001), and both countries combined (p<0.001). These associations were broadly linear with greater mean numbers of outlets per 1000 people occurring as deprivation levels increased.

Conclusions

Observed associations between presence or absence of fast food outlets and neighborhood deprivation may provide support for environmental explanations for the higher prevalence of obesity in poor neighborhoods.

Section snippets

Background

The prevalence of obesity in developed countries has rapidly increased in recent years.1 It has been proposed that environmental, rather than genetic, influences may be the most important factors predicting increasing rates of overweight and obesity.2, 3, 4 Multilevel cross-sectional studies have found positive associations between the prevalence of adult overweight and obesity and neighborhood deprivation after adjusting for a range of individual sociodemographic measures5, 6, 7; consequently,

Methods

Every McDonald’s restaurant listed in the online Yellow Pages12 for Scotland and England was identified (n=942) as of January 2005. (Welsh and Irish McDonald’s restaurants were not identified, as up-to-date multiple deprivation indicators were not then available in Wales or Ireland.) The full unit postal code was obtained for each restaurant, which was then assigned an Index of Multiple Deprivation (IMD) score by linking the location of outlets to the relevant census “data zones” (Scotland)13

Results

Table 1 shows the mean number of McDonald’s restaurants per 1000 people by quintile for Scotland, England, and both countries combined. For English SOAs, there is a statistically significant (p<0.001) positive linear association between quintile of area deprivation and mean number of outlets per 1000 residents—as areas become more deprived, the mean number of outlets per 1000 people increases. For Scottish data zones, a similar relationship is observed (p<0.001), although Quintile 2 has a

Conclusions

Studies investigating neighborhood differences in overweight and obesity have found a greater prevalence of these conditions in more deprived neighborhoods, and have suggested that environmental promoters of obesity (such as access to fast food outlets) may be more common in these areas.5, 6 Two local case studies undertaken in the United States and Australia have indicated that such an association may exist.10, 11 Although restricted to one fast food chain, the results presented here represent

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