The effect of fast-food availability on fast-food consumption and obesity among rural residents: an analysis by race/ethnicity.

Rural areas of the United States tend to have higher obesity rates than urban areas, particularly in regions with high proportions of non-white residents. This paper analyzes the effect of fast-food availability on the level of fast-food consumption and obesity risk among both white and non-white residents of central Texas. Potential endogeneity of fast-food availability is addressed through instrumental variables regression using distance to the nearest major highway as an instrument. We find that non-whites tend to exhibit higher obesity rates, greater access to fast-food establishments and higher consumption of fast-food meals compared to their white counterparts. In addition, we found that whites and non-whites respond differently to the availability of fast-food in rural environments. Greater availability is not associated with either greater consumption of fast-food meals or a higher obesity risk among the sample of whites. In contrast, greater availability of fast-food is positively associated with both the number of meals consumed for non-white rural residents and their obesity. While our results are robust to specification, the effect of availability on weight outcomes is notably weaker when indirectly calculated from the implied relationship between consumption and caloric intake. This highlights the importance of directly examining the proposed mechanism through which an environmental factor influences weight outcomes.