Peter James1, Mariana C Arcaya2, Devin M Parker3, Reginald D Tucker-Seeley4, S V Subramanian5. 1. Harvard School of Public Health, Department of Epidemiology, 401 Park Drive, 3rd Floor West, Boston, MA 02215, USA. Electronic address: pjames@hsph.harvard.edu. 2. Harvard Center for Population and Development Studies, 9 Bow Street, Cambridge, MA 02138, USA. Electronic address: mca767@mail.harvard.edu. 3. The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, 18 N Park Street, Apt C, Hanover, NH 03755, USA. Electronic address: devinmarisaparker@gmail.com. 4. Department of Social and Behavioral Sciences, 450 Brookline Avenue, Dana Farber Cancer Institute, Center for Community-Based Research, LW743, Boston, MA 02115, USA. Electronic address: retucker@hsph.harvard.edu. 5. Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Avenue, Kresge Building 7th Floor, 716, Boston, MA 02115-6096, USA. Electronic address: svsubram@hsph.harvard.edu.
Abstract
BACKGROUND: Disproportionate access to unhealthy foods in poor or minority neighborhoods may be a primary determinant of obesity disparities. We investigated whether fast-food access varies by Census block group (CBG) percent black and poverty. METHODS: We measured the average driving distance from each CBG population-weighted centroid to the five closest top ten fast-food chains and CBG percent black and percent below poverty. RESULTS: Among 209,091 CBGs analyzed (95.1% of all US CBGs), CBG percent black was positively associated with fast-food access controlling for population density and percent poverty (average distance to fast-food was 3.56 miles closer (95% CI: -3.64, -3.48) in CBGs with the highest versus lowest quartile of percentage of black residents). Poverty was not independently associated with fast-food access. The relationship between fast-food access and race was stronger in CBGs with higher levels of poverty (p for interaction <0.0001). CONCLUSIONS: Predominantly black neighborhoods had higher access to fast-food while poverty was not an independent predictor of fast-food access.
BACKGROUND: Disproportionate access to unhealthy foods in poor or minority neighborhoods may be a primary determinant of obesity disparities. We investigated whether fast-food access varies by Census block group (CBG) percent black and poverty. METHODS: We measured the average driving distance from each CBG population-weighted centroid to the five closest top ten fast-food chains and CBG percent black and percent below poverty. RESULTS: Among 209,091 CBGs analyzed (95.1% of all US CBGs), CBG percent black was positively associated with fast-food access controlling for population density and percent poverty (average distance to fast-food was 3.56 miles closer (95% CI: -3.64, -3.48) in CBGs with the highest versus lowest quartile of percentage of black residents). Poverty was not independently associated with fast-food access. The relationship between fast-food access and race was stronger in CBGs with higher levels of poverty (p for interaction <0.0001). CONCLUSIONS: Predominantly black neighborhoods had higher access to fast-food while poverty was not an independent predictor of fast-food access.
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