Fast Food Density in New York City ARTICLE in PRESS Health & Place

ARTICLE IN PRESS Health & Place 15 (2009) 364–373 Contents lists available at ScienceDirect Health & Place journal homepage: www.elsevier.com/locate/healthplace Inequality in obesigenic environments: Fast food density in New York City Naa Oyo A. Kwate a,Ã, Chun-Yip Yau b, Ji-Meng Loh b, Donya Williams a a Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 W. 168th Street, 5th Floor, New York, NY 10032, USA b Department of Statistics, Columbia University, 1255 Amsterdam Avenue, New York, NY 10027, USA article info abstract Article history: The high prevalence of obesity in African American populations may be due to the food environment in Received 14 January 2008 residential communities, and the density of fast food restaurants is an important aspect of the Received in revised form restaurant landscape in US cities. This study investigated racial and socioeconomic correlates of fast 30 April 2008 food density in New York City. We found that predominantly Black areas had higher densities of fast Accepted 7 July 2008 food than predominantly White areas; high-income Black areas had similar exposure as low-income Black areas; and national chains were most dense in commercial areas. The results highlight the Keywords: importance of policy level interventions to address disparities in food environments as a key goal in Fast food obesity prevention efforts. Neighborhoods & 2008 Elsevier Ltd. All rights reserved. African American/Black Racial segregation Obesity Introduction These studies point towards the role of social processes as mediators of associations between segregation and overweight/ Public discourse and public health research on obesity have obesity, including institutional forces other than the concentra- intensified in the wake of marked increases in US obesity rates, tion of poverty. A likely mediator is the food environment in Black increases that have been particularly acute among the disadvan- neighborhoods. Environments that promote high energy intake taged (Drewnowski and Specter, 2004). For African Americans, and sedentary behavior have been described as obesogenic obesity is endemic—the National Health and Nutrition Examina- (Swinburn et al., 1999) (also termed obesigenic). Research on tion Survey (NHANES) gave prevalence rates at 45% in 2003–2004 the food environment in Black neighborhoods has focused on (Ogden et al., 2006). Given that many African Americans are access to resources that mitigate against obesity—supermarkets obese, and that in most US cities, African Americans reside in and high-quality produce. These studies show that access is often segregated neighborhoods, it is not surprising that research has inadequate for African Americans (Horowitz et al., 2004; Inagami documented an association between residential segregation and et al., 2006; Lewis et al., 2005; Morland et al., 2002; Schulz et al., obesity. However, this association is not purely compositional in 2005; Zenk et al., 2005). Less research has been conducted on nature. Although Blacks are 1.7 times as likely as Whites to be disparities in the availability of fast food, despite its implication in obese, they are 3.1 times as likely to reside in relatively obese overweight and obesity. Fast food is high in calories, fat, and communities, and individuals living in neighborhoods with high cholesterol (French et al., 2000), has an extremely high energy- proportions of obese residents are more likely to be obese density profile (Prentice and Jebb, 2003), and is often served in themselves, net of individual-level factors (Boardman et al., large portion sizes (Brownell and Battle Horgen, 2003; Nestle, 2005). A positive association also exists between BMI and 2002). Some research has begun to investigate obesity-related metropolitan area level segregation after adjusting for composi- correlates of fast food density and consumption, documenting tional differences in socioeconomic and other factors. Compared associations with weight gain, insulin resistance, overweight/ to a person living at the lowest level of segregation (isolation obesity, and acute coronary syndromes (Alter and Eny, 2005; index ¼ 0.25), the odds of being overweight increased by 77% for Bowman and Vinyard, 2004; Jeffrey et al., 2006; Pereira et al., residents living in areas with the highest level of segregation 2005). (isolation index ¼ 0.83) (Chang, 2006). Fast food consumption has been found to be a strong contributor of dietary fat among African American women (Daroszewski, 2004), and between 1985–1986 and 2000–2001, Blacks frequented fast food restaurants (FFR) significantly more Ã Corresponding author. Tel.: +1212 305 5736; fax: +1212 305 0315. often than Whites (Pereira et al., 2005). These consumption levels E-mail address: [email protected] (N.O.A. Kwate). may stem from greater availability of fast food in neighborhoods 1353-8292/$ - see front matter & 2008 Elsevier Ltd. All rights reserved. doi:10.1016/j.healthplace.2008.07.003 ARTICLE IN PRESS N.O.A. Kwate et al. / Health & Place 15 (2009) 364–373 365 rather than from greater intrinsic demand. As in international non-borrowed assets in order to open a restaurant (‘‘Purchasing settings (Cummins et al., 2005; Macdonald et al., 2007; Reidpath Your Restaurant’’, 2007). Given that franchisees in Black neighbor- et al., 2002), US research on disparities in fast food density has hoods have often been African American or affiliated with African focused on area income. This research has tended to document the American institutions (Love, 1995; Roberts, 1987; Schlosser, 2001), inverse relationships between income and fast food exposure that but Blacks have significantly less wealth than Whites (Conley, have been observed internationally (Burdette and Whitaker, 2004; 1999; Shapiro, 2005), the financial requirements for franchising Morland et al., 2002; Zenk and Powell, 2008). However, other may act as a barrier to their operation. studies have reported that middle- and high-income neighbor- Thus, we sought to investigate inequalities in the density of fast hoods have greater numbers and proximity to fast food (Austin food in New York City (NYC), the most populous, and a highly et al., 2005; Wang et al., 2007). segregated US city. Our aims were fourfold. First, we investigated Anecdotal evidence of low diversity of dining options in African whether fast food density was positively associated with the American neighborhoods has been borne out by empirical percentage of Black residents in the city’s census block groups, research (Lewis et al., 2005), but less research has investigated and whether an interaction with area income was evident. Second, fast food prevalence as a function of neighborhood racial we investigated whether predominantly Black block groups showed demographics. It has been argued that residential segregation variability in fast food density by income. Third, we examined works to increase the density of fast food in Black neighborhoods whether predominantly Black and White areas with similar income by creating localized geographic market areas, fostering economic, levels had similar densities of fast food. Fourth, we investigated business, and land use characteristics that promote fast food, whether predictors of restaurant density differed for national chains concentrating available labor pools, and weakening community compared to local outlets. We hypothesized that fast food density political strength that would be deployed to oppose fast food would be positively associated with the proportion of Black siting (Kwate, 2008). Some research does show fast food to be residents; that there would be no relationship between area income more prevalent in Black neighborhoods. In New Orleans census and fast food density in predominantly Black areas; that Black areas tracts with at least 2000 people per square mile, fast food density would have higher fast food density than comparable White areas; (the number of restaurants per square mile in geographically and that the relationship between percentage Black and fast food described shopping areas) was predicted only by percent Black. density would be strongest for local outlets. On average, predominantly Black neighborhoods contained 2.4 FFR per square mile, while White neighborhoods contained 1.5 (Block et al., 2004). In contrast, Zenk and Powell (2008) found Method that nationwide, Black neighborhoods had 30% less restaurants than White neighborhoods, and in the 20 largest cities, Black Geography neighborhoods had 44% less. Morland et al. (2002) and Powell et al. (2007a) found fast food to be more prevalent in racially mixed We examined fast food density in the 5730 census block and predominantly White, rather than Black neighborhoods. groups comprising NYC’s five boroughs: Manhattan, Brooklyn, The mixed findings indicate the need for additional investiga- Queens, The Bronx, and Staten Island. In 2000, NYC had 8,008,278 tions of racial disparities in fast food density. There is also little residents, of whom 24.5% were Black, 27% Latino, 35% White, and available data on the distribution of fast food within predomi- 9.8% Asian, and the median household income was $38,909 (New nantly Black neighborhoods that vary in income level. Fast food is York City Department of City Planning, 2005). Although NYC is inexpensive, takes less waiting time, and has a restricted menu, diverse in its racial/ethnic composition, it remains highly and thus should appeal to individuals with low income, those in a segregated, as shown in Fig. 1. NYC’s

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