The availability of fast-food and full-service restaurants in the United States: associations with neighborhood characteristics

Abstract

Background: Parallel to the rising obesity epidemic, food consumption patterns and household expenditures show a marked upward trend in total energy intake derived from away-from-home sources.

Methods: This study conducted cross-sectional multivariate analyses to examine associations between local-area racial, ethnic, and income characteristics and the availability of full-service and fast-food restaurants. Based on a U.S. national census of 28,050 ZIP codes that cover a population of 280,675,874 people, restaurant outlet data were linked to 2000 Census Bureau data based on ZIP code tabulation areas and analyses were undertaken using negative binomial count models and ordinary least squares regression analyses.

Results: Study results showed that higher- versus lower-income, predominantly black and racially mixed versus predominantly white and Hispanic versus non-Hispanic neighborhoods had fewer available full-service and fast-food restaurants. Near-low- and middle-income neighborhoods had the highest number of available restaurants with 1.24 and 1.22 times number of full-service restaurants and 1.34 and 1.28 times the number of fast-food restaurants compared to high-income neighborhoods. Predominantly black neighborhoods were found to have 58.2% and 59.3% of the number of full-service and fast-food restaurants available in predominantly white neighborhoods. No statistically significant differences were found in the relative availability of fast-food versus full-service restaurants by income, race, or ethnicity in the national sample used. However, across urban areas, near-low-, middle-, and near-high- versus high-income neighborhoods and predominantly black versus white neighborhoods were found to have moderately higher proportions of fast-food among total restaurants.

Conclusions: In urban areas, higher proportions of available fast-food restaurants out of total restaurants in predominantly black versus predominantly white neighborhoods may contribute to racial differences in obesity rates.