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Neighbourhood deprivation and access to fast-food retailing

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Authors:
Summary:

The authors sought to determine whether geographic access to fast-food outlets varied in relation to the deprivation of the area, and the socioeconomic ranking of local schools. They also assessed associations with access to healthier food outlets, namely supermarkets. Neighbourhood deprivation was assessed using census data, and school socioeconomic data were obtained from the Ministry of Education. Travel distances between neighbourhoods and schools and the nearest fast-food and health food outlets were calculated. There were significant negative associations between neighbourhood deprivation and local access to both multinational and independent fast-food outlets, both p < 0.001. In the least socially deprived areas, the travel distance to fast-food outlets was at least twice as far as that in the most deprived areas. A similar relationship was found for healthier food outlets such as supermarkets (p < 0.001). Neighbourhood deprivation correlates to geographic access to both fast-food outlets and supermarkets.

Comment:
This study showed that urban planning, particularly in regard to positioning of fast food outlets in deprived neighbourhoods, is an important factor in creating obesogenic environments. I am a little concerned that the authors seem to believe that having a similar pattern of supermarkets should allow people in deprived neighbourhoods to make a ‘healthy choice’. The nature of fast food outlets (where food is presented as ‘meals’, staff ask that you consider ‘upsizing’ portions and you can spend $5 without embarrassment) is quite different to supermarkets (where food is packaged separately and there may be an expectation to purchase and therefore spend more) and this must be taken into account. Pukana, a Mäori TV show for tamariki, is currently showing a competition in which tamariki from different schools must create meals with $10 or less to spend at the supermarket. The camera follows the kids as they make their choices and a Mäori nutritionist then explains why the choices were good or not. Even I have picked up a few tips!
Reference: Am J Preventative Medicine 2007; 32(5):375-382
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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