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    • Greater access to fast food chains translates

    2018-10-26

    Greater access to fast food chains translates into an environment with increased opportunities to purchase and consume such items (Brug, 2008; Thornton, Bentley & Kavanagh, 2009). As governments at the Federal, state, and local levels strive to find new ways to improve enba health outcomes, a growing amount of attention has been directed towards potential environmental-level factors that may contribute to detrimental health. Whilst a number of other countries have produced large scale investigations on fast food restaurant distribution (Cummins et al., 2005; Macdonald et al., 2007; Maddock, 2004; Mehta & Chang, 2008; Pearce et al., 2007; Pearce, Hiscock, Blakely & Witten, 2009; Powell et al., 2007; Zenk & Powell, 2008), Australia to date has not. Given the current interest among researchers and policy makers in aspects of the built environment that potentially contribute to obesity, it is timely to update prior findings that have thus far been limited in scope. The present study includes a comprehensive assessment of the location of four of Australia׳s largest fast food chains across the whole state of Victoria, Australia. Fast food restaurant locations are considered at two geographic levels and assessed in relation to area-level disadvantage, urban/regional location, and around schools. This study concludes by offering insights into planning and policy mechanisms that may help control the proliferation of fast food restaurants within vulnerable communities.
    Methods
    Results SA2s had a median geographic size of 18km2 and a median population of ~11,500 people, with an average of 31% of the population aged 25 years or less (Table 1). Over half of the SA2s had at least one fast food restaurant. LGAs are larger administrative units with a median size and population of > 1500km2 and ~42,000 people, respectively, and again with an average of 31% aged 25 years or less. Just over three quarters of LGAs had at least one fast food restaurant, with an average of seven fast food restaurants per LGA.
    Discussion This study׳s results support evidence from prior international investigations across large-areas that are limited to major fast food chains (Cummins et al., 2005; Macdonald et al., 2007; Pearce et al., 2007). However, given known differences exist with regards to other aspects of the food environment between developed nations, large-scale quantification of this within Australia is long overdue; particularly given that prior Australian studies that have included measures of fast food restaurant location have been limited in their scope (Burns & Inglis, 2007; Reidpath et al., 2002; Thornton et al., 2012a). With the majority of food environment studies in recent years being focused on socioeconomic inequalities, exploration of urban–regional differences remain rare. Results indicate a higher mean number of fast food restaurants in the major city area compared to inner regional and outer regional areas but this difference did not remain once the administrative units׳ geographic size, population and percentage of the population under the age of 25 years were adjusted for. Our study could not differentiate suburban areas from urban areas within the major cities category like prior work from Powell et al. (2007); nor did it have a measure of proximity from neighbourhoods like Pearce et al. (2007). In subsequent analysis however, our study explored school access by urban–regional locality, finding, like Pearce et al. (2007), that schools in major city (urban) areas were more proximate to fast food restaurants than schools in non-urban settings. To the authors׳ knowledge, there is no published data from Australia on chain fast food restaurant locations relative to schools. The present study shows a closer proximity to and greater density of fast food restaurants near secondary schools compared to primary schools. Prior work from the US also found that fast food restaurants were more prominent around high schools (~student age 14–18 years) compared to middle schools (~student age 11–14 years) (Zenk & Powell, 2008). This is likely to be a reflection of the fact pupils attending secondary schools are generally of an age where they have their own money, utilise fast food restaurants as a social gathering place, and have greater independence in terms of their travel patterns, with each of these factors making them more likely to be potential customers than younger children who are more reliant on their parents/carers. Furthermore, Australian schools tend to not have a school-provided meal system meaning those who do not bring lunch from home would potentially purchase food. This may occur on or off school grounds depending on whether the school has food available for purchase and the rules in relation to allowing students to go off-site.