Pearce Jamie, Blakely Tony, Witten Karen, Bartie Phil
GeoHealth Laboratory, Department of Geography, University of Canterbury, Christchurch, New Zealand.
Am J Prev Med. 2007 May;32(5):375-82. doi: 10.1016/j.amepre.2007.01.009.
Obesogenic environments may be an important contextual explanation for the growing obesity epidemic, including its unequal social distribution. The objective of this study was to determine whether geographic access to fast-food outlets varied by neighborhood deprivation and school socioeconomic ranking, and whether any such associations differed to those for access to healthier food outlets.
Data were collected on the location of fast-food outlets, supermarkets, and convenience stores across New Zealand. The data were geocoded and geographic information systems used to calculate travel distances from each census meshblock (i.e., neighborhood), and each school, to the closest fast-food outlet. Median travel distances are reported by a census-based index of socioeconomic deprivation for each neighborhood, and by a Ministry of Education measure of socioeconomic circumstances for each school. Analyses were repeated for outlets selling healthy food to allow comparisons.
At the national level, statistically significant negative associations were found between neighborhood access to the nearest fast-food outlet and neighborhood deprivation (p<0.001) for both multinational fast-food outlets and locally operated outlets. The travel distances to both types of fast food outlet were at least twice as far in the least socially deprived neighborhoods compared to the most deprived neighborhoods. A similar pattern was found for outlets selling healthy food such as supermarkets and smaller food outlets (p<0.001). These relationships were broadly linear with travel distances tending to be shorter in more-deprived neighborhoods.
There is a strong association between neighborhood deprivation and geographic access to fast food outlets in New Zealand, which may contribute to the understanding of environmental causes of obesity. However, outlets potentially selling healthy food (e.g., supermarkets) are patterned by deprivation in a similar way. These findings highlight the importance of considering all aspects of the food environment (healthy and unhealthy) when developing environmental strategies to address the obesity epidemic.
致胖环境可能是肥胖症流行趋势加剧（包括其不平等的社会分布）的一个重要背景解释因素。本研究的目的是确定获得快餐店的地理途径是否因社区贫困程度和学校社会经济排名而异，以及此类关联是否与获得更健康食品店的关联有所不同。
收集了新西兰各地快餐店、超市和便利店的位置数据。对数据进行地理编码，并使用地理信息系统计算从每个普查街区（即社区）和每所学校到最近快餐店的出行距离。出行距离中位数按每个社区基于普查的社会经济剥夺指数报告，以及按教育部对每所学校社会经济状况的衡量指标报告。对销售健康食品的店铺重复进行分析以作比较。
在国家层面，对于跨国快餐店和本地经营的店铺，均发现社区到最近快餐店的可达性与社区贫困程度之间存在统计学上显著的负相关（p<0.001）。与最贫困的社区相比，在社会剥夺程度最低的社区，到这两类快餐店的出行距离至少是其两倍。对于销售健康食品的店铺，如超市和小型食品店，也发现了类似模式（p<0.001）。这些关系大致呈线性，在贫困程度更高的社区出行距离往往更短。
在新西兰，社区贫困程度与获得快餐店的地理途径之间存在很强的关联，这可能有助于理解肥胖症的环境成因。然而，潜在销售健康食品的店铺（如超市）在贫困程度方面也呈现类似模式。这些发现凸显了在制定应对肥胖症流行的环境策略时，考虑食品环境（健康和不健康）所有方面的重要性。
