Racial and socioeconomic health disparities are real, but the reasons for them are complex. A new study from Kansas State University has identified one likely contributor: restaurant options in poor communities.
According to the study, published in the American Journal of Health Behavior, people who live in neighborhoods with public housing are more likely to face fast-food options that are too high in calories and deficient in vegetables and fruit.
"There is the thought that people are unhealthy because they make poor choices, and that can certainly be true," lead researcher Katie Heinrich said in a press release. "But there is a huge influence from the environment that people are in that goes beyond individual responsibility.
“Here we saw that 75 percent of the time it's going to be very easy to pick an unhealthy entrée from a menu because those unhealthy entrées make up the majority of a menu.”
The study looked at data from restaurants (both fast food and table-service) within an 800-mile radius of 13 public housing communities and four residential neighborhoods in Kansas City, Kan., and Kansas City, Mo.
Though all of the communities had a similar number of restaurants overall, those located in proximity to public housing had the least-healthy options and were also more likely to push those unhealthy items on children and the already at-risk populations.
As expected, those neighborhoods with more table-service restaurants had greater access to healthy options. Those in lower-income areas were pushed to “upsize” their high-calorie meals and children were brought into the unhealthy fold with the lure of toys, mascots and other incentives.
"This is important because if you go to a restaurant that has a few healthy choices and a lot of unhealthy choices, the chance of picking an unhealthy entree increases significantly," Heinrich said. "There has been a lot of research looking at the 'food desert' concept in which healthy foods are less available or accessible in lower-income neighborhoods. In this study we found that both neighborhoods had equal access to foods, but that the quality of those available to public housing was much lower."
It’s a conservative and close-minded argument to suggest that those living in such communities shouldn’t be spending their little bit of money at restaurants — but is an argument that many such people throw around in the face of health disparities. But when a dollar menu meal is cheaper and often more filling than options at a grocery store, their point is moot. Further, grocery stores are scarce in “food deserts,” where convenience stores and fast food make up the closest meal options.
"I think that there is a delicate balance between trying to make healthy food choices and having your environment facilitate healthy choices," Heinrich said. "But if we don't set up environments where the majority of choices can potentially be healthy, it becomes much more likely that people are going to make unhealthy choices."
For more on racial and socioeconomic health disparities from this author, see “Growing socioeconomic disparities in obesity rates” and “Race, poverty and psychology.”