title: Do minority and poor neighborhoods have higher access to fast-food restaurants in the United States?
abstract: BACKGROUND
  Disproportionate access to unhealthy foods in poor or minority neighborhoods may be a primary determinant of obesity disparities. We investigated whether fast-food access varies by Census block group (CBG) percent black and poverty.
  
  
  METHODS
  We measured the average driving distance from each CBG population-weighted centroid to the five closest top ten fast-food chains and CBG percent black and percent below poverty.
  
  
  RESULTS
  Among 209,091 CBGs analyzed (95.1% of all US CBGs), CBG percent black was positively associated with fast-food access controlling for population density and percent poverty (average distance to fast-food was 3.56 miles closer (95% CI: -3.64, -3.48) in CBGs with the highest versus lowest quartile of percentage of black residents). Poverty was not independently associated with fast-food access. The relationship between fast-food access and race was stronger in CBGs with higher levels of poverty (p for interaction <0.0001).
  
  
  CONCLUSIONS
  Predominantly black neighborhoods had higher access to fast-food while poverty was not an independent predictor of fast-food access.
authors.affiliation: Harvard School of Public Health, Department of Epidemiology, 401 Park Drive, 3rd Floor West, Boston, MA 02215, USA. Electronic address: pjames@hsph.harvard.edu.
authors.forename: Peter
authors.initials: P
authors.lastname: James
authors.affiliation: Harvard Center for Population and Development Studies, 9 Bow Street, Cambridge, MA 02138, USA. Electronic address: mca767@mail.harvard.edu.
authors.forename: Mariana C
authors.initials: MC
authors.lastname: Arcaya
authors.affiliation: The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, 18 N Park Street, Apt C, Hanover, NH 03755, USA. Electronic address: devinmarisaparker@gmail.com.
authors.forename: Devin M
authors.initials: DM
authors.lastname: Parker
authors.affiliation: Department of Social and Behavioral Sciences, 450 Brookline Avenue, Dana Farber Cancer Institute, Center for Community-Based Research, LW743, Boston, MA 02115, USA. Electronic address: retucker@hsph.harvard.edu.
authors.forename: Reginald D
authors.initials: RD
authors.lastname: Tucker-Seeley
authors.affiliation: Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Avenue, Kresge Building 7th Floor, 716, Boston, MA 02115-6096, USA. Electronic address: svsubram@hsph.harvard.edu.
authors.forename: S V
authors.initials: SV
authors.lastname: Subramanian
mesh_terms: D001741:Black or African American; D019352:Censuses; D057140:Fast Foods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016014:Linear Models; D008913:Minority Groups; D009765:Obesity / Q000209:etiology; D011204:Poverty Areas; D012111:Residence Characteristics; D012147:Restaurants / Q000706:statistics & numerical data*; D014481:United States
keywords: Food access; Poverty; Race