title: An ecological analysis of food outlet density and prevalence of type II diabetes in South Carolina counties.
abstract: BACKGROUND
  Studies suggest that the built environment with high numbers of fast food restaurants and convenience stores and low numbers of super stores and grocery stores are related to obesity, type II diabetes mellitus, and other chronic diseases. Since few studies assess these relationships at the county level, we aim to examine fast food restaurant density, convenience store density, super store density, and grocery store density and prevalence of type II diabetes among counties in South Carolina.
  
  
  METHODS
  Pearson's correlation between four types of food outlet densities- fast food restaurants, convenience stores, super stores, and grocery stores- and prevalence of type II diabetes were computed. The relationship between each of these food outlet densities were mapped with prevalence of type II diabetes, and OLS regression analysis was completed adjusting for county-level rates of obesity, physical inactivity, density of recreation facilities, unemployment, households with no car and limited access to stores, education, and race.
  
  
  RESULTS
  We showed a significant, negative relationship between fast food restaurant density and prevalence of type II diabetes, and a significant, positive relationship between convenience store density and prevalence of type II diabetes. In adjusted analysis, the food outlet densities (of any type) was not associated with prevalence of type II diabetes.
  
  
  CONCLUSIONS
  This ecological analysis showed no associations between fast food restaurants, convenience stores, super stores, or grocery stores densities and the prevalence of type II diabetes. Consideration of environmental, social, and cultural determinants, as well as individual behaviors is needed in future research.
authors.affiliation: Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA. dalhasan@email.sc.edu.
authors.forename: Dana M
authors.initials: DM
authors.lastname: AlHasan
authors.affiliation: Department of Epidemiology and Biostatistics, Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA. jmeberth@mailbox.sc.edu.
authors.forename: Jan Marie
authors.initials: JM
authors.lastname: Eberth
mesh_terms: D003132:Commerce; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000209:etiology*; D004463:Ecology; D004777:Environment; D004779:Environment Design; D057140:Fast Foods; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000209:etiology; D015995:Prevalence; D012111:Residence Characteristics; D012147:Restaurants; D013022:South Carolina / Q000453:epidemiology