Heather D’Angelo, PhD and her colleagues from the Gillings School of Public Health, the University of North Carolina, Chapel Hill, recently connected the dots between tobacco outlets (TO), fast food restaurants (FFR), and their proximity to schools in their recently-published article, Sociodemographic Disparities in Proximity of Schools to Tobacco Outlets and Fast-Food Restaurants (American Journal of Public Health/National Center for Biotechnology Information). Their work reflects never-before-conducted research that is important for coalitions as they address the negative health outcomes associated with tobacco and fast-food (cancer and cardiovascular disease, for example). D’Angelo and her coauthors were particularly interested in how the presence of these two elements were associated with socioeconomic status and race/ethnicity.
How they did it
A random sample of 97 counties within the contiguous United States were selected, representing 18,379 schools – including primary, middle, and high schools. “Business lists and data from the National Center for Education Statistics were used to calculate the numbers of tobacco outlets and fast-food restaurants within 800 meters of public schools in these 97 US counties,” notes the study.
The number of TOs and FFRs are disproportionately located near schools that attract low income and Hispanic students. “More than 50 percent of schools with a majority of Hispanic students had both a fast-food restaurant and tobacco outlet nearby, compared with 21 percent of schools with a majority of White students. And the odds of having a TO or FFR near such schools? Each 10 percent increase in the number of low-income and Hispanic students enrolled in a school led to a 3 to 5 percent increase in the odds that a school would have a fast-food restaurant and a tobacco outlet nearby. In particular, the researchers found higher density of FFRs and TOs near high schools than near other schools. “High schools had 40 percent more FFRs and 24 percent more TOs within 800 meters than did primary schools, and high schools had nearly 1.5 times greater odds of having both an FFR and a TO nearby,” the study affirms.
Why this study is important
D’Angelo and her colleagues tell us that Hispanic students, Black students, and those receiving free or reduced-price lunches are disproportionately exposed to tobacco outlets and fast-food restaurants near their schools. Place this information against the following informational backdrop:
- Smoking starts early and is highest among lower income youth
- Nearly 90 percent of adults who smoke start before they reach age 18
- Tobacco use rates are higher among Hispanic versus White middle school-aged students
- Smoking and dietary habits influence each other
As such, D’Angelo’s study points to the fact that easy access to tobacco and fast foods may influence and contribute to poor health outcomes for young people who are experimenting with tobacco and regularly eating fast foods. The study shows that they can grow into adults who continue to make the same choices. The data also suggests that TO and FFR retailers and marketers may be well aware of the fact that promoting their products so close to schools are taking advantage of, “the autonomy and purchasing power of older youths,” potentially setting the stage for poor health outcomes.
How coalitions can help
D’Angelo notes that while more research on this topic needs to be completed, “Licensing or zoning policies restricting the location of fast-food and tobacco retail outlets in school neighborhoods could reduce youth access to fast-food and tobacco products and advertising.” Coalitions can also support and contribute to the completion of studies that continue to examine the impact of fast-food and tobacco outlets on specific communities and how protective factors, such as school, parent, and student education can influence behaviors can influence the adoption of healthy behaviors.