Inequality in Obesigenic Environments: Fast Food Density in New York City

Public discourse and public health research on obesity have intensified in the wake of marked increases in US obesity rates, increases that have been particularly acute among the disadvantaged (Drewnowski and Specter, 2004). For African Americans, obesity is endemic-the National Health and Nutrition Examination Survey (NHANES) gave prevalence rates at 45% in 2003-2004 (Ogden et al., 2006). Given that many African Americans are obese, and that in most US cities, African Americans reside in segregated neighborhoods, it is not surprising that research has documented an association between residential segregation and obesity. However, this association is not purely compositional in nature. Although Blacks are 1.7 times as likely as Whites to be obese, they are 3.1 times as likely to reside in relatively obese communities, and individuals living in neighborhoods with high proportions of obese residents are more likely to be obese themselves, net of individual-level factors (Boardman et al., 2005). A positive association also exists between BMI and metropolitan area level segregation after adjusting for compositional differences in socioeconomic and other factors. Compared to a person living at the lowest level of segregation (isolation index=0.25). the odds of being overweight increased by 77% for residents living in areas with the highest level of segregation (isolation index=0.83) (Chang, 2006).