Many researchers, public health officials and policy makers suggest that neighborhood characteristics may influence dietary and physical activity patterns and thus influence obesity risk. Because of the evidence that fast food consumption is linked to obesity, researchers interested in neighborhood effects on health have often focused on fast food outlet availability, but have assessed fast food availability as an isolated component of the overall food and retail environment. When we analyzed links between adolescent obesity in New York City and the density of fast food outlets in neighborhoods as a single measure of neighborhood food availability, we found that a higher density of fast food restaurants was associated with lower adolescent obesity. But when interpreting this finding, one needs to understand that fast food restaurants don’t exist in a vacuum, they are part of a larger ecosystem of neighborhood businesses and are embedded within larger trends of neighborhood economic development and investment.
There are a number of reasons to suspect that overall economic development in a neighborhood might matter for resident’s health. A larger retail presence might provide what Jane Jacobs termed “eyes on the street” to prevent crime, a political lobby to support neighborhood services, and, of course, employment for local residents. We used the number of banks within the neighborhood as a measure of local economic development, a neighborhood resource not expected to directly influence adolescent’s physical activity or dietary patterns.
We found that the density of banks correlates with the density of fast food outlets in a neighborhood and that the density of banks within a neighborhood was also associated with lower adolescent obesity. Since banks could not reasonably be assumed to directly affect adolescent health on their own, we interpret this finding to suggest that investment patterns might relate to adolescent obesity. These analyses adjusted for measures of the family’s income and for neighborhood poverty rates, so these findings are not simply a function of childhood poverty. These findings, we think, show the complexity of studying the effects of neighborhood food environments and overall development patterns on health. It also highlights the importance of studying the health effects that result from the complex ecosystem of economic and residential investment.
A paper describing this research will be published soon in Health and Place and is available online here. For these analyses we used data from the 2007-2008 NYC FITNESSGRAM program linked to the Census tract of residence. This is the first in a series of papers we are publishing investigating the complexity of the urban economic ecosystem, including investigating how the density and diversity of food options in neighborhoods might influence obesity outcomes. We think that this paper provides a preliminary finding that we hope will encourage more research that investigates how economic development might influence health outcomes.