BACKGROUND
More than a third of children and adolescents consume foods from quick-service restaurants (QSRs) daily, which is associated with an increased risk of diet-related adverse health conditions.
OBJECTIVE
To examine trends in the proximity of top-selling QSR chains to all public schools across the United States (US) between 2006-2018 by community, school, and student-level characteristics.
DESIGN
This longitudinal study examined changes in the number QSRs between the 2006-2007 and 2017-2018 school years using data from National Center for Education Statistics, Infogroup US Historical Business Data, and the US Department of Agriculture's Economic Research Service.
STATISTICAL ANALYSES PERFORMED
A mixed-model ANOVA using census tract as a random effect and accounting for repeated measures by school was used to examine the proximity of QSRs near schools. Models adjusted for demographic and census tract population density. Data were analyzed in 2021.
RESULTS
In 2006, 9% of schools had QSRs within 400m, and 25% of schools in the most populated areas had at least one QSR within 400m. There were more QSRs near schools with a high percentage of poverty (12%), and near schools with high school students with the highest population of Black or African American (16%) and Hispanic or Latino (18%) students. By 2018, the percent of QSRs within 400m of all public schools increased to 12%. The increase over time was greater near schools with a high percentage of poverty (16%) and near schools with high school students with the highest population of Black or African American students (22%) and Hispanic or Latino (23%) students.
CONCLUSIONS
This is the first nationwide study to examine trends in QSR proximity to all public schools. QSRs were most likely to be located near schools with high school students, near schools with a high percentage of poverty, and near schools with a higher proportion of racial and ethnic minority students. Over time, there were greater increases in QSRs near these schools which may have important implications for children's health and diet-related disparities.