Separate and unequal: the influence of neighborhood and school characteristics on spatial proximity between fast food and schools.

OBJECTIVE Social science and health literature have identified residential segregation as a critical factor in exposure to health-related resources, including food environments. Differential spatial patterning of food environments surrounding schools has significant import for youth. We examined whether fast food restaurants clustered around schools in New York City, and whether any observed clustering varied as a function of school type, school racial demographics, and area racial and socioeconomic demographics. METHOD We geocoded fast food locations from 2006 (n=817) and schools from 2004-2005 (n=2096; public and private, elementary and secondary) in the five boroughs of New York City. A point process model (inhomogeneous cross-K function) examined spatial clustering. RESULTS A minimum of 25% of schools had a fast food restaurant within 400 m. High schools had higher fast food clustering than elementary schools. Public elementary and high schools with large proportions of Black students or in block groups with large proportions of Black residents had higher clustering than White counterparts. Finally, public high schools had higher clustering than private counterparts, with 1.25 to 2 times as many restaurants than expected by chance. CONCLUSION The results suggest that the geography of opportunity as it relates to school food environments is unequal in New York City.