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Supermarket and Fast Food Outlet Exposure in Copenhagen: Associations with Socioeconomic Characteristics

Svastisalee CM, Nordahl H, Glumer C, Holstein BE, Powell LM, and Due P. Public Health Nutrition, 14(9):1618-1626, 2011.

Objective: To investigate whether exposure to fast-food outlets and supermarkets is socio-economically patterned in the city of Copenhagen.

Design: The study was based on a cross-sectional multivariate approach to examine the association between the number of fast-food outlets and supermarkets and neighbourhood-level socio-economic indicators. Food business addresses were obtained from commercial and public business locators and geocoded using a geographic information system for all neighbourhoods in the city of Copenhagen (n 400). The regression of counts of fast-food outlets and supermarkets v. indicators of socio-economic status (percentage of recent immigrants, percentage without a high-school diploma, percentage of the population under 35 years of age and average household income in Euros) was performed using negative binomial analysis.

Setting: Copenhagen, Denmark.

Subjects: The unit of analysis was neighbourhood (n 400).

Results: In the fully adjusted models, income was not a significant predictor for supermarket exposure. However, neighbourhoods with low and mid-low income were associated with significantly fewer fast-food outlets. Using backwise deletion from the fully adjusted models, low income remained significantly associated with fast-food outlet exposure (rate ratio = 0·66-0·80) in the final model.

Conclusions: In the city of Copenhagen, there was no evidence of spatial patterning of supermarkets by income. However, we detected a trend in the exposure to fast-food outlets, such that neighbourhoods in the lowest income quartile had fewer fast-food outlets than higher-income neighbourhoods. These findings have similarities with studies conducted in the UK, but not in the USA. The results suggest there may be socio-economic factors other than income associated with food exposure in Europe.

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