Do fast food restaurants surrounding schools affect childhood obesity?

Jebaraj Asirvatham,Michael R Thomsen,Rodolfo M Nayga,Anthony Goudie

doi:10.1016/j.ehb.2019.01.011

Abstract

In this study, we estimate the effect of fast food environment surrounding schools on childhood body mass index (BMI). We use two methods that arrive at a similar conclusion, but with different implications. Using school distance from the nearest federal highway to instrument for restaurant location, we find the surrounding restaurants to only marginally affect a student’s BMI measure. The effect size also decreases with increasing radial distances from school, 0.016 standard deviations at one-third of a mile and 0.0032 standard deviations at a mile radial distance. This indicates the decreasing influence of restaurants on a child’s BMI as its distance from school increases. On a subset of students who were exogenously assigned to different school food environment, we find no effect of the fast food restaurants. An important contextual aspect is that nearly all schools in this sample observed closed campus policy, which does not allow students to leave campus during lunch hours.

Highlights

Rising rates in childhood obesity have become an important worldwide health and public policy issue
We address biases in the estimation using an instrumental variables approach, where the instrument is the proximity of the school to US highways that create a demand for fast food restaurants to serve highway travelers
Our research objective is to estimate the impact of fast food restaurants surrounding the schools on a child’s body mass index (BMI) z-score, and check if there are any differences in the effects by radial distance of restaurants from school

Summary

Introduction

Rising rates in childhood obesity have become an important worldwide health and public policy issue. Even though this has received more attention in the United States, childhood obesity is a growing problem in other countries, including those in Europe and Asia. Because the majority of children attend public schools, there is much interest in regulating the food environment in schools to promote health objectives (Story et al, 2009; Sharma et al, 2009). For example, banned food promotion in schools, whereas Mexico and India have banned sales of sodas and certain unhealthy foods in schools (Villanueva, 2011; Barquera et al, 2013; Khandelwal and Reddy, 2013). In the US, regulation has mostly focused on school meals and those foods stocked in school vending machines. Addressing childhood obesity has become a policy priority, especially because obesity during childhood may continue into adulthood (Serdula et al, 1993)

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