Abstract
Online food delivery services facilitate ‘online’ access to food outlets selling food prepared away-from-home. Online food outlet access has not previously been investigated in England or across an entire country. Systematic differences in online food outlet access could exacerbate existing health inequalities, which is a public health concern. However, this is not known. Across postcode districts in England (n = 2118), we identified and described the number of food outlets and unique cuisine types accessible online from the market leader (Just Eat). We investigated associations with area-level deprivation using adjusted negative binomial regression models. We also compared the number of food outlets accessible online with the number physically accessible in the neighbourhood (1600m Euclidean buffers of postcode district geographic centroids) and investigated associations with deprivation using an adjusted general linear model. For each outcome, we predicted means and 95% confidence intervals. In November 2019, 29,232 food outlets were registered to accept orders online. Overall, the median number of food outlets accessible online per postcode district was 63.5 (IQR; 16.0–156.0). For the number of food outlets accessible online as a percentage of the number accessible within the neighbourhood, the median was 63.4% (IQR; 35.6–96.5). Analysis using negative binomial regression showed that online food outlet access was highest in the most deprived postcode districts (n = 106.1; 95% CI: 91.9, 120.3). The number of food outlets accessible online as a percentage of those accessible within the neighbourhood was highest in the least deprived postcode districts (n = 86.2%; 95% CI: 78.6, 93.7). In England, online food outlet access is socioeconomically patterned. Further research is required to understand how online food outlet access is related to using online food delivery services.
Highlights
In 2018, half of food expenditure in the USA was on food prepared away-from-home (United States Department of Agriculture Economic Research Service, 2020), and between 2008 and 2012 over one quarter of adults in the UK consumed at least one meal prepared away-from-home each week (Adams et al, 2015)
Whole regarding associations between food outlet access with food related practices and related outcomes is equivocal (Fleischhacker et al, 2011; Wellard-Cole et al, 2021). This is a reflection of meth odological heterogeneity across studies, including the use of different geographical measures of food outlet access and conceptualisations of neighbourhood food environments, as well as varying food environment contexts across countries (Wilkins et al, 2017; Wilkins et al, 2019)
Given that the aims of our study were related to online food delivery services generally, we refer to Just Eat as the ‘online food delivery service’ hereafter
Summary
In two UK studies that used similar methods and were conducted in large samples of adults, neighbourhood exposure to fast-food outlets was positively associated with fast-food consumption (Burgoine et al, 2014; Burgoine et al, 2016), and this food practice has been associated with excess weight gain over time (Pereira et al, 2005) It has been consistently reported across international contexts that more deprived areas have a higher number of food outlets selling food prepared away-from-home (Block et al, 2004; Maguire et al, 2015; Simon et al, 2008; Smoyer-Tomic et al, 2008), which may be contrib uting to observed inequalities in diet and health. The ability to acquire food prepared away-from-home is no longer restricted to physical food outlet access, and a notable limitation of previous research is that alternative ways of accessing this food were not considered, which could prove to be important
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
