"Unhealthy Food Choices" Litter California's Path to Better Health 

19/01/07 When Californians step out their door, they are four times more likely to find fast food than they are to come across a grocery or produce store. This according to "Searching for Healthy Food: The Food Landscape in California Cities and Counties," an analysis of the distribution of retail food outlets in large cities and counties throughout the state, released by the California Center for Public Health Advocacy (CCPHA).

"Ready access to healthy foods like fruits and vegetables is critical to Californians struggling to address the state's out-of-control obesity crisis," said Dr. Harold Goldstein, executive director of CCPHA. "Sadly, fast-food outlets and convenience stores far outnumber healthier food outlets in major cities and counties throughout California, making the hunt for nutritious options a daunting challenge."

With growing evidence that what people eat -- and their likelihood of being obese -- is influenced by the food environment in which they live, the CCPHA study looks at the distribution of retail food outlets. An inventory of supermarkets, produce vendors, convenience stores and fast-food restaurants was gathered in California cities and counties with populations greater than 250,000. By contrasting the number of outlets likely to offer healthier food options like fruits and vegetables (grocery and produce stores) to the number of fast-food and convenience stores, the study creates a local Retail Food Environment Index (RFEI). The higher the RFEI index, the more likely consumers will find unhealthy food options.

Statewide, California is home to 14,823 fast-food restaurants and 6,659 convenience stores. By contrast, the state has 3,853 supermarkets and 1,292 produce stands (including farmers markets), giving it an RFEI of 4.18. This disproportionate access to fast-food outlets and convenience stores is, according to the study's authors, especially alarming in light of the growing obesity epidemic.

"There is growing evidence that a community's food landscape has a potent influence on the health of its residents," Goldstein said in explaining the value of the study. "For the first time, California cities and counties have a way to compare their communities with others in the state."

San Bernardino County, home to America's first McDonald's, had the dubious distinction of having the highest ratio among California counties at 5.72. Other counties with more than five times the number of unhealthy retail food options as healthy options include Sacramento (5.66), Fresno (5.34), Orange (5.13) and Solano (5.03). Santa Cruz County recorded the state's lowest RFEI (1.84).

Cities offered even more localized and alarming findings. Of the 13 cities analyzed, two (Bakersfield at 6.63 and Fresno at 6.23) have at least six times the number of fast-food restaurants and convenience stores as supermarkets and produce vendors, and two (Long Beach at 5.80 and Riverside at 5.58) have at least five times the number. Only two large cities have retail food environment indices less than the statewide average: Oakland (3.81) and San Francisco (3.85).

The study released by the California Center for Public Health.

Advocacy illustrates why a key component in my comprehensive health care reform proposal is an obesity prevention initiative. Obesity is a leading cause of preventable deaths and an economic drain on the state. With everyone -- families, schools, the public and private sectors -- teaming up on innovative strategies to provide more nutritious food options and increase access to physical activity, we can lead the nation in tackling the obesity crisis by creating healthier communities," said Governor Arnold Schwarzenegger.

"It is time for California to shift the balance," says Goldstein. "We need state and local leaders to take a closer look in their own backyard and enact policies to make it as easy for Californians to find healthy foods when they walk out their doors as it now is to find unhealthy foods."