Online Program

Disparities in the restaurant food environment: Evidence from the Assessing the Nutrition Environment in Wisconsin Communities (ANEWC) study

Monday, November 2, 2015 : 1:10 p.m. - 1:30 p.m.

Ana Martinez-Donate, PhD, Department of Population Health Sciences, University of Wisconsin - Madison, Madison, WI
Jennifer Valdivia Espino, BS, Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI
Amy Meinen, MPH, RD, UW Madison Department of Family Medicne, Wisconsin Obesity Prevention Network, Madison, WI
Anne Escaron, PhD, MPH, Division of General Internal Medicine, University of California, Los Angeles, Los Angeles, CA
Anne Roubal, MS, Department of Population Health Sciences, University of Wisconsin, Madison, WI
F. Javier Nieto, MD, MPH, PhD, Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI
Kristen Malecki, PhD, MPH, Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI

Meals prepared outside the home contribute significantly to Americans’ caloric intake. Previous research has shown that low-income and minority-populated areas have a greater density of fast-food restaurants. This study examines disparities in the restaurant food environment among a statewide sample of Wisconsin adults.


A semi-random sample (N=380) of Wisconsin adult residents was selected from the 2009-2010 Survey of the Health of Wisconsin. Restaurants within a 2- and 5- mile buffer of participant’s households in urban and rural areas, respectively, were enumerated. We used the Nutrition Environment Measures Survey for Restaurants (NEMS-R) to obtain food environment scores for each restaurant. Number of restaurants and average NEMS-R scores within each participant’s buffer were linked to SHOW individual data. Unadjusted and adjusted linear regressions were estimated to determine the association between restaurant environment data and individual demographic characteristics.


Individuals 61 years and older had better price scores compared to other age groups (p< .01). Individuals with a college education had better barrier scores than those with less than a college education (p<.05). Low-income participants resided in areas with more fast food restaurants than higher-income participants (p<.05). Urban residents and minorities lived in buffers with better facilitators/supports, pricing, and kids’ menu scores (p<.05) compared to rural and non-Hispanic whites.


Significant disparities in the restaurant food environment of Wisconsin adults exist by age, education, income, urbanicity, and race/ethnicity. More research to understand the impact of these differences on dietary practices, body mass index, and health outcomes must be conducted.

Learning Areas:

Social and behavioral sciences

Learning Objectives:
Describe methods to measure the food environment surrounding individuals. Discuss differences in the restaurant food environment by gender, age, income, education, minority status, and/or urbanicity.

Keyword(s): Health Disparities/Inequities, Nutrition

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an Associate Professor of Population Health Sciences at the University of Wisconsin, Madison. I led the study from which data for this study originate. I have over 15 years of experience conducting research on socio-ecological determinants of health behaviors, including healthy eating.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.