Socioeconomic inequalities in food outlet access through an online food delivery service in England: A cross-sectional descriptive analysis.
Applied geography (Sevenoaks, England) 2021 ; 133: None.
Keeble M, Adams J, Bishop TRP, Burgoine T
DOI : 10.1016/j.apgeog.2021.102498
PubMed ID : 34345056
PMCID : PMC8288297
URL : https://linkinghub.elsevier.com/retrieve/pii/S0143622821001144
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.
Lay Summary
The way that takeaway food is purchased is changing.
In the past, buying takeaway food in person was the norm. However, like many other aspects of everyday life, this behaviour has been digitalised, and it now seems normal to purchase takeaway food through online food delivery services like Just Eat.
To date, no research has captured online access to takeaway food outlets, nor investigated if the number of food outlets accessible online varies by deprivation across England. A growing body of evidence is beginning to demonstrate that takeaway food available online is high in calories, fat and salt. Online food delivery services could be encouraging those with access to registered food outlets to eat more of the unhealthy items available. Moreover, as food sold online is largely prepared in existing kitchen facilities, which are mostly located in more deprived areas, online access might contribute to inequalities in poor diet and diet-related health.
In this research, we collected data about each of the 30,000 food outlets registered to accept orders through Just Eat, which is the market leading online food delivery service in England. We counted the number of food outlets that could be accessed online from 2118 points (centres of postcode districts) across England, the number of cuisines types that were accessible at these locations, and compared the number of food outlets that could be accessed online with the number accessible in person. We tested whether these counts were different in deprived and less deprived areas.
A median of 64 food outlets and 39 unique cuisine types were accessible online per postcode district, and online food outlet access was widespread across England. In the most deprived areas, the number of food outlets that could be accessed online was almost 50% greater than in the least deprived areas. This might mean that people living in these areas are more likely to use online food delivery services.
When we compared the number of food outlets that could be accessed online with the number that could be accessed in-person, we found that the percentage was similar in the least and the most deprived areas. This suggests that online food delivery services expand overall food outlet access for all populations.
In future research we will investigate how the opportunity to place orders through online food delivery services is linked to use of this purchasing format, and what this might mean for public health.