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It has been hypothesised that deprived neighbourhoods have poorer quality food environments which may promote the development of obesity. We investigated associations between area deprivation and the location of the four largest fast-food chains in Scotland and England. We found statistically significant increases in density of outlets from more affluent to more deprived areas for each individual fast-food chain and all chains combined. These results provide support for a 'concentration' effect whereby plausible health-damaging environmental risk factors for obesity appear to be 'concentrated' in more deprived areas of England and Scotland.

Investigating the role of the social and material environment in determining mortality, morbidity and health behaviour has become increasingly popular in epidemiological research. However, despite calls to use more innovative data about areas, there is still a tendency to use 'off the shelf' data derived from pre-existing routine surveys and censuses. Many researchers argue that innovative ecological data about areas is difficult to collect and use effectively, difficult to compare and hard to interpret and analyse. This paper considers an approach to obtaining and interpreting innovative ecological data, and is based on a case study of empirical data collection in the UK. The paper focuses on issues of scale, quality, generation, use and interpretation of data. While it is important to start with a priori theories about the way specific domains of the local environment might influence health, we report that finding robust measures of these domains at the correct spatial scale is difficult and time consuming. However we argue that the attempt to measure specific chains of causation is important enough for public health for this approach to followed and improved upon.

Objectives: To investigate associations between measures of neighbourhood social and material environment and self rated health., Design: New contextual measures added to cross sectional study of a sample of people from the Health Survey for England and the Scottish Health Survey to provide multilevel data., Participants: 13,899 men and women aged 16 or over for whom data on self rated health were available from the Health Survey for England (years 1994-99) and the Scottish Health Survey (years 1995 and 1998)., Results: Fair to very bad self rated health was significantly associated with six neighbourhood attributes: poor physical quality residential environment, left wing political climate, low political engagement, high unemployment, lower access to private transport, and lower transport wealth. Associations were independent of sex, age, social class, and economic activity. Odds ratios were larger for non-employed residents than for employed residents. Self rated health was not significantly associated with five other neighbourhood measures: public recreation facilities, crime, health service provision, access to food shops, or access to banks and buildings societies., Conclusions: Some, but not all, features of the neighbourhood environment are associated with self rated health and may be indicators of important causal pathways that could provide a focus for public health intervention strategies. Associations were more pronounced for non-employed residents, perhaps because of greater exposure to the local environment compared with employed people. Operationalizing specific measures of the characteristics of local areas hypothesised to be important for living a healthy life provides a more focused approach than general measures of deprivation in the search for area effects.