The socioeconomic patterning of Great-Britains retail food environment: A repeated cross-sectional study of area-level deprivation and food outlet density from 2011-2024

BackgroundAlthough previous research has demonstrated socioeconomic differences in the distribution of food outlets, no study to date has examined these patterns across the entire territory of Great Britain (GB) over time. This study provides an up-to-date repeated cross-sectional analysis into changes in GBs retail food environment from 2011 to 2024 and its socioeconomic distribution. MethodsCoordinates of all fast-food outlets and supermarkets in GB from the Ordnance Survey Points-of-Interest data were used to calculate outlet densities within small areas, adjusted by yearly population estimates and linked to Index of Multiple Deprivation measures. Counts of the different food outlets were combined in the modified Retail Food Environment Index (mRFEI). Multi-level linear regression and beta-regression models were used to assess associations between deprivation and the retail food environment (fast-food outlets, supermarkets and mRFEI). ResultsIn GB, fast-food outlet density increased by 36%, supermarket density increased by 17% and mRFEI decreased by 5% from 2011 to 2024. More deprived areas were associated with greater fast-food outlet density and lower mRFEI in all years compared to less deprived areas; the gap in fast-food outlet density between the most and least deprived areas widened by 28% from 2011-2024. There were no statistically significant differences in supermarket density by area-level deprivation. ConclusionsOur findings indicate that higher densities of fast-food outlets in more deprived areas are not offset by equivalent access to supermarkets offering healthier foods, potentially limiting healthier dietary choices for residents in these communities. Given the links between food outlet exposure and dietary behaviours in GB, policies aiming to improve dietary outcomes should prioritize more deprived areas, thereby contributing to the reduction of socioeconomic inequalities in the retail food environment, diet, and health outcomes.