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Food advertisement exposure is associated with increased caloric intake, but little is known about food/beverage placements in the digital media environment. We aimed to examine the correlation between the number of people who follow food and beverage brand social media accounts (i.e., user engagement) and state-level obesity rates; quantify social media followers’ use of “healthy” vs. “unhealthy” hashtags; and analyze the relationship between user engagement and hashtag usage. We identified the 26 fast-food and beverage brands with the highest advertising expenditures and used Demographics Pro to determine the characteristics of social media users amongst the 26 brands. A series of regression analyses were conducted that related the mean percentage of brand followers and state-level obesity rates. We then identified 733 hashtags on Instagram and 703 hashtags on Twitter, coding them as “healthy”, “unhealthy”, “neutral”, or “unrelated to health”. Intercoder reliability was established using ReCal2, which indicated a 90% agreement between coders. Finally, we conducted ANCOVA to examine the relationship between the mean percentage of brand followers and their hashtag usage. There was a significant, positive correlation between the state-level obesity rate and the mean percentage of followers of sugary drink or fast-food brands on Instagram and Twitter, but such a correlation between obesity and low-calorie drink brand followers was only found on Twitter. Our findings illustrate the relationship between the social media food environment and obesity rates in the United States. Given the high rates of engagement with food brands on social media, policies should limit digital advertisements featuring fast-food, sugary drink, and low-calorie drink brands.

Background Fentanyl is a pressing concern in the current drug supply. Social media data can provide access to near real-time understanding of drug trends that may complement official mortality data. Design The total number of fentanyl-related posts and the total number of posts for eight drug subreddit categories (alcohol, cannabis, hallucinogens, multi-drug, opioids, over the counter, sedatives, stimulants) were collected from 2013 to 2021 using the Pushshift Reddit dataset. The proportion of fentanyl-related posts as a fragment of total subreddit posts was examined. Linear regressions described the rate of change in post volume over time. Results Overall, fentanyl-related content increased across drug-related subreddits from 2013 to 2021 (1292% increase, linear trend p ≤ 0.001). Opioid subreddits (30.62 per 1000 posts, linear trend p ≤ 0.001) had the most fentanyl-related content during the examined time period. Multi-drug (5.95 per 1000; p ≤ 0.01), sedative (3.23 per 1000, p ≤ 0.01), and stimulant (1.60 per 1000, p ≤ 0.01) subreddits also had substantial increases in fentanyl-related content. The greatest increases occurred in the multi-drug (1067% 2013:2021) and stimulant (1862% 2014:2021) subreddits. Conclusion Fentanyl-related posts on Reddit trended upward, with the fastest rate of change for multi-substance and stimulant subreddits. Beyond opioids, harm reduction and public health messaging should ensure inclusion of individuals who use other drugs. Supplementary Information The online version contains supplementary material available at 10.1007/s11606-023-08256-7.

Purpose: This descriptive study aimed to (1) compare the number of food and beverage advertisements (ads) located in a Caribbean-American neighborhood and non-Latinx white neighborhood in New York City (NYC), and (2) qualitatively assess and compare the culturally targeted marketing themes of the food and beverage advertisements in both neighborhoods. Methods: Three research assistants photographed all outdoor food and beverage advertisements ( n =361) across a 1.6 kilometer distance on a high-retail street in a Caribbean-American neighborhood and a non-Latinx white neighborhood. We used content analysis to evaluate advertising themes, and sorted food into nutritional categories (e.g., fast food and alcohol). We identified two neighborhoods with similar income levels in Queens, NYC, USA—South Ozone Park residents are predominantly non-white Caribbean Americans based on data from the NYC Department of City Planning, whereas residents of Steinway are predominantly non-Latinx white. Results: We identified a significantly higher proportion of fast-food advertisements in the Caribbean-American neighborhood (19.78%, n =36) compared with the non-Latinx white neighborhood (5.03%, n =9; p <0.001). Among beverage advertisements, 30.77% ( n =56) featured alcohol brands in the Caribbean-American neighborhood, whereas 22.91% ( n =41) featured alcohol brands in the non-Latinx white neighborhood. In the Caribbean-American neighborhood, 24.18% ( n =44) of food and beverage advertisements referenced Caribbean culture. Conclusions: The Caribbean-American neighborhood in this study had more fast-food advertisements relative to non-Latinx white neighborhoods. More research is needed to understand the effects of culturally targeted ads on Caribbean-American communities.