Unhealthful Food-and-Beverage Advertising in Subway Stations: Targeted Marketing, Vulnerable Groups, Dietary Intake, and Poor Health

Abstract

Unhealthful food-and-beverage advertising often targets vulnerable groups. The extent of such advertising in subway stations has not been reported and it is not clear how ad placement may relate to subway ridership or community demographics, or what the implications might be for diets and diet-related health in surrounding communities. Riding all subway lines (n = 7) in the Bronx, NY, USA, investigators systematically assessed all print ads (n = 1586) in all stations (n = 68) in 2012. Data about subway ridership came from the Metropolitan Transportation Authority. Demographic data on surrounding residential areas came from the U.S. Census Bureau. Data on dietary intake and diet-related conditions came from a city health-department survey. There were no ads promoting "more-healthful" food-or-beverage items (i.e., fruits, vegetables, whole grains, nuts, water or milk). There were many ads for "less-healthful" items (e.g., candies, chips, sugary cereals, frozen pizzas, "energy" drinks, coffee confections, hard alcohol, and beer). Ad placement did not relate to the number of riders entering at stations. Instead, exposure to food-or-beverage ads generally, and to "less-healthful" ads particularly (specifically ads in Spanish, directed at youth, and/or featuring minorities), was directly correlated with poverty, lower high-school graduation rates, higher percentages of Hispanics, and/or higher percentages of children in surrounding residential areas. Correlations were robust to sensitivity analyses. Additional analyses suggested correlations between ad exposures and sugary-drink consumption, fruit-and-vegetable intake, and diabetes, hypertension, and high-cholesterol rates. Subway-station ads for "less-healthful" items were located disproportionately in areas home to vulnerable populations facing diet and diet-related-health challenges. The fact that uneven ad placement did not relate to total rider counts suggests ads were not directed at the largest possible audiences but rather targeted to specific groups.

Disparities in Sugary Drink Advertising on New York City Streets

“…Often, targeted marketing appears to influence purchasing and consumption patterns effectively. 22,35 The current findings coupled with research demonstrating that areas with higher percentages of food advertisement had increased odds of sugary drink consumption, 12,17,20 obesity, 12 and diabetes, 20 highlights the important role targeted advertising might play in perpetuating poor health and contributing to persistent health-related disparities in NYC neighborhoods. Given the rising national attention around policy proposals to reduce consumption, 36 understanding how sugary drink advertising is placed across neighborhoods can inform community-based and policy efforts that aim to address sugary drink overconsumption.…”

“…In Queens, there was a surprising inverse association observed with the percentage of Latino residents, which is the opposite of what previous research has found. 20,33 As there is considerable diversity within Latino communities (e.g., country of origin, years of acculturation, income, and education levels) and where Latinos reside in NYC, 34 further research may provide additional context to these findings. It is also meaningful that although the percentage of white, non-Latino residents was excluded from adjusted analysis owing to issues of multicollinearity, its significant inverse association at the city level and in 3 of 5 boroughs suggests a protective effect in neighborhoods with large white, non-Latino populations.…”

How to be SSB-free: Assessing the attitudes and readiness for a sugar sweetened beverage-free healthcare center in the Bronx, NY

“…[31]. In the Bronx; African-American and Spanish-speaking populations are exposed to more processed food commercials and advertisements than white residents[32,33]. Over the next decade, the marketing of sugar-sweetened beverages is expected to increase dramatically worldwide.…”

When food isn't medicine - A challenge for physicians and health systems

“…Promotion of unhealthful items is also a problem within and outside other food sources ( Ohri-Vachaspati et al, 2014 ) and more broadly in patient communities ( Lesser et al, 2013 ). Advertisements for high calorie, low-nutrient foods appear more often in African American and Latino neighborhoods ( Yancey et al, 2009 ), with subway-station ads in particular targeted to neighborhoods with higher poverty, lower high-school graduation rates, higher percentages of Hispanics ( Lucan et al, 2017 ).…”