SOCIAL SCIENTIFIC LITERATURE REVIEW
The secondary sources that I used to support my research discussed three main themes. The first theme discussed is the rising prevalence of obesity among youth and adolescents. Several of these authors provide statistics and talk about how obesity rates are higher among certain groups and regions than others. The second theme is the concept of targeted food marketing, which is demonstrated in two different ways: the clustering of unhealthy food outlets near schools or low-income areas, as well as targeted advertising towards children through the use of tie-ins and premiums. The final theme discussed is the way that the McDonald’s Corporation has contributed to child obesity and played a role in promoting unhealthy eating habits.
Prevalence of Child Obesity
Fast-food comprises an increasing proportion of Americans’ diet. These meals and snacks prepared away from home typically contain more total calories and a higher percentage of fat compared to food that is prepared at home. This higher calorie and fat consumption among fast-food eaters is a likely contributor to increasing risk of obesity. Healthy People 2010 identified overweight and obesity as 1 of 10 leading health indicators of the United States population, calling for a reduction in the proportion of children and adolescents who are overweight (Ogden and Carroll 2010). The Center for Disease Control and Prevention (CDC) provides statistics on the prevalence of obesity among children and adolescents aged 2-19 years by sex and age, from the years 1963-1965 through 2011-2012. From ages 2-5 years, the prevalence of obesity in children has steadily increased since 1971 and began to decrease in 2011. From youth aged 6-11 years old, the prevalence of obesity has dramatically increased each year since 1966, especially rising during the period of 1976-1980 to 1988-1994, and once again spiking from 1988-1994 through 1999-2000 (Fryar, Carroll, and Ogden 2014:5). Among adolescents aged 12-19, the prevalence of obesity followed a similar trend to those aged 6-11 years. In 2015, the prevalence of obesity among United States youth was 18.5% (Hales et al. 2017:3). This percentage has increased rapidly from approximately 4% in 1963. Good taste, accessibility, and cost are often cited as factors in the decision to eat fast food (Lydon et al. 2011). Similarly, Lucan, Barg and Long (2010:631) determined that the factors that may encourage disease-promoting diets include individual tastes and preferences, cultural values and heritage, social and economic context, and systemic influences like media and marketing. These authors also stated that low-income African Americans tend to have diets that promote obesity, morbidity, and premature mortality because they are low in fruits and vegetables and high in processed foods (Lucan, Barg, and Long 2010). In the US, low socioeconomic status Black, Hispanic and Native American populations, along with rural populations, experience a higher-than-average burden of obesity and other diet-related chronic diseases (Kraft, Thatcher, and Zenk 2020). Due to this disparity, Ro and Osborn (2018) focus on food insecurity, which is an important driver of health disparities, not only because the condition itself is socially patterned, but because it is associated with poorer health outcomes. Individuals who consume fast-food typically report that they do so because it is convenient. In response to critics, many fast-food establishments have begun to include more healthful items in their menus. While this has increased the number of healthy items people purchase, it has not seemed to curb customers’ appetites for other, less healthy items. Other attempts have been made as well, including a decision to remove the toy from children’s Happy Meals at McDonald’s, which did not last long (Lydon et al. 2011). Angela Hilmers (2012) discusses how policy initiatives, such as calorie labeling in fast-food restaurants, are intended to help customers make informed menu choices. However, assessments of the effectiveness of these regulations have yet to prove consistent results. Efforts to get parents to pay closer attention to their children’s weight and body mass index (BMI) can be controversial, because some parents can become overly restrictive about their children’s food intake (Kumanyika and Grier 2006:198). Addressing childhood obesity issues requires particular sensitivity to differences in attitudes about weight that may be the products of culture and economic insecurity.
Targeted Food Advertising
Targeted food advertising is a common practice of many fast-food companies. Studies suggest that low-income or predominately Black neighborhoods have higher densities of fast-food outlets (Lamichhane et al. 2013). Additionally, the clustering of both healthy and unhealthy food outlets can be typical in more rural states like South Carolina, which lacks specific land-use zoning and are typified by clustering of retail locations around roads with higher traffic volume (Lamichhane et al. 2013:9). Grier and Davis (2013) discuss the ways in which obesity disparities challenge the public health community, policy makers, and the food marketing industry as they work to identify appropriate interventions regarding food marketing to youth. The location-related concern is that the closer fast-food outlets are to a youth’s school or home, the more fast-food he or she will eat, and therefore more likely he or she will become overweight or obese. Fast-food restaurants are often systematically concentrated around schools, giving children greater access to this low-quality food (Grier and Davis 2013). Bryman (2003) also discusses targeted food marketing towards children by introducing the concepts of “McDonaldization” and “Disneyization”. He states that “Disneyization” is “the process by which the principles of the Disney theme parks are coming to dominate more and more sectors of American society as well as the rest of the world,” (Bryman 2003:154). Bryman substituted the phrase “Disney theme parks” for “fast-food restaurants”, specifically referring to McDonald’s. He proposes the idea that McDonald’s is a Disneyized institution, since the principles of Disneyization are closely connected with the rise of consumerism. Bryman quoted a McDonald’s managing director who once said, “McDonald’s sells a system, not products” (2003:164).
Advertising to Children
Children influence how billions of dollars are spent through household purchases and are the future of adult consumers (Story and French 2004:2). The largest source of media messages about food towards children is through television. To target youth, Disney has launched cross-selling campaigns and tie-ins worth millions of dollars to promote its films and characters. In 1996, Disney signed a ten-year global agreement with McDonald’s to place Disney toys in Happy Meal boxes, and many child advocates and media experts believe that this marketing is escalating public health concerns (Story and French 2004). Food promotions have been seen to have a direct effect on children’s nutrition knowledge, preferences, purchase behavior, consumption patterns and diet-related health (Dixon et al. 2017). Premium offers linked to products, such as toys, collectables, and giveaways, are designed to incite product purchases. Product placement was first recognized as a successful marketing technique when the character E.T. in Steven Spielberg’s 1982 movie, E.T., ate Reese’s Pieces, resulting in a national spike of 66% in product purchases (Calvert 2008:209). A previous study showed that McDonald’s restaurants released cross-promotional tie-in toy premiums with kid’s meals three times more frequently than other fast-food restaurants, and that young children’s knowledge of fast-food was associated with a greater frequency of eating at McDonald’s (Dixon et al. 2017:343). These premiums are a source of entertainment for children; often, the McDonald’s Happy Meal box itself can be manipulated in some way to create a racetrack, playhouse, or game (Hourigan 2020:7). In 2009, fast-food companies spent approximately $600 million on child-targeted marketing, which is defined as marketing to children under the age of 12 (Emond et al. 2019:135). Children as young as three years old recognize and form positive impressions about child targeted brands. Additionally, parents play a primary role in shaping young children’s diets, and preschool age children’s fast-food intake is strongly positively correlated with parental fast-food consumption (Emond et al. 2019).
McDonald’s Role in Public Health
Fast-food companies, mainly McDonald’s, find themselves at the center of controversy in today’s society regarding their impact on public health. The World Health Organization (WHO) stated that food companies should “practice responsible marketing that supports the Strategy, particularly with regard to the promotion and marketing of foods high in saturated fats, trans-fatty acids, free sugars, or salt, especially to children,” (Lewin, Lindstrom, and Nestle 2006:329). McDonald’s is the largest food service company in the world, with over $20 billion in sales in 2005, and the company serves 50 million people daily in more than 30,000 outlets and 119 countries (Lewin, Lindstrom, and Nestle 2006:330). With that kind of presence, McDonald’s gets attention, and its products and marketing practices often draw criticism because of their influence on child health. The McDonald’s Corporation website reveals evident efforts to promote health; however, their primary marketing methods to children continue to promote hamburgers, sodas, and fries (Lewin, Lindstrom, and Nestle 2006). Catherine Adams, the Vice President of the McDonald’s Corporation, states that they listen to their customers, and work with experts in science, health, and agriculture. However, she concluded her public statement by acknowledging that McDonald’s has “taken a seat at the table of obesity discussion,” but their role is not apologetic as they are a partner who is equally dedicated to responsible and sustainable solutions (Adams 2007:157). Ronald Adams discusses the movie Super Size Me, where Morgan Spurlock committed himself to an exclusive McDonald’s-only diet for 30 days. At the end of the experiment, he gained 18 pounds, experienced mood swings, lost sex drive, and suffered liver damage. His body fat composition increased by 7%, and his cholesterol went up, along with his blood pressure (Adams 2005:297). McDonald’s representatives attempted to discredit the film, but soon phased out their supersize menu after facing backlash. Adams (2005:298) assesses the question: To what extent, if any, should the fast-food industry be held accountable for the obesity crisis? He finds that the causes of obesity are complex, and it is difficult to isolate the specific role played by fast-food; however, it is evident that both obesity rates and fast-food companies have both grown exponentially (Adams 2005).
These scholarly articles support my three central themes and help address the main aspects of my research question: child obesity rates, targeted marketing, and the way in which McDonald’s advertises to children. Both the statistics provided and previous research allow me to build off of these topics and frame my research around the connection between the child obesity epidemic and the growing fast-food industry.
