McDonald’s (NYSE: MCD) is the largest fast-food hamburger chain in America with nearly 16,000 locations nationwide. In areas that have the most McDonald’s per capita, the population tends to have higher rates of obesity and heart disease. While a direct connection cannot be made between McDonald’s and negative health outcomes, areas with clusters of fast-food restaurants of any type typically have less healthy populations.
To identify the states with the most and least McDonald’s per capita, 24/7 Wall St. reviewed the concentration of McDonald’s restaurants in every state per 100,000 residents with data from restaurant reviewer and data compiler Menuism. Ohio has the highest concentration of McDonald’s with 7.1 locations per 100,000 people. This is more than twice the amount in New Jersey, the state with the lowest concentration of McDonald’s.
The association between the obesity rate and the concentration of McDonald’s restaurants in an area seems to be stronger than with other fast food chains. Of the 10 states with the highest concentration of major fast food restaurants, excluding McDonald’s, five have obesity rates higher than the nation. However, of the 10 states with the highest concentration of McDonald’s, all 10 have higher obesity rates than the nationwide rate.
Click here to see the states with the most McDonald’s.
Areas that have higher concentrations of McDonald’s and poorer health outcomes tend to have other traits that can lead to poor health. For example, areas with high concentrations of McDonald’s tend to be poorer. In all but one of the 10 states with the most McDonald’s, the typical household earns less than the national annual median household income.
Many other traits related to poor health are common among states with the most McDonald’s. For one, residents tend to engage in less healthy behaviors. For example, adults report being less physically active, and the smoking rates are higher in these states. Nine of the 10 states with the most McDonald’s outlets per capita have a higher smoking rate than the nationwide rate.
Whether unhealthy residents in an area are McDonald’s customers, or whether consuming fast food like McDonald’s hamburgers actually leads to such poor health outcomes, is difficult to determine with confidence. Nonetheless, residents in areas with high concentrations of McDonald’s locations tend to be less healthy than in areas with a lower concentration.
To identify the states with the greatest concentration of McDonald’s restaurants, 24/7 Wall St. reviewed location data for McDonald’s, Burger King, Wendy’s (NASDAQ: WEN), Taco Bell, KFC — which is a division of Yum! Brands (NYSE: YUM), Subway, Starbucks (NASDAQ: SBUX), Pizza Hut, Dunkin’ Donuts (NASDAQ: DNKN), and Chick-fil-A from Menuism. Population data, income, educational attainment rates, and poverty statistics are from the U.S. Census Bureau’s 2014 American Community Survey (ACS). Self reported obesity rates are from County Health Rankings & Roadmaps, a Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute joint program. We also considered self-reported adult consumption of fruits and vegetables from the Centers for Disease Control and Prevention’s 2013 State Indicator Report on Fruits and Vegetables.
These are the states with the most and least McDonald’s outlets per 100,000 residents.
50. New Jersey
> No. of McDonald’s:3.5 (per 100,000 people)
> Obesity rate: 24.7% (11th lowest)
> Pct. consuming vegetables less than daily: 22.2% (21st lowest)
> Median household income: $71,919 (2nd highest)
49. Utah
> No. of McDonald’s:3.8 (per 100,000 people)
> Obesity rate: 24.9% (12th lowest)
> Pct. consuming vegetables less than daily: 19.8% (9th lowest)
> Median household income: $60,922 (13th highest)
48. California
> No. of McDonald’s:3.8 (per 100,000 people)
> Obesity rate: 22.5% (3rd lowest)
> Pct. consuming vegetables less than daily: 16.5% (2nd lowest)
> Median household income: $61,933 (9th highest)
47. New York
> No. of McDonald’s:3.9 (per 100,000 people)
> Obesity rate: 24.1% (7th lowest)
> Pct. consuming vegetables less than daily: 23.0% (25th highest)
> Median household income: $58,878 (16th highest)
46. North Dakota
> No. of McDonald’s:3.9 (per 100,000 people)
> Obesity rate: 30.2% (15th highest)
> Pct. consuming vegetables less than daily: 27.1% (6th highest)
> Median household income: $59,029 (15th highest)
45. Rhode Island
> No. of McDonald’s:4.2 (per 100,000 people)
> Obesity rate: 26.4% (17th lowest)
> Pct. consuming vegetables less than daily: 20.7% (14th lowest)
> Median household income: $54,891 (19th highest)
44. Alaska
> No. of McDonald’s:4.2 (per 100,000 people)
> Obesity rate: 28.4% (25th highest)
> Pct. consuming vegetables less than daily: 19.7% (8th lowest)
> Median household income: $71,583 (3rd highest)
43. South Dakota
> No. of McDonald’s:4.2 (per 100,000 people)
> Obesity rate: 29.8% (17th highest)
> Pct. consuming vegetables less than daily: 26.3% (9th highest)
> Median household income: $50,979 (22nd lowest)
42. Idaho
> No. of McDonald’s:4.2 (per 100,000 people)
> Obesity rate: 27.7% (23rd lowest)
> Pct. consuming vegetables less than daily: 20.1% (10th lowest)
> Median household income: $47,861 (14th lowest)
41. Arizona
> No. of McDonald’s:4.3 (per 100,000 people)
> Obesity rate: 23.5% (4th lowest)
> Pct. consuming vegetables less than daily: 20.6% (12th lowest)
> Median household income: $50,068 (21st lowest)
40. Connecticut
> No. of McDonald’s:4.4 (per 100,000 people)
> Obesity rate: 24.7% (10th lowest)
> Pct. consuming vegetables less than daily: 20.6% (12th lowest)
> Median household income: $70,048 (4th highest)
39. Massachusetts
> No. of McDonald’s:4.4 (per 100,000 people)
> Obesity rate: 23.7% (6th lowest)
> Pct. consuming vegetables less than daily: 20.7% (14th lowest)
> Median household income: $69,160 (6th highest)
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38. Colorado
> No. of McDonald’s:4.4 (per 100,000 people)
> Obesity rate: 20.1% (the lowest)
> Pct. consuming vegetables less than daily: 19.1% (7th lowest)
> Median household income: $61,303 (12th highest)
37. Texas
> No. of McDonald’s:4.5 (per 100,000 people)
> Obesity rate: 28.4% (25th lowest)
> Pct. consuming vegetables less than daily: 21.8% (16th lowest)
> Median household income: $53,035 (23rd highest)
36. Pennsylvania
> No. of McDonald’s:4.6 (per 100,000 people)
> Obesity rate: 28.8% (23rd highest)
> Pct. consuming vegetables less than daily: 23.9% (20th highest)
> Median household income: $53,234 (22nd highest)
35. Hawaii
> No. of McDonald’s:4.6 (per 100,000 people)
> Obesity rate: 22.1% (2nd lowest)
> Pct. consuming vegetables less than daily: 22.6% (24th lowest)
> Median household income: $69,592 (5th highest)
34. Washington
> No. of McDonald’s:4.6 (per 100,000 people)
> Obesity rate: 27.2% (19th lowest)
> Pct. consuming vegetables less than daily: 18.8% (5th lowest)
> Median household income: $61,366 (11th highest)
33. Delaware
> No. of McDonald’s:4.7 (per 100,000 people)
> Obesity rate: 29.0% (22nd highest)
> Pct. consuming vegetables less than daily: 23.8% (21st highest)
> Median household income: $59,716 (14th highest)
32. Nebraska
> No. of McDonald’s:4.7 (per 100,000 people)
> Obesity rate: 29.5% (18th highest)
> Pct. consuming vegetables less than daily: 26.2% (10th highest)
> Median household income: $52,686 (24th highest)
31. North Carolina
> No. of McDonald’s:4.8 (per 100,000 people)
> Obesity rate: 29.1% (20th highest)
> Pct. consuming vegetables less than daily: 21.9% (18th lowest)
> Median household income: $46,556 (11th lowest)
30. Vermont
> No. of McDonald’s:4.8 (per 100,000 people)
> Obesity rate: 24.4% (8th lowest)
> Pct. consuming vegetables less than daily: 18.1% (4th lowest)
> Median household income: $54,166 (20th highest)
29. New Mexico
> No. of McDonald’s:4.8 (per 100,000 people)
> Obesity rate: 23.6% (5th lowest)
> Pct. consuming vegetables less than daily: 21.9% (18th lowest)
> Median household income: $44,803 (8th lowest)
28. Florida
> No. of McDonald’s:5.0 (per 100,000 people)
> Obesity rate: 25.5% (14th lowest)
> Pct. consuming vegetables less than daily: 22.6% (24th lowest)
> Median household income: $47,463 (12th lowest)
27. Georgia
> No. of McDonald’s:5.1 (per 100,000 people)
> Obesity rate: 29.0% (21st highest)
> Pct. consuming vegetables less than daily: 23.2% (23rd highest)
> Median household income: $49,321 (17th lowest)
26. Oregon
> No. of McDonald’s:5.2 (per 100,000 people)
> Obesity rate: 26.0% (15th lowest)
> Pct. consuming vegetables less than daily: 15.3% (the lowest)
> Median household income: $51,075 (23rd lowest)
25. Minnesota
> No. of McDonald’s:5.2 (per 100,000 people)
> Obesity rate: 26.3% (16th lowest)
> Pct. consuming vegetables less than daily: 23.6% (22nd highest)
> Median household income: $61,481 (10th highest)
24. New Hampshire
> No. of McDonald’s:5.2 (per 100,000 people)
> Obesity rate: 27.3% (20th lowest)
> Pct. consuming vegetables less than daily: 17.6% (3rd lowest)
> Median household income: $66,532 (7th highest)
23. South Carolina
> No. of McDonald’s:5.3 (per 100,000 people)
> Obesity rate: 31.6% (9th highest)
> Pct. consuming vegetables less than daily: 27.3% (4th highest)
> Median household income: $45,238 (9th lowest)
22. Virginia
> No. of McDonald’s:5.3 (per 100,000 people)
> Obesity rate: 27.3% (21st lowest)
> Pct. consuming vegetables less than daily: 22.2% (21st lowest)
> Median household income: $64,902 (8th highest)
21. Montana
> No. of McDonald’s:5.4 (per 100,000 people)
> Obesity rate: 24.6% (9th lowest)
> Pct. consuming vegetables less than daily: 21.7% (15th lowest)
> Median household income: $46,328 (10th lowest)
20. Mississippi
> No. of McDonald’s:5.4 (per 100,000 people)
> Obesity rate: 35.3% (the highest)
> Pct. consuming vegetables less than daily: 32.3% (2nd highest)
> Median household income: $39,680 (the lowest)
19. Maine
> No. of McDonald’s:5.4 (per 100,000 people)
> Obesity rate: 27.9% (24th lowest)
> Pct. consuming vegetables less than daily: 18.9% (6th lowest)
> Median household income: $49,462 (19th lowest)
18. West Virginia
> No. of McDonald’s:5.5 (per 100,000 people)
> Obesity rate: 34.1% (3rd highest)
> Pct. consuming vegetables less than daily: 26.2% (10th highest)
> Median household income: $41,059 (2nd lowest)
17. Nevada
> No. of McDonald’s:5.5 (per 100,000 people)
> Obesity rate: 25.4% (13th lowest)
> Pct. consuming vegetables less than daily: 24.4% (18th highest)
> Median household income: $51,450 (24th lowest)
16. Wyoming
> No. of McDonald’s:5.5 (per 100,000 people)
> Obesity rate: 26.6% (18th lowest)
> Pct. consuming vegetables less than daily: 22.4% (22nd lowest)
> Median household income: $57,055 (18th highest)
15. Iowa
> No. of McDonald’s:5.6 (per 100,000 people)
> Obesity rate: 30.7% (12th highest)
> Pct. consuming vegetables less than daily: 26.9% (7th highest)
> Median household income: $53,712 (21st highest)
14. Oklahoma
> No. of McDonald’s:5.6 (per 100,000 people)
> Obesity rate: 32.4% (6th highest)
> Pct. consuming vegetables less than daily: 26.8% (8th highest)
> Median household income: $47,529 (13th lowest)
13. Illinois
> No. of McDonald’s:5.7 (per 100,000 people)
> Obesity rate: 27.4% (22nd lowest)
> Pct. consuming vegetables less than daily: 25.2% (15th highest)
> Median household income: $57,444 (17th highest)
12. Alabama
> No. of McDonald’s:5.8 (per 100,000 people)
> Obesity rate: 33.6% (4th highest)
> Pct. consuming vegetables less than daily: 24.3% (19th highest)
> Median household income: $42,830 (4th lowest)
11. Kentucky
> No. of McDonald’s:5.9 (per 100,000 people)
> Obesity rate: 32.3% (7th highest)
> Pct. consuming vegetables less than daily: 25.2% (15th highest)
> Median household income: $42,958 (5th lowest)
10. Wisconsin
> No. of McDonald’s:5.9 (per 100,000 people)
> Obesity rate: 29.4% (19th highest)
> Pct. consuming vegetables less than daily: 26.0% (12th highest)
> Median household income: $52,622 (25th highest)
9. Indiana
> No. of McDonald’s:5.9 (per 100,000 people)
> Obesity rate: 31.4% (11th highest)
> Pct. consuming vegetables less than daily: 27.3% (4th highest)
> Median household income: $49,446 (18th lowest)
8. Tennessee
> No. of McDonald’s:6.0 (per 100,000 people)
> Obesity rate: 32.2% (8th highest)
> Pct. consuming vegetables less than daily: 25.4% (14th highest)
> Median household income: $44,361 (6th lowest)
7. Missouri
> No. of McDonald’s:6.1 (per 100,000 people)
> Obesity rate: 30.6% (13th highest)
> Pct. consuming vegetables less than daily: 25.2% (15th highest)
> Median household income: $48,363 (15th lowest)
6. Arkansas
> No. of McDonald’s:6.2 (per 100,000 people)
> Obesity rate: 33.3% (5th highest)
> Pct. consuming vegetables less than daily: 28.6% (3rd highest)
> Median household income: $41,262 (3rd lowest)
5. Louisiana
> No. of McDonald’s:6.3 (per 100,000 people)
> Obesity rate: 34.3% (2nd highest)
> Pct. consuming vegetables less than daily: 32.5% (the highest)
> Median household income: $44,555 (7th lowest)
4. Maryland
> No. of McDonald’s:6.3 (per 100,000 people)
> Obesity rate: 28.4% (24th highest)
> Pct. consuming vegetables less than daily: 22.8% (25th lowest)
> Median household income: $73,971 (the highest)
3. Kansas
> No. of McDonald’s:6.3 (per 100,000 people)
> Obesity rate: 30.2% (16th highest)
> Pct. consuming vegetables less than daily: 22.2% (21st lowest)
> Median household income: $52,504 (25th lowest)
2. Michigan
> No. of McDonald’s:6.4 (per 100,000 people)
> Obesity rate: 31.4% (10th highest)
> Pct. consuming vegetables less than daily: 23.2% (23rd highest)
> Median household income: $49,847 (20th lowest)
1. Ohio
> No. of McDonald’s:7.1 (per 100,000 people)
> Obesity rate: 30.5% (14th highest)
> Pct. consuming vegetables less than daily: 26.0% (12th highest)
> Median household income: $49,308 (16th lowest)
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