McDonald’s (NYSE: MCD) isn’t America’s largest fast food chain — there are only about 14,000 stores around the country, as opposed to more than 25,000 Subway outlets. It is, however, the largest hamburger chain by far — its nearest competitor, Burger King, has only about 7,500 stores — and the most iconic.
Using data collected from the McDonald’s website, 24/7 Wall St. has identified the number of McDonald’s locations in every state. The tally ranges from 25 in North Dakota to 1,295 in California. The concentration of McDonald’s restaurants also varies considerably.
Five of the 10 states with the highest concentrations of McDonald’s per 100,000 residents — West Virginia, Arkansas, Kentucky, Oklahoma, and Michigan — are also among the 10 states with the highest rates of obesity. However, there is virtually no research that establishes a causative link between the availability of Big Macs and Quarter Pounders — or any other fast food — and adverse health outcomes.
A 2011 study in The Journal of Rural Health, for instance, found an association (though not a causative link) between fast food outlets and negative health outcomes in metropolitan areas but not in a rural setting. In 2013, a National Heart, Lung, and Blood Institute’s CARDIA (Coronary Artery Risk Development in Young Adults) study found no association between BMI (body mass index) and density of fast food restaurants and convenience stores. In a systematic review of some 46 studies published between 2005 and 2015 on the relationship between a fast food environment and obesity rates in the United States and abroad by The Journal of Obesity and Weight Loss Therapy, the overwhelming majority found little or no consistent correlation between obesity and fast food.
On the other hand, a study published in 2015 by two researchers from the Geospatial Sciences Center of Excellence at South Dakota State University discovered that populations in urban settings served primarily by full-service restaurants and grocery stores had a lower obesity rate than those where fast food places and convenience stores predominated.
It is important to remember, though, that there are many other factors other than restaurant choices that may also contribute to obesity and other potentially diet-linked conditions such as cardiovascular disease and diabetes. Low income, high poverty rates, and relative unavailability of fresh fruits and vegetables also contribute to unhealthy lives.