CCPHA researchers cited other research to prove a connection between a high RFEI, obesity and poor health. It noted that other research studies show the nearness of supermarkets has a positive influence on people's dietary behaviors and health. They are more likely to eat healthy diets than others farther away. It reported another study that showed those people in Chicago living where there is a high ratio of fast-food restaurants to grocery stores had more diabetes, cancer and heart diseases.

The researchers seemed to assume that "A" caused "B" only because they happened together, or because "B" followed "A". In addition, they compared two unlike conditions—the positive effect on health of living near supermarkets to the negative influence of many fast-food outlets where there are fewer supermarkets. They cannot make credible comparisons without other information such as what products those supermarkets and fast-food outlets offer and what food products consumers want.

CCPHA researchers also ignored other obesity and health causes. Medium-income neighborhoods usually have more supermarkets close by than low-income and wealthy neighborhoods do. Nevertheless, the residents in affluent areas enjoy better health than medium-income residents do that live near supermarkets. Another cause not considered in this conclusion is that supermarket chains offer different food products in their stores according to consumer demands in the neighborhood. About healthy choices, many people buy fresh vegetables and fruit and drown them in unhealthy fat, sugar and salt.

CCPHA researchers ignored other important cultural trends when they decided their RFEI indicated Californians had more unhealthy than healthy food choices. They did this although they included information from other studies that show changes Americans' lifestyle since 1970 likely affect obesity and health. From then until 2003, families increased their spending for meals outside the home from 27.6 to 41.9 percent of their food budget. In addition, the percentage of calories from meals outside the home increased. Fast-food outlets gained an increasingly bigger share of this money since 1982. We must consider this cultural change in food consumption because this period coincides with the period when Americans' weight gains happened.

Families from all income groups joined this cultural trend to eat more meals outside the home. However, lower income families consumed more meals from fast-food outlets than from healthier full-service restaurants because of cost. Therefore, the ratio between the number of fast-food and full-service restaurants in an area is a better indicator of Californians' access to healthy or unhealthy food choices than is the CCPHA RFEI.

Ironically, we cannot figure a new RFEI based on the number of full-service or table service eating places because the CCPHA study did not count them. This shows how a study designed to collect information to prove a presumption often makes this finding no matter the facts. One gets different results when they collect all available relevant information and allow it to decide the conclusion.

The cultural trend to eat outside the home probably will continue. Therefore, educating Californians about proper diet and health so they demand healthier food choices from restaurants will improve their health faster than government regulations that manipulate the number of retail food outlets by type.

Kenneth Brooks is a freelance writer and speaker. Contact him at P.O. Box 882, Vallejo, CA 94590. opinion@ethicalego.com