Seeing Health: Examining the Association Between Hispanic Caribbean Restaurant Characteristics and Healthy Menu Images in New York City

Hispanics experience more diet-related health disparities in comparison to non-Hispanic whites. Community nutrition environments can influence health outcomes, but restaurants are a largely untapped research area. This study examined how Hispanic Caribbean restaurants promote healthy eating through menu design, and which Hispanic Caribbean restaurants characteristics are associated with healthy menu images. We hypothesize that healthy menu images will be associated with more affluent neighborhoods. We examined the nutrition environment in a random sample of 89 Hispanic Caribbean restaurants in New York City. This analysis included a subsample of Hispanic Caribbean restaurants that had menus with images (n=51). Hispanic Caribbean restaurants were classified as having healthy menu images if at least half of all images showed a potentially healthy option (i.e. non-fried entrée, a non-fried, non-starchy vegetable side, or both). Descriptive analysis and logistic regression were used to examine the association between healthy menu images and restaurant characteristics, including Hispanic Caribbean cuisine served, type (fast-casual vs. sit-down), and neighborhood characteristics (gentrification status, supermarket to bodega ratio, Hispanic-Caribbean population density). Significance was established at p\u3c 0.10 accounting for the exploratory nature of the analysis. Healthy menu images were found in 39.2% of the sample and associated with neighborhood gentrification. Compared to Hispanic Caribbean restaurants in non-gentrifying neighborhoods (poor), those located in gentrifying areas had higher odds for healthy menu images (AOR:12.744, p=0.030). No significant associations were found between healthy menu images and supermarket to bodega ratio, restaurant type, Hispanic Caribbean population density, and cuisine type. The design of a menu and its inclusion of images can direct a customer’s attention to specific items, increasing the likelihood that those items will be ordered. Our research indicates potential differences in healthy menu images in Hispanic Caribbean restaurants by neighborhood gentrification, underscoring inequities in these areas’ food environments. More research is needed to examine menu design in ethnic restaurants, to inform future health promotion interventions in low-income, non-gentrifying neighborhoods