Americans love fast food. (We spent $165 billion on it in 2010.) But we don't all love it equally. Like the obesity rate, fast-food consumption varies widely by region. Residents of some states disproportionately choose fast food over other options when they go out to eat, with consequences for the state's collective health.
Using government data on the percentage of restaurants in each state that serve fast food and the percentage of dining-out dollars the average resident spends in them each year, Health.com identified the 10 states where fast-food consumption is most prevalent. Here they are, in alphabetical order.
Fast-food restaurants account for just 44 percent of Alabama eateries (that's the fifth-lowest rate in the U.S.), but residents still manage to spend close to 60 percent of their annual dining-out budget on quick-and-easy meals. In a state where more than two-thirds of people are overweight, 80 percent of adults don't eat enough fruits and veggies, and rates of heart disease and diabetes are sky high, that's not good news.
"Fast food" doesn't mean only big chains with drive-thrus. The government agencies that collect data on restaurants consider any place without table service to be in the fast-food category, whether it's a McDonald's, a sub shop, or a takeout BBQ joint - like George's, in Brewton, Ala.
Colonel Sanders was clearly on to something when he began selling takeout fried-chicken dinners to busy families during the Depression. Decades later, Kentuckians now spend 56 cents of every restaurant dollar on KFC and other fast food.
In fact, KFC's parent company, Yum Brands, which is based in Louisville and also owns Pizza Hut and Taco Bell, has begun lobbying Kentucky's governor to allow food stamps from certain residents to be accepted at fast-food places. Kentucky, which has the country's second-highest obesity rate, would be just the fourth state to approve the practice.
The Popeyes restaurant chain, which was founded near New Orleans in 1972 and prides itself on its fried chicken, biscuits, and red beans and rice, recently launched a new branding campaign to play up its Louisiana heritage - and its besting of KFC in a nationwide taste test.
They may disagree on whose chicken is best, but Louisiana residents certainly share Kentuckians' love of fast food. They spend nearly as much money on fast food (54 percent of their restaurant budget), and, just like the Bluegrass State, their rates of obesity, heart disease, and diabetes rank among the top five in the country.
Of all the states on our list, Maryland - home of the Roy Rogers burger chain - has the lowest proportion of fast-food restaurants (40 percent). But that doesn't prevent residents from spending nearly half of their dining-out dollars in them.
And fast-food establishments are still too plentiful for some. The abundance of fast food in Prince Georges County, a densely populated area bordering Washington, D.C., prompted a state senator to propose a countywide moratorium on new restaurants in 2010. "Our county is inundated with unhealthy food choices," a supporter of the bill told the Washington Post. "In some areas, if someone wants a healthy choice, there are no options."
Residents spend a whopping 62 percent of their dining-out budget on fast food - the highest rate in the country. It may not be a coincidence that Mississippi also boasts the highest percentage of overweight (70 percent) and obese (33 percent) adults.
In some areas, such as the Delta region, food deserts that feature a bevy of fast-food options and a lack of fresh, healthful alternatives may be part of the problem. "You can find fried chicken and fried fish and fried potato logs and fried pies at convenience stores in just about any little town," an NPR correspondent (and native Southerner) reported recently from rural Holmes County, the poorest and most obese county in the state.
Buckeyes spend more than half of their restaurant dollars in fast-food establishments, including the many large chains - such as Wendy's, Arby's, White Castle, Qdoba Mexican Grill, and Jump Asian Express - that were founded or have their headquarters here.
In a 2005 report highlighting Ohio's alarming obesity rates, the Health Policy Institute of Ohio identified "the growth of fast food and full service restaurants" and "unhealthy food environments" - namely, "readily available, inexpensive, high-sugar, [and] high-fat foods" - as two of the main culprits behind the state's population-wide weight gain.
Just over half of the restaurants in Oklahoma serve fast food. (That includes no fewer than 271 locations of the Sonic drive-in chain, which was founded here.) Sooners make good use of them. Statewide, they spend an average of 58 cents of every restaurant dollar on fast food - and some spend far more.
In 2007, Fortune named Oklahoma City the fast-food capital of America because it consistently appears near the top of the list of cities with the most "heavy users" of fast food. Market research showed that 55 percent of the city's residents visited a fast-food restaurant at least 12 times in the previous month, and that those fast-food fans averaged 21 monthly visits.
Houston has a problem - as do Dallas, San Antonio, El Paso, and Corpus Christi. In 2010, these cities accounted for half of the top 10 slots in Men's Health's annual list of the "fattest" U.S. cities. (Not surprisingly, some also have unusually high rates of "heavy users" of fast food.)
The state's weight problem is especially bad among kids. More than 20 percent of all 10- to 17-year-old Texans are obese, thanks in part to food desserts and financial hardship - a combo that encourages fast-food consumption. "About half of Texas children grow up in low-income households, where cheap but satiating junk food might be all that fits the family budget," the CEO of an advocacy group noted in 2010.
The Beehive State has a longstanding love affair with fast food. Utah is home to the first KFC franchise (which opened in South Salt Lake in 1952), as well as beloved regional chains such as Crown Burgers and Arctic Circle - home of "fry sauce," a ketchup- and mayo-based dipping sauce that has been called one of the state's "great contributions to mankind."
Utah's "family-oriented" culture has been cited as one reason for the popularity of fast food. As a columnist for the Salt Lake Tribune summed it up, "Utah has big families. Big families eat a lot. Ergo, Utah families need a lot of cheap food."
In 2008, the Associated Press named Huntington, W.V., "America's fattest city." One-third of adults in the metro area are obese, and fast food seems to be partly to blame. As the news service noted, the Huntington phone book lists almost 200 pizza joints - more than the number of health clubs and gyms in the entire state.
A year later, British celebrity chef Jamie Oliver (shown at left) showed up to reform residents of their fast-food habits on national TV - and was reduced to tears by the angry reception he received. "We don't want to sit around and eat lettuce all day!" a local radio host reportedly told Oliver. "Who made you the king?"