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Quite simple! It is location, economics and consumer demand.
Is it just as difficult to find a healthy restaurant, as it is to find high-end cuisine in a lower class/income neighborhood? It is a matter of knowing your potential customer, what the local discourse is familiar with and how much they can afford. Fast food venues are plentiful in lower class areas, because they are affordable and advertised; although I find that there is a misconception about what a healthy restaurant really is.
Is a healthy restaurant defined as a self- absorbing yuppie serving organically fresh vegetarian fare with prices to rival a three star Michelin or is it the local Vietnamese immigrant who opens a small restaurant and serves unbelievably fresh, healthy and tasteful food at prices lower class customers can afford? I think they are both valid, but the Vietnamese restaurant is more a reality in the lower class area given the price, yet take that same Vietnamese restaurant and put it in an upper class neighborhood and the prices double. It boils down to what people are familiar with, what they can afford and how open their minds are to try foods from different cultures.
Growing up in a lower class neighborhood was quite ironic to this issue, because the Italians ate Italian and Puerto Ricans ate Puerto Rican etc. We did not adventure enough into foods other than what we where used to. It is funny that the neighborhood is now a culinary shrine for authentic and healthy Mediterranean and Caribbean cuisine and of course, affordable. Not to say that some of the foods are not incredibly fattening, but understanding what to order and how much of it to eat is important. A beautiful Sicilian seafood salad or a Puerto Rican Soupa de Platano are both healthy and affordable in lower class neighborhoods, at least in the area I grew up in.
I find more and more these days that people from the upper class neighborhoods travel to the lower class neighborhoods to eat, because they understand that there is more diversity, un-marketed healthy joints and local gems to be found. How funny!
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