Table 2 Health and equity impacts of McDonald’s operations

Work and workforce conditions

• McDonald’s invests heavily in employment and training, is strongly committed to an inclusive workplace and occupational health and safety standards.

• McDonald’s is a respected national training provider and provides high level youth employment. However, McDonald’s does not pay penalty rates and many jobs are filled by casual and part-time workers with the low-levels of unionisation across the fast food industry.

Social conditions

• McDonald’s provides a low cost option for financially struggling families and a venue for inexpensive social interaction.

• However, location near schools has potential impacts on easy access to unhealthy food options and childhood obesity.

• Concerns have been raised over the negative impacts on housing prices in the vicinity of McDonald’s new outlets, and over impacts on local cafes and other services due to the comparative size and scale of McDonald’s operations.

• Negative health impacts reported include physical and psychological effects from community efforts to stop the proliferation of new McDonald’s outlets.

Environmental conditions

• McDonald’s ‘Five Pillars’ sustainability framework is a positive initiative.

• However, resource-intensive operations would impact on global climate change both directly and indirectly, with externalisation of costs to the community.

• High level littering, food wastage, and impact on social amenity are other negative aspects.

• There is potential for ‘greenwash’ as part of corporate relations strategies and its links to community group abatement projects.

Economic conditions

• McDonald’s provides positive impacts from employment; including in their outlets and supply chains and from construction and infrastructure provision.

• Franchises provide positive economic benefits through a proven business model.

• However, there is externalisation of costs to the public from profit shifting, tax havens, and service fees paid back to USA headquarters.

• The health costs of non-communicable diseases and environmental impacts from McDonald’s operations are externalised to the community.

Health related behaviours

• Consumption of McDonald’s cheap and palatable but ultra-processed food and sugary drinks can contribute to increased levels of overweight and obesity, which is negatively correlated with socio-economic status.

• There is a link between consumption and McDonald’s sophisticated and integrated marketing strategies, including from the influence of the ‘halo effect’ and ‘health washing’.

• Bundled products, drive through outlets and home delivery also influence consumption patterns.

• There is an association between consumption of McDonald’s products, lower socio-economic status, and children and young adults; with implications for health equity