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Clustering of fast-food restaurants around schools facilitates fast-food consumption among students, which may cause obesity. We examined the prevalence of fast-food restaurants and identified the clusters of fast-food restaurants near secondary schools in Hong Kong.    Methods  We collected data of Western fast-food chain restaurants and 490 secondary schools in Hong Kong. Descriptive statistics and buffer analysis identified the prevalence of fast-food restaurants around the secondary schools within 400-m and 800-m buffers. Additional analyses compared schools stratified by the 3 main regions in Hong Kong, district-level population density, and median monthly household income. We used Getis-Ord GI* hot spot analysis to measure spatial clusters of fast-food restaurants around schools and Global Moran’s  I  to measure the spatial autocorrelation based on each school and the number of fast-food restaurants within the 400-m buffer.    Results  The average number of fast-food restaurants within 400 m and 800 m of a school was 2.0 and 6.3, respectively. Seven in 10 secondary schools had at least 1 fast-food restaurant within 400 m. The number of schools with no fast-food restaurants was higher in Hong Kong Island, considered the “rich region” in Hong Kong. Hot spots of clusters were significantly located in the high-density downtown areas. We observed significant spatial autocorrelation between fast-food restaurants and secondary schools in the areas with high density, low income, and high income ( P  < .001, z > 2.58).    Conclusion  Fast-food restaurants were substantially clustered around secondary schools in Hong Kong. Territory-wide studies about the health effect of fast-food clusters around schools on children and adolescents are warranted in Hong Kong.

Geographic Clustering of Fast-Food Restaurants Around Secondary Schools in Hong Kong