Geospatial Distribution of Food Environments and Their Association with Sociodemographic Factors in Two Mid-Sized Chilean Cities

Background/Objectives: The spatial interaction between obesity, diet-related chronic diseases, premature mortality, food environments, and social determinants of health is a global concern. This study aimed to analyze the spatial distribution of healthy and unhealthy food outlets in two medium-sized cities in southern Chile. Methods: A cross-sectional observational study was conducted to characterize the food environment in two medium-sized cities in Chile. Food outlets were geolocated and classified as healthy, regular, or unhealthy, and into four food environment categories (institutional outlets, informal markets, formal markets, and restauration) using validated instruments. Results: Of 1972 identified sites, 1949 were geolocated. Among these, 246 (12.6%) were classified as healthy, 461 (23.7%) as unhealthy, and 1242 (63.7%) as regular. Food environments comprised 1441 stores (73.9%), 366 restauration (18.8%), 136 street food outlets (7.0%), and six institutional food outlets (0.3%). The two lowest socioeconomic quintiles (Q1–Q2) exhibited a lower proportion of healthy food outlets (39.4%). Significant positive spatial autocorrelation was observed for stores, restaurants, and street food outlets (p < 0.005). Conclusions: Food environments were unequally distributed, with a higher density of healthy food outlets in areas characterized by greater population density and higher socioeconomic status. The observed spatial autocorrelation highlights the need for targeted public health interventions to reduce inequalities in access to healthy foods. These findings provide evidence to support policies aimed at promoting more equitable and healthier food environments in medium-sized cities.