Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain.
Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain; Department of Geology, Geography and Environmental Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain.
Environ Res. 2022 Mar;204(Pt C):112323. doi: 10.1016/j.envres.2021.112323. Epub 2021 Nov 10.
Neighborhood accessibility and availability of alcohol products has been associated with increased alcohol consumption and harms among adolescents. This availability has been shown to be higher in neighborhoods with lower socio-economic status (SES). The aim of this study was to examine inequalities in alcohol outlet density and proximity around schools by area-level SES in Madrid, Spain. Data on schools, SES, alcohol outlets and population density at census tract level were obtained through public databases from the local government of Madrid. We examined (1) density as the number of alcohol outlets around schools within 3 buffers (i.e. 200 m, 400 m and 800 m) and (2) proximity as the distance from schools to their nearest alcohol outlet. We performed multilevel analyses to examine the associations between alcohol outlet density and proximity and SES, adjusted by population density. Secondary schools (n = 576) located in less deprived areas had lower densities of alcohol outlets at walking distances of 200 and 400 m (50% and 37% lower, respectively p < 0.05). No significant differences were found for the proximity measures. The socioeconomic level of the area in which adolescents go to school is a determinant of their exposure to alcohol, where those who study in high SES areas have lower exposure to alcohol outlets. This study highlights the need to prioritize equity in the design and implementation of policies to limit alcohol accessibility among adolescents, including establishing minimum distances between schools and alcohol outlets or limiting the number of outlets per inhabitant in neighborhoods.
社区可达性和酒精产品的可获得性与青少年饮酒量增加和伤害有关。研究表明,社会经济地位(SES)较低的社区酒精产品的可获得性更高。本研究旨在研究西班牙马德里地区按 SES 水平划分的学校周围酒精销售点密度和接近程度的不平等现象。通过马德里地方政府的公共数据库,获得了关于学校、SES、酒精销售点和人口密度的普查区层面数据。我们检查了(1) 学校周围 3 个缓冲区(即 200 米、400 米和 800 米)内的酒精销售点密度,(2) 学校到最近的酒精销售点的距离。我们进行了多水平分析,以检查酒精销售点密度和接近程度与 SES 之间的关联,调整了人口密度。位于较贫困地区的中学(n=576)在 200 米和 400 米的步行距离内,酒精销售点密度较低(分别低 50%和 37%,p<0.05)。对于接近度指标,没有发现显著差异。青少年就读学校所在地区的社会经济水平是他们接触酒精的决定因素,在 SES 较高的地区学习的青少年接触酒精销售点的几率较低。这项研究强调了在设计和实施限制青少年获得酒精的政策时,需要优先考虑公平性,包括在学校和酒精销售点之间建立最小距离,或在社区内限制每个居民的销售点数量。