Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
Center for Survey Research and Evaluation, National Institute of Public Health, Cuernavaca, Mexico.
BMC Public Health. 2023 Jul 10;23(1):1321. doi: 10.1186/s12889-023-16251-0.
The association of the built environment and the structural availability of services/amenities with adolescent birth rates (ABR) has been overlooked in Latin America. We investigated the association of the availability, and changes in the availability, of services/amenities with ABR in 92 Mexican cities.
We estimated ABR using data on live birth registration linked to municipality of residence at the time of birth from 2008-2017. The number of services/amenities were obtained from the National Statistical Directory of Economic Units in 2010, 2015, and 2020 and grouped as follows: education, health care, pharmacies, recreation, and on- and off-premises alcohol outlets. Data were linearly interpolated to obtain yearly estimates. We estimated densities per square km by municipality. We fitted negative binomial hybrid models, including a random intercept for municipality and city, and adjusted for other social environment variables.
After adjustment a 1-unit increase in the density of recreation facilities, pharmacies, and off-premises alcohol outlets within municipalities was associated with a 5%, 4% and 12% decrease in ABR, respectively. Municipalities with higher density of education, recreational and health care facilities had a lower ABR; in contrast, municipalities with a higher density of on-premises alcohol experienced a higher ABR.
Our findings highlight the importance of economic drivers and the need to invest in infrastructure, such as pharmacies, medical facilities, schools, and recreation areas and limit the availability of alcohol outlets to increase the impact of current adolescent pregnancy prevention programs.
在拉丁美洲，人们忽视了建筑环境与服务/设施的结构性供应与青少年出生率（ABR）之间的关系。我们调查了服务/设施的供应情况及其变化与 92 个墨西哥城市 ABR 之间的关系。
我们利用 2008-2017 年与出生时居住地有关的活产登记数据估计了 ABR。2010 年、2015 年和 2020 年从国家经济单位统计目录中获得了服务/设施的数量，并将其分为以下几类：教育、医疗保健、药店、娱乐和现场及非现场酒类销售点。数据采用线性内插法获得每年的估计值。我们按城市计算了每平方公里的密度。我们拟合了负二项式混合模型，包括对城市和县的随机截距，并调整了其他社会环境变量。
调整后，城市内每增加一个单位的娱乐设施、药店和非现场酒类销售点的密度，与 ABR 分别下降 5%、4%和 12%相关。教育、娱乐和医疗保健设施密度较高的城市 ABR 较低；相比之下，现场酒类供应密度较高的城市 ABR 较高。
我们的研究结果强调了经济驱动因素的重要性，需要投资于基础设施，如药店、医疗设施、学校和娱乐区，并限制酒类销售点的供应，以增加当前青少年妊娠预防计划的效果。
